Join Dr. Marcie Stoshak-Chavez, MD, FACEP, Director of Healthcare Strategic Advisory Services at Perficient and Mr. J.D. Whitlock, Director of Clinical & Business Intelligence at Catholic Health Partners to learn how analytics is being used to measure and monitor performance and provide service-line directors and financial administrators with reporting and analysis that enhances clinical care processes and business operations.
Learn how clinicians and administrators armed with the data-driven insights from the EMR and beyond can:
Derive meaningful insights for care delivery by analyzing clinical, financial and operational data
Collaborate more effectively and improve quality of care by securely sharing insights among providers
Meaningfully measure and understand performance across key Federally mandated measures and take prescribed action
Stay on top of shifts in regulatory policy that impact reimbursements and quality requirements
Going Beyond the EMR for Data-driven Insights in Healthcare
1. Going Beyond the EMR for Data-Driven
Insights in Healthcare
August 7, 2013
2. AGENDA
IBM
• The Market Forces Driving Healthcare Changes
• Turning Data Into Healthcare Insights
• Where Analytics Impacts Healthcare
Perficient
• Understanding Analytics Impact At The Point of Care
• Healthcare Analytical Data Sources
• Trends Analytics Are Driving
• Demonstration of Analytics at Work
Catholic Health Partners
• Case Study in Analytics Project and Results
Q&A
• Chat Questions Live
Agenda & Speakers
sri.srinivasan@us.ibm.com
Dr. Marcie Stoshak-Chavez-MD
Strategic Healthcare Advisor
Sri Srinivasan
VP Healthcare Information Management
JD Whitlock
Director of Clinical & Business
Intelligence
http://www.linkedin.com/in/jdwhitlock
Marcie.Stoshak-ChavezMD@perficient.com
4. Market Forces Driving Healthcare Challenges
Industry Challenges
and Opportunities
Primary Care and HC workforce
shortages demand workforce
productivity and efficiency
New approaches to
health and care delivery
increase complexity and
competition
Increasing costs
with shrinking
reimbursements
Increasing incidence and
cost of chronic diseases
Empowered consumers
expect better value,
quality, and outcomes
Healthcare is shifting
from local to state and
national contexts
Changing demographics
and lifestyles drive
associated costs
5. Healthcare Transformation Requires
Answers to Key Questions
How can I target consumer
engagement activities to improve
outcomes and the patient
experience?
How can I effectively measure
provider/treatment effectiveness
and take targeted action to
improve quality and reduce
costs?
How can I proactively manage
clinical and financial risk and
remain competitive in an
uncertain market? How can I identify at-risk and
chronically ill patients and
apply treatments that meet the
needs of the individual?
6. Transforming Data into Healthcare Insights
Population Management
We identified & recommended
vaccination for patients at risk
for meningitis within hours of
the outbreak.
Intervention
The patient’s BP and sugar levels
spiked, I need to communicate
with her and direct her to
treatment.
Patient Engagement
My reports show a decline in satisfaction
based on sentiments expressed on our
member portals and social networking
sites.
Care Management
We reduced readmission rates by
assigning a care manager to heart
patients with no emergency
contact on file.
Health Economics
I have evidence that demonstrates a
lower total cost of care and better
outcomes with a seemingly more
expensive drug or treatment.
With Big Data…
Email, Fax
Dictation, E
MR Notes
Customer
Sentiment Devices
7. Every Organization is on its
Own Analytics Journey
Foundational
• What happened?
• When and where?
• How much?
Operational, Tactical
• What will happen?
• What will be the impact?
• Dashboards
• Clinical data repositories
• Departmental data marts
• Enterprise data warehouse
BI Reporting
• Enterprise analytics
• Unstructured content analytics
• Outcomes analytics
• Evidence-based medicine
Population Analytics
• Streaming analytics
• Similarity analytics
• Personalized healthcare
• Consumer engagement
Care Optimization
Advanced, Predictive
• What are potential
scenarios?
• What is the best course?
• How can we pre-empt and
mitigate the crisis?
9. As a leading provider of services in the healthcare industry, Perficient has delivered both
strategic consulting and advanced technology solutions to many of the top provider, payer, life
science and government healthcare organizations.
