THE NATION'S LARGEST CANCER TREATMENT AND RESEARCH NETWORK

Cancer is a terrifying word. It's even worse when it's a diagnosis from your doctor. "The American Cancer Society calculated that there were approximately 1.5 million new cases of cancer diagnosed in 2009. " When it comes to fighting cancer, there are thousands of healthcare professionals who specialize in the diagnosis and treatment of cancer; as well as the research and discovery for a cure. Cancer Centers of the Carolinas is at the forefront of the fight.

Cancer Centers of the Carolinas (CCC) is a community-based, physician-owned practice with 24 board-certified oncologists practicing in multiple locations throughout the Upstate of South Carolina. CCC is the Upstate's largest cancer care group treating over 6,000 new patients annually. CCC specializes in medical oncology, radiation oncology, gynecologic oncology, hematology, blood and marrow transplantation, and clinical research. CCC is a National Cancer Institute grant recipient and is home to South Carolina's first FACT* accredited Stem Cell Transplant Program. (FACT: Foundation for the Accreditation of Cellular Therapy).

Cancer Centers of the Carolinas is affiliated with US Oncology, Inc., which is headquartered in The Woodlands, Texas. The CCC works closely with physicians, manufacturers and payers to identify and deliver innovative services that enhance patient access to advanced cancer care. US Oncology supports one of the nation's foremost cancer treatment and research networks accelerating the availability and use of evidence-based medicine and shared best practices. US Oncology is affiliated with more than 1,300 physicians operating in 493 locations, including 98 radiation oncology facilities in 39 states.

When there are major victories in the numerous battles on the various types of cancer, the credit is often given to the doctors and nurses on the front lines of patient care. But behind the scenes, another dedicated work force of financial, clinical and IT staff are also engrossed in ensuring patients have every opportunity for success. Their daily challenge is to synthesize and create meaningful and insightful reports based on volumes of financial, clinical, and operational reports and data to support the informational needs of providers, researchers, administrators, etc., allowing them to address the on-going and critical quest to properly diagnose and treat all types of cancer, as well as successfully navigate the increasingly complex healthcare reimbursement system, and more.

THE CHALLENGES OF MULTI-SITE DATA SUPPORT

Cancer Center of the Carolinas uses Monarch from Datawatch Corporation to gather, analyze and disseminate across their oncology practice network vital information from all of the data sources faster, more efficiently and cost effectively than traditional Business Intelligence (BI) reporting solutions.

At Cancer Centers of the Carolinas, a US Oncology affiliated practice; Sophia Charles-Irby is an indispensable member of the team who supports reporting for ten places of service (POS) providing outpatient oncology and hematology care. She is responsible for the development and support of numerous critical interfaces between the many disparate clinical and financial systems. For more than a decade she has compiled data from myriad sources inside and outside of Cancer Centers of the Carolinas. She weaves this data into a variety of coherent research, clinical and financial reports. "Until Monarch, creating these reports was near impossible. Much of our data comes from our Impact Mosaic/Electra, an Electronic Medical Records (EMR) system and Allscripts Tiger, our Practice Management system," said Charles-Irby. The EMR system is a paperless digital repository of all patient data. These records include physicians' reports, diagnosis and treatments, as well as financial and insurance records. The Practice Management software deals with the day-to-day operations of a medical practice i.e., scheduling appointments, lists of insurance payors, performing billing tasks, etc. The resulting impact of these two systems is an abundance of critical data that required extensive analysis for financial, clinical and operational trends.

While using an EMR and Practice Management system dramatically decreases the need for paper files, extracting and analyzing the necessary information from these proprietary systems is extremely challenging. Charles-Irby is responsible for compiling the data and creating and running all of the reports for each department at Cancer Centers of the Carolinas. Her reports range from regular month-end accounting, to all the patient and clinical studies conducted across all of the practice locations, to dozens of ad-hoc reports requested every week. For Cancer Centers of the Carolinas, if these data summaries aren't delivered, entire departments come to a standstill. "Before Monarch, month-end reporting was excruciating," said Charles-Irby. "I had to lock the system down while I ran these reports, preventing any other departments from using it for two to three days. It wasn't uncommon for each report to take five or six hours to complete. I was also limited to a small number of canned reports that I could run and even then, I still had to manually transfer the data to a Microsoft Excel® spreadsheet for analysis and dissemination."

