The statistics were telling: 15 per cent to 20 per cent of neurosurgery patients developed infections in the drains that neurosurgeons implanted to draw away fluids, a complication that not only threatened lives, but also led to hundreds of thousands of dollars in treatment costs annually.
Dr. Daniel Stålhammar, a neurosurgeon for 40 years, believed his hospital, Sahlgrenska University Hospital in Gothenburg, Sweden, could do better. He turned to computers for help.
That may not be surprising, but his choice of IT tools is: Stålhammar picked business intelligence software to improve patient outcomes and ultimately save lives.
“I needed to handle large databases and have tools to make proper decisions on which patients were to be selected for specialized and very expensive care,” he says.
In Canada, hospitals also use predictive analytics to treat patients as well as stay on budget.
Stålhammar used QlikTech International AB’s QlikView to analyze multiple databases containing patient information against established medical measurements and likely outcomes. This tool has helped the hospital reduce its rate of medical complications, sparing patients any additional pain and problems and eliminating the need for many costly tests and treatments.
“Certainly, [this accomplishment] would be possible without technology, but that would take a lot of work [from] several people working continuously. That costs a lot, and it is very difficult to keep performance 24 hours a day on the highest level. There will be mistakes, misunderstandings, etc., resulting in repeated failures,” says Stålhammar. “By automatic alerts provided by QlikView, this will simply not happen.”
This innovative use of QlikView software earned QlikTech International and Stålhammar’s project a victory in the Business & Related Services category in the Computerworld Honors Program.
To be sure, Stålhammar was no stranger to using software prior to implementing the BI application. He had used other IT tools, such as Excel, to help sort and analyze data. And he had worked on computerizing patient records at his hospital.
Such experiences, he says, allowed him to recognize how computers could help doctors make critical decisions by providing them with analysis of information that they just couldn’t access quickly enough through manual systems. And when he saw another hospital using QlikView, he saw the possibilities that this particular application could bring to his own medical work.
“I understood how extremely fast they could make searches, and how they could combine all data in an illustrated way,” he says.
For Stålhammar, the choice made sense, even though his hospital’s administration used other BI applications for analyzing data. QlikView seemed to work faster than other systems, he says, and that was important, since the information is needed to make quick, informed decisions on patient care. Plus, QlikView presented information in a visual fashion that made it easy to see associations between data.
“You could see these patterns with other tools, but it was much easier with QlikView,” Stålhammar says.
Predicting Outcomes
Stålhammar wanted the application to process medical tests and observations from neurosurgery patients alongside likely outcomes, to determine patterns and the best treatment protocols.
“There are a number of predictors for head injury patients. You can weigh them together to get a score, and you can do that rather early and see [whether a] patient is in danger of a bad development,” Stålhammar says.
The predictors include a patient’s age, cranial pressure and white blood cell counts. Taken together, those metrics can indicate potentially life-threatening complications.
Stålhammar worked with the hospital IT staff to develop the tool, turning to Johan Rylander, a solutions consultant at QlikTech, for support. Although Stålhammar’s use of QlikView isn’t typical, pulling together the application wasn’t particularly tricky, Rylander says.
“All the data sources were already defined. Dr. Stålhammar already knew what he needed, and I helped him to translate his ideas,” explains Rylander.
But challenges still arose, of course. Stålhammar wanted to display several lab results in a single chart, yet those lab results all used different scales. Those differences forced Rylander to find ways to manipulate the code to create accurate, compatible and understandable displays.
It was also a challenge to integrate pictures, which take up a lot of memory, Rylander says. To deal with that, he put in links to pictures, allowing users to call up only the images needed without putting them in the QlikView file itself.
Stålhammar first started using QlikView in 2001. But after he retired in 2007, the project lost momentum — a fate that can befall many IT initiatives that lack a project champion to lobby for them.
Meanwhile, Stålhammar’s colleagues in other departments have expressed interest in the QlikView system but, he says, “the doctors in Sweden have been remarkably slow to adopt this new technology.”
There is some movement, however. Dr. Peter Nyberg, chief of the Department of Orthopedic Surgery at Sahlgrenska University Hospital, is following Stålhammar’s example and using QlikView to analyze patient data to improve care.
“My interest is to get quick and reliable analysis from a quality system,” Nyberg says, explaining that in the past, there have been challenges in connecting the different hospital databases and getting useful analysis from them.
Despite those earlier challenges, Nyberg decided to try QlikView based on Stålhammar’s experience.
“Why should hospital personnel take hours or weeks [finding that data]? What they really want is to have the results,” Nyberg says.
Boris Evelson, an analyst at Forrester Research Inc., says he’s not surprised by the doctors’ use of QlikView. BI tools are reaching into every market segment, Evelson says, because they not only help improve productivity and efficiency, but also help organizations to remain competitive.
“Business intelligence is definitely exploding in every market segment,” he says, “because intelligence is the main competitive differentiator these days.”
Pratt is a Computerworld contributing writer in Waltham, Mass. Contact her at marykpratt@verizon.net.