Perficient Technology Solutions
• Top tier healthcare industry authorized IBM partner
• Healthcare Analytics / Business Intelligence
• Portal design and development
• Enterprise Content Management solutions
• Master Data Management solutions
• Multi-Sourcing solutions
Perficient Consulting Services
• Business value assessment/financial sustainability modeling
• Requirements analysis/product selection
• Architecture planning and platform selection
• Custom solution design and development
• Implementation services
• Usability testing and user-centered design
• Consumer readiness assessments (PEMM)
• ICD-10/5010 conversion
• Technology enabled process improvement
• Business integration
• Process/workflow design
• Enterprise Application Integration (EAI)
Industry Expertise
10. The Rapidly Changing Healthcare Landscape
Commercial
r e g u l a t o r y
Operational
Personalized Healthcare
Value Based
Purchasing
Bundled
Payments
Meaningful
Use
Mobile Health
T r i p l e A i m
11. Clinical Intelligence
Moving from:
To:
• Excel Spread Marts
• Retrospective manual reporting
Transactional
reporting
• Dashboards
• Clinical Data Repositories
Data Integration
and warehousing
• Enterprise Evidence Based Medicine
• Outcomes
Clinical Intelligence
Analytics
• Population Based “Wellness”
• Personalized Medicine
Predictive Analytics
13. Use Cases for Clinical Intelligence
Use Cases Use Cases
Determine and model total cost of care across all
settings (acute, ambulatory, home care) by population
or individual
ID risk to patients by looking at environmental factors e.g.
asthma, flu breakout
Care coordination New age case management (CRM for patients)
Match payer and provider data-verify rollout of
preventative programs
ID labor savings. Correlate staffing to predicted
demand/activity
Meds Mgmt./Reconciliation/Med Therapy
Mgt./Prescription fill compliance
Physician attribution and/or care team – quality
outcomes – patient satisfaction
Analyze population health levels based on various
grouping (geo, facility, provider, etc.)
Monitor and track (real time) compliance to regulatory
and/or clinical guidelines across settings
Understand resource utilizing productivity, throughput
and access
Chronic care cost modeling to support payments and
allocation
Evaluate readmission across continuum Support transitions of care through transfer of data
Resource planning/physician profitability (contract
management, preferences, outcomes
Aggregate and manage data across all care settings
(cost, care)
Support 65 ACO measures Comparative Effectiveness / waste reduction
Monitor/track patients experience beyond HCAPS
(coordinate w/workforce, predict experience)
Creation of new evidence base for guidelines
13
14. Use Case:
Measure & Act on Population Health
Reduce the cost of care
…by identifying environmental and
lifestyle factors that contribute to
disease progression
Improve outcomes
…by getting a 360 view of patients
across the care continuum
Mobilize resources
…by understanding vulnerabilities
within your patient population in
times of crisis
Reduce readmissions
…by identifying at-risk patients in
need of a more robust care plan
Comply with federal
requirements
…by improving readmission
reporting
Compare provider
effectiveness
…by stratifying patient
population by disease typeSustainability & Collaboration
Real-time, meaningful insight into clinical and
environmental factors
15. ID At-Risk Patients and Adjust Care with
Insight into Clinical and Factors
EMR
Doctor’s notes,
dictation
Mobile
Health
Email, Apps
Insurance
Claims, DRG, eligib
ility
Events
Weather, local
events, disease
outbreaks
Monitors/
Sensors
At home and
bedside vital
signs
• Predict patients at risk for
readmission and change course
• Anticipate and take pre-emptive
action during disease outbreaks
• Understand and take the next
best action for the patient
New
Capability
Outcomes
Improved health
outcomes
Prescriptive care
Reduced costs
and readmissions
Communities
Patients like me
Retailers
Groceries,
prescriptions,
OTC drugs
Research
Genomics, environm
ental
19. • Largest health system in Ohio
• 24 Hospitals
• 800+ employed physicians
• $3.8B revenue
• Medicare Shared Savings Program ACO (1 July 2012 start) with 24K
patients
• Largest single-instance Epic client
• VISION: “CHP will transition to value-based care through a high
quality, affordable system of care that improves the health of
individuals and the communities we serve”
Catholic Health Partners
20. 20
CHP Population Health Management Tools
Claims
Physicians
Value Analytics Team
Care Coordinators
