A case study for a health care provider for a strategic plan on enterprise architecture.

1. HCGlobalCase Study …an architectural approach for business growth and patient well being. Bill Wimsatt, Enterprise Architect

2. State of the Healthcare Industry Cost of Healthcare is increasing annually - US spends ~17% of GDP Aging population placing intense pressure on system Extremely mobile world population sets stage for pandemic possibilities Increasing regulation

3. Healthcare Environment Struggles Incentive System Vs Payment Systems Community Practice Vs Hospital

4. HCGlobalBusiness Goals Modernize for growth and for intra/inter-organizational interoperability Develop a care model that is patient-centric Become premier Cancer diagnostic and treatment center Increase specializations through mergers

5. HCGlobalIT Goals IT Modernization with SOA Improve customer experience with PHR Create world class data intelligence and reporting Standardize/Improve exchanges with CCD HL7 IT Plan for business growth Comply with HIPPA Physician portal

6. Leading edge capability Aligned to some best practices No capability Aligned to most best practices First generation effort Assess – Plan - Execute HCGlobalmaylargely achieve the targeted future state by the end of 2013 and must focus on driving business benefits from the capabilities. Core Data capabilities are required to enable key business capabilities. Data Access Service Delivery Model PMRI Infr. Simp.

8. Improve efficiencyby reducing redundant care activities

9. Support consumer directed health information management

10. Comply with regulations

11. Enhance operational productivity and efficiencyROI

13. Improve efficiencyby reducing redundant care activities

14. Support consumer directed health information management

15. Comply with regulations

16. Enhance operational productivity and efficiencyROI

17. Interoperability Framework Contracts Sales Service Marketing Contracts Sales Service Healthcare Financial Apps Healthcare Clinical Apps Healthcare Administrative Apps Order Management Supply Chain Internet Procurement Financials Human Resources Projects Order Management Supply Chain Internet Procurement Financials Human Resources Projects Oracle E-Business Platform Oracle E-Business Platform Harmonized Platform Enterprise Integration Common Language Future Investment

19. Analytics

21. Entity Identification

22. Distributed Data Access (CRUD)

23. Indexing

24. Replication

26. Provider/Patient Registries

27. Communications

29. Detection & Notification

31. Legacy System Adapters

32. SimulatorService Library Common Services

33. Interoperability Providers Patients Administrators Researchers NewApplications Point of CareAppliances Internet HL7 IFEngine BusinessIntelligence DataMining DataAccess Registries Data Warehouse Healthcare Transaction Base ClinicalDataRepository Messaging Services Person Services Terminology Management Security and Auditing ExternalWarehouse Clinical Trial System (OC) Clinical Information Systems Laboratory Information Systems

35. Improve efficiencyby reducing redundant care activities

36. Support consumer directed health information management

37. Comply with regulations

38. Enhance operational productivity and efficiencyROI

39. Blueprint Summary – Core Data Objectives and Scope The goal is to build baseline competencies and functionality that will positionHCGlobalto develop enhanced capabilities. PMICore Data

40. Patients vs Patience Do we know the patient? What ‘view’ of the patient are you allowed to see? Is this the correct patient? What other information do we know about the patient? What can we do with this patient information? How do we get to theother informationabout the patient? How do we keep the patient information in-sync? Patient ID: The ‘Foundation’ of Interoperability

41. Interoperability Starts with Patient Identification P&C policyholder data Debbie Dozier -Becker 9146 E VIA DEL SOL NETOWN, CA 45883 Local identifier 12/19/61 – 727 Trusted systemof record Claims and billing data Debbie Becker 9146 VIA DEL SOL NETOWN, CA 45883 480-473-3486 5555-55-1234 Debbie Becker NULL 5555-55-1234 Local identifier DBECKER1234 Debbie Dozier NEED INFO 5555-55-1234 Local identifier 12345ABCDE 1: 12/19/61 – 727 2: DBECKER1234 3: 12345ABCDE 4: HOSPABC98765 5: BECKER4807343486 Commercial policyholder data Debbie Becker 9146 E VILLA DEL SOL NETOWN, CA 45885 Local identifier HOSPABC98765 Web self service data Debbie Becker 9146 VIA DEL SOL 480-473-3486 Local identifier BECKER4804733486 Patient Master Derive & standardize data for efficiency Find all potential matches Use sophisticated probabilistic statistics to compare many attributes & score records

43. Transaction Time Window (RT/NRT)

44. Cost of Money

45. Need to bill at time of discharge

46. Comprehensive Data Environment

47. Care Team – Medical Records – Finance

48. Real Time ICD-10 coding

50. Improve efficiencyby reducing redundant care activities

51. Support consumer directed health information management

52. Comply with regulations

53. Enhance operational productivity and efficiencyROI

54. Healthcare 2.0 Architecture 18 Provider, Payer, Purchaser Applications Collaborate Communicate Devices

55. Platform for Innovation Patient Care Treatment P4P Research Profitability/Efficiency Innovation Innovation Time in Market "If automakers were paid by the bolt, cars would be brimming with bolts," Harvard Medical School professor Jeff Levin-Scherz, April 2010 Harvard Business Review Advanced Data Research with 11g RDF Collaboration Structured & Unstructured Content Access

56. Moving Beyond Standard BI & Statiscal Analysis Patient “has manifestation” spinal injury Procedure “has associated anatomic” cell tissue damage Procedure “decreases” recovery time Extreme lateral interbody infusion (XLIF) Minimizes tissue damage Decreases recovery time Std. Insurers “experimental procedure” – accepted use Nuvasive “provides” XLIF products University Research Insurance Industry Datastore Medical Technology Database

58. Improve efficiencyby reducing redundant care activities

59. Support consumer directed health information management

60. Comply with regulations

61. Enhance operational productivity and efficiencyROI

62. Systemic Approach to Business Value Financial Hospital Bed Days Headcount productivity Colon Cancer Screening Capital equipment cost avoidance Costs per ED Visit Cost per Prescription Generic Prescribing Non Financial Customer satisfaction Intellectual property risk reduction Product development agility Regulatory compliance

63. Structure for Maintaining & Monitoring Portfolio 18 % 50 % 27 %

64. Communication

65. Thank You Bill Wimsatt Enterprise Architect waw@1783.com