IBM Software

White Paper

Using analytics and collaboration

to improve healthcare quality
and outcomes

Healthcare

Using analytics and collaboration to improve healthcare quality and outcomes

Contents
2 Executive summary
4 Advancing patient safety
5 Improving clinical outcomes
7 Promoting wellness and disease management
8 Moving toward better collaboration and analytics
11 How IBM can help

Executive summary
Healthcare provider organizations are facing major market and
regulatory changes that are driving a fundamental shift in the
expectations of all stakeholders. They are looking to transform
their organizations in ways that will allow them to maintain
the highest standards of quality while transitioning to new
business models based on outcomes and value.
To address these market forces, providers need to adopt new
approaches that will enable them to deliver better quality and
outcomes, and focus on giving patients the full value of the
money they spend on healthcare. Many organizations realize
that enhancing collaboration and utilizing analytics will help
them achieve these goals, but are not sure exactly what is
needed or how to get there.
Collaboration in the healthcare setting means much more than
people working together to treat patients. It is about
connecting care delivery channels so that evidence-based
insights and clinical knowledge can be coupled with patientspecific information to personalize care. Achieving this level of
insight requires organizations to do a better job of aggregating
trusted patient data and applying specialized knowledge to
improve decision making, care delivery and health outcomes.
Access to more and better information alone does not ensure
effective collaboration. The ability to analyze that information
and turn it into meaningful change is what will make the
biggest difference in helping to ensure the long-term success of
healthcare providers transformation efforts.

Smarter Analytics

Many organizations are already improving performance by

leveraging analytics. Those organizations using analytics to
achieve competitive advantages are 2.2 times more likely to
substantially outperform their industry peers, and 84 percent
more likely to have information management and business
analytics integrated into their core business strategy.1
As healthcare organizations attempt to enhance processes to
improve care and outcomes, most will focus first on one of
three core areas where collaboration and analytics can yield the
greatest benefits: advancing patient safety, improving clinical
outcomes and promoting wellness and disease management.
Organizations that use collaboration and analytics capabilities
across all three areas will achieve the most significant
competitive advantages from a financial, marketing, consumer
targeting, safety and outcomes perspective and will be better
equipped to:

Comply with safety and quality reporting requirements

Predict and prevent adverse events and readmissions
Identify new effective treatments and care plans
Measure and effectively communicate results to consumers
Identify and manage a defined population of patients
Coordinate care among care team members
Manage wellness and diseases instead of treating illnesses

This white paper discusses how organizations can benefit from

implementing collaboration and analytics processes in the
three core areas, how healthcare organizations are successfully
using collaboration and analytics to improve outcomes and
value, and the best way for organizations to achieve their
collaboration and analytics goals.

Using analytics and collaboration to improve healthcare quality and outcomes

Advancing patient safety

Patient safety failures, often called silent killers, result from
medication errors, medical administration errors, wrong-site
surgical errors, hospital-acquired infections, falls and other
accidents and problems. Hospitals want to advance patient
safety practices to keep patients safer and reduce their legal
and financial risk. Improving safety is especially important as
both patients and payers look more closely at provider patient
safety ratings and reward or penalize organizations based on
their results.
To advance patient safety, healthcare organizations are looking
for ways to efficiently comply with required safety reporting
requirements, predict and prevent adverse events and reduce
preventable readmissions. Although there are some established
patient safety reporting metrics that hospitals already participate
in, such as Leapfrog and the US National Committee for
Quality Assurance, organizations are struggling with how best
to gather and measure data to meet new reporting requirements,
track patient safety with key performance indicators (KPIs),
define the patient safety attributes they want to improve
and make sense of all of the data dispersed throughout their
enterprise, including data in unstructured formats such as
electronic medical records, patient charts, incident reports and
so on. In addition, healthcare organizations are attempting to
quantify the impact of safety metrics and gaps on outcomes and
quality of care.

With regard to patient safety, healthcare organizations want to

have the capabilities to:

Provide early alerts on adverse events to prevent infections

or outbreaks
Offer cost-effective preventative programs to decrease costly
emergency room care
Create a standardized and timely set of patient safety data
Move toward automated enterprise-level reporting
Enable physicians, nurses and other caregivers to proactively
identify patients at risk for readmission
Identify allergies and medications to prevent adverse
drug interactions

Analytics can help organizations realize these patient safety

goals and more. For example:

North Carolinas Duke University Health System prides

itself on a deep culture of innovations that manifests in every
part of the organization, from clinical operations that are
consistently ranked among the top 10 in the United States
to world-class academic and research capabilities that drive
breakthrough discoveries. Duke University Health System is
using analytics to help improve patient safety.
By drilling down into millions of clinical records and then
applying analytics, Duke University Health System is able
to detect near-miss situations, develop predictive models
that automatically flag potential high-risk future scenarios,
define best clinical practices and train hospital personnel on
best practices and how to better detect potential patient
safety issues.

