To arrive at a technical solution that actually solves the business needs of a healthcare organization, you need a use-case-driven approach that sets a clear path towards strategic benefit.
A use-case-driven process requires users to consider and plan how they will use the technical solution, how they will measure adoption and impact, and how it supports accountability within the healthcare organization.
In this post, we’ll take a look at some standard considerations you should implement when planning and defining a use-case-driven solution in your healthcare organization. Consider this a general guide, applicable to a wide range of possible business goals within a healthcare organization. With a firm foundation in place, we’ll then follow up with a final post in this series that explores a real-world example of a population-specific total cost of care (TCOC) use case.
Challenges in Aligning Business and IT
It is typical for care coordinators, clinic managers, actuaries and other business users within a healthcare organization to rely on their IT team for technical solutions that enable specific use cases. In cases where data and analytics such as TCOC metrics are involved, they may request IT to build some type of report or a dashboard. They may also assume if a user can get that specific patient population report or that specific TCOC metric, then they’ll know exactly what to do with it.
Far more frequently, IT teams receive an assignment but have a limited understanding of why the business users need it and how they will implement, adopt and use the solution – they are simply told what to build.
Many healthcare organizations’ IT teams deal with a variety of constraints, including:
- Technical debt
- A lengthy backlog of work
- Current systems and applications
- Level of skills and expertise
- Organizational dynamics.
Assuming a business user can cut through all the red tape and that the required data is already available in the healthcare organization, developing actionable analytics is further challenged if the broader context is not understood and the business side is not engaged.
When business users ask for an analytics metric, they need to consider upfront the implications of how that metric will impact other users, stakeholders, patients and the business. Defining a use case for the data and analytics in question can help to reveal these implications.
Defining Use Cases in Healthcare
A comprehensive breakdown of use cases should address your business problem and strategic benefit, define adoption scenarios by role, specify desired analysis or reporting, and articulate how you will measure improvement and adoption. Required components also include who is requesting the use case and will defend its prioritization as well as management’s accountability. When defining a use case, address the following questions:
- What problem needs a solution?
- What are the expected outcomes or improvements?
- What is the business context for that? Simply saying, “I need a report” or “ability to perform analysis” is insufficient and does not qualify as a business problem. Don’t use technical verbiage or specifics about how IT (or your chosen developer) needs to build the solution. Instead, focus on what the solution needs to achieve and your desired outcome.
- What are specific barriers currently preventing a user from meeting the objectives that are met with this use case?
- How does this use case strategically impact the department, organization or patient population at large?
- What benefits might you expect?
- What would the timeframe be for achieving those improvements?
- Why would an executive choose to fund and prioritize this effort?
- Who will adopt the resulting solution, and how will their process change or improve?
- How will your healthcare organization apply the analytics in a job setting for a specific role, and how will the results guide that person’s decision making?
You could use the same report or metrics differently depending on the role, so adoption scenarios should be role specific. It’s also important to articulate what next action you can take based on the presented information. For example – if a certain number in a report is within a specific range, what actions may it trigger?
Desired Analysis or Reporting (for a data analytics use case):
- What reporting requirements are necessary for success?
- What metrics, KPIs, views, slicers or filters do you need?
- In what format will you or IT deliver the solution?
Measuring Improvement and Adoption:
- How you expect the analytics to drive improvement and how you will gauge success:
- How will you know the business situation has improved through this use case?
- What are the desired outcomes, and how will you measure these?
- Are there specific metrics you will track to measure benefits or improvements?
- How will you know the business is using the solution?
- How will you measure adoption?
- Will those adoption metrics change based on role? For this to work, there should be at least a few metrics you can track and measure both before and after the implementation of the solution.
- How will management ensure the business uses the new analysis or report?
- Who is accountable, and how does accountability differ at each level of management? These details affirm commitment and outline how you will create accountability for both adoption and results.
Benefits of the Use-Case-Driven Approach
The outlined approach achieves several goals. It formalizes the process to better understand who will use the requested solution, how they will use it and how you can measure that use. Adoption scenarios help ensure the final product will have the information needed for users to have a positive impact on a business or healthcare problem.
Understanding strategic benefits allows for easier prioritization of use cases to maximize value to the healthcare organization. Measuring improvement, adoption, and accountability also prepares the business to be able to report on the impact and success of the solution and to make necessary adjustments as the use case matures over time. Finally, the development team has a better direction due to the additional details that allow them to see a bigger picture, which will impact how the problem is solved technically.
This approach is different from the one where the focus of a data analytics use case is entirely based on the desired analysis or reporting, with little additional context. It may certainly be simpler and faster to hand off to IT for implementation, and it may reduce the amount of required collaboration and increase the speed of delivery. But in most cases, it requires multiple iterations to get the users what they need and may not result in actual business improvements.
The proposed use case-driven approach will take more upfront time and effort for the business users and will increase the overall scope due to tracking adoption and accountability. But, it illustrates the essence of what it means to be a truly data-driven healthcare organization, with data at the core of decision making and strategic planning.
In the next part of this series, we’ll discuss a specific example of how you can implement a use case that leverages TCOC for a targeted population at a healthcare insurance organization.