The transition from a reactive to a proactive approach to healthcare management

The purpose of this paper is to describe the prevailing conditions facing today's healthcare administrators, examine current issues in strategic planning for large health agencies and propose an exemplary framework for migration to a predictive analytics capability.

The nature of the job

A perennial concern among healthcare managers is the reactive nature of their role. Immediacy and urgency tend to characterize issues that arise in healthcare; the corresponding tendency toward a reactive management style is prevalent. Coupled with the tendency of available information to be limited and historical in nature, it dictates a style of management that tries to solve tomorrow's challenges with yesterday's information.

The nature of the data

Early information systems offered some relief to the manager through firstgeneration basic statistical tabulations produced by report generators. Later, the introduction of second-generation data handling and reporting tools in the 1990s offered significant improvements in timeliness and relevance of management information.

This early online analytical processing (OLAP)/cube technology helped bring valuable information to the frontline manager through reports, drill-down capability and query analyses. While certainly a step up from legacy reportgenerator output, the main limitation of these reports and online dashboards was that they were based, again, on retrospective data. Although they offered only a rear-view mirror perspective on past events, they were considered adequate for monitoring departmental budgets and reporting on operational metrics.

As managers' information needs became more sophisticated, some limitations of this early business intelligence technology became evident. Plans were developed and performance monitored mainly on the basis of historical behaviors of the health system rather than on insight into future needs.

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