The Benefits of Big Data at a Small Practice

Women's Healthcare Associates, LLC., an OB/GYN practice located in Portland, Ore., began looking into using a big data solution about four years ago, said Gary Henderson, director of information technology. What started Henderson and his team on their data-focused journey was the reality that insurance companies and referring primary-care practices were increasingly asking for disease monitoring and risk stratification data.

In addition, many of the insurance companies the practice contracts with want to coordinate value-based arrangements where quality improvement measures are required for compensation. The draw for his practice, said Henderson, was the need to have insight into clinicians' behavior so that the practice could change how it operated in order to achieve the appropriate quality measures.

Because it's an OB/GYN practice, Henderson's team needs to share quality measurements with primary-care practices, in addition to the payers it contracts with. The measures his team focuses on include [Healthcare Effectiveness Data and Information Set] (HEDIS) measures such as smoking cessation and depression screenings during pregnancies.

In addition to pulling information from the EHR, the practice's business intelligence platform also relies on information in its human resources system and radiology information system (RIS). Access to both data sources is valuable because it helps the practice measure the productivity of its clinical and administrative staff members. For example, the practice can now see how many ultrasounds are being done and how long they take, as well as help the practice  better understand the total cost of care, said Henderson.

Having access to imaging information - particularly with pregnant women - is immediately relevant to the practice. That's because, while an insurance company may recommend having a woman imaged twice during her pregnancy, the clinicians may support having her imaged three times, based on the evidence.

The biggest win is simply having the data to put in front of clinicians to demonstrate how they're doing on the measures we're tracking, said Henderson. Clinicians also value having access to this data, since they believe it actually helps them do a better job.

Building and designing the data warehouse that retains all of this data was really hard work, for which Henderson tapped an outside consulting firm. Fast forward to today, and he now has two members of his team who use the resulting data analytics to develop reports and dashboards that are presented to employees and clinical leadership - and the information gleaned from those reports is what drives strategic decision-making at the practice.

Looking back, Henderson says he and his team struggled with figuring out the right data to measure and how to get at that data. In terms of clinician engagement, the best way to approach this type of project is to focus on curiosity and improvement - rather than about it being punitive, he said.

Achieving success with a business intelligence platform is no small feat for small- to medium-sized practices, said Laura Chmar, who works on accountable core organization (ACO) initiatives at Aledade, an ACO services company. Still, especially with the pressing need to get ahead of the public heath epidemic associated with opioids and addiction, there's no time to waste. What practices need is the ability to isolate this data, and with the help of a clinician, determine the right way to identify the right treatment paths, she added.