Growing use of data of all types and the need to speed reporting led to big changes in the BI stack at Boston Children's Hospital, according to Ron Wilkinson, senior business intelligence program technologist at the major U.S. pediatrics center. Moving to a new platform can help solve such problems, but it means spending significant time planning and re-training end users, Wilkinson and his colleagues noted.
Wilkinson is part of a team that implemented a business intelligence (BI) stack that includes the IBM-Netezza data warehouse appliance -- a product that Boston Children's Hospital is using to improve centralized reporting, a system that had previously relied on an Oracle data warehouse. He and other team members recently shared their experiences as part of a meeting of The Data Warehousing Institute's Boston chapter, held at the hospital's facility in Waltham, Mass.
Ad hoc reporting doesn't happen by itself.
architect and healthcare information analyst, Boston Children's Hospital
Bringing together clinical and financial data has traditionally been hard to do, Wilkinson said, pointing to a litany of factors that make it harder now than ever before. Users ask for new and more complex reports, but then need new training once the platform they requested is built.
Boston Children's Hospital is a noted research institution -- and its medical researchers always need greater amounts of data for their studies. The data they require covers everything from tissue sample information, to historical patient records, to patients' vital signs that are being monitored around the clock. The hospital maintains databases on quality of care, the rate of patient "bounce back" or how quickly they are readmitted to the hospital, chronic disease, nurse and clinician assignments and much more.
At the same time, a new economic and regulatory environment has created a need for better analytics of patient and staff safety data, cost containment information and equitable care monitoring data. And new reimbursement models mean change on the financial analysis side of the health sector, as well. "To do all that well, we need to do unprecedented data integration. That is one of our major incentives," Wilkinson said.
Just call me lightning
The incumbent platform for business intelligence at the hospital was an Oracle data warehouse matched to SAP Business Objects Data Integrator ETL and SAP Business Objects Business Intelligence (xi 3.1) reporting tools, as well as iDashboard visualization front ends, Wilkinson said.
That original platform is still in place, but over the last year selected analytical processes and reports have been redone on the new platform in order to speed up work and better tackle an ever-increasing load of reporting.
With the existing system, Children's business intelligence staff faced issues beyond familiar ones like not having enough employees to field all requests for reports.
"It was impossible for the central reporting group to keep up with demand. We really weren't doing a good job of getting good quality information to our senior leadership," he said.
According to Wilkinson, some of the issues they faced with the legacy system included poor integration of data from financial, clinical and patient management systems, data models that complicated reporting and slow performance, especially for complex jobs.
"Complex queries could take hours to run and sometimes would not complete, which can be very, very frustrating," he said.
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The new BI stack matches the Netezza massively parallel processing appliance with Informatica ETL processes and MicroStrategy front-end dashboarding, he said.
"Using it for what it was designed for, it was literally a 100-fold speed difference between what we were doing in Oracle," Wilkinson said. "The same query in Oracle would be a hundred times faster in Netezza."
Despite its fast speed, however, there are areas where it does not excel. For example, it doesn't handle large text jobs well. It is also possible to construct a query in such a way that it will actually run very slowly in Netezza, Wilkinson explained.
However, "for good, solid BI reporting with a dimensional model, it's like lightning," he said.
Lessons learned in building a new BI stack
Careful planning is needed to successfully roll out a new BI platform to users. To ensure the new BI stack is actually employed for its intended purposes, the hospital's BI team focused on training, said Josh Merrill, architect and healthcare information analyst for the hospital.
A lesson the Children's crew tried to convey was that focus is needed on full-fledged training from the get-go, especially where users have already become accustomed to self-service BI report creation.
There is a risk of being fairly mature in BI as an organization and then changing tools, said Virginia Coburn, manager of the enterprise reporting group at Boston Children's Hospital. "You can't really swap it out from under them without a good strategy." Ad hoc reporting support adds to the difficulty one finds in changing platforms, she said.
Data managers can create tools that provide ease of use, but without a firm plan for teaching users how to use those tools to parse data and make decisions, it doesn't work, according to Merrill. In other words, like much in life, you only get one chance to make a first impression.
"If they don't understand what is [happening] on day one, they are never going to," he said.