MOVING TO THE CLOUDMODERNIZING DATA ARCHITECTURE IN HEALTHCARE

About Perficient

Perficient is the leading digital transformation

consulting firm serving Global 2000 and enterprise

customers throughout North America.

With unparalleled information technology, management consulting,

and creative capabilities, Perficient and its Perficient Digital agency

deliver vision, execution, and value with outstanding digital

experience, business optimization, and industry solutions.

Perficient Profile

Founded in 1997

Public, NASDAQ: PRFT

2016 revenue $487 million

Major market locations:Allentown, Atlanta, Ann Arbor, Boston, Charlotte, Chicago,

Cincinnati, Columbus, Dallas, Denver, Detroit, Fairfax,

Houston, Indianapolis, Lafayette, Milwaukee, Minneapolis,

New York City, Northern California, Oxford (UK), Southern

California, St. Louis, Toronto

Global delivery centers in China and India

3,000+ colleagues

Dedicated solution practices

~95% repeat business rate

Alliance partnerships with major technology vendors

Multiple vendor/industry technology and growth awards

Speaker Introductions

James Gaston, FHIMSS MBA

Sr. Director, Maturity Models,

HIMSS Analytics

Tom Lennon

Director, Healthcare Analytics,

Perficient

Jim Kouba

Director, Healthcare Solutions,

Perficient

HIMSS Analytics

WelcomeJames E. Gaston, MBA FHIMSS

• Senior Director, Maturity Models, HIMSS Analytics

• Decade of experience in acute care hospital, research and admin

• Decade of experience of data warehousing and C&BI at Blue Cross Blue Shield Plan

• 25 years in healthcare IT, and analytics

James.Gaston@HIMSSAnalytics.org

@JamesEGaston

https://www.linkedin.com/in/jamesegaston/

Healthcare Information and Management Systems Society (HIMSS)

HIMSS is a global, cause-based, not-for-profit organization focused on better health through information

technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information

technology.HIMSS Annual Conference, Corp Membership, Thought Leadership, etc.

Marketing Arm, Healthcare IT News, Local Forums, Content Creation & Syndication, etc.

LOGIC™, CapSite, Maturity Models, Insight & Research, Essentials Briefs, etc.

Healthcare’s Most Comprehensive Market Intelligence Resources & Advisory Solutions

Health IT Market Intelligence

Health ITInsight & Research

Healthcare Organization Benchmarking

Uniquely Positioned to

Deliver Actionable Intelligence

HealthcareDeliveryOrganizations

Health ITSolutions

http://www.himssanalytics.org/research/essentials-brief-2017-cloud-study

Healthcare Cloud Insights

High level of cloud usage, but mainly limited to specific functions

Yes65%

No32%

Unsure3%

Does your organization currently utilize the cloud or cloud services?

For the purposes of this study, the cloud was

defined as a model of networked online storage

where data is stored in virtualized pools hosted

by third parties and accessed through a web

service application programming interface (API),

a cloud storage gateway or via a web-based

user interface. Use cases of the cloud in

healthcare include hosting of applications,

disaster recovery/back up and hosting of

primary data storage.

Roughly 65% of study respondents currently

utilize the cloud or cloud services within their

organization. Much of the usage leans toward

clinical application and data hosting, data

recovery and backup, and the hosting of

operational applications.

n=64

Organizations beginning to see the value of IT scalability and flexibility

Meet organizational need for a scalable, always-on solution

34%

Address disaster recovery needs

27%

Lower current IT maintenance costs

12%

Lack of internal IT staff or IT expertise

on site10%

Enhance our information/data

security7%

Other10%

Which of the following best describes the primary reason your organization adopted cloud services?

When asked for the primary reason for the

adoption of cloud services, respondents

indicated their need for scalability for an

‘always-on’ solution. With the increased focus

on hosting clinical applications addressing the

organizational need for essential, ‘always-on’

clinical solutions through the cloud seems to be

resonating across the market.

While scalability and disaster recovery are top

of mind for many organizations, it is somewhat

surprising to see only 12 percent of those that

utilize the cloud did so to lower IT costs. The

past 10 years of IT adoption has required

healthcare organizations to build up massive IT

infrastructures that are expensive to maintain. It

will be interesting to see if market sentiment

around the cloud and IT maintenance changes

significantly in the next few years, especially if

organizations shift from a capital spending to

operational spending model for some of their IT

infrastructure. n=42

Understanding the benefits and risks of the cloud still hampering market sentiment

Not currently in our budget36%

Privacy and security concerns

29%

Feel the risks currently outweigh

the benefits21%

IT operations are solely internal to

organization14%

Which of the following describes the primary reason your organization does not currently use or have plans to invest in cloud services?

While roughly 36% of respondents

that do not use the cloud and

currently have no plans to do so

indicated budgetary reasons, there

still seems to be a clear lack of

understanding around the benefits

and risks of the cloud as well as how

the cloud addresses privacy and

security.

