Data Analytics: Demystifying the Hype · The CFO desired to mitigate the financial risk of, and...

Data Analytics: Demystifying the HypeJon Tanis, CDHA | Sept 19, 2019 | HFMA Northwestern Ohio Chapter

Northwestern Ohio Chapter

Bridges boast human ingenuity.

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Golden Gate Bridge Mackinac Bridge

http://goldengate.org/exhibits/exhibitarea4a.php http://fishreportonline.blogspot.com/2017/08/daves-midwestern-ohio-memories-from-50s.html


Bridges offer historical beauty.

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Tower Bridge Brooklyn Bridge

https://mashable.com/2016/01/21/london-tower-bridge/#TjmaDppCVGq5 https://www.npr.org/sections/thesalt/2017/01/30/511204977/a-sip-of-history-the-hidden-wine-cellars-under-the-brooklyn-bridge


Bridges create practical utility.

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http://www.garciabridge.com/garciaresume.html http://www.tampabay.com/photos/2018/03/05/runners-conquer-the-sunshine-skyway-bridge-in-inaugural-10k-run/


Analytics is a bridge from data to action.

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DataAction

People

Process

Technology

Northwestern ohio chapter

My three objectives.

Define what data really is. (Hint: an asset.)

Show why analytics is a bridge to action.

Discuss how to better leverage your data.

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Define what data really is. (Hint: an asset).

Data is the new oil. It’s not about quantity or quality, but refinement.

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Volume

What is big data (and does it matter)?

3 quintillion bytes of data are generated… every day.

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Volume

Velocity

Variety

Veracity

Variability

Extracting business value from the 4 V's of big data, IBM. http://www.ibmbigdatahub.com, https://datascience.berkeley.edu/big-data-infographic/

The entire Netflix catalog… streamed over

9,000 times.


Volume


Streaming data are driving rapid responses.

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Velocity

Variety

Veracity

Variability

https://www.cnet.com/roadshow/news/the-ford-gt-generates-100-gb-of-data-per-hour/

Velocity

The Ford GT’s 50 sensors generate

100 gigabytes of data per hour.


Comprehend Medical can identify medical conditions, anatomic terms, medications, details of medical tests, treatments and procedures.

Volume


80% of healthcare data is unstructured.

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Velocity

Variety

Veracity

Variability

Variety

https://www.healthdatamanagement.com/news/providers-need-new-tools-to-make-sense-of-unstructured-datahttps://healthitanalytics.com/news/amazon-takes-on-unstructured-ehr-data-with-machine-learning-nlp


Volume


$3.1 trillion - IBM’s estimate of the yearly cost of poor quality data, in the US alone.

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Velocity

Variety

Veracity

Variability

https://www.healthcareitnews.com/news/ridding-ehrs-dangerous-often-undetectable-bad-data, https://hbr.org/2016/09/bad-data-costs-the-u-s-3-trillion-per-year

Veracity

Incorrect or missing data in electronic health records was the No. 2 hazard to put patients at risk in 2015.


Volume


Data is increasingly difficult to interpret.

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Velocity

Variety

Veracity

VariabilityVariability

“My daughter got this in the mail!”

“She’s still in high school, and you’re sending her coupons for baby clothes and cribs? Are you trying to encourage her to get pregnant?”

https://www.forbes.com/sites/kashmirhill/2012/02/16/how-target-figured-out-a-teen-girl-was-pregnant-before-her-father-did/#3836a6736668


Extracting value from small data.

A David vs. Goliath Story

Faster insight Simpler start-up Cheaper IT infrastructure Fewer skillset requirements Lower risk to produce an ROI

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What’s different about data analytics?

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Process PeopleTechnology


Advanced processes are creating more data…

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By ChristophRoser. Please credit "Christoph Roser at AllAboutLean.com". - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=47640595

and accelerating our journey to a 4th Industrial Revolution (aka Industry 4.0)

That generate more data.


