SAS Portal Solution Helps Fast-growing Dutch Hospital Diagnose Clinical Challenges

The population of Almere in The Netherlands will double in size by 2010, placing greatly increased demands on essential services. In healthcare, the local hospital Flevoziekenhuis has ambitious plans to care for 85 percent of the population; these plans include upgrading its infrastructure by 2006 and investing in specialties like dental surgery, gastro-enterology, IVF and kidney dialysis. The number of hospital beds will grow from 295 to 375, headcount will rise by 50 percent (1,200 staff and 80 doctors are already employed) and annual patient numbers will increase from 270,000 to 400,000. Moreover, in 2003 Flevoziekenhuis became a teaching hospital, further expanding demands on the infrastructure.

With so many additional patients, increased activities and new processes, the potential for information overload is huge. However, using information intelligently is the key to delivering consistently high levels of care, controlling costs and managing performance. Critically, Flevoziekenhuis also needs to evaluate growth trends and forecast demand accurately. A SAS business intelligence solution, including the SAS^® Information Delivery Portal for personalized content delivery, is supporting the hospital in each of these areas – with measurable benefits that include a reduction in waiting times.

Assessing performance
Senior managers in areas like finance, as well as department heads and clinicians, need to take a close look at all processes and outcomes to assess performance – only then can decisions be made with confidence. Raw data wasn't a problem; Flevoziekenhuis had masses of data across multiple systems and departments in both paper and electronic form. However, it was unable to consolidate this data and lacked the analytics and reporting capabilities to turn it into useable information. Previous approaches, including paper records and manual spreadsheets, were incomplete, time-consuming, error-prone and difficult to maintain.

Another key issue was linking costs with hospital activities and "products". The Dutch government recently introduced the DBC (Diagnostic Behandeling Combinatie) system for naming hospital "products" through a combination of diagnostics and treatment. By registering the entire patient process via the DBC, the objective is to improve insights into patients and procedures and so allow resources to be allocated more quickly and appropriately – to help manage waiting lists, for example. Flevoziekenhuis' existing set-up meant it was impossible to implement the DBC system.

In short, the hospital wanted a single high-performance solution to draw all the strands together: one that was both user-friendly and flexible enough to meet multiple requirements and deliver targeted reports to managers, clinicians and other groups.

Why SAS?
A major reason for choosing SAS was that it offered its own fully integrated solution, unlike other suppliers on the "approved" vendor list who used third-party software. Flevoziekenhuis also wanted to ensure that managers didn't spend too much time and effort on reporting: they needed customized information at the touch of a button, with immediate access to the full picture, plus the ability to drill down on specific areas.

"We spent three months doing a thorough selection of the software on the market – SAS was without a doubt the best," says Johan Mooij, Directeur Beheer, Flevoziekenhuis. "SAS has the best knowledge in areas like data warehousing, while the other suppliers were really just for reporting. They were not experts like SAS. SAS also offered the best value solution in terms of price/quality; another reason for eliminating the other suppliers was concern that consultancy costs would be high and that it would be difficult to monitor and control costs for the project. With SAS on board, however, the first results arrived just six weeks after implementation started."

Flevoziekenhuis now has an end-to-end solution that meets its operational and clinical requirements while satisfying the needs of the DBC: a cost-effective system for all hospital divisions that provides instant access to integrated information on patients, care and related processes. Mooij adds, "We're also very pleased with the support provided by SAS – its people really know what they are talking about."

Portal power for better patient care
Data is extracted from all sources at Flevoziekenhuis and integrated within a data warehouse. Here, manipulation using a central set of definitions and business rules ensures data consistency and quality, a key requirement for content delivery portals. SAS retrieves, reports and provides results through the Web-based SAS Information Delivery Portal. This enables information to be provided in easily digestible ways, with reports tailored for specific user and departmental needs; in fact, people can personalize their own desktop and control information flows according to their source, neatly avoiding information overload while increasing efficiency and productivity. As needs change, the portal can quickly adapt to meet them.

"Managers are enthusiastic about the information now at their fingertips," says Mooij. "Before, many of them never used the paper reports and often made decisions based on gut feeling. SAS is changing working practices as managers and doctors now have a better overview of patients and patterns, and not just case-by-case. They can plan more efficiently, which ultimately means better patient care." Other important advantages include the ability to "push" and "pull" information, more effective communication through role-based templates, ease of deployment, low maintenance, centralized administration and near-zero desktop management.

With intelligence available at the click of a mouse, there was an immediate and dramatic reduction in the time "wasted" by information consumers at Flevoziekenhuis: they no longer had to seek out information because it arrived at their desk automatically. The benefits are also measurable: improved performance management and resource allocation meant waiting list times for planned patients fell from 16 weeks to nine weeks in under a year.

The way ahead – with SAS
"We've seen a huge impact on internal communications, with the ability to give people access to critical information quickly, securely and at a reasonable cost," adds Mooij. "I'd definitely recommend SAS to any other hospital, and particularly those in The Netherlands – it would be good to share our success so that, together, we can all improve patient care."

Future plans include sharing information with the Zorg Group Almere (ZGA), an organization that provides after-hospital care. "The next step is to incorporate all relevant information around the patient," concludes Mooij. "Using SAS, we'll be able to grow patient numbers by 100 percent while only increasing our IT department by 50 percent. This was another important reason for choosing SAS."

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