Fast-growing Dutch hospital diagnoses clinical challenges with SAS® Enterprise BI Server

Although the population of Almere in the Netherlands has doubled in recent years, its local hospital, Flevoziekenhuis, remains committed to providing care to 85 percent of the community. At the same time, the number of hospital beds grew from 295 to 375, headcount rose by 50 percent and annual patient numbers increased from 270,000 to 400,000. To support such growth, the hospital uses SAS Enterprise BI Server.

During that period of growth, Flevoziekenhuis expanded its infrastructure to offer services like dental surgery, gastroenterology, IVF and kidney dialysis. And it became a teaching hospital, which put even more demands on 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.

With SAS, Flevoziekenhuis gets an enterprise business intelligence solution that offers personalized content delivery to support so many critical decisions – with measurable benefits that include a reduction in waiting times.

"Using a clear and integrated dashboard from SAS, we are better able to improve quality of care and results," says Ivo van der Klei, the hospital's Chief Financial Officer. "We get a hospitalwide view of operations, finance, production and HR and can drill down per division or specialty. We can improve metrics such as productivity per specialist and predict financial results. And we get better marketing results through customer segmentation."

Assessing performance
Senior managers in areas such as 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 they make decisions  with confidence.

Before SAS, raw data wasn't a problem; in fact, Flevoziekenhuis had masses of data across multiple systems and departments in both paper and electronic form. However, the hospital was unable to consolidate this data and lacked the analytics and reporting capabilities to turn it into usable 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 requires the DBC (Diagnose Behandeling Combinatie) system for naming hospital products through a combination of diagnostics and treatment. The objective is to improve insights into patients and procedures in order to allocate resources more quickly and appropriately. Previously, Flevoziekenhuis could not 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 that used third-party software. Flevoziekenhuis also wanted to ensure that managers didn't spend too much time and effort on reporting. Managers 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.

"The hospital spent three months doing a thorough selection of the software on the market, and SAS was without a doubt the best," says van der Klei. "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 in terms of price and 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. "We're also very pleased with the support provided by SAS," says van der Klei. "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 and reports results through a Web-based 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 pleased to now have the information right at their fingertips," says van der Klei. "Before, many of them did not use paper reports and often made decisions based on gut feeling. SAS has changed work practices as managers and doctors now have a better overview of patients and patterns, and not just case by case. More efficient planning can result in 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 increase in the efficiency of information consumers at Flevoziekenhuis. They no longer had to seek out information, because it arrived at their desks 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. "Using SAS, we'll be able to grow patient numbers by 100 percent while only increasing our IT department by 50 percent," says van der Klei. "This was another important reason for choosing SAS."

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," says van der Klei. "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."

The results illustrated in this article are specific to the particular situations, business models, data input, and computing environments described herein. Each SAS customer’s experience is unique based on business and technical variables and all statements must be considered non-typical. Actual savings, results, and performance characteristics will vary depending on individual customer configurations and conditions. SAS does not guarantee or represent that every customer will achieve similar results. The only warranties for SAS products and services are those that are set forth in the express warranty statements in the written agreement for such products and services. Nothing herein should be construed as constituting an additional warranty. Customers have shared their successes with SAS as part of an agreed-upon contractual exchange or project success summarization following a successful implementation of SAS software. Brand and product names are trademarks of their respective companies.

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