Spreadsheets or BI: when a hospital needs to change its method
Spreadsheets are great for getting started and for one-off analyses. The problem begins when they become the hospital's management system.
The spreadsheets or BI question comes up in almost every growing hospital: spreadsheets that used to work start taking days, numbers begin to diverge and the board waits longer and longer for the close. There is no single answer, but there are clear signs that the method needs to change.
What spreadsheets do well
Spreadsheets are fast, flexible and everyone knows how to use them. For a one-off analysis, a feasibility study or a new KPI still being tested, they are unbeatable. The problem is not the spreadsheet, but when it becomes the hospital's management system: the place where official KPIs are calculated every month.
Seven signs it is time to change
- Closing the KPIs takes days after the accounting close.
- There are different versions of the same number in different meetings.
- Analysis depends on one person: when they go on vacation, the KPIs stop.
- No one can drill down to the cause: the spreadsheet shows margin fell, but not where.
- No one understands the formulas anymore: tabs linked to tabs, broken links, old macros.
- Data is copied by hand from information system reports, month after month.
- Sensitive data circulates by email, in files without access control.
Three or more of these signs indicate that the cost of the spreadsheet is already higher than it looks.
The hidden costs of each path
| Spreadsheet | BI | |
|---|---|---|
| Visible cost | Almost zero | Implementation and subscription or staff |
| Time cost | Hours of manual work every month | Concentrated in implementation |
| Error risk | High: manual copying, broken formulas | Low once validated |
| Dependence | On whoever builds the spreadsheet | On the vendor or BI team |
| Security | Files circulating, hard to control | Per-user access and logging |
| Depth | Limited to what was copied | From total down to encounter |
Build in-house or buy?
Building in-house gives full control, but it requires a team that understands data, the hospital information system and accounting and management rules at the same time, and that keeps maintaining everything when the chart of accounts, payers or processes change. Buying a ready-made solution shortens the time to the first useful dashboard and transfers maintenance, but it requires assessing the vendor carefully: data source, rules, security and who maintains it.
The assessment criteria are in the table in the hospital BI guide.
A transition without disruption
The change does not have to happen all at once:
- Start with the board's KPIs, the ones that take the most time.
- Run BI and the spreadsheet in parallel for one or two closes, explaining every difference.
- Once the numbers match, retire the official spreadsheet and keep spreadsheets only for one-off analyses, fed by BI exports.
In Clic Health, every dashboard exports the data on screen to Excel, precisely so the spreadsheet stays useful where it is best. See how Tasy data becomes KPIs and what implementing BI requires.
Related questions
Does BI completely replace Excel?
No, nor should it. BI replaces the spreadsheet as the official source of KPIs. Excel remains useful for one-off analyses, fed by BI exports.
Does a small hospital need BI?
The signs apply to any size. In smaller hospitals, the gain usually comes from time saved and fewer errors at the close.
How long does it take for BI to replace spreadsheets?
It depends on the number of KPIs and the data quality. A good practice is to run in parallel for at least one close before retiring the official spreadsheet.
Written by the team behind Clic Health: accountants, controllers and developers with more than 20 years of work in hospital management.