BURIED IN REPORTS AND DATA

The number and frequency of reporting challenges increased as the amount of data increased. In addition to month end financial reports, Charles-Irby also compiled reports on Cancer Centers of the Carolinas research and clinical trials. Before a new drug trial began, physicians needed reports indicating which patients were qualified to participate. Reports were also required that showed treatment patterns and success rates. Frequently, reports were also needed about the status of previously submitted claims; as well as requests for details about denied claims. If particular research, clinical or lab reports were delayed or data was incorrect, treatment could be unnecessarily postponed. With all of the reporting challenges and delays, Charles-Irby needed a solution to speed reporting and data analysis to make better use of the volumes of existing data. Initially, Cancer Centers of the Carolinas employed a traditional BI solution to assist in the extraction, filtering, aggregation and report writing functions. Unfortunately, its performance didn't meet the needs and expectations of Cancer Centers of the Carolinas; making an alternative BI solution necessary.

Monarch Slashes Reporting Time

Research quickly led Charles-Irby to Monarch, a Windows-based, BI data mining solution that is uniquely capable of extracting user specified data from any 'traditional' existing reports created within any information system and is equally adept at pulling data directly from SQL database tables and views as well as spreadsheets. It provides easy data analysis, graphing and data exporting to other applications, and takes information currently "hidden in plain sight" and transforms it into live, actionable data for rapid analysis and use across an organization.

Charles-Irby initially experimented with a single copy of Monarch to see firsthand what could be achieved. "It was truly amazing," said Charles-Irby. "I was able to instantly collect the correct data for my reporting requirements, and quickly and easily perform my month-end reporting. With Monarch, I achieved in less than one day what used to take me three days."

Cancer Centers of the Carolinas quickly purchased multiple copies of Monarch. "Monarch has made my job much easier and less stressful," said Charles-Irby. "With Monarch, I can quickly and easily pull from hundreds of our data files stored in multiple systems to build models and generate the data summaries I need. What's more, I can get information and reports in a level of detail never before achievable." With Monarch, Charles-Irby can easily bring in a large data set, build filters, and output these reports to an Excel spreadsheet complete with individual color tabs for each department. "Now, Cancer Centers of the Carolinas can rapidly close their month-end books and be certain that the data is correct because the Monarch models have been built and tested for both accuracy and repeatability, saving me countless hours of reinventing the wheel every month." And thanks to Monarch, Cancer Centers of the Carolinas can report on the past trends and predict future trends. "For example, Nurse Managers are using my reports to create future nurse visit schedules based on past months data and trends," said Charles-Irby.

REPORTING BY FOCUS AREA

"There are three major areas that need special reporting on regular monthly basis; Research, Clinical & Quality and Financial," said Charles-Irby. "With Monarch, I can provide this critical information to my colleagues faster, more accurately and cost-effectively than ever before."

Research Reporting

"Monarch Helps Speed Drug Trial Patient Selection "

Research reports allow Cancer Centers of the Carolinas to quickly access and monitor the outcomes and status of the many active drug trials. With reports generated by Monarch, doctors and researchers can now quickly spot similarities in results, compare outcomes by group, identify successes and end non-productive tests. Charles-Irby said, "When we begin a new drug trial there are numerous requirements for enrolled patients, such as age ranges, specific diagnoses and more. With Monarch I can quickly generate a report of matching candidates based upon data stored in our EMR System. This speeds the drug trial patient selection process and gives cancer patients the best chance of beating their specific type of cancer."

Clinical Reporting

"Monarch Reveals Declining Trend in Radiation Treatment "

Clinical reports give administration a broad overview of the many Cancer Centers of the Carolinas facilities and a clear perspective on treatment trends. For example, thanks to Monarch, Cancer Centers of the Carolinas realized they needed to investigate a declining trend in the volume of radiation therapy treatments being administered in their centers. Armed with this vital data, they were able to identify the cause of the decline and establish a plan of action to reverse the trend.

