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Doctor Practice Uses BI Tools To Improve Care

Marianne Kolbasuk McGee
Senior Writer, InformationWeek

Southeast Texas Medical Associates has employed IBM business intelligence software to analyze patient care and reduce hospital readmissions.

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When discussions focus on healthcare providers doing sophisticated analysis of clinical data, academic medical centers with deep research pockets usually come to mind. Those examples include the Mayo Clinic, Cleveland Clinic, and other large prestigious, healthcare providers that have ambitious projects related to personalized medicine and other care initiatives.

But as more doctor practices across the U.S. roll out e-medical record systems to collect and manage their patient information, those smaller organizations can also tap into the power of analytics tools to glean better insight into the care they provide their patients.


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That's something that's already happening at Southeast Texas Medical Associates, or SETMA. Through the use of business intelligence and analytics tools with the medical records data of thousands of patients, the mid-size doctor practice in Beaumont, Texas is improving treatment programs, reducing hospital readmissions, developing preventative care programs, and boosting staff productivity.

SETMA, with 29 primary care physicians in three locations, rolled out a NextGen EMR in 1998, which at the time required lots of customization by SETMA since there were few pre-configured templates available, said the practice's CEO Dr. James Holly. But two years ago, SETMA begun using IBM Cognos business intelligence tools to analyze data in a data mart developed for keeping extracted data from those patient records.

The tools are enabling SETMA to run real time analysis on the health and treatment trends of patients, including those with chronic illnesses like diabetes, and to audit performance of SETMA clinicians, to ensure they are providing evidence-based standards of care to patients, and adhering to best practices and other quality measure sets from a number of sources. Those quality measures include the Healthcare Effectiveness Data and Information Set (HEDIS) from the National Committee for Quality Assurance; the Centers for Medicare and Medicaid's Physician Quality Reporting Initiative, and also care benchmarks from the National Quality Forum.

The analysis has helped SETMA identify "interruptions of care" that some patients experience, enabling the practice to act quickly on resolving those issues, even to the extent of reminding diabetic patients around the holiday season that they need to be extra diligent about exercise, glucose testing, and diet as they partake in end of year celebrating, said Holly.

"Healthcare is behind the times in the use of BI," said Holley. "But everything that BI can do in other industries, it's doing for us in healthcare, leveraging points to improve care," said Holly.

SETMA is using the analysis tools to "eliminate the ethnic disparity in care," said Holly.

"How do you know the disparities till you have the ability to ask questions," he said. The analysis allows SETMA to identify issues that can play factors in patient outcomes, such as in situations when patients need to be readmitted to the hospital not long after being discharged.

According to a 2010 study by the University of California San Francisco, nearly one in five Medicare patients in the U.S. have an unplanned readmission to the hospital within 30 days of being discharged.

Page 2: Readmissions down by more than 20%
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