Riverside Health System

Riverside Health System featured in Healthcare Informatics Magazine

"A standout in the industry"

August, 2008 – Healthcare Informatics: "For many years, John Stanley, CIO of Riverside Health System, Newport News, Va., ran an executive information system for his management team and board, but has lately begun to drill down into deeper layers of data. “We had started with our main indicators, about 26-27 of them. People said, ‘This is doing very well, but we need to blow out the quality area and have a sub-scorecard that gives more depth and more indicators.’” Today, Stanley says he can pinpoint turnover down to the very departments, and patient satisfaction down to the nursing units.

Stanley is using SciHealth (Atlanta) for his scorecard. “The scorecard product has mapping utilities that say, ‘This is what I'm getting in column one, two, three and four.’ It's like a giant spreadsheet.” His system-support department manages the dashboard. “They're not IT professionals, they're just using that file and mapping it,” he says. “We may have to write a report to get information out, and in some cases we do some calculations, but it's not that technical.”

How long did it take to set that up? “Our first scorecard was at the top level,” he says. “It shows us what we're doing (over the entire) health system,” explained Stanley. “It took about three months to introduce the software, and do the mapping. We have 150 indicators now. Peer pressure works.” Afterthe vendor trained the staff and the mapping was rolled out to 500 leaders and managers, Stanley brought up 300 doctors and their office manager.

And what about the doctors? Especially when it comes to pay-for-performance, most say bringing physicians on-board, on any level, is the hardest part. “We're beginning to have our quality people introduce dashboards to physician leadership,” says Schooner. “And you have to be very careful because the data absolutely has to be rock solid and beyond reproach.”

At Riverside, Stanley's doctors have found that using the dashboards helps them to improve core clinical outcomes measures. “All the doctors can go to the scorecard and click on the highest level of practice and see if they're meeting all their indicators on diabetes. There's a sense of outcomes.” He says they can then click on the practice and see that four physicians are doing fine, and the fifth might be behind on his screenings. Then they click on the physician to see what measures they've been tracking — and click on the measure. “And what we love is that it's all right there in front of them and they don't have to hop from system to system,” says Stanley.

That type of application remains a standout in the industry. So for a CIO just beginning to walk down the dashboard path, what advice is out there?

Many say start at the top. “A lot of hospitals develop these scorecards for a particular reason and now they're all struggling to get executive buy in,” says Stanley. “Our executives drive our bus. If all you want the scorecard to do is measure your improvement in the ED, it's going to be limited to that area. We started at the top,” he explains.

Salem suggests faculties start with an organizational strategic plan. “A lot of hospitals have already bought into this and adopted a balanced scorecard and are running around with it on an Excel spreadsheet — it takes 50 analysts a month to put it together, and it's color coded. It's static, with no trends, no drill down.” But, she says, don't abandon it. “Embrace the strategy and then align the strategy throughout the organization. Start at the top and roll it down. Every department should have it, and have the same or similar goals.”

Schooler recommends CIOs ask themselves two major questions. “First and foremost, do I have the source data identified and available? The requisite technologies may not be in place, and that's a bigger deal than a lot of people think. Second, you have to understand the priority areas for your organization because you can go off into every corner and start building a dashboard.”" - Healthcare Informatics, August, 2008

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