An integrated approach to KPI and MDM in healthcare

The spotlight on IT in the healthcare industry has never been more blinding. Healthcare reform (e.g., Meaningful Use, ICD-10 conversion) has mandated IT investment in the name of improved clinical/quality outcomes, reduced medical errors and standardized care. Even without these reforms, however, the increasing role of IT in positively impacting the cost and quality of patient care has become a top priority for healthcare provider organizations.

KPI is King

At the center of demonstrating – and measuring – success is the Key Performance Indicator (KPI).  The healthcare industry has a very large number of complex KPI.  From research to patient care to operations and finance, KPIs and their management (metadata management, master data management) are critical to overall organizational success.

But with increased reliance on these comes increased complexity and costs, both in creation and management of all this data.*

(*Do not confuse “all this data” with “big data.”  As told in the story of an online bookseller’s success, a big data approach involves storing everything first and interpreting later. The KPI model, in traditional data management style, identifies desired data first and stores that data in context.)

Creating a KPI Monster

Because of the sheer volume of KPIs in use, as well as the complexity of calculating even one KPI, the intricacy of the KPI world should not be underestimated.

Consider the many factors to be addressed in determining “ER waiting time”: information about each patient, symptoms they present with, severity of the condition, real-time calculations about number of patients in various stages of treatment, and the list goes on.

Herein lies the potential for creating a monster.

A KPI is very far downstream in the business objectives pipeline, and the work involved in calculating any KPI runs the gamut from validating the integrity of the data, to executing the data product the KPI and its underlying data live in, to managing systems for analyzing and reporting on that KPI. This lifecycle includes:

• Managing the sources of the data
• Data quality and cleansing
• Managing the definition of the data elements used in the KPI
• Tracking ownership of the KPI and data element definition
• Metadata management
• Transparent definition of the calculations used to create the KPI
• Maintaining KPI “trendability”

Managing KPIs, particularly in healthcare, is extremely complex. Healthcare has more stakeholders than in typical corporate KPI’s, and each of those groups may be interested in different metadata about those KPIs. For instance, “over 75 years of age” and “super senior” might be compatible in spoken language, but have a completely different taxonomy when expressed in metadata.

Often, however, the IT systems responsible for KPI management are already overly complex and serve too many disparate functions, as they’ve usually evolved over a long period of time by many, many people.

In turn, the IT department’s management of these systems is hyper-focused on routine execution of processes that could and should be automated, and ends up expending its resources on troubleshooting and supporting. Statisticians, who ideally evaluate the trends and spot opportunities for improvement, may spend more time manually calculating standard statistics than doing the value-added analysis they were hired to do.

The prospect of adding new KPIs means the exponential addition of – potentially – thousands of data points, and incorporation into an IT system that is already overburdened.  And with an exponential increase in complexity comes an exponential increase in management costs.

Where KPI is King and MDM is Hero

The underlying goal in a KPI model is to create a structured, common language, understandable to all of your stakeholders, to communicate what’s supposed to happen and then build execution engines to translate that into actual activity. Welcome to Master Data Management (MDM).

Creating a common language means developing an XML (Extensible Markup Language) – whose words and letters are always pronounced (defined) exactly the same – and there is no guesswork, unlike, say the English language, which is full of pronunciation exceptions. So “super senior” or “redhead” would ALWAYS mean exactly the same thing to all stakeholders.

Now that all parties, even IT, understand and speak the same language, life for all stakeholders becomes less about tedious maintenance and troubleshooting, and more about value-add and better outcomes:

1. The potential for interpretation errors between the groups is dramatically minimized.
2. All stakeholders can have their ownership and interest enforced on the KPI.
3. KPI is “trendable” and reliable over time.
4. The underlying technology that executes the KPI-MDM pipeline can be updated with little or no need for bringing together the disparate parties to redevelop the definition of the KPI.
5. As much as possible, statisticians and researchers are empowered to specify and own their KPI.

The beauty of a properly built and executed KPI strategy is that you can leverage the talent and skills you already have using well-proven technology. There’s no compelling reason to invest in risky, cutting edge technology because you already know exactly what you need. (Again – highlighting the separation of this discussion from “big data.”)

