4-page Case Study - Posted 3/2/2012
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Long-Term Care Provider Uses BI to Improve Decision-Making, Saves Millions of Dollars
Life Care Centers of America, which operates more than 200 skilled nursing and other care facilities, knew that its continued growth had to be fueled by continued innovation. When its traditional reporting tools could no longer support its need
for proactive management, Life Care needed another way to gain consistent, accurate, and timely data for better analysis and decision-making. It found it in a Microsoft Business Intelligence solution, built on technologies that Life Care already licensed and
that were familiar to its IT staff and business users. Now, operational leaders have concise and actionable data at their fingertips. IT costs for business intelligence are down by 90 percent. Measures of clinical outcomes are rising. Better, data-driven decisions
about staffing and overtime levels contributed to multimillion-dollar annual savings.
Life Care Centers of America finds serving its aging residents to be deeply rewarding. Using aging data to help do so, however, isn’t as satisfying.
Nursing homes are changing, along with most of the rest of the U.S. healthcare industry. Years ago, older people typically went to nursing homes to live for months or years at a time; today, they go to assisted living and retirement centers that are more
cost-effective at providing an appropriate level of care. Nursing homes, meanwhile, have become skilled nursing facilities that support more acute patients after their discharges from hospitals. For non-critical patients that nevertheless require significant
amounts of assistance, skilled nursing facilities can provide appropriate levels of care, at hundreds to thousands of dollars a day less than hospitals typically require.
Life Care Centers of America, which operates more than 200 skilled nursing and other care facilities, envisions its growth coming from this post-acute healthcare environment. It’s building the foundation for that growth with initiatives such as adding a
full-time physician to each of its facilities.
“We’re the first major provider in long-term care to have a dedicated, full-time physician on-site,” says Mark Gooch, Director of Business Intelligence at Life Care Centers of America. “As the acuity of our residents continues to rise, we have to be ready
with higher levels of care. Being proactive on this is the key to our own long-term health.”
||Historical performance data is nice, but our leaders can use Microsoft BI proactively to see what’s coming over the horizon.
Director of Business Intelligence, Life Care Centers of America
Being proactive requires making data-driven decisions before potential problems become actual ones—something for which the company’s longtime performance management system wasn’t optimized. It aggregated data in the form of quarterly scorecards, which the leader
of each facility used to analyze his or her facility’s overall performance. But, because aggregating the data was largely a manual process, the data was prone to error, and while it was possible to aggregate the data, it was difficult to explore the detailed
information on which the aggregations were built. Perhaps worst of all, the data was up to 100 days old when it was finally consumed. “It didn’t even come fast enough for us to be reactive,” says Gooch, with a rueful smile. “There was nothing proactive we
could do with data that old.”
Gooch and his colleagues wanted a business intelligence solution that offered top performance without a top price. They considered solutions from vendors including IBM Cognos, SAP BusinessObjects, MicroStrategy, and others. While those solutions offered
varying levels of performance, they all came at what Life Care considered prohibitive prices.
Licensing cost was just one concern. A potentially greater cost was the additional, perpetual operating expense. “We would have to train, hire, and maintain additional staff to operate these other options,” says Gooch. “Our policy throughout—both for IT
staff and for our leaders—has been to keep BI [business intelligence] simple. This wouldn’t have been simple.”
Life Care found a solution that was both simple to use and simple to choose: Microsoft Business Intelligence. Life Care already used Microsoft technologies—its IT staff was familiar with the Microsoft SQL Server 2008 R2 Enterprise data management software used
with Microsoft Business Intelligence. Its employees were familiar with Microsoft Office and Microsoft SharePoint Server, also parts of the business intelligence solution. “Because we already knew the software, it didn’t take us long to choose it,” says Gooch.
To help design and implement its Microsoft Business Intelligence solution, Life Care turned to BlueGranite, a Microsoft Partner Network member with multiple Gold competencies.
