1. Health:
An
Amazing
Challenge
for
Informa4on
Architecture
Junkies

2. Cradle
to
Grave

3. 192
1/Doctor
8
Visit
5/Hospital
Stay

4. 192
$69 Year of
/
Hospital Care

5. 198
2
DRGs
Introduced
as way to
manage
costs

6. 2013
• ACA (October)
• ACO
• Full Capitation
• ICD 10

7. Current
Macro
IA
Trends
• Explosion
of
new
informa0on
from
EMR
and
only
about
half
are
at
Stage
II
MU
• Shi=ing
and
Evapora0on
of
Pa0ents
• Care
Management
is
Rapidly
Changing
• You
have
to
Care
for
Community,
Not
Just
Pa0ents
(I
think
this
makes
it
easier,
not
harder
for
IA)

8. Our
Shared
Language
• Hierarchy
of
Data:
Figure
out
what
goes
where
and
why
and
what
you
should
do
first
• Taxonomy,
First
Not
Last
– Cross
Walks
• Curated
Views,
Last
(you
need
experience)
• Interface
Engines,
Connec0ng
to
the
world
– (SeeBeyond,
CloverLeaf)

9. The
Importance
of
Place
as
New
Informa4on
Parameter

10. ShiF
in
Who
is
Paying
for
What

11. Diseases
are
Growing,
Declining,
and
Being
Eliminated
ALL
at
the
same
4me

12. What
Needs
to
be
Captured
NOW!
Hospitaliza4ons
-­‐
40,692,505
(.13)
Outpa4ent
-­‐
96,404,868
(.308)
Emergency
Dept
-­‐
136,176,760
(.4355)
Physician
Office
Visits
-­‐
1,045,262,266
(3.343)

13. US
Healthcare
Efficiency
Index

14. Health
Expenditure
Projec4ons
Billions
Na4onal
Health
Expenditures
5000
4500
4000
3500
3000
2500
2000
1500
1000
500
0
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019

15. US
Health
Expenditures
Other
Personal
Health
Other
Prof
Services,
74.6
2011
Care,
90.3
Dental
Services,
111.8
Home
Health
Care,
82.8
Nursing
Home
Care,
156.2
Physician
and
Clinical
Srvc,
556.1
Prescrip4on
Drugs,
274.5
Other
Medical
Products,
70.9
Insurance,
189.5
Hospital
Care,
827.3
DME,
28.1
Other
Non-­‐DME,
42.8
Public
Health,
84.6
Research,
54.2
Structures,
130

16. The
Real
Physician
Story
• 985,375
Total
Physicians
• 752,572
Pa0ent
Care
Focused
• 125,928
Inac0ve
• 64,153
Not
Classified
• 9,458
Unspecified
Physician
Specialty
• 432
Address
Unknown

17. Transac0ons
=
Fluidity

18. How
are
we
going
to
track
health?
PHR
à
EHR
à
EMR

19. Coding
MDC
Major
Diagnos4c
Codes
DRG
Diagnos4c
Related
Groupings
ICD9
à
ICD10
2014
–
Interna4onal
Classifica4on
of
Diseases
HCPCS
–
Healthcare
Common
Procedural
Coding
System
CPT4
–
Clinical
Procedural
Terminology
SnowMed
-­‐
Systema4zed
Nomenclature
of
Medicine

20. Quality
Mafers

21. Nearly 50 Million Uninsured and Growing
The
Uninsured

27. Before you
count your
chickens,
understand
how the egg
is made