The Impact of Business Intelligence on Healthcare Delivery in the USA

Abstract

Introduction To improve healthcare quality, safety, and efficiency is an economic and national necessity. The role of technology to ensure healthcare quality and control cost is an ongoing debate within the industry and a subject of interest to researchers. Delivering quality healthcare requires the integration of patient health information from many different sources and availing a diverse set of users; health providers must be able to readily access and use the right information at the right time and patients should be able to access their health information in order to be able to self-manage their conditions. Supporters of the adoption of advanced technology in healthcare consider it as an opportunity not only to enhance the quality of health services, but also transparency of economic activities and the availability of information in real time (Mettler, 2009). As technology has enhanced diagnosis and treatment options and since lifesaving medicines are entering the market at an increasing rate, life expectancy is on the rise. Healthcare organizations are investing millions in computer systems, diagnostic technology, and preventive care programs in an attempt to meet healthcare quality goals. These developments, however, come with a huge price tag. Health care costs now consume nearly 18 percent of the U.S. GDP (Ramsey, Ganz, Shankaran, Peppercorn, & Emanuel, 2013). Payers face difficulties compensating providers for high-cost treatments made possible by advances in technology. Claims that are inflated as well as outright fraudulent are intensifying the problem. The payers and providers in the healthcare industry, public and private, are looking into technology to costs, while keeping the quality care intact. The predicament doesn't end with the notion of quality versus cost; the healthcare industry is experiencing more scrutiny and complexity than any other single industry in modern history. Health providers and the affiliates have to understand and respond to privacy laws and information security. In addition, a vast range of factors such as health care practice regulations, patient records and requirements, practice and staff management, training, financial stability, facilities and equipment management influence the holistic view of quality healthcare. Another force altering the current condition of healthcare in the United States is the passing of the Patient Protection and Affordable Care Act (PPACA). Healthcare industry is under pressure to costs and better manage care. Burke and Ingraham (2008) note that healthcare in the U.S. is at the point of colossal change. The entire industry is struggling with the notion of management of quality and cost metrics. Intensified focus on compliance with evidence-based care protocols and, a staggering number of reimbursement programs affect revenue and the ability to compete. Healthcare industry executives must evaluate an increasing amount of information to best assess their organization's wellbeing and future. Furthermore, data overload is a common problem for many care providers and executive teams, who are grappling with too much information and looking to find ways to simplify acquiring knowledge from raw data (Byrnes, 2012). Coddington (2012) argues that decision-support capabilities allow collecting data from multiple sources, such as cost accounting systems, electronic health records and other sources, and make them available to physicians and other users. He suggests that a balance between cost control and the other priorities of healthcare organizations is necessary to provide quality care. The most important issue surrounding quality healthcare is the development of measurement goals to find validated metrics. Since usually high quality is perceived to be correlated with high cost, a statement such as reduce costs, while keeping the quality care intact, sounds paradoxical. However, Process improvement initiatives facilitated by business intelligence solutions constitute a cost-effective option. …