“BlueGranite clearly ‘out-experienced’ the other vendors we looked at,” says Gooch. “They had the expertise to build a BI solution customized for our industry and our company—and to transfer their knowledge to us, so we can now successfully manage the solution
The Life Care solution went live in 2010. Based on Microsoft technologies from end to end, it is fed by a collection of financial, clinical, and human resources-related data sources. Various nightly and monthly SQL Server processes load this data into Life
Care’s enterprise data warehouse, which is used as the source for the Online Analytics Processing [OLAP]–based analytics. “We have been asked many times to start tracking data and processes that used to exist only in [Microsoft] Excel spreadsheets. Our ability
to quickly create a new data source using SQL Server or SharePoint Server and then pull it into our data warehouse for BI has proved to be invaluable.”
A Look into Past, Present, and Future
Life Care’s business intelligence users primarily access and analyze data through three main dashboards. The dashboards use a combination of PerformancePoint Services in Microsoft SharePoint Server 2010, Excel Services in Microsoft SharePoint Server 2010,
and SQL Server Reporting Services web parts, which are presented through Microsoft SharePoint Server 2010. The dashboards provide distinct looks into the past, present, and future of Life Care operational performance.
The Historical Dashboard is the company’s primary source for trending data over months, quarters, and years. As with the other dashboards, it provides one-click access to highly aggregated information, and “two- and three-click” access to
increasingly refined subcategories of data, for those who need further detail. Green-Yellow-Red “traffic light” icons provide at-a-glance information on which trends are On Target, Slightly Off Target, and Off Target relative to specified parameters. The trending
capability is represented through various web parts. (See Figure 1.)
The Interim Dashboard provides a near real-time snapshot of daily measures of operational performance. A leader can use the Interim Dashboard to get frequent updates on the status of his or her facility on multiple operational measures,
chosen specifically to reflect the company’s business goals. For example, an unexpected change in census, clinical, or labor measures provides an immediate opportunity for a leader to investigate and address those changes proactively.
The Projections Dashboard provides a short-term financial projection based on month-to-date data, which is automatically updated each day. The predictive analytics tool gives leaders an opportunity to discern and address areas of concern
days or weeks faster than they could with only traditional end-of-month reports. (See Figure 2.)
|Figure 1. The Historical Dashboard provides trending information based
on financial, clinical, and human resources-related data.
About 650 of the company’s leaders have access to the Microsoft Business Intelligence solution. Security is controlled by their individual roles within the company, as indicated in their Active Directory Domain Services accounts.
A leader, for example, can only access information about his or her facility. Region and Division Vice Presidents can access data regarding their areas of responsibility, while C-level executives can access enterprisewide data. “With a couple of clicks of
the mouse, our leadership teams can access significant analytical power,” says Gooch.
Life Care continues to expand and refine its business intelligence solution. Gooch expects the company to increase clinical analysis capabilities particularly for predictive analytics. “As our industry migrates to electronic health records, the opportunities
for business intelligence to make a difference in the quality of care to our residents will grow exponentially,” he says.
By centralizing and automating its business intelligence system using Microsoft Business Intelligence, Life Care has created a solution that produces a single set of accurate and timely data, eliminates “data overload,” delivers an enviable return on investment
through better decision-making, and reduces IT costs.
Makes BI Simple, Saves 80 Percent of Search Time
Leaders often manage multiple issues at their facilities at once; to do so, they need concise and accurate data that they can act upon. Life Care achieved its goal to keep business intelligence simple by identifying and presenting the company’s key
performance indicators in a straightforward and organized manner. By using Microsoft business intelligence, leaders can see the information they need at a glance, drill into granular performance data, and avoid having to continually shuffle through piles of
static reports to make daily decisions.
The simplification of business intelligence also promotes end-user adoption. “We could build the greatest BI solution on the planet, but if our leaders don’t know how to use it, it’s all for nothing,” says Gooch. “Our leaders range from seasoned veterans
to recent college graduates, and their computer literacy is just as varied. We put a decent amount of thought into designing a solution that can provide valuable information at multiple levels of complexity. We typically see our leaders start out in a very
basic way in their analytical journey. As they get more comfortable with the solution and learn that they can trust it, their appetites typically move them toward more detailed data. With our Microsoft BI solution, we can give all of them the amount and type
of access with which they’re comfortable.”
Gooch estimates that leaders who use Life Care business intelligence now save up to about 80 percent of the time they formerly spent searching for performance data from multiple sources and in many static reports. “That’s a significant savings, and it means
that they’re using Microsoft BI to gain more time for mission-critical efforts, such as visiting with residents, family members, and employees,” he says.