Are you ready for the future by creating the KPI-MDM strategy that can be ported into the future?  This readiness starts with the understanding that an investment into IT infrastructure has proven ROI. The KPI model underscores the value IT brings to healthcare – and any industry whose outcomes can be objectively measured.

Between government mandated healthcare improvements and internal, mission-based commitments to providing quality health care, healthcare providers are recognizing both the need, and the opportunity to deliver better results through IT.

Mind Over Machines delivers elegant, sophisticated IT solutions that help you achieve your strategic enterprise goals. Connect with me on LinkedIn or send me a message and we can discuss your organization’s business challenges.

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The amenities of virtualization

Your system is mission critical. It has hundreds, thousands, or even millions of daily users and it must continue to perform its functions no matter what. But it’s now 10-15 years old, and though it has served its purpose faithfully and is still a solid performer, the time has come to plan for your aging system’s future.

It’s time to make a move, and you know it.

Whether you’re a hospital managing critical patient care records, or a financial institution conducting transactions, or any industry processing payroll or operations data – you need to fully understand the many options, risks, and costs associated with any modernization solution.

But like moving to a new home, the options are endless. Which neighborhood do you want to be in? What’s available in your price range? Is it better to buy or rent? What’s included in the monthly fees? How about security? What type of building do you prefer? What type of amenities do you need today – and what will you need in the future?

For your systems move, the considerations are actually quite comparable. And the “cloud” community offers an amazing assortment of amenities, from efficiencies to services to cost savings.

Location, location, location…in the cloud

The computing industry is witnessing a paradigm shift in the way it operates. There is an acute awareness among consumers and enterprises that access to their IT resources can take the form of a “utility” model known as the “cloud.” This has profoundly reshaped IT processes and the IT marketplace. At its most basic, cloud computing is about the ability to enhance enterprise value through more efficient use of IT resources.

One of the more innovative ways to boost capacity and add capabilities in a cloud environment is by the virtualization of services and infrastructure. While virtualization has been around for quite some time, cloud computing (the new kid on the block) has breathed new life – and purpose – into “older” technologies, and has nudged enterprise evolution one step further down the line.

Virtualization is a method of abstracting applications and their underlying resources from the host hardware. This creates a virtual machine (VM) that hosts the instance of the operating system that was once physical. Sort of like a portable condo unit.

Basic analogy: A VM is to its infrastructure as a condo is to its building. Each VM has its own unique properties with access to shared hardware resources, like an individual condo shares basic common property resources, e.g., hallways, utilities access, elevators, etc.

The Amenities of Virtualization

• Central Management: Just as the property owner manages the overall building, cloud technology allows for the central management and sharing of resources for a pool of physical hardware. Meanwhile each VM (condo unit) can then be managed separately from the hardware server (building) that hosts it. Decorate, furnish, paint and accessorize your condo in your own style, and the property management will take care of everything outside your “four walls.”
• Availability/Reliability: Systems availability is critical particularly during peak utilization times or inclement weather. By making use of virtualization in the cloud, your system can be made to fail over from one server to another – with no impact on users. So when the neighbor above you blows a fuse during your dinner party, or a big storm knocks out power to the building, your power source is seamlessly rerouted and your guests are none the wiser.
• Improved Performance/Scalability: During peak utilization times, or when the average load stays high, your application can be given more resources from the cloud to perform better without an interruption in service. No worries about slowed or stalled internet access because everyone in the building is online at the same time.
• Efficiency/Elasticity: On the other end of scaling up is scaling down. Because they’re no longer tethered to hardware, applications that are virtualized can dynamically re-allocate resources and scale back during low-demand times. This elasticity maximizes efficiencies and is a key consideration in developing a cloud computing strategy. Systems efficiency is a major thorn in the sides of CIOs, who grapple with servers that operate at as little as 3 to 4% of capacity. The loose condo analogy here: the building has built-in capacity to both meet additional occupancy demands (maybe seasonal) and conserve resources when the building is not fully occupied – without interrupting service or adjusting fees for the individual condo units.
•  Reduced Cost: Virtualization in the cloud reduces or eliminates the capital cost of upgrading hardware for scaling – since that cost is built into the monthly cost of the cloud services. Instead of 125 individually installed water heaters, it’s one large water heating system – and the cost is already covered in your monthly fee agreement.

