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Advanced Analytics Adoption at UNC Health Care System: A Clinical Operations Case Study

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Agenda

• Advanced Analytics Maturity and Adoption

• The UNC Health Care System Approach

• Case Study

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Health care insights today…

• Can take a long time to create

• Often show different answers to the same question across organizational groups

• Describe issues / risks that have already happened, not what is coming

• Frequently show a fraction of the picture (telling “what” without the factors producing “what”)

• Are often not actionable or connected to workflow

• Can be based on unrepresentative populations with uncharacterized biases

• Do not always differentiate between “good to know / do” vs. “important to manage / act”

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Growing up is hard to do…

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DETECT

OPTIMIZE

COLLECT

INFLUENCE

COUNT PREDICTMODELFACTOR

Maturity of Insight

Matu

rity

of

Acti

on

Image via Flickr user chazoid

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Copyright © HIMSS Analytics 2016

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Traditional Functions Must Adapt

John Kotter’s “dual operating system” describes how convergence is needed to adapt to transformational changes

Allows organizations to capitalize on rapid-fire strategic challenges and still meet fundamental needs

Successful clinical transformation works as a dual structure that empowers traditional functions to react more effectively to change

Accelerate; John P. Kotter; Harvard Business Review Press; 1 edition (April 8, 2014)

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High Level View of UNC HCS Approach

Solution Management

Agile Development

Solution Management: processes that ensure that solutions meet the needs of customers. Modeled after “product management.”

Agile Development: processes that ensure that quality solutions are engineered on a reliable schedule.

Accelerators For Our Analytics Maturity StrategySolution ManagementRequirements, Consensus, Priority

Data GovernanceDefinitions, Standards, Use, and Interpretation

Design & EngineeringDeveloping Capabilities

Community EngagementUser adoption and education

Consulting ServicesExecutive Project Support

Operational Reporting StrategyRequirements, Consensus, PriorityCoordinated with ISD

Organizational Benefits

Reduce the time, effort, and resources currently associated with doing analyses

Increase the quality of data and analytical insights

Improve the empowerment and ease by which users can gain insights from analyses

Build expertise in data and analytical sciences

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Being Effective in Transition to Analytics Maturity

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FROMTraditional Approach

TOMature Analytics Adoption

Managing Projects Developing Products

Analytics as ademand-driven support function

Analytics as a strategic business function

Data development driven by demand, developed for single use

Strategically build reusable data assets

Proliferation of dashboards and reportsFocus on capabilities, support with

repeatable framework of tools

Hypothesis (Questions) are pre-definedQuestions are not pre-defined,

start with data

Timeline is project-driven Timeline is based on gaining capabilities

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Finding the “Sweet Spot” in Change Management

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Case Study: Throughput

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Agenda

• Begin with the end in mind

• Our Process

• Understanding the Challenges

• What do we want to achieve?

• Initial Focus and Priorities

• Results to Date

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Begin with the end in mind

Service LineThroughput Challenges

Predictive models to drive

business decisions

EnterpriseThroughput

Insights

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Our Process

Work with stakeholders to

understand challenges

Define and prioritize

requirements in backlog

Rapidly develop most important requirements

Demo and receive feedback

at least every other week

Log feedback and prioritize within

backlog

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Understanding the Challenges

High hospital occupancy rates

Little slack in the system

Delay of important services

Bottlenecks and increased LOS

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What do we want to achieve?

Appropriate utilization of hospital services

Matching capacity to demand for hospital

Process Optimization

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Identify high priority turnaround times

Emergency Department

Radiology

EVS

Rehabilitation Therapies

Patient Transport

• Emergency Department arrival to departure

• Radiology

• Ultrasounds

• CT

• MR

• X-ray

• Therapy Evaluations

• Occupational Therapy

• Physical Therapy

• Speech Therapy

• Patient Transport

• Inpatient Rooms

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Start delivering value through data and insights

• Use historical data visualized in Tableau as part of the requirements gathering process

• Create insights that answer questions that the business asks on a regular basis

• Enable customers to ask new questions

• Accumulate as much feedback as possible and iterate

• Always treat the process as a team sport!

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Keep delivering value while evolving the solution

• Meet weekly with stakeholders

• Balance between value, complexity and what’s implementable now vs. later

• Demonstrate what has been completed every 2 weeks

• Communicate the short term with details and the long term with variability

• The long term will evolve as customers see more data and insights

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Be Inquisitive

• Consistently ask your customers if what you are doing is valuable

• Ask your customer for examples of how your solution is impacting their organization

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Increase the complexity of questions that can be answered…

What is our average bed turnaround?

What would our average bed turnaround be if we added X housekeepers?

How will reducing our bed turnaround by Y minutes during second shift affect ED wait times?

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Initial predictive model for bed turnover

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What’s Next?

• Continually evolve to answer increasingly insightful and complex questions

• How would increasing the following impact the ED?

• Patient transporters

• Observation rooms

• ED providers

• ED exam rooms

• How would decreasing bed turnover in the afternoon affect ED wait times?

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Thank you!

Jeff Fullerjeffrey.fuller@unchealth.unc.edu

Jason Glovierjason.glovier@unchealth.unc.edu