Additional clinical reports developed with Monarch also provide a precise view of other trends in patient care, such as a comparison of outcomes for brand versus generic drugs ordered by individual physicians. The reports are an essential indicator to illustrate and monitor the performance of brand and generic medications, as well as the prescribing patterns of individual physicians. By measuring outcome and utilization statistics, Cancer Centers of the Carolinas has the information needed to make the most appropriate decisions for the patients based on clinical, quality and financial indicators.

With Monarch, much of the work can be automated to run overnight. Charles-Irby runs scheduled reports for all department heads; with a tab to identify each. Monarch flags potential problems based on business rules which are implemented as pre-built conditional logic and filters, and creates output reports into MS Excel, which are then distributed to each department for review and correction. Monarch makes it easy to rapidly uncover and correct human errors, preventing what can be dire consequences. For example, if a specific drug is prescribed at a level higher than a set safety threshold, Monarch can automatically flag these inconsistencies based on criteria established by Charles-Irby. For quality review, Cancer Centers of the Carolinas employs bi-annual chart reviews. Random patient charts are selected and analyzed. "Using Monarch, we can quickly gather all of the information and know that the data will be accurate," said Charles-Irby.

Financial Reporting

"Monarch Saves Cancer Centers of the Carolinas $30K! "

Financial analysis now goes well beyond the normal month-end reports Charles-Irby creates. To ensure that only the correct data is captured and transmitted as part of a claim, Cancer Centers of the Carolinas was investigating the purchase of a claims scrubbing software solution to detect and correct potential billing errors prior to submission to the insurer. Monarch eliminated the need for this purchase saving Cancer Centers of the Carolinas approximately $30,000. Now, Cancer Centers of the Carolinas can produce the same results by using Monarch to extract data from daily charge files that are flagged for review when they violate pre-set business rules. And, thanks to Monarch, Cancer Centers of the Carolinas are now submitting clean data for all claim types. Even better, the denial rates and payables have significantly decreased.

With Monarch Charles-Irby has also created a new "Co-Pay" report which is provided to the front office staff at each Cancer Centers of the Carolinas practice site. This report shows the co-pay amounts, and if there are errors, allows a correction to be made at the time of the patient's visit; thereby increasing cash flow and reducing the operational burden of collecting unpaid co-pay amounts. What's more, front office staff is freed from the burden of manually digging through each patient's file for insurance information. "Because of Monarch, these reports give our revenue cycle team a clear look at the payments coming in daily and what outstanding charges need to be billed to insurance, said Charles-Irby."

What's more, the enhanced reporting capabilities created via Monarch give Cancer Centers of the Carolinas the ability to oversee the remittance process with paid or denied claims in greater detail than ever before. Cancer Centers of the Carolinas can now show which patients have the appropriate benefit coverage, yet were improperly denied. They can also use this data to empower patients with the correct information in order to get approval for coverage; eliminating interruption in valuable treatments.

EXPANDING THE USE OF MONARCH ACROSS THE US ONCOLOGY NETWORK

Charles-Irby's success with Monarch has quickly spread across Cancer Centers of the Carolinas. "Each month, I get more requests for specialized reports that would be impossible to create if I didn't have Monarch, said Charles-Irby." As the knowledge spreads about the results which can only be accomplished thanks to Monarch, Cancer Centers of the Carolinas will continue to push the limits of their data. Charles-Irby would like to see Monarch spread to other practices in the US Oncology network as they continue in their never ending pursuit of providing outstanding patient care.

ABOUT MONARCH

An affordable, programming-free Business Intelligence (BI) solution, Monarch allows users to unlock critical data buried in reports and other business documents without programming, as well as import and combine information from additional data sources, such as PDFs, databases or spreadsheets. Monarch is designed to help users work smarter and faster by giving them the information they need, in the format they want, to make better business decisions.

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