Earlier this fall, with another flu season approaching, Kaleida Health realized it needed a quick and effective remedy for flu data analysis. Its management and operations team needed up-to-the-minute data to respond to the growing threat, and the Department of Health was demanding daily statistics to help track the toll that the flu -- particularly the deadly H1-NI flu -- was taking on the community.
Kaleida Health, a five-hospital network based in Buffalo, N.Y., faced some unique challenges. It is the largest healthcare provider in western New York state and the only pediatric hospital in the region. With the flu, especially the H1-NI, affecting grade-school children, there was added pressure to come up with a system to accurately track both patients and healthcare workers reporting flu-like symptoms.
“We not only have five hospitals but all these off-site clinics, as well as clinics within the schools. So we needed to track patients not only in the emergency room, but how many people are going to their primary care physicians with symptoms as outpatients,” said Dan Gerena, director of business intelligence and corporate analytics at Kaleida Health.
The solution turned out to be “The Flu Monitoring Dashboard,” developed by Kaleida staff using Oracle Business Intelligence Suite Enterprise Edition (OBIEE) dashboard technology. The dashboard, part of a broader business intelligence (BI) system, collects automatic updates from across Kaleida Health’s network. It replaced a system that required hospital staff to manually track patients with flu-like symptoms from reports that had to be run daily.
But tracking patients, particularly children and the elderly, with symptoms in multiple locations wasn’t even half the battle. Kaleida employs 10,000 people, most of whom deal with patients directly and so are also likely targets for the flu. Kaleida Health care workers have 1 million patient encounters a year that all happen on a one-to-one basis, according to Gerena.
“We also needed a way to track how many employees were calling in sick with flu-like symptoms to determine if there were any areas where people were transmitting it to each other and if that would result in a shortage of nurses to deploy,” he said.
A third constituency that needed a 360-degree view of what was going on included top hospital administrators and many internal departments, including human resources.
The Flu Monitoring Dashboard was cobbled together in just nine days and launched in September. The hardest part was determining who needed what information. The process started with a clean sheet of paper, Gerena said, and going around to interview all departments and individuals who would be using the dashboard. Collecting all that information took about two days.
“We had to talk to all the constituencies and figure out what each of them needed and how far they needed to drill down in the data,” he explained. “Once we knew what they wanted to see and how they wanted to see it, it was just the heads-down work of building it, tweaking it and asking their feedback on how it looked as we went along.”
What made constructing the Flu Monitoring Dashboard easier was the OBIEE dashboard technology, Gerena said. Kaleida transitioned to OBIEE from Oracle’s Discoverer product, which he said could have produced a comparable dashboard but would not have been as easy to use.
“Discoverer isn’t a good solution for all these different people answering different questions,” he said. “They would have to run the reports, export them, look at them and then figure it all out. What OBIEE brought to the table was the ability to present it all visually in a dashboard form.”
One example where Kaleida used the OBIEE dashboard for strategic planning was analyzing volume spikes in the ER of people coming in with flu-like symptoms and what time of day or night they occurred. With this information, Kaleida staff knew when they should start diverting patients with flu-like symptoms to a clinic across the street, so the flu patients wouldn’t infect ER patients who were there with other maladies. By doing this, Kaleida improved the quality of care for both sets of patients.
“You had all these sick kids coughing on kids with broken arms and legs, so we diverted them to a pediatric clinic across the street separating true emergencies from those with flu-like symptoms,” Gerena said.
A team of 35 people at Kaleida regularly use the dashboard, including the five hospital presidents, five chief nursing officers, the chief of emergency medicine, and the chief medical officer.
The team and technology behind the Flu Monitoring Dashboard
The OBIEE dashboard was created by four members of a business intelligence team, along with one programmer in IT who built all the interfaces. At Kaleida, the BI team is a standalone group that reports up to the finance department.
“We handle the whole continuum of managing the metadata to building the calculations to building the reports dashboard and educating the users,” Gerena said.
Along with OBIEE, Kaleida uses Oracle’s 10g database and Lawson’s ERP software. Kaleida has no plans to upgrade any time soon to the 11g database, mostly because Lawson has yet to certify that version for use with its products. There is nothing in 11g that would make a significant difference in the features and performance of Kaleida’s dashboards anyway, Gerena said. He is, however, looking forward to the next version of OBIEE, due around mid-2010.
“We’ve heard whispers there will be some workarounds that will let us do things like having a page item that allows us to filter its unique values,” he said. “It should make life easier for us.”
Because the product’s graphical interface has the look and feel of many websites, training time and costs for first-time users were minimal.
“OBIEE is pretty intuitive. You can look at a table and click the links to drill down. It is really just a matter of logging in,” Gerena said.
The Flu Dashboard is one of 25 dashboards that Kaleida’s management team has access to through the company’s “Magellan” Balanced Scorecard system. The other 24 dashboards are also powered by OBIEE.
“We have five components under Magellan -- financial, quality, growth and strategic, staffing, and operational. All of our metrics data fall into one of those five categories,” Gerena said. “The Flu Dashboard falls under quality and is just one component of quality.”
Besides offering executives a more precise overview of daily operations and finances, the dashboards also help formulate short-term decision making such as deploying the necessary number of nurses and medical resources to handle a spike among incoming patients. Eventually, the dashboard will help with developing new lines of business, physician recruitment and staff retention.
An added benefit of the Flu Monitoring Dashboard is that it gives Kaleida a template to build on for other contagious illnesses.
“If we have a SARS outbreak a year from now, we can leverage this [Flu Monitoring Dashboard] as a prototype and just change some of the underlying logic,” Gerena said. “From an emergency preparedness perspective, this is a good thing.”