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Columbia Valley Community Health

Columbia Valley Community Health logo"For Columbia Valley Community Health, the power and the value of BusinessObjects Edge Series lie in its potential to help us save lives."

Dr. Grant Scull
assistant medical director
CVCH

Challenge

The Columbia Valley Community Health (CVCH) clinic, a Federally Qualified Health Center, began operations in 1972 when a group of 24 concerned Wenatchee, Washington citizens came together with a common desire to alleviate the poor health conditions of people living in the area. Early services included screenings by nurses in outreach vans along roadside in rural areas.

It's a mission that stands as firm today as it did then. This nonprofit community clinic still serves the area's Medicaid and under served populations, including many migrant Hispanic farm workers. In addition to its primary care practice, CVCH also provides a dental practice, a behavioral health practice, and comprehensive maternity support services. Pharmacy, Radiology, and Chronic Disease Management departments are the clinic's most recent service enhancements. CVCH also operates another clinic 40 miles away in Chelan Washington. The organization employs 270 people.

From Charts to Electronic Medical Records
Three years ago, CVCH decided to deploy NextGen's Electronic Medical Records system. According to Dr. Grant Scull, Assistant Medical Director at CVCH, this significant undertaking was based not so much on the usual goals of eradicating paper and improving efficiencies, but more on the hope that by aggregating patient data in electronic format the clinic staff could more easily access and analyze it to provide better care.

Over time, CVCH had collected huge amounts of clinical data, but it was impossible for clinicians to open up hundreds of patient charts to try and gather information about discrete patient populations. "We felt it was time to take that information and couple it with our collective expertise to provide more proactive patient care and improve health outcomes," recalls Dr. Scull.

From Single Point of Care to Case Management
The move from paper charts to an EMR system was the beginning of CVCH's Business Intelligence (BI) strategy. It also signaled the clinic’s commitment to a different way of providing care. In the traditional point-of-care model, a patient visits a physician for a specific reason and the visit, including symptoms and treatment prescribed, is recorded in the chart. This works well for an acute illness, but the majority of health care dollars are spent on managing chronic disease, like diabetes, which is better handled via a different model of care called case management.

"This model allows us to search data on entire populations to apply best practices that are evidence-based, without the patient having to come to the doctor," explains Dr. Scull, who is also a family physician at CVCH. "So with diabetes, for example, it means taking the information we have on all our diabetic patients to identify which practices worked well and which ones didn’t, and then modifying our treatments to proactively improve health outcomes for diabetic patients before they present for care in our office."

Information is key to the success of this approach. CVCH had taken the first step in deploying an EMR system to collect its patient data. After three years, CVCH's management and clinicians were eager to put that information to use. The clinic needed a business intelligence solution geared for a growing mid-sized organization. Yet CVCH also required enough BI capabilities to help it provide more efficient, appropriate care that would improve outcomes and even save lives.

Approach

So, when CVCH hired its first CIO, Mike Hodgson, one of his top priorities was to evaluate and deploy a BI solution. "I talked to key partners in the organization, and the consistent theme was, 'You are here to get us data'," he recalls. "Frankly, what they said was 'You are here to put Crystal Reports out' but the more I asked them questions the more I realized they didn't just want static reports, but a complete BI solution that any health practitioner in the clinic could use with ease."

Coming from a Fortune 500 environment, Hodgson was familiar with the benefits of enterprisegrade business intelligence solutions—and the resources and money they require. While he spent time looking for an alternative BI solution more suited to his new organization's size and budget, the IT department of 8 people worked diligently to keep up with the demand for Crystal Reports.

"We looked at Business Objects BI solutions because they are compatible with our infrastructure, and we wanted to take advantage of the investment we had in those custom reports," says Hodgson. "We took our time evaluating Crystal Enterprise, and then the Crystal Vision tool became available. By the time we were ready, Business Objects had released Edge Series. Every step along the way, Business Objects continues to improve the BI options for mid-sized companies. I can't think of another product that I've been this excited about at this price point. Edge Series' level of sophistication for the cost is outstanding."

