Post on 23-Jan-2015
description
Going Beyond the EMR for Data-DrivenInsights in Healthcare
August 7, 2013
AGENDAIBM
• 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-MDStrategic Healthcare Advisor
Sri SrinivasanVP Healthcare Information Management
JD WhitlockDirector of Clinical & Business
Intelligencehttp://www.linkedin.com/in/jdwhitlock
Marcie.Stoshak-ChavezMD@perficient.com
Healthcare Challenges
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
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?
Transforming Data into Healthcare Insights
Population ManagementWe identified & recommended vaccination for patients at risk for meningitis within hours of the outbreak.
InterventionThe patient’s BP and sugar levels spiked, I need to communicate with her and direct her to treatment.
Patient EngagementMy reports show a decline in satisfaction based on sentiments expressed on our member portals and social networking sites.
Care ManagementWe reduced readmission rates by assigning a care manager to heart patients with no emergency contact on file.
Health EconomicsI 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, EMR Notes
Customer Sentiment Devices
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?
Analytics at the Point of Care
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
The Rapidly Changing Healthcare Landscape
Commercial
Initiatives
regulatory
OperationalPatient engagement
ACO
Population wellness
Personalized Healthcare
Value Based Purchasing
Bundled Payments
Meaningful Use
Mobile Health
Triple Aim
P4P
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 MedicinePredictive Analytics
Clinical Analytics for Providers
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
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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
ID At-Risk Patients and Adjust Care with Insight into Clinical and Factors
EMRDoctor’s notes,
dictation
Mobile Health
Email, Apps
InsuranceClaims, DRG,
eligibility
EventsWeather, local events,
disease outbreaks
Monitors/SensorsAt 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
NewCapability
OutcomesImproved health outcomes
Prescriptive care
Reduced costs and readmissions
CommunitiesPatients like me
RetailersGroceries,
prescriptions, OTC drugs
ResearchGenomics,
environmental
Trends for Analytics in Healthcare?
Analytics at Work in Healthcare
• 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
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CHP Population Health Management Tools
Claims
Physicians
Value Analytics TeamCare Coordinators
Explorys (Clinical Quality
Dashboards)
Epic 2012
Multiple Data Sources
InforMed(Risk Profiling)
PremierConnectEDW
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• 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
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PremierConnectData Model
Powered by:
“Big Data”Data Warehouse
Appliance
PremierConnect
CHP Data Sources … Stored in … Viewable via …
Claims
Quality
Clinical
Operations
Revenue
Supply Chain
EnterpriseBusiness
Intelligence Suite
Powered by:
Dashboards
“Drillable” Interactive Reports
“Self-Service” BI Tools
Ad-hoc Reports
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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
Questions?
www.slideshare.net/PerficientInc
www.facebook.com/Perficient
www.perficient.com/Thought-Leadership/Social-Media/Blogs
us.linkedin.com/company/Perficient
sri.srinivasan@us.ibm.com
Dr. Marcie Stoshak-Chavez-MDStrategic Healthcare Advisor
Sri SrinivasanVP Healthcare Information Management JD Whitlock
Director of Clinical & Business Intelligence
http://www.linkedin.com/in/jdwhitlock
Marcie.Stoshak-ChavezMD@perficient.com
Thank you for your timeand attention today.
Please visit us at Perficient.com