Make sense of your data with PerformancePoint Server

The logistical challenges of operating a 24-hour service mean that NHS decision-makers need accurate information at their fingertips. Paul Curran discovers that performance targets and financial pressures are driving many to dig more meaningful data from their disparate and legacy systems.

There’s no shortage of data in NHS organisations. The challenge is finding it and interpreting it in a way that allows their service managers and frontline staff to plan and allocate resources effectively.

“Decision-makers in NHS trusts rely heavily on instant, meaningful information to meet performance targets, claim Payments by Results (PbR) payments and win patients against competing healthcare providers,” says Daniel Wakefield, sales director at Microsoft partners 21C. “That means capturing, storing and analysing data, then presenting it in a digestible form that allows them to make informed decisions.”

That’s easier said than done, however, according to John Murray, programme manager for corporate systems at Lincolnshire Partnership NHS Foundation Trust. He says tracking metrics and measuring performance indicators usually involves emailing spreadsheets across the organisation - a long-winded and labour intensive process to publish data.

“Trusts like ours are generally very good at gathering data and storing it in individual administration systems,” he says. “But you need a holistic and flexible solution that lets you perform ad hoc analysis by extracting data from those many different sources. Equally important, you need to get up-to-date, accurate information back to the teams to help them improve patient care.”

The Business Intelligence path for Lincolnshire

Back in 2007, the senior management team at the Lincolnshire trust was experiencing all these information challenges.

“Our information strategy showed we needed integrated information, but we didn’t have an integrated system, so we invited Microsoft to help us create a vision for how their technologies could be applied to our specific needs.

“This helped us understand how we could extract data from existing systems - such as the patient administration system (PAS), HR, finance and clinical systems - and place it in a data warehouse. From there, it could be extracted, analysed and presented to users via an intranet with a front-end reporting and analytics interface,” Mr Murray says.

In March 2008, the trust appointed 21C to carry out the work and by June they had implemented SQL Server as the data warehouse and Office PerformancePoint Server (now a part of the SharePoint suite and called PerformancePoint Services) to manage the data.

SharePoint provides the back-end tools and connections to put information from different data streams in front of users in a simple way: through the Microsoft Office software with which many of them are already familiar.

Clear and understandable dashboards

As well as providing standard operating reports, Mr Wakefield says the initial focus at Lincolnshire has been on developing dashboards for key performance indicators (KPIs) that show at a glance how a department or service is measuring up.

“We involved the service very early in the design, and used an iterative approach of taking a performance metric, developing the code to extract the data and understand the logic that’s applied by the information teams to the data,” he says.

“We then put a presentation layer on top and release it over the intranet - whatever makes that information meaningful. And by clicking on the graphical presentation, users can drill down to see the detailed data that underpins any of the performance metrics.”

Drilling down

“The ability to drill down on an ad hoc basis for reporting purposes is critical,” Mr Wakefield adds. “It means they can conduct more proactive planning. We now have trend analytics which allow us to make predictions or break data down by demographic requirements. This is becoming crucial in delivering cost-effective patient care.”

Mr Wakefield says the strength of PerformancePoint has been two-fold: firstly, it extracts data from multiple sources; secondly, it presents it in a concise way that’s appropriate to each user, for example:

• Top-line metrics can be presented simply, for example using a ‘traffic light’ to show good or bad performance;
• Graphs can be used for spotting trends or spikes;
• Scorecards demonstrate performance across comparable departments or individuals;
• Dashboards collate related metrics together. Everyone gets just the right amount of data to make useful and informed decisions - without a statistical overload.

“A dashboard on every desktop”

Heads of service and general managers were first to have access to the system, which is gradually being rolled out to middle managers and frontline clinicians. Mr Murray says: “Already PerformancePoint Services is proving useful by giving us up-to-date waiting list information on a weekly basis and enabling us to track how long patients have been waiting to be seen.

“By giving us accurate and timely information, PerformancePoint Services is enabling us to move closer towards a service line management model, whereby control is de-centralised and given back to managers who know best how to run their individual operations and satisfy demands for quality service using available resources.”

Mr Murray says his trust will “continue to increase the amount of data available to users. Once everyone is happy with this style of access and can see its benefits, we’ll increase the range and depth of information that we can put through all our systems. Our ambition is to have a dashboard on every desktop,” he concludes.

PerformancePoint now integrated with SharePoint

Microsoft recently announced that it is to consolidate the scorecard, dashboard and analytical capabilities from PerformancePoint Server into SharePoint Server as PerformancePoint Services, making these capabilities available to thousands of SharePoint users.

“For NHS trusts, it means SharePoint gets even better; for our partners, it means their installed base will grow significantly," says Microsoft technical strategist Richard Lane.

Microsoft will release a third and final service pack for PerformancePoint this summer, after which it will cease developing PerformancePoint as a standalone product. Mr Lane says Microsoft is making this change in order to make Business Intelligence (BI) more accessible within organisations.

“PerformancePoint uses the SQL Server database as an underlying platform and Office applications such as Excel as the user interface, and that won't change. Microsoft is simply removing the barriers for customers who want to deploy a complete BI solution by leveraging their existing investments in SharePoint Server, SQL Server, and Excel.

“Unlike competitor products, which require complex clients to be installed on users’ machines, and training in how to use them, PerformancePoint Services brings added value to SharePoint users by enabling them to drill deeper into the data using familiar tools, like Excel. It means NHS employees will no longer rely on their information department to crank up reports – with just a few clicks, they will now be able to extract that information themselves.”

One version of the truth

What’s more, Mr Lane says those trusts that have satisfied the NHS Infrastructure Maturity Model (NIMM) process to qualify for the NHS Enterprise Client Access Licence (CAL) will be entitled to take advantage of the features offered by PerformancePoint Services at no additional cost.

“It will put BI tools and real time information at the fingertips of a head of ward, for example, who previously relied on someone else for the data, with all the delays that can involve for a time-critical department,” he says.

“PerformancePoint Services provides a single version of the truth, because rather than working on copies of the data, it extracts all information into a data warehouse for analysis and reporting - the dashboards and KPIs then work on that data in real time. It means users will now be able to manipulate complete sets of original data using their familiar Excel toolset.”

PerformancePoint Services in other trusts

Daniel Wakefield says PerformancePoint Services is already in action in a range of applications in trusts around the UK. For instance, it is being used for trust board performance reporting at Kent and Medway Partnership Trust and at NHS Wandsworth to monitor and analyse a range of important business threads, such as immunisation and vaccination uptake in the borough.

Other PCTs are using PerformancePoint to measure A&E waiting times and alcohol-related admissions, CDiff trends, and ever-increasingly, for service line reporting.

“The great thing about this framework approach to building a performance management environment is that a trust can start small on an individual business topic and extend its performance management system - bringing in new data sets and systems as required,” he says.

“Trusts need to become more metrics-focused. By leveraging PerformancePoint Services, they can keep costs down, but more importantly meet the growing needs of their patient population. This new integrated data environment provides greater levels of accuracy and ultimately serves patients better.”