Staying Calm in a Crisis

Feature Article | November 9, 2009 by Tim Clark

BI-Software hilft, Personalauslastung und Medikamentenvorräte optimal zu koordinieren. (Foto: Jupiterimages)

BI-Software helps to run medical business in case of crisis like swine flu. (photo: Jupiterimages)

The ability to sense and respond to demand accurately is an age-old challenge that few companies have mastered – and when demand involves the preservation of human life, the stakes suddenly become much higher. Emergency Medical Associates (EMA), a healthcare company located in Livingston, New Jersey, that services more than 21 emergency rooms, is continually faced with this challenge in its caring for thousands of patients on a daily basis. But thanks to its steadfast reliance on powerful and easy-touse SAP BusinessObjects business intelligence solutions, EMA can care for patients more efficiently, even when an unexpected crisis such as the recent global outbreak of the H1N1 virus creates a sharp increase in patient visits.

“Unlike other companies that might only deal with revenue and expenses and costs of goods sold, we deal specifically with patients, where every data point represents an activity in an emergency department,” says Jonathan Rothman, director of data management, EMA. “Our industry is about caring for patients, the types of services performed, and the outcome. That’s what makes what we do unique. Each data point is a person, not just dollars and cents.”

Raising the red flag

In April 2009, EMA noticed a dramatic increase in total patient volume soon after press coverage of a potential swine flu outbreak in Mexico surfaced. Crowds of people, commonly referred to as the “worried well,” flocked to EMA’s emergency departments, complaining of fever and flu-like symptoms. Thankfully, Rothman said, the majority of people who visited an EMA emergency room during this first wave of the swine flu did not have the flu, but instead had other conditions that resulted in fevers or upper respiratory infections.

But the next wave of swine flu came back with a vengeance in June and showed statistics higher than EMA has witnessed in its emergency departments in over four years.

“We compare the flu information to a long history of information,” says Rothman. “When the statistics for that day go above twice the standard deviation against the mean, our business intelligence tool raises a red flag.”

Using SAP BusinessObjects Web Intelligence and Xcelsius software, EMA provides emergency room managers, physicians, and administrative staff with self-service, Web-based access to a wide range of clinical, financial, and operational metrics.

As soon as EMA determined there was a true swine flu outbreak, for instance, the information was sent to as many people as possible, including every single emergency department and medical physician who worked for EMA, as well as local and state health agencies and the Centers for Disease Control and Prevention. “First, you have to determine that there is an outbreak based on the data, then you move into action and develop something like what we developed – an H1N1 task force to specifically disseminate information about what’s going on in our emergency departments and what doctors and nurses should do,” said Rothman. “Isn’t that what this is all about? Affecting something within operations based on the information that you’ve been given?”

Making a positive impact

For EMA to make a positive impact on its operations, it relies on the SAP system to cull data from the company’s 21 different emergency departments and bring it together in a centralized location. About 4,000 patients per day (over 1.2 million annually) are processed through the system that helps EMA come up with meaningful conclusions. “Once we’ve looked at the data and understand what types of patients we’ve been seeing over a certain period of time, we can determine if we need to increase staff,” says Eric Handler, emergency physician, Saint Barnabas Medical Center. “During the swine flu outbreak, we noticed a significant increase in volume coming into the emergency department during the evening hours. So we were able to add nurses and an on-call physician and notify someone at home if they needed to come in and help out. Examining the data was very important in staffing the emergency department at a critical time.”

With better access to better information, EMA physicians have maintained or increased their compensation – even with falling reimbursements per patient visit and more uninsured patients. Emergency department managers can now measure physician performance against predefined targets and track clinical metrics through personal portals. Besides responding to emerging trends such as flu epidemics that require greater staffing, managers can track various measures of patient care.

SAP BusinessObjects business intelligence solutions have helped EMA reduce the number of patients who leave before treatment to below national levels. They provide EMA with key metrics to identify and remove roadblocks in patient care. Patients move more quickly into treatment rooms, wait less time to see doctors, and spend less time in emergency rooms overall. This increases the number of patients seen per physician hour and reduces the per visit cost for information services.

Improved reporting has also increased EMA’s competitive advantage in attracting new contracts. Financial statements are more thorough and are produced more efficiently. The ability to monitor the key quality of care metrics has launched new compliance programs.

EMA is also using SAP BusinessObjects business intelligence solutions to handle human resources tasks, asset management, and profitability analyses. “These accomplishments have been possible because we developed and distributed business intelligence that department managers, physicians, and administrative staff are willing to use,” says Rothman. “We created a comfortable environment, making the most of our high-powered technology.”

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