Smarter Analytics

The Hospital for Sick Children (SickKids) in Toronto, the

largest center dedicated to improving childrens health in
Canada, wanted to improve outcomes for infants afflicted with
life-threatening nosocomial infections. Findings from a
research study conducted at the University of Virginia
indicated that infants who had contracted the disease could
have undetectable changes in heart rates up to 24 hours
before overt signs of trouble occurred. SickKids is combining
the research findings with more than a thousand data streams
from bedside monitors and analytics to better detect potential
signs of an infection.
The project, called Artemis, is a research collaboration
between SickKids, the University of Ontario Institute of
Technology and the IBM T.J. Watson Research Centers
Industry Solution Lab. About one-third complete, to date
the project has gathered data from 300 children. It is still too
early to report on success, but researchers and clinicians are
hopeful that Artemis will deliver significant future benefits
for many types of medical diagnostics.

Advancing patient safety will go a long way toward helping

provider organizations improve care quality and outcomes, but
enhanced collaboration and use of analytics have additional
direct benefits on efforts to improve clinical outcomes.

Improving clinical outcomes

Improving the outcomes of clinical treatments and processes
has been a focus of healthcare providers for many years, but it
is now more important than ever as they strive to become
more competitive and participate in accountable care
organizations (ACOs). Analytics help providers identify new
effective treatments and care plans, and measure compliance
against those plans, which is necessary to ensure high quality
rankings, qualify for reimbursement based on new funding
models and gain insights in time to have a positive effect on
patient outcomes.
As consumers become more responsible for their own
healthcare, many are evaluating providers based on quality
rankings that are influenced by outcomes, such as those
published by the US Department of Health and Human
Services (HHS). A recent study by the HHS Agency for
Healthcare Research and Quality (AHRQ) found that
consumers were more likely to choose high-value providers
when presented with strong, unambiguous quality and cost
information.2 Therefore, it is increasingly important for
organizations to measure and effectively communicate cost and
quality results to consumers.
To provide high-value care while improving outcomes, and
operate within the cost constraints of the new reimbursement
models, the most effective approach for health organizations is
to actively participate in collaborative care initiatives.
Competitive healthcare organizations are using analytics to
help in this process.

Using analytics and collaboration to improve healthcare quality and outcomes

As organizations begin to examine what they need to do to

enhance clinical outcomes, they are asking how they can:

Move from a fee-for-service to a performance-based

reimbursement model
Effectively aggregate patient records to deliver a true
longitudinal view
Give physicians and other caregivers the information they
need to make more-informed decisions
Assess whether patients are following treatment protocols
Identify and implement new treatment protocols
more quickly
Determine which individual providers are delivering superior
efficacies on specific morbidities
Enable providers to collaborate more effectively

Analytics help provide answers to all of these questions and

more. For example:

California Pacific Medical Center in San Francisco is one

of the largest private, not-for-profit academic medical centers
in California. Through the medical centers Research Institute,
patients and physicians have opportunities to participate in
groundbreaking clinical studies in a number of disciplines
including cardiology, oncology and neurology.
The cardiac research program is involved in a number of
complex, multidisciplinary projects to advance the treatment
and survival rate of patients with cardiovascular disease. These
projects require thousands of data elements to be managed
and analyzed to determine more effective ways to treat
patients; develop accurate cardiac risk models that improve
long-term outcomes, shorten patient stays and reduce costs;
and establish new, proven treatment protocols that can be
shared with and adopted by cardiologists worldwide.

Smarter Analytics

Southeast Texas Medical Associates (SETMA), an

innovative and award-winning primary healthcare group
based in Beaumont, Texas, is using analytics technologies
to reduce hospital readmission rates. The practice analyzes
clinical data to help it identify the causes of patient readmission
and develop more comprehensive treatment and intervention
care plans that prevent patients from returning to the hospital.
In just six months, SETMA reduced the number of hospital
readmissions by 22 percent.
Physicians collect and analyze data that identifies patient
characteristics that resulted in lower readmission rates
including ethnicity, socioeconomic groups, follow-up care
received, and how much and how quickly patients were
able to receive care. Analytics are also used to determine
similarities among readmitted patients, and develop posthospital treatment plans that include recommendations vital
to many patients recovery such as immediate at-home care
or interventional support for patients who live alone.

