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At Marshfield Clinic, IT is a major part of the strategy for providing better care to patients. The group of 40 medical clinics in Wisconsin was one of the first to launch electronic health records, developing its own system to monitor and manage them. Now, it's using SAP BusinessObjects for something Dr. Robert Carlson calls "healthcare intelligence." He's hoping to combine the knowledge of the medical community with the analytics that business intelligence (BI) software can provide to enable better preventative care. "Imagine, if you will, instead of waiting for patients to get significantly sicker or to have an adverse event, we can use these dashboards to find patients whose quality informatics are above a certain threshold and intervene before they have a significant event," said Carlson, CIO and Director of Applied Sciences at Marshfield. "Being able to identify a continuum of care as opposed to an episode of care and keeping people out of the hospital."
Marshfield Clinic is a reflection that companies are still buying BI software in this recession, a conclusion reached in a recent Forrester Research report. In turn, Business Objects, purchased by SAP more than a year ago, has been the major driver of software sales in the company. Sales of SAP BusinessObjects software accounted for two-thirds of SAP's revenue growth in 2008. Marshfield selected it this past summer to replace Cognos, which it had been using for about five years. An aging population, incidence of chronic disease and the changing reimbursement infrastructure all require better information to enable the medical profession to deliver better care, Carlson said. For this reason, the clinic purchased the entire SAP BusinessObjects XI platform to help it do everything from better managing its own finances to helping doctors more easily identify patients at risk for certain illnesses. "We need to become a much more data-driven organization," he said. Other companies involved in the medical field are following suit. Emdeon, based in Nashville, Tenn., sells software that physicians' offices and insurance companies use to process medical and dental claims, electronic remittances, real-time insurance eligibility requests, and HIPAA-based transactions. Emdeon is an Oracle ERP customer and selected the SAP BusinessObjects XI platform -- right now it's using Crystal Reports -- after a review of Cognos, Microstrategy and Microsoft, according to Gene Boerger, vice president of advanced business reporting. It bought nine licenses. "One of the drivers for us was the stability and scalability of the environment," he said. "For us, it was about data organization and consolidation. We were looking at what we felt was the next generation XML-based data access layer." Before Emdeon launched SAP BusinessObjects, it had to filter through 10 different reports to manage information about claims. Boerger said that getting the information to both internal support teams and customers was very difficult. With SAP BusinessObjects, Emdeon was able to consolidate those reports into one and make the traditionally paper-based reports available online. This allows the organization to conduct self-service research, run claims processing more easily, and distribute reports to customers more quickly and efficiently, Boerger said. For instance, one of Emdeon's goals was that when a doctor's office or insurance company requested information about a claim, they would receive that information in a report in five seconds or less. Today, he said, 96.7% of all requests are handled in five seconds or less. Marshfield Clinic, on the other hand, was swayed by the full spectrum of BI software tools SAP BusinessObjects offered and by its BI product roadmap. The clinic eventually wants to provide BI tools to as many employees as want them, so it needed everything from basic dashboard capabilities for physicians to more sophisticated tools like Web Intelligence for workers with a data analysis background to build and run their own queries. "One of the things that attracted us to BusinessObjects is that it has the full spectrum and it's on a roadmap to further develop capabilities," said Marshfield Division CIO Jeremy Meller. "BusinessObjects was not the cheapest system on the market. But when you look at the full value proposition and what it can bring … BusinessObjects is clearly the leader in usability of integration and overall capabilities of the systems." Marshfield is currently running a pilot of a "Quality of Care" dashboard using Xcelsius, which monitors major health statistics like hypertension and coronary artery disease. In about a month, the dashboard will be made available to more than 200 primary-care physicians to give them insight into a large number of medical quality indicators. Marshfield is live on its first universe, a collection of objects for a set of users, and will continue to go live with additional dashboards, scorecards and universes over the next six to 12 months, Meller said. But Carlson thinks widespread adoption will evolve in a subtle way -- by getting the right information correlated and proving that it works. It'll be his job to let the evolving practice of medicine drive what he's doing in IT, he said. "I don't think we're going to wake up one morning and it'll be fully implemented," Carlson said. "But I think there's a growing recognition, as we see some of the younger physicians start to enter practice, that having good information tools is not just a luxury anymore, but a growing expectation."
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