Source: http://www.diagnosticimaging.com/practice-management/content/article/113619/1664518
The pressure to get faster, more efficient, and more productive is mounting. Healthcare reform, increasing regulations, and declining reimbursements are bearing down. Radiology departments and imaging centers are looking for ways to improve performance. Dashboards are lighting the way.
Dashboards that analyze data going back months or years show where a facility or department has been. Executive dashboards show whether a facility is aligned with the goals of the facility. They are actually reports, prepared by hand, from data laboriously pulled from PACS or RIS and assembled in a spreadsheet. They provide a retrospective on the past quarter or year, laying the foundation for trending analyses, which can be used to predict the future path of an organization.
Tactical dashboards are different. They uncover problems that need to be fixed and the details necessary to put those fixes in place. They are the glitz of healthcare analytics, displaying information in real-time about key indicators such as scanner volumes or report turnaround times.
Tactical dashboards hold the potential to make daily operations transparent, defining them in terms of metrics that quantify staff productivity, the utilization of scanners, and wait times. The complexity of these processes obscures them from view.
Siemens offers its syngo Portal Executive. This dashboard tool works in concert with syngo software to keep track of referral patterns, analyzing, for example, whether patient flow from key referring physicians is continuing, increasing, or decreasing. Portal Executive can also be used to look for—and find clues to remedy—inefficiencies that are holding back exam volumes. This, however, is retrospective. Kurt Reiff, vice president of image knowledge and management for Siemens Healthcare, is driving the company toward a more ambitious future.
“What we really need is perspective,” Reiff said. “If my business develops in a [particular] direction, how do I have to invest my money? Do I buy a CT or an MR? Where is my best return on investment? I think this is where this is heading.”
In the meantime, the real-time feedback possible with some dashboards offers the opportunity to spot problems in their earliest stages. Needles, bars, or numbers moving into red, yellow, or green provide an instant read on what’s happening in the department or facility.
Carestream’s Digital Dashboard monitors server performance, user volumes, and storage utilization. The dashboard supports Carestream’s RIS/PACS, but also can verify that other vendors’ devices are connected and operating on the network. The data can be presented onscreen or through e-mails and text messages that alert recipients to problems such as a failure in network connectivity or storage issues.
Leslie M. Beidleman uses the Carestream dashboard to ride herd on PACS at about a half dozen hospitals and clinics in the Mercy Health Partners network in Toledo, OH. As regional PACS administrator, Beidleman uses the dashboard to keep tabs on the amount of space available on the facilities’ several servers, as well as to check processes such as archiving and study backup.
“It gives a good quick view of things,” she said.
Those data points can also be manually captured in a spreadsheet for later comparison, a trick that came in handy recently when Beidleman noticed that the number of studies needing backup was increasing. This led to finding the problem on the servers, which brought the number down very quickly.
Productivity, finances, and quality are woven tightly together. If workflow improves, financials go up, as does the quality of services. Reduce the number of retakes by improving scan quality and productivity improves, as does the bottom line. Patient and referring physician satisfaction rise. Demand may rise. Workflow becomes more challenging. Pressure mounts for greater efficiency, which is achieved by optimizing scan volume and minimizing patient wait times.
Demand may vary across several sites of an enterprise, as referring physicians send more or fewer patients later or earlier in the day to one place or another. When managing that enterprise, scheduling changes smooth the flow. Proactive monitoring keeps services on track while trending analyses allow strategic planning to meet future needs through asset utilization.
Such introspection works well when the goal is to improve individual performance. But a myopic view of the world can lead to missed opportunities. With McKesson’s benchmark collaborative, radiology departments can see how they stack up against others that are similar in size, makeup, and procedures. Reports can be customized to include certain specific metrics that have meaning to just your radiology department. This, according to McKesson executives, produces business information about inefficiencies, which can be turned into models that illustrate how those inefficiencies can be fixed. These lead to strategies about how to use staff and equipment more efficiently and effectively.
“It is a gold mine of information about their internal operational performance that they simply did not have before,” said George Kovacs, director of product marketing in McKesson’s Medical Imaging Group.
McKesson’s report allows the user to drill down starting at the most general comparison, a piece of a bar or pie chart, and see what’s underneath. Users can follow evidence that leads to the root cause of an operational inefficiency and then see how different actions, such as those taken by others in the collaborative, may resolve the problem.
Such comparisons provide the context for making strategic decisions. But even such complex and contextual analyses are only that, analyses. The ultimate expression of the dashboard is as a means to solve the problems. The automation that goes into summing up operational data needs to be extended to automatically fix problems rather than simply alert administrators to their presence.
“We want to identify the problem and instantiate the appropriate business logic to fix it,” said Dr. Paul Chang, vice chair of radiology informatics and pathology informatics at the University of Chicago.
For example, rather than programming an electronic dashboard to flash red when patient wait times go beyond a certain point, software might automatically reroute patients among scanners to spread the load.
Business intelligence can play a major role in safety as well, for example, in radiation monitoring. Rather than documenting the number of patients overexposed to radiation and waiting for human intervention to change the protocols, Chang advocates building software that recognizes and then stops the overexposure before it happens.
Today’s radiology dashboards are informational at best. The widespread adoption of RIS and PACS provides operational data to be tapped. Ros believes there is tremendous opportunity for vendors to create dashboards that deliver comprehensive operational analyses. But Geis thinks it may be awhile before this opportunity is fully realized.
When they do arrive, dashboards will provide the means to several ends: information that can be used by radiology departments and imaging facilities to increase productivity, financial performance, and quality.
