Supporting Healthcare Transformation with an Enterprise Analytics Program
Christopher Donovan, MBAExecutive Director Enterprise AnalyticsCleveland Clinic
Cleveland ClinicProfile
Industry Transformation
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Optum to buy DaVita Group for $4.9 billion
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• Capturing, integrating and interpreting data from all available sources
• Predictive algorithms that surface opportunities for intervention and prevention
• Thoughtful use of augmented intelligence
• Seamless connections to patients and partners as healthcare becomes “borderless”
• New skills, knowledge and pipelines
• Mature data governance
Digital Transformation at CC
Patients - main patient-facing elements; patient portals, multichannel commerce and customer apps
Ecosystem - supports the creation of, and connection to, external ecosystems, marketplaces & communities. (API mgt, control & security)
Internet of Things (IOT) - connects physical assets for monitoring, optimization, control and monetization. Capabilities include connectivity, analytics and integration of core and IOT systems
IT Systems - supports back office and operations; such as ERP and core systems
Data & Analytics - information management and analytical capabilities. Data management programs and analytical applications fuel data-driven decision making, and algorithms automate discovery and action
Adapted from Gartner - A Digital Business Technology Platform Is Fundamental to Scaling Digital Business
Analytics is Core to a Digital Platform
Patients
Analytics
Customer Facing &
Public APIs
Partner & Supplier Analytics
PatientAnalytics
Business & Operational
Analytics
IoTAnalytics
SocialNetworksPatient Portal &
Apps
Multichannel Interaction & Commerce
Connected Things
(Customers)
Connected Things
(Partners)
OT Systems
Connected Things
(Enterprise)
EndpointComputing
CoreSystems
Back-Office Systems Employee
Collaboration and Workplace
Supplier Portal &
Apps
Enterprise Run Ecosystems
API Management Industry &
Partner-run Ecosystem
Business IntelligenceAlgorithms & AI
Engines
PATIENTS ECOSYSTEMS
THINGS IT SYSTEMS
ANALYTICS
Adapted from Gartner - A Digital Business Technology Platform Is Fundamental to Scaling Digital Business
Analytics is Core to a Digital Platform
Business Intelligence
Customer Facing &
Public APIs
Partner & Supplier Analytics
PatientAnalytics
Business & Operational
Analytics
IoTAnalytics
SocialNetworksPatient Portal &
Apps
Multichannel Interaction & Commerce
Connected Things
(Customers)
Connected Things
(Partners)
OT Systems
Connected Things
(Enterprise)
EndpointComputing
CoreSystems
Back-Office Systems Employee
Collaboration and Workplace
Supplier Portal &
Apps
Enterprise Run Ecosystems
API Management Industry &
Partner-run Ecosystem
Algorithms & AI Engines
PATIENTS ECOSYSTEMS
THINGS IT SYSTEMS
ANALYTICS
Adapted from Gartner - A Digital Business Technology Platform Is Fundamental to Scaling Digital Business
Analytics is Core to a Digital Platform
PatientAnalytics
Patient Portal & Apps
Connected Things
(Customers)
CoreSystems
Algorithms & AI Engines
Business & Operational
Analytics
IoTAnalytics
API Management
Business Intelligence
International Institute for Analytics
2.252.882.89
2.963.05
3.193.233.29
3.433.553.583.62
3.914.56
Airlines
Utilities & Telecom
Digital Natives
Grocery
Financial ServicesConsumer BrandsGeneral RetailPharma & Med DevicesManufacturing
Automotive
Healthcare - Providers
Healthcare - InsuranceInsuranceSpecialty - Retail
Industry Best In Class
Maturity Score
Medians
Com
petit
ive
Adv
anta
ge
Adapted from: Copyright © 2012, SAS Institute Inc. All rights reserved. ANALYTICS MATURITY GOAL: FROM REACTIVE TO PREDICTIVE
How do we act on it?
What’s the best that can happen?
What will happen next?
Why is this happening?
What actions are needed?
What were the key drivers?
How many, how often, where?
What Happened?
Sophistication of Analytics
StdReports
AdhocReports
DataExploration
AlertsScorecards
StatisticalAnalysis
Forecasting
PredictiveAnalysis
Optimization
Proactive Decision Making
Reactive Decision Making
Driving Analytic Maturity
Develop the ability to act on insights from all available data to
improve patient outcomes, affordable care, education and
research
DataEnhance the value of CC data assets
PeopleDevelop an analytically
capable organization
ProcessValue
analytics over instinct
TechnologyCreate a modern analytics platform
CC Enterprise Analytics Vision
Matrix Program Leadership
Executive Director Medical Director
IT
Infrastructure
CIOADMIN
Financial DSS / BI
CFOMed Ops
Clin Ops BI
CMOOEstablished new
program leadership positions with new, formalized matrix reporting to drive
alignment
Executive Steering
Committee
Operational Leadership
TeamAdvisory Council
Data Governance
Council
Operational leaders who are data
domain SME’s and recognized as
authoritative relative to their data
domains
Limited membership -core functional owners
Broad, open membership
Institute Leadership
Council
Program Governance
• Responsibilities of the data and analytics team:–Provision of trustworthy, available data –Deployment of modern, useable analytics tools–Development of enterprise scale vision, training and support–Development of expertise and “consulting” around
measurement, performance management, and “math”
• Responsibilities of the enterprise:–Become facile users of data related insight–Broadly disseminate an analytically oriented culture –Commitment to developing required skills
A Shared Effort
Dashboards
Enterprise Data Vault
Hadoop
Data Labs
External Data
Data Asset Management
Enterprise Data Views Analytic Engine
Analytics Spreadheet Reporting KPIs
Data Integration
Metadata Data Quality Business Glossary Master Data ManagementETL
Analytic Tools
CC Enterprise Analytics Platform• Enterprise data store capable of
capturing a wide variety of structured, unstructured and streaming data
• Curated data views for easy access with standard, reusable definitions and data models
• World class advanced analytics providing nuanced capability and supporting open source frameworks
• Flexible integration with external and novel internal data stores
• State of the art visualization and access capabilities to facilitate data discovery and drive analytic culture
http://sloanreview.mit.edu/article/minding-the-analytics-gap/
• Two important abilities- Ability to produce results- Ability to consume results
• As organizations mature… - How do each of these change?- How do they change relative to each other?- What are the implications for managing?