The industrial revolution… in healthcare.

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Data is fueling the fourth industrial revolution in healthcare

Large datasets, utilized effectively, mean three things for care: it can be more predictable, more personalized and more precise.https://www.newstatesman.com/spotlight/healthcare/2018/11/data-fueling-fourth-industrial-revolution-healthcare November 28, 2018

…previous industrial revolutions forever altered how people around the world live and work... As we look to the future, the Fourth Industrial Revolution has the potential to be truly game-changing for patients, especially in the areas of disease management, aging, and the discovery and development of new medical innovations.

https://www.weforum.org/agenda/2016/01/three-ways-the-fourth-industrial-revolution-could-transform-healthcare January 24, 2018

Fourth Industrial Revolution Technologies Are Transforming Healthcare

Northwestern ohio chapter 17



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The most common fallacy in analytics.

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A revolution toward self-service analytics.

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2011 Gartner Magic Quadrant 2017 Gartner Magic Quadrant



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“The Sexiest Job of the 21st Century”

“Think of him or her as a hybrid of data hacker, analyst,communicator, and trusted adviser. The combinationis extremely powerful - and rare.”

Source: https://hbr.org/2012/10/data-scientist-the-sexiest-job-of-the-21st-century/

The birth of the Data Scientist.


Bridging the gap between IT and finance.

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https://www.mckinsey.com/business-functions/mckinsey-analytics/our-insights/ten-red-flags-signaling-your-analytics-program-will-fail

BUSINESSSKILLS

TECHSKILLS

ANALYTICS SKILLS

Understanding ofthe problem

Ability todeliver solutions

BusinessUsers

ITStaff


How is the finance professional changing?

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Traditional Finance Staff Next-Gen Finance Professional

Accounting Mindset Business Mindset

Microsoft Excel Expert Capable in Advanced Tools

Reacts to Analysis Requests Proposes Analysis Questions

Summarizes the Story in Data Reveals the Story from Data

Refines Forecast Models Develops Predictive Algorithms

Data Aware Data Literate


Show why analytics is a bridge to action.Breaking down analytics through 3 finance initiated, analytics-enabled projects.

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Three Examples Initiated by the CFO

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OR Utilization ED Population Health Credit Balance Remediation


Hospital Profile

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600+ total beds

25+ operating rooms

19K+ surgeries annually

$500M annual revenue

OR Utilization


Defining the Challenge

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Surgeons expressed difficulty scheduling cases due to a poorly optimized block schedule and limited OR capacity.

Reports showed the ORs were underutilized.

The CFO needed to understand this dichotomy and develop a strategy to move forward.


Obtained a data extract.

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First Case On-Time Start

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Procedure Time Variance by Surgeon

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Room Turnover Time

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Room Turnover Time by Hour

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FCOTS Opportunity

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$2.3million

Over 6 Months


Room Turnover Opportunity

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$4.6millionOver 6 Months


Health System Profile

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2,000+ total beds

10+ primary, specialty, long-term care facilities

10K+ physicians, nurses & staff

200K+ ED visits annually

$1.5B+ annual budgetED Population Health



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The CFO desired to mitigate the financial risk of, and improve health outcomes for, ED high utilizers who accounted for a disproportionate share of ED visits

and cost.


All patients with at least 4 ED visitsin a 6 month period.

All ED visits over a 24 month period.

③ with any unfunded encounterin the last 6 months.

② with any unfunded activity duringthe 24 month period.

Top 100 of ⑤sorted by level

of subsidy.

④ with a chronic condition asdefined by clinical coding.

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ED High Utilizer Funnel

1

2

3

4

5

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Financial Impact of ED High Utilizers

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0 500 1,000 1,500 2,000 2,500

Rank of High Utilizers by Subsidy

($24.0M)

($22.0M)

($20.0M)

($18.0M)

($16.0M)

($14.0M)

($12.0M)

($10.0M)

($8.0M)

($6.0M)

($4.0M)

($2.0M)

$0.0M

Cum

The top 100 most subsidized high utilizersaccount for $7,000,000 in subsidy.