programs that promote wellness can improve the overall health

of those with chronic diseases, which will help reduce
healthcare costs.
To successfully implement wellness and disease management
programs, healthcare organizations must be able to accurately
identify populations of patients, coordinate patient care teams,
and shift their focus to managing patient wellness instead of
illness. For example, organizations that are able to identify and
manage patient populations with a specific chronic disease,
such as diabetes or heart disease, can more effectively monitor
these high-risk patients, coordinate care plans and more
rapidly intervene to prevent disease-specific medical
conditions from developing.
Analytics can help provider organizations identify patient
populations and provide insights that effect collaboration across
care teamsboth of which are difficult to achieve today. In
addition, analytics enable organizations to determine how to:

In addition to patient safety and clinical outcomes, collaboration

and analytics can provide significant benefits for the promotion
of wellness and disease management, especially for patients with
chronic diseases.

Promoting wellness and disease

management

As the US reimbursement model shifts its focus to a persons

overall health versus treating episodes of care, healthcare
providers must focus more on managing wellness. Individuals
with chronic conditions today account for 75 percent of total
US healthcare expenditures.3 More than 125 million Americans
suffer from at least one chronic condition and 75 million have
two or more chronic conditions.4 Disease management and

Better manage the health of defined populations

Identify the best potential candidates for wellness and disease
management programs
Determine the patient and clinical information needed to
better promote wellness or manage diseases
Communicate and monitor patients outside of care venues
Define and manage the data touchpoints across the
continuum of care
Aggregate the information required to demonstrate better
outcomes and qualify for bundled payments
Calculate the return on investment (ROI) for population
health management and wellness programs

Using analytics and collaboration to improve healthcare quality and outcomes

Analytics also help organizations support effective prevention

and disease management programs. For example:

Seton Healthcare, the leading provider of healthcare services

in central Texas, wanted to identify patients with congestive
heart failure who were most likely to be readmitted to the
hospital and provide them with proactive disease management
to reduce cost and mortality rates, and improve patient quality
of life.
Seton is utilizing analytics technologies to extract key
elements from unstructured data such as physician notes
and discharge summaries, and apply proven predictive
models against structured and unstructured data to achieve
rich clinical and operational insights. Trends and patterns
in patient care and outcomes are identified by detecting
correlations or disparities that were previously hidden in
inaccessible free-text files. Access to this new information
allows Seton to improve disease management processes
and prevent avoidable readmissions.

An Australian company that is transforming the

management of chronic diseases developed a chronic
disease management network, an automated collaborative
management system that drives the uptake and ongoing
use of patient care plans to manage chronic diseases. The
network uses innovative decision support and rules-based
technologies combined with broadband and mobile services
to assist with evidence-based practices, care coordination,
wellness monitoring, patient self-management and
performance analysis.
By enabling the creation of best-practice patient care plans and
allowing caregivers to track and share patient information
and care plans, the network helps ensure the effective delivery

of a collaborative treatment plan. Users of the system have

benefited from a 100 percent increase in evidence-based care
and best-practice treatment, a 140 percent increase in
care team collaboration across providers and a 60 percent
improvement in the use of patient care plans.
Many healthcare providers are already on their way to
improving care and quality through better collaboration.
What steps do organizations that want to embark on this
journey need to take? The following is an overview of a
proven processone that many providers have already
deployedthat will help organizations get started.

Moving toward better collaboration

and analytics
Healthcare provider organizations that want to achieve better
collaboration and analytics proficiency to improve care quality
and outcomes will need to follow a number of steps to get there.
To begin, they must evaluate their own organization and decide
which of the three core areas (patient safety, clinical outcomes
or wellness and disease management) they should focus on first.
The choice is often based on which area will deliver the greatest
value in the shortest timeframe, but some organizations have
pressing operational or risk issues that will drive their decision.
Once the area of focus has been determined, organizations
will need to plot where they fit on the business optimization
maturity curve (see Figure 1) and understand what they
need to do to advance along that curve. From there, they
will develop an actionable, customized plan to successfully
implement analytics for the first core area and create an
infrastructure that will effectively support all three core areas.
At all times, the focus should be on mapping their strategy to
overall business goals and objectives.