Building Analytic CapabilitySo
phist
icat
ion
Maturity
http://sloanreview.mit.edu/article/minding-the-analytics-gap/
Soph
istic
atio
n
Maturity
Ability to Produce
Ability to Consume
Make analytics easier to consume
Waste
Different growth curves produce waste
http://sloanreview.mit.edu/article/minding-the-analytics-gap/
Soph
istic
atio
n
Maturity
Ability to Produce
Ability to Consume
Make analytics easier to consume
Minding the Analytics Gap
http://sloanreview.mit.edu/article/minding-the-analytics-gap/
Soph
istic
atio
n
Maturity
Ability to Produce
Ability to Consume
Make analytics easier to consume
Increase understanding of
analytics
Minding the Analytics Gap
Addressing differentiated requirements through appropriate tool, capability and
training curriculum
Quantitative Analysts
Business Analysts
Key leaders & decision makers
Front line and operational managers
DataScientists
ExecLeaders
Driving Analytic Maturity
Developing new talent pipelines through enhanced internships and
updated job descriptions
Show Complexity
Show the Math
Workflow Integration
How do we make this easier to consume?
• Enterprise Data Platform– 1,400 + database accounts created
– Loaded 12 TB of data into environment
– Hadoop environment in prod with 90 TB of data
– 99 enterprise data labs in production
– Fully integrated analytics environment
– 638 user accounts from 37 different enterprise business units
– Over 5,100 data mappings have been promoted to our PROD environment to date–Processed 294 billon rows of data
– 10,000 distinct dashboard views published
Accomplishments – Data & Technology
Dashboards
Enterprise Data Vault
Hadoop
Data Labs
External Data
Data Asset Management
Enterprise Data Views Analytic Engine
Analytics Reporting KPIs
Data Integration
Metadata Data Quality Business Glossary Master Data ManagementETL
Analytic Tools
Leveraging the enterprise platform– Revenue cycle project driving $8.5m savings over 5 years– HIM compliance reporting – discharge audits from 1% to 100% with lower costs & FTEs ($280k
savings over 5 years)
– Cancer center pilot demonstrated an 18% reduction in manual data retrieval and 250 hrs saved per year
– Captured 2,000+ variant control files for annotation and genotypic / phenotypic analysis
Advanced analytics– International patient program pricing – projecting $6m of improved collections for 2017
– Applied Monte Carlo simulations to contract negotiations – saving 80 hours per negotiation
Population Health– HCC improvement effort – achieved 83% RAF compliance through November (vs. 2016 63%)
Accomplishments – Delivering Value
Hadoop Genomics Pilot
• Loaded 996 VCF files from GeneBank(Cardiovascular Cohort)
• Matched with EMR derived phenotypic data
61 cases with mutations in colon cancer related genes
34 cases with no clinical indication of colon cancer risk
25 cases with no noted colonoscopy
Opportunity: 15 cases with increased risk and no colonoscopy
• Connecting genomic data with traditional patient data from our EMR
• Develop differentiated care paths and treatment options
• Identify populations at risk where early intervention has preventive potential
• Historic challenges regarding size and complexity of the datasets
• Ability to blend, explore and analyze the data
Leveraging Genomic Data
Applying Analytics to Drive Value
Applying Advanced Capability
• Financial Scenario Modeling:- Planning Tool for MNS/Financial Planning- Flexible scenario analysis tool capable of
producing rolling 5 year utilization and financial projections
• 6 Scenarios developed • Charge and Rate Scenario• Encounter Movement• Payer Volume Change• Institute Volume Change• Shared Savings• Narrow Network Products
Can we understand how costs are behaving over time?
Can moving averages keep us from reacting to short-term changes?
Is there an opportunity to reduce the width of the band around the mean tech direct cost?
Changing the Discussion
Variability at lower LOS tied to variability within various resource areas
• These resource areas have the widest range of cost for encounters with LOS <= 3 days
• Can this variability be reduced?
Finding Hidden Opportunity
All Encounters APR Severity = 1 APR Severity = 2
• Expectation is that lower APR Severity generally translates to lower LOS and costs. • Encounters with lower APR Severity (1 & 2) and higher costs/LOS (clusters 2 - 4) may represent Coding or
Utilization opportunities
Visualizing Data for Insight
Excludes physicians with less than 5 encounters
Exploring Variability
Total Population
5 Selected physicians
Are We Building Analytic Maturity?
Stage 1: Analytically Impaired
Stage 2:Localized Analytics
Stage 3: Analytical
Aspirations
Stage 4: Analytical
Companies
Stage 5: Analytical
Competitors
Source: 2017 IIA Maturity Survey
3.06
2017
2.17
2014
1.91 2.25 3.21
Lowest Score
Median Highest Score
Healthcare –Providers Best in Class
Parting Thoughts
• Learn from others• Comprehensive strategy – not just a technology
problem• Recognize that this is culture change• Establish your key principles & anchor to them• Drive to demonstrable value
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