The second 100 most subsidized highutilizers account for $3,000,000 in subsidy.


Patient Clinical History

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59% of ED high utilizers have presented with a substance abuse diagnosis compared to only 13% of other unfunded patients.

Substance Abuse Diagnoses

69% of ED high utilizers have presented with a mental & behavioral health diagnosis compared to only 20% of other unfunded patients.

Mental & Behavioral Health Diagnoses

20% of ED high utilizers have experienced homelessness during the 24 month analysis timeframe compared to only 2% of other unfunded patients.

Experienced Homelessness


Leveraging Analytics to Measure Success

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Before Program Participation After Program Participation


ED Care Transition Patient Interventions

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Developed and implemented targeted and intentional interventions to encourage patients to seek primary and preventative care.

Established a specialized case management function focused on this patient population with lower case loads.

Supported the resolution of social issues (e.g. expansion of ‘healthcare’ definition).

Utilized patient navigators, social workers, case managers to keep in close contact with patients to achieve compliance through IT monitoring.


Patient Intervention & Impact

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120participantsin program

48%enrollment

rate

24days to

enrollment

4months totransition

466reduced EDencounters

per year

150reduced inpatient

encounters per year

$5.8Mreduced subsidyper year (at full

caseload)


Physician Group Profile

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30+ physicians

300K+ encounters annually

$100M+ reimbursement annually

$1M+ outstanding credit balances

10+ years of credit balance aging

Credit Balance Remediation



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The CFO learned he inherited a $1M+ open credit balance situation and needed to quantify and mitigate the financial / compliance risk while

prioritizing resources for resolution.


A practical, analytics-enabled approach.

1. Inventory and prepare the data.

2. Diagnose the common root-causes.

3. Develop rules-based reason stratification.

4. Recalculate the posting error / overpayment amount.

5. Determine payer(s) with associated overpayment.

6. Set the lookback period and overpayment date.

7. Prioritize resolution and prevention.

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Inventory and prepare the data.

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Diagnose the common root-causes.

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Develop rules-based reason stratification.

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Of 40+ reasons, the top 5 reasons accounted for over 65% of the gross credit balance amount.

Reason % Posting Error OverpaymentSingle payer fully adjudicated the charge. Patient paid amount is the exact amount of the credit balance.

24% $0 ($300K)

Single payer on the charge. Patient overpaid payer balance remaining by the primary payer.

13% $0 ($150K)

Single payer adjudicated the charge and the patient credit balance was due to a patient overpayment.

13% $0 ($140K)

Voided charge with outstanding adjustments and/or payments. 10% ($80K) ($60K)

Voided charge with no adjustments and/or payments. 5% $2K ($30K)


Determine payer(s) with associated overpayment.

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Set the lookback period and overpayment date.

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Prioritize resolution and prevention.

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Monitor & ControlPrioritize & Execute Standardize & Train


Analytics is a bridge from data to action.

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DataAction

People

Process

Technology


Discuss how to better leverage your data.A framework to bridge the gap from data to action in the finance function.

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Northwestern Ohio Chapter 55

Assess

Plan

Prove • What is our analytics maturity?• What can we build upon?• What should we rebuild?

• Where do we want to be?• What changes enable it?• How do we implement?

• What was successful?• Where can we improve?• How can we build upon our

experience and learnings?

A framework for rapid analytics transformation.


The top 5 take-ways to remember.

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1. In a world of BIG DATA, don’t underestimate small data.

2. Empower your staff with self-service analytics tools.

3. Be leaders who bridge the gap between ops and IT.

4. Identify the issue, then think about the data.

5. Start small, but start.


Q&AJon Tanis, [email protected]

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Data Analytics: Demystifying the Hype · The CFO desired to mitigate the financial risk of, and...

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