 

How great would it be to pick up your condo and effortlessly move it into a nicer building with better amenities? With virtualization, if at any time the overall system performance no longer satisfies service requirements, monitoring services can migrate instances of the OS to more powerful hardware and reestablish service-level guidelines.

Virtualization is just one piece of a multifaceted modernization puzzle. The organizational priorities that would dictate any modernization decision are as varied as homebuyers’ preferences, are ultimately dependent on an organization’s place (and awareness of this place) in its own history, and of course, always start with strategic goals – not technology goals.

Is your enterprise ready to make a move? Want to know more about how virtualization and cloud computing would fit into your enterprise evolution? Connect with me on LinkedIn or send me a message and we can discuss your organization’s plans for the future.

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Over 250 business executives joined SmartCEO and Title Sponsor Comcast Business in celebrating 29 finalists and 9 winners at the 2013 VOLTAGE Awards.

Baltimore, MD (May 10, 2013) — Baltimore SmartCEO and Title Sponsor Comcast Business announced today the 2013 VOLTAGE Award honorees. The VOLTAGE Awards program celebrates the role that technology plays in the business community and the future impact the technology sector will have on economic growth. The 2013 VOLTAGE award finalists collectively generate more than $49.6 billion in annual revenue and employ over 177,000 individuals in Greater Baltimore.

The VOLTAGE Awards recognize the accomplishments of Greater Baltimore’s pioneering Technology Innovators and Technology Implementers. The finalists are recognized for their creative vision, leadership philosophies, innovative strategizing and undeniable work ethic. The 2013 VOLTAGE finalists are profiled in the May 2013 issue of Baltimore SmartCEO magazine.

Winners were revealed at the Baltimore SmartCEO VOLTAGE awards ceremony on May 9, 2013, at the Westin BWI Hotel in Linthicum, MD. More than 250 local C-level executives and guests attended to celebrate the achievements of the finalists and winners. The winners are:

Cyber Incubator, Technology Implementer, Emerging

Charm City Circulator, Technology Implementer, Small

Marlin Steel Wire Products, LLC, Technology Implementer, Medium

TBB Global Logistics, Inc., Technology Implementer, Large

Kaiser Permanente of the Mid-Atlantic States, Technology Implementer, Blue Chip

Unbound Concepts, Inc., Technology Innovator, Emerging

CSA Medical, Inc., Technology Innovator, Small

Mind Over Machines, Inc., Technology Innovator, Medium

SURVICE Engineering Company, Technology Innovator, Large

“It’s no secret that the evolution of technology is what drives business forward. These companies are pushing the limits of innovation – streamlining processes, finding efficiencies and discovering the next great product,” says Craig Burris, founder and president of SmartCEO. “Sharing their stories is a humbling experience as these companies are the catalysts for our region’s growth and prosperity.”

About SmartCEO SmartCEO is an exclusive community of CEOs and business executives, highly regarded mentors and well-respected thought leaders whose experiences benefit their organizations and the communities in which they serve. SmartCEO’s mission is to educate and inspire the business community through the pages of its award-winning magazine, connections at C-level events and access to valuable online resources.

For more than a decade, SmartCEO has been a leader in helping CEOs tell their stories in print, in person and most recently in-video. SmartCEO’s Mid-Atlantic focus began in Baltimore and has grown to include Philadelphia, Washington DC and New York City.

About the Voltage Awards

The VOLTAGE Awards program celebrates the role that technology plays in the business community and the future impact the technology sector will have on economic growth. An independent panel of business leaders selects the finalists based on the applications submitted. The VOLTAGE finalists are profiled in the May issue of SmartCEO magazine and celebrated at an awards event in May.

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You don’t know what you’ve got till it’s gone

Big data, with all of its vastness and mystery – and confusion – is actually a remarkably straightforward concept: store everything for later analysis. Because once it’s gone, you can’t get it back. The end.

Ok…so there’s more to the big data story. And while the term big data is both overexposed and under-defined, defining it doesn’t really help solve business problems. (And we won’t even get into Big Data vs. big data, because who really cares except for data practitioners.)

But recounting a business success story that substantiates the notion that you should store every last iota of data – because you don’t know every pattern [read: opportunity] that might be found or explored – should shed some bright light on the awesomeness that is big data.

