Microsoft Health Customer Solution Case Study

Medical Group Uses Reporting Framework to Enhance Care and Control Costs

Overview “As we reduce our inpatient-utilization trends, we will Country or Region: United States Industry: Healthcare see a tremendous cost savings and a huge return on investment down the line.” Customer Profile HealthCare Partners (HCP) provides Rick Liu, Director of Decision Support, HealthCare Partners healthcare to 500,000 patients annually. HCP employs or contracts with more Providing healthcare to more than 500,000 patients each year, than 1,100 physicians and 3,000 specialists, and it partners with many HealthCare Partners Medical Group (HCP) employs or contracts major hospitals. with thousands of physicians and specialists. To provide support

Business Situation services, such as inpatient care management, referrals, and HCP wanted an automated reporting billing, HCP relies on a detailed and dynamic reporting system. framework to help manage its revenue cycle and hospital inpatient bed days at Unfortunately, HCP’s existing reporting framework did not the regional, medical office, and provide the analytical tools or performance that the organization physician levels. required, resulting in high administrative effort, increased costs, Solution and inefficiency. HCP needed a system to manage its revenue HCP worked with Microsoft Gold Certified Partner CitiusTech to develop a cycle and analyze inpatient bed days at every level of the financial and operational reporting organization. Working with Microsoft Gold Certified Partner solution using Microsoft technologies. CitiusTech, HCP developed HCP Report Center, a reporting Benefits solution based on Microsoft technologies. Now, HCP takes  Enhanced care  Better connectivity advantage of advanced analysis capabilities to control costs and  Reduced costs enhance patient care.  Improved productivity

“We were getting the Situation regional business units. However, the HealthCare Partners Medical Group (HCP) system lacked advanced analytics information out there, provides primary and specialty healthcare capabilities, and the Decision Support to more than 500,000 patients annually in department at HCP had trouble getting the but we wanted a better the Los Angeles Metro area of Southern system to meet the needs of regional way to aggregate it for California. Headquartered in Torrance, stakeholders, such as operations managers, California, HCP employs around 500 medical directors, medical office stakeholders who really primary care and specialty physicians in 40 administrators, and clinicians. The Decision medical offices. HCP also contracts with Support staff often had to manually needed it the most.” more than 1,100 independent primary care produce ad-hoc reports, using Microsoft Rick Liu, Director of Decision Support, physicians and more than 3,000 specialists. Office Access database software or Office HealthCare Partners In addition, HCP partners with more than Excel spreadsheet software, and distribute 20 major hospitals to help provide and them by e-mail or sometimes even in paper manage inpatient care. copies.

To provide services to both health The situation not only created significant management organization (HMO) enrollees extra work for support teams, but it often and fee-for-service patients, HCP has resulted in valuable information being contracts with most major HMOs and distributed inefficiently, making it hard to health insurance providers in Southern monitor the overall performance of the California. And because HCP provides a full organization, identify trends, and range of support services for its network of coordinate action. “We were getting the independent physician associations, such as information out there, but we wanted a referrals, accounting, billing, and claims better way to aggregate it for stakeholders services, the medical group has developed who really needed it the most,” says Liu. a significant IT infrastructure to manage “We wanted to consolidate all the financial systems and practices throughout the and bed-day reporting into one central enterprise. application that would provide a Web- based user interface and easy-to-use “We manage both the professional and the advanced analytics capabilities for key institutional aspects of healthcare,” says decision makers in our organization.” Rick Liu, Director of Decision Support at HealthCare Partners. “And because we have Liu also wanted his team to spend less time to manage doctors, outpatient clinics, and on the mechanics of simply producing inpatient admissions, we need systems that reports and more time providing analyses can provide very detailed and dynamic to manage costs and improve patient care. reporting.” “If we could provide more information that was actionable, rather than just reports to HCP developed a reporting system based sift through and read, it would make it on Oracle software to help it manage and easier to get beyond just closing the coordinate its monthly revenue cycle, revenue cycle each month,” he says. inpatient bed days, and other patient utilization metrics across the group’s five Microsoft data management and business intelligence technologies. The system, called HCP Report Center, centralizes financial and inpatient utilization reporting across all dimensions of the organization. With HCP Report Center, stakeholders at HCP can access data marts for subject areas, such as inpatient or outpatient utilization, claims, or referrals, and optimize these complex datasets for enhanced reporting and analysis.

