The cloud has so much appeal: Low capital expense, simple implementation, reliability, and performance. Add to this, that updates, new features, security patching are all managed by someone else with the expertise to do it with a bit of a customer service attitude and what’s not to like? Because all of this is so compelling, organizations overlook some of the critical gaps. One of them is reporting.
Cloud applications are lacking when it comes to reporting. Whether we are talking about widely deployed applications like Salesforce.com, or Concur, or more industry specific applications like PointClickCare or NetSmart there is a common theme: These applications are lacking when it comes to reporting. On one level, the reports and information coming out of them is hard to use, and does not meet the business need, and on another level the data is not integrated with data from other critical applications to provide meaningful context to the information provided. All too often, adoption of cloud applications creates another “information silo” that the business struggles to overcome. Case in point, PointClickCare. Let’s see if this sounds familiar: You have a hard time finding the data you need. The user interface is sorely lacking. You hunt and peck as you navigate views and tables in a database. You’re not sure if the queries you have are pulling the information you want, and in most cases they do not have everything you need, so you have multiple queries. Meanwhile the performance is terrible, the process is slow and you have to assemble and manipulate the data manually in Excel to create the information you need. This is not uncommon, but the problem is even worse.
You are essentially flying blind. In this environment, getting to the point where you can see, examine and understand trends in mission critical information like census, and payer mix is difficult at best and impossible for many. To scratch beneath the surface and understand “the why behind the trend” is even more difficult. There is no trend to examine, and no exploration path to navigate, so you rely on your gut and manage cautiously. Add in the challenges you have with a lack of visibility into accounts receivable, and the difficulty in understanding compliance and revenue issues with mds assessments and you are essentially flying blind. And organizations that operate like this are frozen. They are unable to understand and react to changes in the market, and hesitate to make meaningful changes to operations out of fear. But it does not have to be this way. You can have access to this information, and you can understand mission critical operations, and even generate powerful insights that can lead to significant performance improvements. I know this because I have been a part of this transformation. I have seen struggling organizations improve performance dramatically with the implementation of analytics to support simple process improvements that accumulate and compound over time. It is not rocket science and anyone can do it.
We have helped an organization that services equipment across the country understand their key challenges and use that understanding to improve operational performance and satisfy their most demanding customer. Downtime and repair delays were cut in half and this critical and demanding customer (based in Arkansas) is still a customer, and a happy one. I have helped a manufacturer understand the customers and products affected by production delays, understand the impact to revenue and use data to optimize operations using production capacity. This enabled the team to meet promised (contractual) service levels, but even more importantly eliminated the overtime, stress and errors caused by trying to do all of this manually. The manager I partnered with on this one got a nice promotion!
Most recently, I led a team that helped to turn around the financial performance at a large skilled nursing facility operator with 200+ locations. Like other operators, they were strained on multiple fronts with pressure to reduce costs while improving quality and facing growing competition, in a changing payment environment (PDPM). The focus on quality patient care remained as strong as ever, but without relief from its financial and operational stresses the company’s very survival was at risk. We helped them automate the collection and integration of data from key systems like PointClickCare, Kronos, and DSSI and then organized the data into information to align with key drivers like staffing and expense ratios to census. This also met business demands to explore trends, and provided the ability to drill into the detail behind the numbers, compare facilities and regions with each other to identify strong and poor performers and use that information to create targets used to measure and manage improvement. We used a modern and capable platform to deploy dashboards and related content directly to the managers while providing navigation paths that with minimal training they could use to explore and understand the underlying causes.
The technical environment had a mix of applications on premise and in the cloud. We worked with cloud providers to load data in a nightly batch window and provided access to some data more frequently. Data was integrated across key dimensions like accounts, locations, departments and business units. Everything was automated. We worked with the finance and operations teams to create content that was useful and intuitive to the end users and integrated with existing security to make access appropriate and easy for more than one thousand users at each location, department and function across the organization. Over time this solution has grown to include third party data from CMS, and support more advanced analytics around PDPM, further adding value and capabilities. In the case of PDPM, a handful of very simple use cases related to interrupted stays, CoVid-19 and comorbidities captured on assessments, provided the ability to identify omissions – mistakes really – that were resulting in missed revenue. This is the “low hanging fruit” and I love it when we find this because it feels like we earn our keep in a direct way.
But with the AI capabilities in the latest version of Cognos, and an advanced platform to support it, we will do much more than that – this data can be used to understand how each location differs on a very detailed level, and optimize each location not just based on overall drivers, but on the drivers that have the most impact for that specific location. We can see which patients are handled well, and which patients are a challenge at a location level. This point is subtle, but very important: Across dozens or hundreds of locations and thousands of patients it is common for nothing to stick out. With that sort of volume, everything regresses to the mean and nothing looks interesting. But comparing similar cases across locations within the system is usually interesting. It is almost certain that locations will have different case mixes and different outcomes for similar cases. Finding the differences and investigating the underlying causes usually leads to meaningful insights. And the insights can be care related or business related – One location may have a higher number of cases and better outcomes in major joint replacement cases. This may be because they have a high quality staff that has established a strong referral network based on their results. It may be possible to replicate this success at another location where the number of cases is lower, but the outcomes are just as good. Using the data to tell this story and have these conversations with potential referral partners is a key part of this strategy. In today’s environment being able to demonstrate and prove quality outcomes is critical.
These kinds of opportunities excite me. It is not every day where it feels like we can have so much positive impact with technology. The fact that the post acute care world is hurting right now makes this even more important to us. If anything here connects with the problems and challenges you are struggling with, reach out. We have been there and can help.