The Big Challenge

An online bookseller didn’t know its profit margin on any individual sale, and therefore did not know where to set its price floor on the marketplace to stay competitive. How could they:

1. Accurately predict a total cost per book?
2. Determine a price floor?
3. Price competitively against that floor on the marketplace?
4. Gain a competitive edge?
5. Sell more books?
6. Maximize profits?

The Big Problem

Profits can only be realized after reconciliation. But reconciling costs, from cradle to grave, just wasn’t feasible. Too much data and too many variables in 2 separate ecosystems (supply chain and marketplace) made for too much guesswork in projecting costs and setting prices, and left the bookseller at the mercy of the marketplace and its competitors. Some of the data points to be reconciled, included:

Inventory:

How much did each book cost? How would the exchange rate complicate everything? How many were actually purchased, and also delivered? Is there excess inventory? What about returns? Do you resell them or do the returns become dead inventory?

 Delivery:

What was the real cost of transit? How were changing gas prices accounted for? Was there a gas surcharge? Did the bookseller pay a bulk rate or was the volume too low to qualify? How would quality and speed of delivery affect the feedback rating to avoid getting kicked off the exchange?  Did the load move through a transient storage facility? Was a different shipping rate applied from point B to point C? What about the rates for different delivery vehicles – planes, trains, boats and trucks?

The Big Opportunity

The opportunity was this:  Any time you can quantify a cost or a risk, you can use that data to feed back into your algorithm for determining the floor of your product. Then you can price more aggressively and ultimately take business away from a competitor.

Since they didn’t know ahead of time which data would help quantify that cost or risk, the bookseller stored everything. Because once it’s gone, it’s gone. This big data approach represents a paradigm shift from a traditional data approach, whereby you first figure out what you need and store only that.  (To reiterate: we’re not concerned here whether it’s defined as Big Data or big data.)

*The bonus of a big data approach: it’s more fun, because everyone gets to add their two cents about what’s going to be valuable downstream, for only a nominal cost.

After exhaustive data cleansing and analysis, and then feeding that information back into the pricing algorithm, the bookseller now had created a homeostatic supply-chain and logistics cost-predicting machine!

The Big Payoff

Like the supply chain ecosystem, the marketplace is filled with data to be collected, manipulated, and analyzed – with nearly unlimited capacity to create competitive edge. With the intelligence gathered from the awesomeness of the cost-predicting machine, the bookseller could now focus on leveraging that cost-predictability into book sales.

An online bookselling exchange compares very neatly to any active trading market, e.g. stocks, commodities, etc. You set your prices and then set up the dogfight rules! In simplest terms, the bookseller had to be faster and smarter than its competitors so it could sell more books.

Now that the bookseller could set the price floor on any single book (thank you, supply chain data machine extraordinaire) the dam was burst, and the opportunity on the marketplace exploded. The accuracy of being able to predict actualized costs allowed for aggressive pricing without putting the whole business at risk.

The bookseller’s high-speed transactional system collected price change data on 5 million SKUs of books daily (over 150 million prices) and could instantly respond to penny changes in the price of any one book.

Because the bookseller could predict and respond to price changes so much more quickly than competitors, the bookseller propelled itself into a position where its books were the most likely to show up as the lowest price during 90% of the day.

So at the end of the day (literally) they’d win more transactions because they had the lowest prices for the longest period of time.

Oh, and one last piece of data triumph – this bookseller vaulted from obscurity to a top 10 online seller of books in a little over 18 months.

Looking for a big triumph with your data? Too much data is an awesome problem that we love to tackle. Please feel free to connect with me at Mind Over Machines.

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From scope creep to sales creep, technology project fears that will make you scream

It’s a scary notion, beginning a new technology project. You know it’s going to hurt your budget; you think you know what you need, but then those techie people tell you something completely different; and what if something better comes along while you’re halfway through your project? Your fears are legitimate, and you’re not alone.

The most common concerns we hear:

• Hidden costs – The project will undoubtedly cost more than the initial estimate.  “It always does.”
• Scope creep - Our last project (or several) got so far off track that we ended up having to bring another company in to clean up the mess.
• The bait & switch – they bring in the senior guns (or sales creeps) to sell the job, and then we get stuck with the rookie they just hired to develop our critical system.
• We know we have a problem but we don’t know the solution — so we can’t yet identify the right partner…can we?

