Using Analytics to Improve Efficiency, Part 2

The Quality System Analyst perspective

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(Editor's Note: This is the second part of a three-part series. Part 1 can be found here. Check back for part 3.)

Pacific Diagnostic Laboratories, LLC (PDL) is a full-service laboratory in Santa Barbara, Calif., which employs more than 270 people. It operates three hospital laboratories, an outpatient laboratory and 17 patient service centers serving Southern California. Overall, PDL performs over 12 million tests annually.

Clinical laboratories, Pacific Diagnostic Laboratories included, face tough competition and an even tougher reimbursement environment. As a result, PDL was interested in potential methods to improve clinical, financial, and operational efficiencies. This led to consideration and evaluation of a lab-specific healthcare analytics and business intelligence tool to meet those efficiency goals.

In November 2010, PDL implemented a SaaS-based business intelligence (BI) solution, Viewics Health Insighter (VHI). This series profiles how three different types of BI users at Pacific Diagnostic Laboratories use Viewics Health Insighter to meet those clinical, financial and operational goals.

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Monitoring Lab Performance
Cecily Hintzen is a quality systems analyst for PDL. As a "super user" of VHI, part of her job is to pull data from the LIS and create charts and analyze data to illustrate and monitor laboratory performance.

Prior to installation of VHI, she primarily used an advanced user system in which you need to write all your own formulas.

"When using VHI, I simply drag the dimensions and measures onto a blank dashboard and it automatically sets a visualization of the data. That's really a huge improvement. It makes it a lot easier -- a picture is worth a thousand words," she said. Her previous method had a function for graphs, but most of the time she received the raw data and poured it into Excel without visualization. "With VHI, it visualizes the data right away and in a sharable format, which can be sent to whoever is requesting the data," she noted. "Certain types of reports are set up automatically to run daily, weekly, and monthly, whatever people are requesting."

Although Hintzen has a number of different types of reports set to run daily, weekly, and monthly, she is the go-to person for "on-demand reports." When a report is requested, Hintzen asks for the time period and type of data requested, then simply drags and drops the data into the dashboard. "It generates a report in a shareable format that allows whoever requested the report to drill down into whatever data point that interests them," she said.

Hintzen has found that the tool has saved her an incredible amount of time. She pointed out that some of the reports she creates would have taken hours or even days to create on the previous system.

An example of a report that Hintzen creates is to analyze the amount of time it took to get a result for a specific test, white blood cell counts (WBC), and then compare them over a period of time. She can also analyze the data per facility, department, physician, instrument, or any other metric. The result is an actionable and accurate report that indicates what the mean times are, visually represented, but also provides the outliers. Furthermore, it is possible to click on an outlier and the Accession Number and specific data related to that data point appears, allowing for root cause analysis.

Action Needed
VHI allows users to set up the graphs and analysis so that if results fall outside a specific range, they are color-coded to indicate action needed. This can be set up on the dashboard, and is a way for Hintzen and other users to evaluate quality throughout the entire laboratory system.

Business intelligence tools also allow tracking collection and order-entry errors, a significant aspect of patient care. Hintzen noted, "Recently I developed an approach using VHI to notify each phlebotomist or order/entry tech so they can be aware of the order-entry errors they're making and self-correct them." This has resulted in a significant decrease in order-entry errors.

Around January 2013, the plan was implemented, resulting in a very quick decrease of an overall order-entry error rate of about 1.15 percent to 0.99 percent, which dropped the following month to 0.85 percent and in March 2013 to 0.62 percent. Although it has crept up a little bit since then, it remains significantly below previous error-rate levels. This becomes a prominent component of continuous process improvement, constantly evaluating and modifying processes.

Hintzen indicated that the order/entry techs are responsible for catching and correcting all errors that may occur in the order/entry process, which may require follow-up with physicians and their staff.

It's a very important component of the health system's quality control and quality assurance programs, and business intelligenec has made it an easier, more reliable process. "We make sure the O/E techs realize that they're a crucial cog in the whole machinery, because if they input the wrong information or patient information or wrong physician, or don't get the test inputted accurately, it's going to result in bad experiences for patients and physicians," she said.

She pointed out that doing this as a function of continual process improvement, rather than just dropping it on employees at their yearly evaluations, seemed to result in better employee awareness and ownership of those errors. "When we linked it to performance reviews, all it did was cause pressure," Hintzen said. "But when we gave them a report every week so they could see what was going on, it became self-correcting. We changed the way we used the data, and closing the loop on the data resulted in employee engagement and buy-in."

Part of her position is also to train other people on use of VHI. Though she finds that the biggest barrier to using VHI "depends on their comfort with technology, for me, VHI is super easy. I learn fairly quickly and I've experimented with a lot of different things. The value in VHI is it's meant to be used by many people. There are the typical positive factors, like affordability and ease of use, but what impresses me the most about Viewics is their responsiveness to our requests. I write a lot of the formulas myself, but if I get stuck, I can just send Viewics an email and ask for help, and within hours they're right there."

Justin M. Clark is senior marketing manager, Viewics Inc., Sunnyvale, Calif.


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