grand river

Improving Patient Care Using Data-Driven Technology

Grand River Hospital is a 615-bed community hospital serving 500,000 residents in the Waterloo Region of Ontario, Canada. Outdated data management technology hampered efforts to provide high-quality, cost-effective patient care. An 11-member decision-support team depended on Grand River’s IM/IT department to produce reports from 60+ source systems. Because team members specialized in specific systems, generating cross-segment reports proved difficult.

Hospital officials needed unified, cohesive data to facilitate timely, accurate reporting for decision-makers. So Grand River Hospital implemented integration and business intelligence (BI) technology from Information Builders.

“We are assisting staff throughout the hospital to adopt a data-driven mindset,” says Kathleen Lavoie, director of health information management and chief privacy officer at Grand River. “The Enterprise Data Warehouse with Information Builders enables us to generate reports more quickly, more effectively, and with more sources of data. This broader perspective enables us to answer questions that we could not answer before.”

Extracting, Transforming, and Loading Clinical Data

Seven initial sources were identified for BI – a STAR admissions system, a WinRecs chart reporting system, an HMS surgical system, a PHS scheduling system, an HMM medicine management system, a Fusion dictation system, and a PFM financial system.

IM/IT staff mapped data entities and modules within each source, then used iWay DataMigrator to extract, transform, and load (ETL) five years of historical data into an enterprise data warehouse. DataMigrator’s introspection tools examine database schemas so designers can select what information to access, and develop rules for doing so.

The hospital also used DataMigrator to integrate additional systems, including McKesson applications for patient admissions, discharge, and transfer; pharmacy; surgical suite documentation; patient scheduling; financial; ED Tracking Board; and materials management. Third-party applications for payroll and health records are also being integrated, with many more systems planned.

Having unified information also improves the IM/IT team’s methods and procedures. “We used to have to run reports at night because they would impact the performance of the source systems,” says Deb Haggman, a decision-support consultant and team lead. “Now we can run reports against the data warehouse anytime. The data warehouse makes us more productive and removes a big reporting bottleneck.”

Consolidating Data to Improve Patient Care

Before source data was moved, DataMigrator was used to profile it to ensure integrity and consistency. DataMigrator’s change data capture (CDC) technology extracts new source data daily. Transformation groupings were created to guide how data is loaded into a consolidated domain model. Executives, administrators, doctors, and nurses are all confident in the data’s accuracy.

“Creating the data warehouse forced us to examine the source systems more closely, so now we have a better idea of what we have,” says Lavoie. “Our stakeholders know that the information in the data warehouse accurately reflects the information in the source systems.”

The new data warehouse is the foundation for advanced analytics such as case costing, which helps managers, physicians, and other staff understand which services were provided, when and by whom, and at what cost. Users can determine the average cost of each procedure, and compare Grand River’s costs with other institutions. Hospital administrators can track all expenses incurred by patients throughout their stays.

It used to take three weeks to get these reports; now clinical information is available much faster. The hospital can rapidly track emergency room wait-times, levels of care by department, and patient diagnoses to ensure individuals receive the right medications. They can determine how doctors are performing based on quality outcomes and monitor a variety of hospital procedures. These insights directly impact patient care.

“We can maximize efficiencies and lower costs,” claims Lavoie. “It was difficult to do this previously because it required extracting information separately from more than a dozen source systems. Now we have automated a good part of that process by properly combining and loading data elements into the data warehouse. This is a big success for us.”

Leveraging the Warehouse for End-User Reporting

WebFOCUS and InfoAssist supplement an existing system of dashboards, scorecards, and reports. Lavoie’s team is extending end-user reporting to business unit managers, doctors, and nurse managers – with the goal of delivering self-service BI capabilities enterprise-wide.

“The new data warehouse enables us to answer the questions that stakeholders are asking, and drill into the numbers on the scorecards to obtain a more complete picture,” says Haggman.

“WebFOCUS is very user-friendly and GUI-oriented so we can offer better data visualization capabilities to our users. The reports are very attractive, flexible, and easy to interact with.”

As Grand River builds BI proficiency among users, the IM/IT team will spend less time creating custom reports. The data warehouse has fostered a more data-driven enterprise. “We are able to link systems that were always silos in the past and can turn around reports more quickly,” Lavoie concludes. “We are making our data work for us in a real-time fashion, not just specific elements, but all our data – clinical, administrative, and financial. This is an historical first for the hospital.”


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