Another reason that CVCH chose BusinessObjects Edge Series was the product's ease of use, especially beneficial for a small IT department that wanted to free up the time it spent generating custom reports for the staff. Edge Series requires only one key code and installs on a single server. "With built-in dashboarding, reporting, ad hoc and analysis capabilities, BusinessObjects Edge Series will answer everyone's BI needs at CVCH with a minimal learning curve," confirms Hodgson. "At the same time, we are not going to have to devote a lot of time and resources to our new BI solution."

Results

Columbia Valley Community Health center is rolling out BusinessObjects Edge Series at the same time as it's performing a clinical re-design to facilitate more case management and team-oriented care. "We are already working with our Diabetes Coordinator and our Quality Improvement (QI) supervisor to define their BI needs so we can give them the tools that they need for real-time, valuable information access," says Hodgson. "Once we get started, more and more people are going to want to use the solution and we expect to roll out enterprise wide over the next year or so."

Flexible Access to Data on Demand
CVMH expects to benefit from the flexibility and ease of use of Edge Series, providing ubiquitous access to patient data in different formats. "Dashboarding will help us to manage patient flow and improve our ability to comply with our open access policy that ensures a patient gets an appointment on the day he or she calls," explains Hodgson. "Dashboarding will also provide key performance indictors for our office manager to view online when and where she wants."

The CVCH's QI Coordinator will use the ad hoc capabilities in Edge Series to perform 'what if' scenarios and to run studies on different patient populations so CVCH practitioners can assess the success of different medical protocols. "She is very excited to use ad hoc queries to help us meet the standards of the Joint Commission and Accreditation of Health Organization," adds Hodgson. "The tool is also going to be of value for the CFO to analyze revenue cycles, and for our HR department to look at hiring trends and other information. Everyone in our organization is hungry for information and Edge Series is the best way to provide them with self serve access to the data they need, in the format they like, when they want."

Collaborative Case Management
CVCH will use Edge Series to facilitate collaborative, patient-centered care. "When the doctors, nurses, physicians, dieticians, psychiatrists, and other clinicians that typically make up a care team can all access the same, up-to-date patient data through a simple Web-based interface, then we will achieve truly efficient collaborative health care," enthuses Dr. Scull. "BusinessObjects Edge Series is the only way we can implement case management because it provides an affordable framework for collaborative, real-time information access from anywhere at any time."

This theory is easily applied to specialists that work outside of the clinic, yet play a key role within the health care continuum for its patients. Instead of spending a lot of time packaging patient notes to send to cardiologists or orthopedic surgeons, CVCH is looking forward to using its Edge Series solution to provide outside specialists with this information digitally. "With BusinessObjects Edge Series we hope to make crucial patient information available online—in a format that satisfies all regulatory requirements—to improve the efficacy of care delivered to our patients outside of the clinic," says Dr. Scull. "Imagine if one of our patients visits the emergency ward: wasting no time, the attending physician could discover that patient's pharmaceutical history, recent lab results, and any other pertinent information. Flexible, immediate information access like this could very well effect a significant improvement in his or her treatment at the ER."

At the clinic, Dr. Scull expects that Edge Series will be used to provide proactive, teambased management of diabetic patients and other chronically ill patients. For example, CVCH health practitioners can access data for diabetic women over the age of 60. "We can then look at this subset of our patient population and identify which of those patients are not currently on ACE inhibitors, [a group of pharmaceuticals used to treat hypertension and congestive heart failure]. We know that this medication can significantly reduce the risk of heart attack and stroke. We now have an opportunity to apply that best practice and perhaps call in those patients for a consult before they become symptomatic. That’s preventative care. For Columbia Valley Community Health, the power and the value of Edge Series lie in its potential to help us save lives."

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