A Waste of Time

I recently listened to an interesting podcast about the challenges of embracing innovation. In addition to learning about the fear that teddy bears might destroy society in the early 20th century, one of the frameworks described innovation as solving problems – but also worsening or creating others. For example, the adoption of mobile phones clearly helped address challenges with communication around the globe, but it also aggravated problems like distracted driving.

Just a few decades ago, we navigated most decision making without adequate data. It simply wasn’t available at scale. Today, data is everywhere, but accessibility to information from the data is the new problem. Using data inappropriately or not using it at all leads to misguided decisions. With that in mind, we’ve recently published some materials highlighting the opportunity to rectify “analytics debt” as one of several sources of return on investment (ROI) that come from using Phrase Health. 

So, what is analytics debt? We define it as the gap between the supply of skilled analyst time and the demand for accessible insights. After all, the amount of available healthcare data is exploding. Some reports estimate that 30% of the world’s data is generated from the healthcare industry and it’s growing exponentially. At the same time, this data is locked away in databases that rely on highly technical engineering teams with expertise in languages like SQL. In healthcare, clinician and other operational expertise is also required to coherently interpret available data and mold it into insights. This chasm between available data and accessible insights will continue to grow as the amount and types of data grow at a faster pace than the availability of skilled interpreters.

Managing as an Offensive Lineman

I’m relatively new to my role as a manager. Schooling up to this point mostly taught me to celebrate teamwork and the importance of collaboration. Beyond teamwork and collaboration, I’ve increasingly distilled my primary managerial responsibility to one thing: unlocking the full potential of those around me. We’ve grown our team to include experts experienced in their respective fields; unleashing their capabilities will give us the best chance to execute on our mission of improving the clinician experience and patient outcomes.

Of course, this doesn’t mean giving my colleagues everything they want. We still work within a constrained environment with limited resources. Like most businesses, time is our primary constraint, which makes efficiency key. For example, let’s say our designer wants to tackle the top priority on our roadmap but doesn’t have the clinical context to effectively move forward. Every second that I’m not providing that insight to unblock the designer is wasted. It backs up our product manager who can’t effectively plan timelines, which backs up our engineers to build the optimal solution, which backs up our client success team to communicate effectively with our partners, and so on.

How much is a second of this waste worth? Of course, it’s hard to quantify and it varies by opportunity, but seconds turn into hours, which turn into days, and so on. As a result, while measuring the waste is difficult, recognizing that this waste exists and grows with time is important. So rather than measuring with precision, the goal should be to prioritize based on scalability and by opportunity. 

The Cost of Waiting in Healthcare

There’s no shortage of opportunities for improvement in healthcare. Luckily, there’s also no shortage of mission-driven and well-educated professionals in healthcare. Teams work tirelessly to deliver exceptional results for their patients. Yet, I hear time and again that bottlenecks are holding back informatics and improvement teams. These professionals require up-to-date and actionable insights in order to take on the next iterations of their PDSA cycles. 

This is where analytics debt translates into waste. I had historically assumed a 6-month delay for non-urgent data requests to be about average based on surveys of our end-users. However, a few months ago, a clinician told me it took her about one year to get a report back on some data she had requested for a quality improvement (QI) project. This past month, a QI director told me it took two years for a non-urgent request! At first, I thought she was joking, but she was actually serious that this was the case.

Let’s try to quantify the waste in a specific case. For now, I’ll put aside high-priority projects like hospital-acquired conditions (HACs) that often garner most attention. Instead, I’d like to focus on a case study that demonstrates the value of empowering a single health system stakeholder. At one of our partner sites, a lab tech recognized that she discarded several stool samples due to inappropriate ordering based on established protocols and she wasted time subsequently talking with the inpatient team. To prevent this same error from happening again, the lab tech led an iterative improvement project with the informatics team to drive change via the electronic health record (EHR). After a few PDSA cycles where she monitored changes monthly, she achieved her desired target. This project was estimated to save about $10k per year in lost time and resources, and it streamlined care delivery. Some may scoff at the claim around cost savings, but apply this example to every other clinician and quality-minded colleague that is waiting for insights on hypotheses for improvements that could solve problems that cost $1k, $10k, $100k, or more per day! Unleashing the potential of your entire workforce has extraordinary power to drive improvement that scales cost savings and fosters a culture of empowerment for the betterment of clinicians and patients.

Bringing it Together

Bottlenecks will always exist. Entire domains within project management are dedicated to mapping out efficient systems with tools like Gantt Charts. However, unleashing the ingenuity of highly skilled clinicians, informaticists, and operational teams with insights to fuel quicker PDSA cycles translates into real savings and ROI.