Focus on End Users
To ensure that appropriate and valuable action can be taken on knowledge once it's discovered, the system of delivery and retrieval of information must be addressed. Finding the information is insufficient to generate value; it must be accessible to the parties who can best utilize it. This is especially true when you're not sure what information will end up being most needed; targeting the information to specific individuals or roles within the organization could preclude its potential value. Yet historically, we e-mailed most reports only to those who requested them. Even as our new tools took shape, breaking this habit was one of the toughest challenges.

Our practice is spread across a large geographic region and divided into business units including four medical departments and several support teams. As we've grown, our ability to stay in touch across the practice has become strained. But our best solutions to problems have come from sharing our challenges and ideas across business units. We realized early in the project that we would deliver the greatest value by finding a way to foster interactions across organization boundaries. We found inspiration from another networking pioneer, Robert Metcalfe, who observed that each additional user makes a network more valuable.

Considering the limitations of our legacy reporting solutions, it was easy to conclude that one of the largest obstacles we faced in our quest for greater efficiency was our ability to find and use existing information. And so, in each phase of the project, we also considered the value of sharing information widely. In our patient wait time project, the clinical manager now pulls up her wait time report card, which is updated on demand. Everyone who has a hand in the process now knows how well we're doing, and can adjust their portion of the flow accordingly.

Most of the BI tools we developed were made available to the entire leadership and executive teams as well as the physicians; for the most part, anyone in a management or leadership role was given across-the-board access. The searchable reports are available through a portal. Individual and ad hoc reports are now discouraged; if a metric has value, we load it into the Sharepoint portal and update it with routine scripts, or on demand.

None of this cost a lot: We built most of our reports using Excel macros, pivot tables, SQL stored procedures and Sharepoint's Excel services feature. The development was done primarily in-house, though we had outside help with the more complicated procedures.