Business optimization

How the business applies information to optimize outcomes

Smarter Analytics

Actionable insights,
pre-emptive and
predictive business
management
Information deemed a
strategic asset
Business scenario modeling
Deep analytical skill sets
Information is governed
Consistent and
trusted reporting
Standard data
denitions and
governance
Lack of analytical skill sets
Minimal report standardization
Manual data manipulation
Basic
operational
needs
Data, but no
information

Breakaway

Predictive, real-time analytics

Differentiating

Competitive

Foundational
Master data management
Basic data warehouses and
departmental data marts

Advanced
information
management
Content analytics

Data warehouse
appliance
Dashboards,
scorecards
Structured and
unstructured data

Lev

er

g
agin

big

dat

Ad hoc
Spreadsheets
and extracts

Smarter analytics maturity

How the business manages information and learns from it

Figure 1: Ad hoc organizations use very basic spreadsheets and data extracts that provide them with a lot of data but little information. As they deploy
analytics and data-driven processes, they become breakaway organizations that fully leverage their data, turning it into a strategic asset and utilizing it with
predictive real-time analytics to improve care quality and outcomes.

10

Using analytics and collaboration to improve healthcare quality and outcomes

The strategy and road map will need to account for many of
the challenges healthcare provider organizations will face as
they attempt to improve their collaboration and analytics
capabilities. These challenges will likely include aggregating
widely dispersed data, delivering data in a timely way to the
systems and people that need it, providing caregivers with a
complete and accurate picture of the patient, and alerting
caregivers about patient safety, clinical treatment and care
plan issues at the point of care where they can have an
immediate impact.

Most organizations will find themselves somewhere in the

middle of the maturity curve; the majority will be in the
foundational area of the curve. This means they have
implemented some data warehouses and are doing basic
analytics, but need to move up the business optimization
maturity model to truly address the imperative of collaborating
to improve care and outcomes.
Organizations must next create a strategy and road map for
turning data into information and using it as a strategic asset to
deliver the greatest possible impact. During this process, they
will need to consider how to:

Align people, processes and information to sustain strategic

value over time
Establish end-to-end information-driven strategies and
objectives that promote business priorities
Architect an extensible infrastructure that leverages existing
information assets
Accelerate short-term and long-term ROI

Once the strategy and road map are complete, organizations

can begin implementation. This process involves creating a
trusted, relevant and governed information environment
where data can be managed, integrated and analyzed while
ensuring data quality, security and privacy standards are met
(see Figure 2). The system must be able to accommodate
data from internal and external sources that must be mastered
and managed, and will need to integrate with a range of
transactional, collaborative and analytics applications. Once
the system is complete, healthcare provider organizations will
be able to deliver trusted information and insights that can be
used to improve care quality and drive smarter outcomes.

Smarter Analytics

11

Transactional
and collaborative
applications

Integrate

Manage

Analyze

Content

Data

Master data

External
information
sources

Integrate
and
cleanse

Content

Big data

Business
analytics
applications

Cubes
Streaming
information

Govern

Data warehouse
Streams

Quality

Lifecycle

Security
and privacy

Standards

Figure 2: Data must be managed, integrated and analyzed to deliver trusted information and insights. Data governance processes should be built into the
entire process to ensure that data quality, security and privacy standards are met.

How IBM can help

IBM can guide you on your journey to improving care quality
and outcomes through better collaboration. From assessing
your current place on the maturity curve to developing a road
map and strategy, to implementing new collaboration and
analytics capabilities, IBM has experienced consultants,
products and solutions that can help.

IBM has more than 8,000 employees dedicated to healthcare,

has completed more than 3,000 successful healthcare
transformation initiatives, and holds more than 600 patents in
the life sciences, healthcare and medical device fields. As an
active participant with its healthcare clients and partners, IBM
is working to lay the foundations of a 21st-century healthcare
system by redefining value and success in healthcare and
helping to build a smarter healthcare industry.

For more information

To learn more about IBM solutions for healthcare, visit
ibm.com/analytics/us/en/solutions/industry/healthcare.html

Copyright IBM Corporation 2012

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The client examples cited are presented for illustrative purposes only.
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1

The New Intelligent Enterprise, a joint MIT Sloan Management Review

and IBM Institute of Business Value analytics research partnership.
Copyright Massachusetts Institute of Technology 2011.

Study Finds Consumers Choose High-Value Health Care Providers

When Given Good Cost and Quality Information. http://www.ahrq.gov/
news/press/pr2012/highvaluepr.htm. Accessed August 24, 2012.

Chronic Illness Accounts for 75 Percent of Health Spending, US News &

World Report. http://health.usnews.com/health-news/blogs/on-health-andmoney/2009/01/06/chronic-illness-accounts-for-75-percent-of-healthspending. Accessed August 24, 2012.

Geyman JP. Disease Management: Panacea, Another False Hope, or

Something in Between? Annals of Family Medicine, Vol 5(3), May/June
2007.

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