Security is top of mind across the

healthcare industry and it will take a

combination of solutions and

diligence to constantly ward off

threats to healthcare data.

n=14

We drive the health IT market in the direction it needs to go

Improved

Patient Care

and Health IT

InsightsAnalytics Maturity Adoption Model

Continuity of Care Maturity Model

Digital Imaging Adoption Model

Outpatient EMR Adoption Model

EMR Adoption Model

Cloud Journey:

Large Health System

About the Client

• One of the largest non-profit health care integrated

delivery organizations in the United States

• Committed to improving the health and well being of the

people and communities it serves through leadership,

education, innovation, and excellence in medicine

• Serves the healthcare needs of urban, suburban and

rural communities and includes 15 hospitals and multiple

community health locations

• Just completed a strategic roadmap for a clinical

analytics architecture

• First step was to establish a solid technical and

data foundation for a unified, world-class

enterprise analytics system

• Further position cutting-edge clinical research

and state-of-the-art clinical and business

management analytics

Business Drivers

Key Goals

• Consolidate & rationalize multiple clinical repositories

• Provide an integrated technology platform that is extensible

• Use standardized enterprise class, contemporary

technology that is secure

• Reduce infrastructure costs

• Retire existing technology

Key Challenges

• Current environment fractionated

– Multiple technologies in place

– Decentralized governance

– Gaps in data availability

– Inconsistencies in data representation

• Development in parallel with enterprise rollout of new EHR

– EHR data critical to success

– SMEs first priority is to rollout

– New data structures and content not well understood

• Need to develop skills and knowledge for self-sufficiency

– New staff = steep learning curve

– New technology = extensive training & ramp-up

• Security

Solution

Implemented an EDW on the cloud to provide cost savings and

architecture flexibility. Developed a streamlined migration and

integration of data from the on-premises repositories to the cloud

platform using design patterns that are built specifically for efficient

data movement in a cloud environment.

Solution Components

– Healthcare industry data model

– Cloud database - Infrastructure as a Service (IaaS)

– Perficient Cloud Analytics Gateway

– Secure, high-speed cloud data migration service

– ETL tool for localized job execution control

– Data governance and lineage tool

– Infrastructure optimization tool

Standardized data

for BI reporting

Reduced data

integration

50%

Extensible using industry

standard technologies

Populates key

functional areas

Repeatable and Consistent

Reduces risk through utilizing

tested and proven methodology,

patterns and framework based on

best practices, across multiple

implementations

High Quality

Proven expertise and domain

knowledge of implementation

team, utilizing IBM’s UDMH and

technologies

TimelyLess time to value, while iteratively driving to further value, through reduced data integration times

Meaningful

Meets industry standard

high-value use cases to

aggregate data into data marts

for purpose-built analytics

Attainable

Easy to use framework

through collaborative,

incremental build (not a big

bang approach) and user

engagement and enablement

Scalable

Established framework allows

for incremental value to be

added, with reduced effort

Health Analytics Gateway Features and Principles

On-Premises or Cloud-Based

Key Benefits

• Provided access to historical and operational data from the

consolidated EDW for optimal reporting and comprehensive

clinical research

– Clinical practice and research teams now have a more

holistic view of the patient’s experience over the course

of treatment and clinical interactions

– Removed burden of legacy environments and disparate

repositories through migration to a consolidated, modern

cloud-based data platform

• Improved ability to onboard new systems and integrate new

data sources

• Cloud environment has reduced hardware and server costs,

increased scalability and flexibility, and speeds time to

deployment

Lessons Learned

• Establishing an enterprise-wide steering committee drove more

rapid decision making and enabled buy-in from multiple,

organizational constituents

• Consolidation of vendors and tools enabled more focus in solution

design and issue resolution

– Vendor and client partnership approach established open

dialog and enhanced the solution

– Early collaboration from engineers from all technologies

identified key solution risks and mitigation plans

• Build in time to train resources and fully adopt and internalize the

new technologies

– Expect unanticipated challenges and plan for them upfront

Cloud Journey:

Academic Health Center

About the Client

• One of the largest academic health centers in the

United States

• Combines interdisciplinary teaching, research and

clinical facilities allowing unique opportunity to:

– Prepare the region’s future health care

professionals

– Provide the best available health care to its

patients

– Maintain its position as a leader in life sciences

research

Provide the data and analytics platform and program to power the

organization’s journey to translational and personalized medicine in

support of leading edge value-based care delivery models.

Begin to leverage the wealth of information the collective organization

has across the full population of pediatric and adult patients to improve

care in the short term and provide game changing innovation over the

long term.

Guiding Principles

– Foster Innovation

– Enable Agility

– Favor Intuitive Visualizations

– Learn Fast

Vision

Key Challenges

• Complex organization

– Involved multiple autonomous organizations

– Decentralized funding and governance

– Disparate execution paradigms

• Complex architecture, infrastructure, and operations

– Disparate technology standards and skills

– IT staffs were already stretched thin

– Traditional data consumers now becoming data providers

• Must scale to handle large amounts of data

– Genomics data

– Clinical data

– Claims data

– Environmental data

• Security concerns all around

Key Benefits

• Integrated 6 million adult and pediatric patient records

• Reduced operating cost by 50% > Re-allocate into

other areas

• Able to deliver a broader and richer set of tools and

technologies to data scientists and clinical decision

makers; decreasing prep time by 50% so improving

patient care can be the primary focus.

• Rapid, iterative development of visually oriented

analytics

- Disease surveillance

- Diagnosis prevalence

Initially implemented

– Structured EDW

– Enterprise ETL and RDBMS architecture

– Traditional BI reporting platform

Solution

Eventual solution

– Cloud based, fully managed EDW

– Leverages super-fast SQL query engine

– Local front-end visualization tool

Results

Results

Results

Lessons Learned

• In-house infrastructure provisioning took too long

and stifled innovation

• The pivot to the cloud enabled significant reduction in

IT capital investment

• Using a common external provider eases

organizational anxiety

• Shifts security risks away from an already stretched

internal IT staff

• Analytic insight can be delivered in weeks as opposed

to quarters

• Improved alignment with guiding principles: innovation,

agility, intuitive visualization, and learning fast

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