HCP dedicated a cross-functional team to collaborate with CitiusTech on an iterative development process for HCP Report Figure 1. HCP uses HCP Report Center Center, while stakeholders continued to use to present reports in dashboards by the existing, Oracle-based reporting HCP wanted to build an automated, subject areas, such as member system. A beta version of the system was interactive, and user-friendly analytics and visits or ALOS by region or care deployed to key users who provided reporting solution that would provide easy type. feedback to the HCP team and CitiusTech. access to reports and timely information for After further testing and training, the key decision makers. The medical group system was deployed to end users in fewer needed a system to help manage its than 16 weeks, launching in the last quarter revenue cycle and analyze inpatient and of 2009. outpatient utilization at the regional, medical office, and physician levels. HCP “CitiusTech was a tremendous wanted more dynamic reports that could development partner,” says Liu. “Because identify trends and their causes, while CitiusTech is so focused on the healthcare minimizing the need for ad-hoc reporting. industry, they came in with a very strong understanding of the important metrics in Finally, HCP wanted to extend the solution healthcare, how to deliver them, and how framework to other operational and to calculate them. They met our performance metrics so that the expectations every step of the way.” organization could continue to focus on controlling costs while enhancing the Using HCP Report Center, HCP can quality of care that it provides to patients. consolidate reporting by subject areas and present it to stakeholders in dashboards Solution that display financial view reports, In 2009, HCP began working with operational view reports, and key CitiusTech—a Microsoft Gold Certified performance indicators, such as member Partner that provides technology solutions visits, inpatient days per thousand, or and services to the healthcare industry—to average length of stay (ALOS). Users can design and build a framework for delivering expand or contract reports as needed, for financial and operational reports using “Rather than spending instance by selecting ALOS by region or by After deploying HCP Report Center for region and care type (Figure 1). inpatient utilization, HCP and CitiusTech our time requesting and added more subject areas to the system. The Data Warehouse team manages the “We moved on from the inpatient side to producing reports, we’re data marts with Microsoft SQL Server 2005 areas like specialty referrals, emergency now spending our time data management software, and Decision room and urgent care visits, and claims,” Support develops the reports using SQL says Dennis Swarup, Head of Provider analyzing the data. That Server Reporting Services and Excel Solutions at CitiusTech. “As time goes on, Services in Microsoft Office SharePoint we’ll continue to look at other subject areas helps us achieve our Server 2007. Stakeholders access the and other reporting that HCP wants to overall goal of trying to reports on the HCP Report Center through deliver to the organization.” a Web portal developed on Office manage and control SharePoint Server 2007, and HCP manages Benefits access to the portal with Active Directory By working with CitiusTech to develop the costs without Domain Services. HCP Report Center with Microsoft compromising care.” technologies, HCP has significantly With more advanced functionality in its enhanced its ability to easily access, Rick Liu, Director of Decision Support, new reporting framework, HCP can now aggregate, and analyze information across HealthCare Partners identify and analyze utilization trends. For multiple areas of the enterprise, including instance, the Decision Support department finance, utilization management, and has implemented an early warning system business management. “Now we can use that provides a month-to-date estimate of our reporting and analytics framework to bed days by the end of the month. If an move the organization forward, controlling alarming trend is identified in the middle of costs while enhancing care for patients and the month, care managers can act early to support for doctors,” says Liu. investigate. HCP has also developed a daily inpatient census that is available to regional Enhanced Care medical directors, medical office Better reporting helps HCP care for its administrators, or other stakeholders. 500,000 annual patients. By efficiently monitoring patients from outpatient visits ”A primary care physician can look at the to inpatient stays, HCP can help doctors census and see which of her patients was in provide better care and enhance outcomes. an inpatient facility the night before and HCP is using the data to improve key data identify which are likely to be discharged sharing among clinicians. In particular, this soon,” says Liu. “She can check to see has helped HCP manage the care of whether they had been readmitted from a patients with multiple co-morbidities. By previous admission, and how many prior reducing the chance of unnecessary acute or subacute admissions they may hospital readmissions, HCP can avoid have had. She can then use this information incurring additional inpatient costs and the to ensure that her patients get the follow- risk of further complications for the patient. up care they need and help prevent them from being readmitted to the hospital.” Better Connectivity With HCP Report Center, HCP can extract performance across regions, medical source information that resides in disparate offices, and physicians, making it easier to systems at its many medical offices and manage the revenue cycle. “Rather than partner facilities, load it into a central data spending our time requesting and warehouse, and deliver the information in producing reports, we’re now spending our reports and analyses to key stakeholders time analyzing the data,” says Liu. “That and decision makers throughout the helps us achieve our overall goal of trying organization. “Now we have a central to manage and control costs without repository of all of the reporting for the compromising care.” organization,” says Liu. “It covers all of the relevant subject areas from a clinical management, financial management, and operational management perspective.”