Addressing Your Fears 

Hidden costs. Yes, technology projects are complicated and unforeseen circumstances a right of passage.  Our first piece of advice:  don’t simply go with the lowest bidder, especially one that’s significantly lower than the competitors.  Chances are good they bid low to get the job and you’ll end up with change orders on your desk before the ink is dry on the initial contract.  Ask for an “all in” proposal and hammer them on the details.

Scope creep. Side by side with hidden costs walks its partner-in-crime, scope creep. Just like a fast-growing weed that takes control of your whole garden, the consequences of a project that goes out of scope can be devastating. An overly complex (and therefore unnecessary) design decision in the earliest stages of a project can end up destabilizing the entire project, and threatening your business operations. Our second piece of advice: conduct a basic risk/reward analysis on any proposed solution. What are the business risks associated with this solution, e.g., additional maintenance, training, implementation time? What are the business rewards, e.g., operational efficiencies, revenue increases, cost-savings? Don’t just chase the shiny new technology object.

The bait & switch. Insist on maturity and business qualifications throughout the team. Your company’s critical systems should never be an unsupervised playground for young talent. As discussed in an earlier article, The High Price of Selecting the Wrong IT Partner, “a substantially lower cost proposal often indicates a lack of experience and business expertise, and will likely end up costing much more in the long run. A reputable IT vendor will submit a realistic, comprehensive proposal that addresses your needs. Period.”

Who’s got the right solution? Consider only partners that ask a ton of questions then accurately capture and articulate back to you the essence of your challenge and the project in their proposal.  The more thorough they are in their efforts to understand your business (not just your immediate technology need), your goals, the ultimate technology users and your environment, the more likely they’ll be able to accurately predict the scope of the solution.

What’s your greatest fear in starting a technology project? Leave a comment below, and we’ll help you overcome these fears!

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How innovation helped Aris Melissaratos change the face of Maryland business

In late January, New York City Mayor Michael Bloomberg made a whopping $350 million donation to his alma mater, Johns Hopkins University, pushing his total gifts to the institution over $1 billion. It’s an astounding sum, given out of profound conviction and commitment to the work Hopkins does.

The day the big news broke, Mayor Bloomberg tweeted, “Giving is only meaningful if the money will make a difference in people’s lives. Johns Hopkins makes a difference.” Bloomberg affirmed the importance of research and collaboration brought to life by people who help innovation happen.

Johns Hopkins Senior Advisor to the President for Enterprise Development, Aris Melissaratos is one of those people. He’s moved from Europe to America; from school to industry; from corporate life to startup investing; from private investing to government executive, and now into the academic world. In each context, innovation has been crucial.

From Adversity to Aspiration

Aris’s ethnically Greek family achieved major business success in Romania, but their prominence became dangerous when communists took control of the country after World War II. Wealthy people who stayed behind the Iron Curtain faced seizures or even imprisonment by local communist governments, so the Melissaratos clan headed to Greece, then on to Baltimore in 1956.

Young Aris worked all sorts of jobs in the Baltimore neighborhoods where European immigrant communities settled after stepping off ships nearby. He learned English, then advanced math, then got his degree at Johns Hopkins in electrical engineering.

By the time Aris was hired at Westinghouse, the beginnings of the digital revolution were evident in the projects he managed. Over the next few decades, Aris saw the entire progression of analog to digital systems in electrical engineering.

Math and science teachers sometimes struggle to help students engage with the subject matter: for Aris, advanced electrical engineering coursework came up nearly his first day on the job. “It was mind-boggling how much you could integrate,” he reflects. To make radar work at Westinghouse, he would have to perform every formula he learned in calculus and differential equations back on campus, while managing the mechanization of dozens of mechanical parts and dozens of people who made it happen.

Moving Parts, Moving People

Moving parts and dynamic people are a theme for Aris, who keeps his focus on managing and motivating people in a way that will maximize their human potential. He holds that true for everyone, from janitors to the best engineers in the world. “Each one requires a different kind of career attention,” he emphasizes, and it’s important to make them believe management cares about their future. It’s more important, of course, for that to be true.

From those first projects out of college, Aris rose to become VP of Science and Technology at the company’s Pittsburgh R&D center, modeled after Bell Labs. There he was, a self-described “manufacturing guy from Baltimore,” managing over a thousand PhDs who “literally wrote the book on everything electrical.” He was the first person without a doctorate to hold that position.

