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

13

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

20

CHP Population Health Management Tools

Claims

Physicians

Value Analytics TeamCare Coordinators

Explorys (Clinical Quality

Dashboards)

Epic 2012

Multiple Data Sources

InforMed(Risk Profiling)

PremierConnectEDW

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

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

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

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