Who should be using data analysis and technology to craft success (or possibly survival) strategies for the future? The CIO? COO? CFO? CEO? Our answer would be “none of the above.” Certainly, we need organizational leaders to create the framework, but what we are learning is that we gain more by instructing front line staff to use technology and data analysis as tools for understanding the clinical and business dynamics of their programs.
The behavioral health business environment in our state is changing at warp speed—and as experienced execs can guess—it isn’t changing for the better. Within seven months, new rules will eliminate many persons from service eligibility, reduce reimbursement rates, disallow a number of current services and programs, eliminate certain classes of employees, and create new administrative overhead requirements. We are forced to re-engineer almost all services, systems, and processes—and at the same time focus on strategies for protecting both consumers and employees who will be at risk. This is serious stuff for our organization.
Our goals are to address the threats on all fronts and somehow find the opportunities that might be embedded within this new world order. In order to do that, we believe that each of our county and program teams needs to know and understand the myriad impacts of these changes on their offices and the people who are served through them. From past experience, we have seen some remarkable outcomes when our staff manage their own business units. (See “From top-down to team-based,” Behavioral Healthcare, April, 2008.)
Recently, 26 employees representing each major team within our organization attended an all-day pivot table training session. I was fearful that the processes of understanding, building, and manipulating pivot tables would prove to be too daunting for therapists, case managers, and others with no previous exposure to them. Wrong! Our staff took to the training like mice to mouse pads.
Staff learned to sort, count, and rotate data against any number of factors. They will be identifying the individuals who will be denied future services because of their diagnosis or level of care. They will look at cases where payor-required assessment scores are inconsistent with GAF scores. They will review the intensity of need compared to the intensity and appropriateness of services presently being delivered. They will compare the current length of stay to new services packages that will limit visits.
Over the next six to eight weeks, staff will perform pivot table analyses for every person served by their respective teams. In total, nearly 10,000 cases will be reviewed. Following that, the findings will be aggregated, and financial and impact analyses will be completed. Then the heavy lifting begins as we redesign services and undertake innumerable other measures to “de-perilize” the situation as much as possible.
What do staff say about pivot table analysis? “With me doing it [pivot tables], it helps me much more than if somebody just sends me a report.” “I was petrified at first, but after that it was fun!” “There are ‘Aha moments’ that you don’t get when you’re looking at a report.” What I observed was not the anxiety or confusion that I’d feared, but a great deal of energy and, yes, quite a few “aha moments.” Pivot table analysis yielded immediate insights and generated new perspectives and ideas for follow-up action.