Developing a Practice Dashboard MGMA Anesthesia Administration Assembly May 2008 Joe Laden
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Developing a Practice Dashboard MGMA Anesthesia Administration Assembly May 2008 Joe Laden MGMA member since 1981 AAA Member since inception Business Manager Anesthesia Associates of Louisville, PSC [email protected]
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Developing a Practice Dashboard MGMA Anesthesia Administration Assembly May 2008 Joe Laden MGMA member since 1981 AAA Member since inception Business Manager Anesthesia Associates of Louisville, PSC [email protected]. What is a Dashboard?. Merriam-Webster Dashboard - PowerPoint PPT Presentation
Transcript of Developing a Practice Dashboard MGMA Anesthesia Administration Assembly May 2008 Joe Laden
Developing a Practice DashboardMGMA Anesthesia Administration Assembly
May 2008
Joe LadenMGMA member since 1981
AAA Member since inception
Business ManagerAnesthesia Associates of Louisville, PSC
What is a
Dashboard?
Merriam-Webster
Dashboard
1.a screen on the front of a usually horse-drawn vehicle to intercept water, mud, or snow
2.a panel extending across the interior of a vehicle (as an automobile) below the windshield and usually containing instruments (as a speedometer) and controls
What is a
Business Intelligence Dashboard?aka
Digital DashboardElectronic Dashboard
Information DashboardScorecard
The UltimateAnesthesia Dashboard
What is a not a dashboard,
But might look like a dashboard?
Click above to activate calculator, click here to go to next slide
Click above to activate calculator, click here to go to next slide
Click above to activate calculator, click here to go to next slide
Click above to activate calculator, click here to go to next slide
Dashboard definition and characteristics of good dashboard
design.
Stephen Few . . . .
“Visual display Of
the most important information needed to achieve one or more objectives
Which Fits entirely on a single computer screen
So it can be
Monitored at a glance”Stephen Few
www.perceptualedge.com
Visual Display
• Text Units 12,000 12,300 11,700 13,024 12,670Hours 1,200 1,230 1,195 1,200 1,140
• Graphics
Achieve Objectives
•Monitor Anesthesiologist/ACT Work Output:•Units •Minutes•Cases
•Monitor Reimbursement for Work Performed•Monitor Collection Efficiency •Monitor Hospital Efficiency (O.R. Utilization)•Make decisions about staffing•Determine need for hospital subsidies
Monitor Single Screen at A Glance
• Static• Text • Graphics • Mixed
• Dynamic• Selectors• Drilldown
•Portal to Reporting System
May be OK to have multiple screens/pages
YTD-2008 Budget YTD-2007
Patient Revenue 145,000 140,000 160,000
Hospital Subsidy 15,000 15,000 10,000
Billing Expense 8,700 8,400 9,600
Corporate Expense 2,650 3,000 2,750
CRNA Expense 58,500 55,000 5,300
MD Expense 75,500 72,000 74,000
Net 14,650 16,600 78,350
Mini G/L
Additional Characteristics of Good Dashboards
Small, clear, concise and intuitive display mechanisms
Customized to each person, group or function
Replace hunt and peck data gathering from many reports
Fine tuned to deliver insight in a powerful way
Problems with “Dashboard” Model for Business Intelligence
• Vehicle dashboard is real time
• Provides no trending & historical data
• Provides no comparisons
• Monitors relatively few indicators
Audience for Your Practice Dashboard
•Board of Directors•Shareholders•Practice Manager•Billing Manager
Dashboard contents should be targeted to its readers
Where are anesthesia dashboards available today?
• Anesthesia Billing Software Vendors• Anesthesia Billing Companies• Anesthesia Practice Management Companies• Report Hosting Companies• DIY for Small – Medium Size Groups
Tools to Produce You Own Dashboard
•Excel / Word Text DashboardCheap and Easy
•Excel Charts (graphs)Cheap, but more difficult
•Excel Pivot TablesPowerful but need transaction data
•Xcelsius/EngageExpensive & Complicated but more powerful
•Custom Programming IT expertise and expense, specialized
software
Steps to Prepare You Dashboard
•Determine Your Audience
•Review Current One Page Reports
•Decide Which Key Performance Indicators to Display
•Determine How to Gather Data
•Decide on Dashboard Construction Tool
KPIAnesthesia Key Performance Indicator
Categories
1. Anesthesiologist/ACT Production2. Billing & Collection3. Practice Operations
ExpensesPersonnel
Anesthesiologist/ACT Production KPI
• Cases• Units
• Base• Time• Flat Fee Procedures
• Minutes/Hours• Gross Billing
Billing & Collection KPI
• Payments
• Gross and Net Collection Ratio
• A/R Aging
• Days in A/R
Practice Operations KPI
• Personnel & Cost•MD•CRNA
• Overhead• Corporate• Billing Costs
KPI Coupled with Timing
Per
MonthDayYearQuarterWeek
KPI Coupled with Comparative Timing
• Year vs year• Year to Date vs. Last Year to date• Quarter vs Same Quarter last year• Trailing 12 months vs. Trailing 12 months prior year
KPI vs. Comparative Benchmarks
• Facility vs. Facility• MD vs. MD• Payer vs. Payer• MGMA Physician Compensation and Production Survey• MGMA Single Specialty Practice Cost Survey
KPI Top and Bottom
Top 10 and Bottom 10:
• Surgeons (collected per hour)• Anesthesiologists (units per year)• CRNA’s (hours billed/ hours paid)• Payers (collected per unit)• ASA Codes (units per case)
Other Combinations
•Units per case, MD, CRNA, Hour•Revenue per O.R., MD, Case, Hour•Units, Hours and revenue per Surgeon
Operating Room or Facility
The Data to Ink Ratio: (Edward Tufte)
Ink that represents data vs.