Encourages Proactive Decision-Making
|Figure 2. The Excel Services worksheet in the Projections
Dashboard automatically refreshes its calculations on a daily basis.
Leaders can now use their Interim and Projections Dashboards to identify and analyze daily swings in various measures in order to proactively adjust their decisions. Each facility leader is in charge of what is in effect a multimillion-dollar business with
hundreds of employees, and each rarely has enough time to sit down and sort through all the paperwork that the business generates. Business intelligence has to be accurate, timely, and actionable to meet their needs.
“The faster we get the data to them, the faster they can ‘see into the future’ and address issues proactively,” says Gooch. “We used to distribute quarterly performance reports that were up to 100 days old; now we distribute near real-time data that is consistent
and accurate, so it’s ‘actionable.’ Because the data is aggregated automatically and accessible to each end user based on his or her role, each leader sees only data that applies to his or her specific area of responsibility. Historical performance data is
nice, but our leaders can use Microsoft BI proactively to see what’s coming over the horizon.”
Reduces IT Support Costs for Business Intelligence by 90 Percent
Life Care began to see savings immediately upon implementing its Microsoft Business Intelligence solution. Labor support costs for the new solution are 90 percent lower than for the former solution, due to the highly automated nature of Microsoft Business Intelligence.
The licensing cost for the new solution was two-thirds less than the cost of competing solutions—saving the company about US$200,000. Because the solution runs on familiar SQL Server and SharePoint Server software that Life Care already uses, there was no
need to hire, train, and maintain a separate team of IT support staff.
“The reduced operating expense and effort is probably the biggest benefit we see on the IT side from choosing a Microsoft-based business intelligence solution,” says Gooch. “Choosing something else would have created a challenge in finding the talent to
manage it, and convincing those people to move to a relatively small town. With Microsoft, we know the software, have the people to manage it, and our leaders know how to use it.”
Makes “Real Difference” in Health of Residents
||As the acuity of our residents continues to rise, we have to be ready with higher levels of care. Being proactive on this is the key to our own long-term health.
Director of Business Intelligence, Life Care Centers of America
Life Care is deeply dedicated to providing quality healthcare to its residents. So it was natural for the company to apply its Microsoft Business Intelligence solution to enhance the quality of that care.
The privately owned company doesn’t release proprietary data, but it says that on the industry’s most-watched measures of clinical outcomes, it is using Microsoft Business Intelligence to make a great story even better.
“Our leaders can easily track exactly how they’re doing on key clinical measures,” says Gooch. “Any deviation from projected levels gives us the opportunity to review procedures, reinforce training, and address potential issues as soon as possible. What
excites me about the future of our clinical analysis is that we’re just starting to explore the possibilities. We hope to further integrate our electronic health record data with predictive analytics which, in turn, will help us become more proactive in caring
for our residents. With Microsoft Business Intelligence, we have a tool that we can use to make a real difference in the health of our residents.”
Saves Millions of Dollars Annually Through Better Decision-Making
“The long-term care industry is very labor-intensive,” says Gooch. “We have virtually a one-to-one ratio of employees to residents. So it was inevitable that we’d apply our Microsoft Business Intelligence solution to the task of labor management.”
This has proved tremendously rewarding for Life Care. Government regulations require the company to maintain specific labor levels at each facility it operates—but how Life Care chooses to maintain those staff levels can have a big impact on operating costs.
“We had grown accustomed to casually backfilling our staff requirements with overtime instead of truly dealing with the staffing issue head-on,” says Gooch. “That led to excessive expense.”
Now, Life Care uses business intelligence to help identify the facilities and specific departments where overtime is being used on a daily basis. “For the first time, our various levels of leadership have a daily reminder of where their facility or facilities
stand on overtime use and where they’re headed,” says Gooch. “That’s a powerful motivator to get overtime numbers down through better scheduling—and it’s working. Excessive overtime was never an insurmountable problem, but we didn’t create enough awareness—ideally,
daily awareness—around it. Now, where we identify a concern, we use education and awareness to help address it.”
The result: Life Care is on track to see a multimillion-dollar reduction in annual overtime costs in the first year’s use of its Microsoft Business Intelligence solution.
Microsoft SQL Server 2008 R2
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