FOUNDATIONS FORCLINICAL AND HEALTHCAREBUSINESS INTELLIGENCE

eMids Business Intelligence ConferenceNashville, Tennessee

MAY 2012

James E. Gaston, FHIMSSSr. Dir. of Clinical & Business IntelligenceHIMSS and HIMSS AnalyticsJames.Gaston@HIMSSAnalytics.orgTwitter @JamesEGaston

AGENDA

HIMSS and HIMSS Analytics Orienteering Clinical Intelligence First Steps Practical Application Pulling It All Together

WWW.HIMSS.ORG

HIMSS Vision

Advancing the best use of information and management systems

for the betterment of healthcare.

HIMSS Mission

Lead healthcare transformation through the effective use of

health information technology.

WWW.HIMSSANALYTICS.ORG

http://www.ebooks.himss.org/

http://marketplace.himss.org/

http://www.apple.com/itunes/

Print, Digital, iTunes…all available

ORIENTEERING

CLINICAL & BUSINESS

INTELLIGENCE

ORIENTEERING

Business intelligence (BI) mainly refers to computer-based techniques used in identifying, extracting, and analyzing business data, such as sales revenue by products and/or departments, or by associated costs and incomes.

Business Intelligence supports business decision-making.

http://en.wikipedia.org/wiki/Business_intelligence

ORIENTEERING

Clinical Intelligence (CI) mainly refers to computer-based techniques used in identifying, extracting, and analyzing healthcare data, such as lab results, medical histories, or medical records, to support a healthcare related decision.

Clinical Intelligence supports healthcare decision-making.

ORIENTEERING

C&BI as defined by leading healthcare organizations…“Mining clinical data with an eye towards patient care”

“Access to key information to make care or business decisions that result in the best outcome for the patients and the business”

“To use currently available and create new data sources to drive all aspects of running an organization”

“Supporting clinical excellence”

“Maximizing the quality of care and minimizing the cost”

CLINICAL INTELLIGENCE FIRST STEPS

CLINICAL INTELLIGENCE FIRST STEPS

CLINICAL INTELLIGENCE FIRST STEPS

2011 - 2012 2013 - 2014 2015 +

Meaningful use Drivers• Improve quality, safety, efficiency, and reduce health disparities• Engage patients and family• Improve care coordination, and population and public health• Maintain privacy and security of patient health information

http://www.healthit.gov/

CLINICAL INTELLIGENCE FIRST STEPS

CI is about exposing the clinical decision process, turning a “gut feeling” or intuition into a revealed process that is informed, defensible and consistent

• In the moment of the care decision» Banner Health physicians have access to patient EMR and are

prompted upon a visit to provide diagnosis related care

• Retrospectively examining the circumstances (data)» Geisinger uses their patient data warehouse to identify “care gaps”

and push them to clinicians for review

PRACTICALAPPLICATION

PRACTICAL APPLICATION - BIDMC

“Healthcare CIOs should implement applications which filter data so that it becomes information, transform information into knowledge, and ultimately provide clinicians with wisdom based on that knowledge at the exact time they need it.”

Ten-year-old John Halamka winning the Science Fair in 4th grade with his home-built Van De Graff generator in 1972.

John D. Halamka, MD, MSChief Information Officer of Beth Israel Deaconess Med. Center

Chief Information Officer at Harvard Medical School

Chairman of the New England Healthcare Exchange Network

Co-Chair of the HIT Standards Committee

Harvard Medical School full professor

Practicing Emergency Physician

http://geekdoctor.blogspot.com

http://geekdoctor.blogspot.com/2007/11/data-information-knowledge-and-wisdom.html

PRACTICAL APPLICATION - BIDMC

PRACTICAL APPLICATIONBANNER HEALTH NETWORK

Payment Model + Delivery Model AlignmentTransitioning to a “Value based methodology”for physician reimbursement

Physicians spend more time with patientsNew payment codes incentivize physicians“Holistic” approach to care, including behavioral & social health

Practical ApplicationFind patients that have not recently had a visit and arrange itEnsure proper post acute care follow-upGenerate care plans, engage care managersActiveHealth technology provides registry, risk assessment

PRACTICAL APPLICATION ATRIUS HEALTH

“We also adopted a relatively unique concept in that we wanted to take care of all of our patients exactly the same, no matter what their funding mechanisms were.”

Dr. Gene Lindsey, CEO of Atrius Health

The ACO Shared Savings application process - FierceHealthcare, http://www.fiercehealthcare.com/special-reports/atrius-ceo-interview-inside-pioneer-aco/aco-shared-savings-application-process#ixzz1ywZVYK58 , 2/24/2012

PRACTICAL APPLICATION ATRIUS HEALTH

Multi-pronged Care StrategyCore Strategy Components

Hospital strategy

Post-acute stay facility strategy

Home care strategy

Geriatric care model design

Practical Application

Define “patient care expectations” with “Preferred Partners”

Expect all care to be delivered as defined in agreement

Monitor, benchmark and manage using CI & BI reporting

PRACTICAL APPLICATIONCOMMON THEMES

“You just can’t over communicate what you are trying to achieve…the ongoing communication, not just the printed stuff, but the conversations and dialog, are where it happens”

Mr. Chuck Lehn, SVP and CEO of Banner Health Network

“Compensation is being based on, in part, your quality scores, or your patient satisfaction scores, or the size of the panel of patients you care for as opposed to just the numbers of visits you generated.”

Dr. Rick Lopez, Chief Physician Executive of Atrius Health

PRACTICAL APPLICATION

Recommendations

C&BI should be positioned to enable and support and organizations mission and vision

Engage senior level support

C&BI is an active and engaging process, not a technology or application solution

Ensure physicians have a leadership role and a stake in the process

Establish strong data governance and communication

PULLING IT ALL TOGETHER

Create the foundation, data and environment forClinical Intelligence & Healthcare Business Intelligence

FOUNDATIONS FOR CLINICAL AND HEALTHCARE BUSINESS INTELLIGENCE

Information Management Symposium 2012Nashville, Tennessee

James E. Gaston, FHIMSSSr. Dir. of Clinical & Business Intelligence

HIMSS and HIMSS Analytics

James.Gaston@HIMSSAnalytics.org

Twitter @JamesEGaston

Healthcare BI SummitMinneapolis, Minnesota