Allina Health's $108 million investment in a medical data company has emerged as a simmering frustration for striking Twin Cities nurses, especially when the health system is trying to save money by phasing out the nurses' preferred health insurance.

Allina's investment in Health Catalyst was announced in 2015 as part of a broader effort to use patient data to improve the quality and efficiency of care. But nurses picketing outside five hospitals Tuesday said it's corporate waste that will come at the expense of staff devoted to patient care.

"You want to [put] money into that, but you can't invest in your nurses who heal the sick?" asked Jennifer Abalan, a nurse picketing Allina's Abbott Northwestern Hospital in Minneapolis. Roughly 4,800 nurses are striking at Abbott, United Hospital in St. Paul, Mercy Hospital in Coon Rapids, Unity Hospital in Fridley and Phillips Eye Institute in Minneapolis.

Allina officials said there is misunderstanding about Health Catalyst, which is receiving money that the health system used to spend in-house to analyze data and reduce waste in care — such as preventable hospital readmissions and unnecessary surgical deliveries of newborns.

"They're an organization that helps us pull all that data together," said Dr. Penny Wheeler, Allina's chief executive, who is an unpaid member of Health Catalyst's board.

The strikers also have questioned whether Allina can maintain quality patient care while using 1,400 replacement nurses, and in a separate development Tuesday, the Minnesota Department of Health said it is increasing its oversight of the affected hospitals.

The agency, which oversees hospitals' adherence to state and federal patient care standards, has "taken steps to boost oversight of the facilities' day-to-day operations by increasing the frequency of unannounced on-site visits," said Health Department spokesman Michael Schommer.

Wheeler said Health Department inspectors visited Mercy on Monday and Unity on Tuesday, and did not notify hospital officials of any immediate patient care concerns.

Nurses request audit

Allina's investment in Health Catalyst has not drawn public criticism from leaders of the nurses' union, the Minnesota Nurses Association. But it remains an irritant for many pickets that Allina has the funds for such a large investment while asking them to give up their current health coverage. Allina wants MNA negotiators to agree to move their nurses from union-backed health plans to its own corporate plans before continuing negotiations in other areas such as pay and workplace safety. The health system predicts $10 million a year in savings from the switch.

In a second shot at Allina's spending priorities, MNA leaders Tuesday asked Minnesota Attorney General Lori Swanson to audit the nonprofit health care provider. The union estimates that Allina will spend $25 million to get through the seven-day strike, which started Sunday morning, based on mailings from temp agencies that were hiring replacement nurses. One agency offered $8,400 per week plus travel and lodging expenses.

"If Allina is willing to spend more than $20 million over two weeks to save $10 million per year in health care for nurses, we must truly question their responsibility with patients and the public's money," said Mat Keller, a regulatory and policy specialist for the union. Keller added that Allina netted $1.3 billion total over the past six years and spends $23.9 million per year on executives.

Wheeler acknowledged that Allina is a large, billion-dollar health care provider, but said its annual operating margin — revenues minus expenses — is a meager 3 percent.

"The strike was not our call," she added.

Wheeler also defended the potential of Health Catalyst to save money by identifying inefficiencies in care. She added that it has no role in setting nurse staffing, though she said Allina wants to talk with the union about using a separate computer "acuity" system to set nurse staffing levels based on patients' medical and psychological needs.

The union's complaint about Allina's spending had not reached Swanson's office by early Tuesday afternoon, but a spokesman said the attorney general will take it under advisement.

Jeremy Olson • 612-673-7744