Reduced Costs According to Liu, staff members can now generate reports that used to take weeks in just days, sometimes hours, resulting in a reduction in time and effort of more than 70 percent. More importantly, stakeholders can receive completed reports more easily and quickly with the HCP Report Center Web interface. The organization also expects to reduce operating costs by providing more accurate and timely financial and operational analysis. “I definitely think there are material cost savings that we have achieved and will achieve in the future,” says Liu. “As we reduce our inpatient-utilization trends, we will see a tremendous cost savings and a huge return on investment down the line.”

Improved Productivity By adding a powerful layer of analytics to its reporting capabilities and phasing out manually developed reports, HCP can make the entire organization more efficient and productive. Physicians can monitor patients more easily. Regional managers can evaluate facility performance and take corrective actions. And finance teams can analyze utilization measures and For More Information While HCP provides better reporting, it has Microsoft Health For more information about Microsoft also reduced the complexity of the system Microsoft technology can help healthcare products and services, call the Microsoft for users. “Our stakeholders are medical practitioners and insurance providers in Sales Information Center at (800) 426- professionals, not database experts,” says giving patients the best medical care and 9400. In Canada, call the Microsoft Liu. “Having the Office SharePoint Server coverage possible. Canada Information Centre at (877) 568- interface that interoperates with Microsoft 2495. Customers in the United States and Office products that users are already For more information about Microsoft Canada who are deaf or hard-of-hearing familiar with makes HCP Report Center Health please go to: can reach Microsoft text telephone easy to work with. Our users were easily www.microsoft.com/industry/healthcare (TTY/TDD) services at (800) 892-5234. able to grasp the concepts.” www.microsoft.com/industry/healthcare/pr Outside the 50 United States and oviders Canada, please contact your local www.microsoft.com/industry/government/ Microsoft subsidiary. To access health information using the World Wide Web, www.microsoft.com/industry/healthcare/he go to: althplans www.microsoft.com

For more information about CitiusTech products and services, visit the Web site at: www.citiustech.com

For more information about HealthCare Partners products and services, visit the Web site at: www.healthcarepartners.com

Software and Services  Technologies  Microsoft Office − Active Directory Domain Services − Microsoft Office SharePoint Server − Excel Services 2007 − Microsoft SQL Server 2005 Reporting  Microsoft Server Product Portfolio Services − Microsoft SQL Server 2005

This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY. Document published February 2010