Ink that is not data such as:Company informationDecoration Graph LinesColor gradients
Dashboard Design Mistakes
• Size greater than one screen• Excessive detail or precision• Choosing non-meaningful measure• Inappropriate display media• Meaningless variety• Poorly designed display media• Poor arrangement• Useless decoration• Misuse of overuse of color• Failing to highlight important data• Unattractive visual display
Characteristics of a Good Display
• Excellent organization• Condensed with summaries and exceptions• Customized to user’s needs and objectives• Clear and direct media display
Change Change
2007 vs 2007 vs
2005 2006 2007 2006 2005
Production (units)
Hospital 1 250,954 261,575 274,901 5.1% 9.5%
Hospital 2 97,705 112,521 112,744 0.2% 15.4%
Both OR's 348,659 374,096 387,645 3.6% 11.2%
Revenue (collections)Hospital 1 Collections 7,281,869Hospital 2 Collections 3,163,032Total OR Collections 10,444,901
Hospital 1 Collections/OR 520,133Hospital 2 Collections/OR 451,862Average Collections/OR 497,376 OR's 21Pain Collections 555,650
Total Collections 11,000,550
2005 2006 2007 2008
Collected / Unit (6/hr) $30.61 $31.03 $32.19 $30.44
Collected / Unit (4/hr) $38.27 $38.79 $40.24 $38.04
Change in Collected/Unit 1.4% 3.7% -5.5%
Collect per OR case $ 628 $ 665 $ 705 $ 673
Collect per Pain Case $ 203 $ 197 $ 214 $ 211
Which is Better:
Table Or Chart ?
Category Current 31 - 60 61 - 90 91 - 120 120 - 150 151 +
ALL PATIENTS 37.0% 32.2% 8.9% 6.5% 3.7% 11.7%
MEDICARE 57.5% 27.9% 1.7% 5.1% 1.0% 6.8%
BLUE CROSS 44.3% 36.5% 10.2% 3.6% 0.9% 4.6%
PATIENT 4.9% 37.7% 21.8% 12.1% 6.3% 17.2%
HUMANA 60.6% 9.2% 2.5% 3.1% 3.6% 20.9%
TRICARE 32.5% 41.7% 4.5% 3.8% 1.3% 16.1%
UNITED HEALTH 46.9% 40.4% 1.5% -0.2% 4.7% 6.7%
A/R By Percent Outstanding by Carrier
Excel Dashboard Charts
Charles Kydwww.exceluser.com
Kyd Principles
• Dashboards should be produced on paper
• Many tiny graphs using Excel
• Set up workbooks to update easily
Constructing a Dashboard
with
Microsoft Excel . . . .
Producing an Xcelsius Dashboard
1.Construct Excel spreadsheet
2.Layout graphic elements
“CHEATER” DASHBOARD CONSTRUCTION
1. Start with blank PowerPoint Slide2. Display component to place on dashboard3. Capture component with Vista Snipping Tool 4. Paste onto slide5. Resize and reposition
Anesthesia Associates of the United States – May 2008
Presentation Mode
•Paper • Physical• PDF
•Computer Screen1. Spreadsheet2. Web 3. PDF4. PowerPoint5. Flash
Method of Delivery
• Private Web Site• Email
• Spreadsheet• PDF• Flash • Web Link
• Physical Delivery (paper)• DVD/Thumb Drive
Questions Anesthesiologists Ask:
How is the business going?
What will the end of the year look like?
Will your dashboard provide answers?
Take Away Ideas
Dashboards take time, talent and toil to make
Resist the urge to favor flash over function.
Encourage your vendor to produce dashboards
Vendor dashboards must display the data you need, not the data that is easy to display.
Often a paper report with limited graphics is best
Additional Resources
The Effective Use Of Electronic Dashboards To Promote & Improve Overall Practice Performance: An Exploration Into The Use of Electronic Dashboards In A Group Practice Setting.
ACMPE Paper by David G. Owens, FACMPE. Available on the MGMA web site
Dashboard To Monitor Clinical Productivity of Anesthesiology Groups Amr E. Abouleish, M.D., M.B.A., Jody A. Locke, M.A., et al.
Click Here For Web Link
Dashboard Resources On the Web
www.perceptualedge.comwww.edwardtufte.com
www.exceluser.comwww.xcelsius.com
www.dashboardmd.comwww.dundas.com
www.dashboardspy.comwww.mrexcel.com
www.idashboards.comwww.corda.com
http://www.cognos.com/products/now/operational-dashboards.html
For Questions, Comments, Help or to Share Your Ideas:
Joe Laden, Business ManagerAnesthesia Associates of Louisville, PSC
332 W Broadway Louisville, Kentucky 40202
WWW.JOELADEN.COM