Explorys
(Clinical Quality
Dashboards)
Epic 2012
Multiple Data Sources
InforMed
(Risk Profiling)
PremierConnect
EDW
21. 21
• IBM & Premier jointly developed “Healthcare Provider Data Model”
• IBM Technology Stack
– Netezza (Performance)
– Cognos (Industrial Strength BI)
• Premier & Perficient SME & services
• CHP internal focus on analysis and insight, not building a data model
• Leverage existing flow of data to Premier for apps
• Premier Data Alliance Collaborative
PremierConnect
22. 22
PremierConnect
Data Model
Powered by:
“Big Data”
Data Warehouse
Appliance
PremierConnect
CHP Data Sources … Stored in … Viewable via …
Claims
Quality
Clinical
Operations
Revenue
Supply Chain
Enterprise
Business
Intelligence
Suite
Powered by:
Dashboards
“Drillable”
Interactive Reports
“Self-Service”
BI Tools
Ad-hoc Reports
23. 23
Current / Near-Future Projects
Use Cases Description
Claims Based Quality Measures /
Total Cost of Care Dashboards
Claims based NCQA measures and drillable analysis of PMPM / TCOC
Medicare Breakeven Analysis Develop metrics/dashboards to track performance of cost reduction opportunities
Predictive Analytics for Readmission
Risk
Data Alliance Collaborative co-development project: Mine clinical, claims, and
demographic data to determine optimum readmission risk algorithms
Provider Balanced Scorecard Scorecard for employed providers including Patient Satisfaction Measures, Care
Process Measures, and Financial Measures
Key Volume Metrics Automate and improve the process, capabilities and performance of existing Key
Volume metric reporting
Premier QUEST Harm Report Automate and improve report generation. Enhancements to include YTD results
(spark line), more interaction, better visualization and drillable
Community Health Status Analytics Evaluate diversity related disparities of care and evaluate needs of underserved
populations using GIS
25. Thank you for your time
and attention today.
Please visit us at Perficient.com
Notas del editor
SPEAKER NOTES: Industry challenges and opportunitiesCost of treating chronic diseasesShortages of “experienced” IT and clinical resourcesManaging the shift in healthcare fro Inpatient centric to a more affordable community based precision care modelRequires new approaches for identifying patients, providers the EMPI centric functions as well as a solid foundation for any MDM strategy (if polling question floats, then here is where I will insert a comment about a single vendor is not the total solution for addressing the EMPI or MDM Issues)
These questions address Triple Aim initiatives including improving population health, reducing costs and improving the patient experience.
SPEAKER NOTES: Where MDM impacts HealthcareSegue way from Insights to improve business with Big data to where MDM impacts HCPlaces where data existsOperational impactsBusiness of providing high quality healthcare with cost accountability
SPEAKER NOTES:Before you can jump into Big Data and taking advantage of the analytics you can gain from Big Data, you need to understand your organization’s data at the core level. Your ‘Master Data.’ This slide gives some examples of what Master Data is. Master Data is really the core information in an organization that is used to make critical decisions and it is what a lot of business processes are designed around.The problem many organizations are facing, is that this high value data (customer data, product data, patient data) – and relationships in the data are the most central to running business, but the data is often very poor quality – inaccurate, incomplete, missing or duplicated – and thus the business processes that depend on those data can be inefficient, ineffective, and costly or increase business risk. That is important to remember when you are talking to customers about Master Data. Since business processes are designed around their data, you need to engage business people with that. The key isn’t to talk about speeds and feeds you can load data with. The key is to engage business people in a discussion about the effectiveness of key processes and explore that with your prospects. And this applies to all industries.Healthcare – patient registration is a classic example, especially across multiple clinics, hospitals, labs. But we really would like to stress that the EMPI is really just one domain that can be implemented. Outside of the EMPI, there are Provider, Location, and Facility domains that the InfoSphere product can also support. MDM in healthcare is expanding, and the InfoSphere product can support it!