Access to data has already proven its worth. When Hurricane Sandy knocked out a CT scanner at NYU Langone Medical Center (a four-hospital complex anchored by the 705-bed Tisch Hospital), real-time workflow measurements were used to reassign patients to the three remaining scanners more or less seamlessly: 95% of cases were completed in 15 minutes and 99% were done in 30 minutes. “These data have given our people autonomy and mastery,” Recht says. Analytics programs are being run from billing systems, RIS, PACS, and voice-recognition systems, and multiple vendors offer turnkey solutions for both business and clinical analytics. Some patterns and processes are similar in all business-analytics rollouts, but beneath the surface, it’s a mixed bag. With fragmentation being endemic to health care, there is a demand for solutions that stitch everything together—a necessary precursor to a big-data solution. Usable Data Thought leader James H. Thrall, MD, FACR, is an analytics pioneer. Formerly chair of the ACR® board of chancellors, Thrall stepped down as chair of the radiology department at Massachusetts General Hospital (MGH) in Boston (a job he had held for a quarter century). Thrall, who is active on the MGH medical staff and holds a professorship at Harvard Medical School, now spends more time on research, including data analytics. “There is a construct,” Thrall begins, “that goes: data to information to knowledge to wisdom. Data are individual facts, or a collection of individual facts. Information is organization of those data,
We are looking at denials by site and by insurance company, asking whether there is something incorrect that we are doing. We can’t leave any money on the table. —Michael P. Recht, MD
How do you do hand-cleansing protocols or timeout protocols? There are no commercial systems available that encompass all these elements so vital to managing a department. —James H. Thrall, MD, FACR
at some level. Knowledge is a higher-level organization of information. Wisdom is the ability to assimilate knowledge and also to draw inferences based on assimilated knowledge and experience.” Thrall says that business analytics for radiology has reached the information stage—and sometimes, the knowledge stage—but never the wisdom stage. “The big shortcoming I see in information systems—RIS and PACS—is that they provide no analytic capability,” Thrall says. “For example, we practice in nine different locations and we have CT scanners in seven different locations. I’d like to know how many of what kind of CT scans we did in each place. It sounds simple, but the RIS can’t give us that.” Thrall says that to get the data, MGH
has to export the numbers from the RIS daily and feed them into a separate server that has the software to provide the information needed to run the radiology department. “How do you do handcleansing protocols or timeout protocols? There are no commercial systems available that encompass all these elements so vital to managing a department,” Thrall adds. MGH calls its dashboard The Same Page, and it gave Thrall the ability to see how many exams of what type were done at each location. “I could then trend that for a month, a year, or two years,” Thrall says. “That is very basic, tangible analytic feedback you use as the department leader. It took me 15 years to have that on my desktop every day because of how clumsy these systems are.”
www.imagingbiz.com | April/May 2013 | RADIOLOGY BUSINESS JOURNAL 17