End-of-Chapter Application Case

Smart Business Reporting Helps Healthcare Providers Deliver Better Care

Premier, which serves more than 2,600 U.S. hospitals and 84,000-plus other healthcare sites, exists to help its members improve the cost and quality of the care they provide the communities they serve. Premier also assists its members to prepare for and stay ahead of health reform, including accountable care and other new models of care delivery and reimbursement.

Challenge

As Premier executives looked to execute this vision, they recognized that the company’s existing technical infrastructure could not support the new model. Over the years, Premier had developed a series of “siloed” applications, making it difficult for members to connect different data sources and metrics and see the “big picture” of how to drive healthcare transformation. These platforms and associated software systems also lacked the scalability required to support the massive transaction volumes that were needed. At the same time, as Premier integrates data in new ways, it needs to ensure that the historic high level of data privacy and security is maintained. Moving forward with new technology, Premier had to confirm that it can isolate each healthcare organization’s information to continue to meet patient privacy requirements and prevent unauthorized access to sensitive information.

Solution—Bridging the Information Gap

Premier’s “re-platforming” effort represents groundbreaking work to enable the sharing and analysis of data from its thousands of member organizations. The new data architecture and infrastructure uses IBM software and hardware to deliver trusted information in the right context at the right time to users based on their roles. Using the new platform, Premier members will be able to use the portal to access the integrated system for various clinical, business, and compliance-related applications. From a clinical aspect, they will have access to best practices from leading hospitals and healthcare experts across the nation and can match patient care protocols with clinical outcomes to improve patient care.

Applications on the new platform will run the gamut from retrospective analysis of patient populations focused on identifying how to reduce readmissions and hospital-acquired conditions to near–real-time identification of patients receiving sub-therapeutic doses of an antibiotic. Business users within the alliance will be able to compare the effectiveness of care locally and with national benchmarks, which will help them improve resource utilization, minimizing waste both in healthcare delivery and in administrative costs. Additionally, this integrated data will help healthcare organizations contract with payers in support of integrated, accountable care.

Premier’s commitment to improving healthcare extends beyond its member organizations. As part of its work, it teamed with IBM to create an integrated set of data models and templates that would help other organizations establish a comprehensive data warehouse of clinical, operational, and outcomes information. This data model, called the IBM Healthcare Provider Data Warehouse (HCPDW), can help healthcare organizations provide their staff with accurate and timely information to support the delivery of evidence-based, patient-centric, and accountable care.

Journey to Smarter Decisions

Fundamental to helping Premier turn its vision into reality is an Information Agenda strategy that transforms information into a strategic asset that can be leveraged across applications, processes, and decisions. “In its simplest form, Premier’s platform brings together information from all areas of the healthcare system, aggregates it, normalizes it, and benchmarks it, so it impacts performance while the patient is still in the hospital or the physician’s office,” says Figlioli, senior vice president of healthcare informatics at the Premier healthcare alliance. “We wanted a flexible, nimble partner because this is not a cookie-cutter kind of project,” says Figlioli. “Premier and IBM brought to the table an approach that was best of breed and included a cultural and partnering dimension that was fundamentally different from other vendors.”

The organization’s IT division is building its new infrastructure from the ground up. This includes replacing its existing x86 servers from a variety of hardware vendors with IBM POWER7 processor-based systems to gain greater performance at a lower cost. In fact, an early pilot showed up to a 50 percent increase in processing power with a reduction in costs. Additionally, the company is moving its core data warehouse to IBM DB2 pureScale, which is highly scalable to support the growing amount of data that Premier is collecting from its members. As part of Premier’s platform, DB2 pureScale will help doctors gain the information they need to avoid patient infections that are common in hospitals, and will help pharmacists ensure safe and effective medication use.

Data from facility admission, discharge, and transfer (ADT) systems along with departmental systems, such as pharmacy, microbiology, and lab information systems, will be sent to Premier’s core data warehouse as HL7 messages, with near–real-time processing of this data occurring at a rate of 3,000 transactions per second. With the high performance that DB2 data software provides, Premier members can quickly learn of emerging healthcare issues, such as an increased incidence of MRSA (a highly drug-resistant version of staphylococcus aureus bacteria) in a particular area.

Data from IBM DB2 database software will be loaded into the IBM Netezza data warehouse appliance to enable members to conduct advanced analytics faster and easier than was previously possible. IBM Cognos Business Intelligence will be used to help members identify and analyze opportunities and trends across their organizations.

IBM InfoSphere software is used to acquire, transform, and create a single, trusted view of each constituent or entity. The data is then integrated and validated, and clinical or business rules management is applied through WebSphere ILOG software. These rules can help automatically notify clinicians of critical issues, such as the appropriate dosing of anti-coagulation medication. IBM Tivoli software provides security and service management. Application development is built upon Rational® software and a common user experience and collaboration are provided through IBM Connections software.

Business Benefits

Potential benefits for saving lives, helping people enjoy healthier lives, and reducing healthcare costs are enormous. In one Premier project, 157 participating hospitals saved an estimated 24,800 lives while reducing healthcare spending by $2.85 billion. The new system helps providers better identify which treatments will enable their patients to live longer, healthier lives. It also supports Premier members’ work to address healthcare reform and other legislative requirements.

“When I think about my children, I think about what it will mean for them to live in a society that has solved the complexities of the healthcare system, so that no matter where they live, no matter what they do, no matter what condition they have, they can have the best possible care,” says Figlioli.

Over the next 5 years, Premier plans to provide its members with many new applications in support of healthcare reform and other legislative requirements. As capabilities are added, the SaaS model will enable the platform to support its commitment to keep all 2,600 hospital members on the same page, and even expand its user community. With its new approach, Premier IT staff can develop, test, and launch new applications from a central location to provide users with updates concurrently. This is a lower-cost way to give Premier members an analytics solution with a shorter time to value.

Questions for the End-of-Chapter Application Case

1. What is Premier? What does it do?
2. What were the main challenges for Premier to achieve its vision?
3. What was the solution provided by IBM and other partners?
4. What were the results? Can you think of other benefits coming from such an integrated system?

Source: IBM, Customer Success Story, “Premier Healthcare Alliance Making a Quantum Leap Toward More Integrated Care and Improved Provider Performance,” ibm.com/smarterplanet/us/en/leadership/premier/assets/pdf/IBM_Premier.pdf(accessed February 2013).

 

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