At Westinghouse, Aris gained a diversity of experience that allowed him depth of knowledge in many areas along with the connections and silo-smashing privileges any cross-pollinator would dream of. “I got exposed to full range of applications: fossil fuel power; nuclear power, the birth of the nuclear navy” and the list goes on. “It was a fantastic experience.”

In the 90s, Westinghouse brought in outside leadership, then decided to sell its commercial technology operations and push into television. In December 1997, Westinghouse became CBS Corp., and on February 1, 1998, Aris retired.

As his long-time company changed its stripes, Aris witnessed what he calls “a phenomenal sea change” in the way the American economy values innovation. “Instead of manufacturing hard products you could build with your hands, we were moving toward valuing media, concepts, and ideas.”

Spinning Out Innovation at Thermo Electron

After Westinghouse, Aris joined Thermo Electron, a Boston-based advanced engineering company founded by a Greek immigrant who wrote a seminal book on thermodynamics—just the type of innovator Aris could quickly build a rapport with.

Thermo Electron was one of the largest and most innovative instrument companies in the world. Unlike the new Westinghouse, Thermo Electron was innovating and still making physical stuff.

Thermo Electron opted to spin those innovations out, so every product that came out of its labs would be put into a publicly traded company. Thermo Electron profited from the stock issuance, but Aris was startled to see that the process of valuing those Thermo Electron for IPO was, in his words, “unscientific.” Investment firms were hungry for the business preparing those spinout offerings, so few people were complaining, but there was room for improvement.

Then it came time for Aris to take part in Thermo Electron’s own strategic transformation. “The profit and loss sheet must have had 700 lines of contributions from different companies it had acquired. It was a large laboratory essentially.” To make Thermo Electron leaner, Aris sold most of the businesses he was managing, and took control of two himself. Reinvesting the money he had made on Westinghouse shares allowed Aris to invest in dozens of tech startups, including the crème de la crème of Thermo Electron spinouts.

From Private to Public to Academic

From success at Thermo Electron, Aris took his talents to the Maryland Department of Business and Economic Development. Governor Robert Ehrlich was impressed by how quickly Aris got to know the guts of any given company. Lt. Gov. Michael Steele even joked about charging a consulting fee because the advice Aris gave Maryland business was so spot-on.

As the Maryland economy shifted from manufacturing to a technology base, Aris built a staff to nurture Maryland startups and position the state for the modern knowledge economy. After his term at DBED was done, it was on to Johns Hopkins, where Aris would add to his base of knowledge about innovation and economic development.

Hopkins planned to turn its research base into a physical presence that would draw major global life science companies to Baltimore. When the economy soured, that prospect dimmed. “So we ended up emphasizing building companies from within,” Aris recalls. “We spun out twelve in the first year and the average for the previous decade had been four per year.” These are early stage companies that require a lot of patient investment and take a medical concept to fruition, which can take a decade. Johns Hopkins has the institutional patience for research, and Aris Melissaratos possesses books worth of the knowledge it takes to bring innovation to market.

Innovation: The Key to America’s Prosperity 

In 2009, Aris published Innovation: the Key to Prosperity – Technology and America’s Role in the 21^st Century Global Economy. In it, he emphasizes a national strategy of gaining and retaining the global innovation leadership. “Having given up the strength of volume manufacturing to the rest of the world, we can still retain global economic supremacy through innovation,” he says. That vision becomes clear when you read how tested principles and good sense are being applied in equal parts.

In the book, he proposes a much stronger advisor to the President on science and tech, who could work with cabinet members as an equal and have tech transfer become a corporate goal. Large corporations should interact with government agencies to bring products to market, in a broad partnership that includes universities, with their public funding and ability to transfer technology to expert entrepreneurs.

It’s no coincidence that the large-scale push he calls for reflects Aris’s own career-long efforts. And Michael Bloomberg, Bill and Melinda Gates, and many others know that investing in innovation works best when the process is championed and steered by people like Aris Melissaratos. He has thrived through many changes, and under his leadership, the impact of investment in Johns Hopkins innovation will continue to increase around the Mid-Atlantic region, and around the world.

Originally published in SmartCEO magazine, April 2013

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