Strategic Business Intelligence and
Analytics in Healthcare
WUSS 2009 – San Jose
September 1, 2009
4:00pm-4:30pm PST
SECTION: Healthcare Outcomes and Healthcare Research Outcomes
Piedmont Room
Presenter: Bharat Chitnavis

Bharat Chitnavis - Bio
Mr. Chitnavis is the Director of Consulting, Business Intelligence and Analytics for Smith
Hanley Consulting Group, a subsidiary of inVentiv Health, Inc. (NASDAQ: VTIV), the leading
provider of commercialization and complementary services to global pharmaceutical, life
sciences, biotechnology and other industries.
Mr. Chitnavis has broad business, technology, and management experience in the areas of
Business Intelligence, Analytics and Performance Management. Prior to joining Smith
Hanley, he served as Vice President at Business Analytics Partners. Previously Mr. Chitnavis
led a team with American Express Financial Advisors as they spun off Ameriprise Financial
and subsequently assumed the role of Business Intelligence Leader at Ameriprise Financial
until mid-2008. In addition, he has served as Technology Manager at American Express
Company overseeing an Online Customer Behavioral Analytics data warehouse project.
Mr. Chitnavis also spent five years with Compuware Corporation in their Professional
Services Division and has served in several technology management and consulting roles
supporting Fortune 500 companies and State Departments. His clients have included:
Motorola, ON Semiconductor, CVS Caremark (PCS), eCompleteSolutions, State Department
of Pennsylvania, Mayo Clinic (Minnesota), and the State Department of Texas.
Mr. Chitnavis holds an MBA (International Management) from Thunderbird, School of Global
Management, Glendale, Arizona and a Bachelor of Science in Engineering, BITS Pilani, India.
He resides in Phoenix, Arizona.

Abstract
This paper presents a framework for applying Business Intelligence and Analytics
in the U.S. Health Care Information Technology sector. There are numerous
initiatives being pursued by players in the health care value chain, for example,
Electronic Health Records, ePrescriptions, and TeleHealth. Through systematic
application of business intelligence and analytics technologies reversing alarming
health care trends like: (1) medical errors accounting for more deaths than breast
cancer, AIDS and motorcycle accidents; (2) in the U.S. we have the highest (and
rising) health care costs per capita in the world; and, (3) the U.S. has worst
outcomes of all industrialized nations, is possible.
In the author's estimation, the Health Care Industry is 10 to 15 years behind
business in adoption of analytical thinking. This paper highlights analytical
solutions which can help put U.S. health care players on a path to
competitiveness.

Approach
Timeline Past Present Future
National
Industry
Drilldown
Firm
Division (Case Study)

Over the years…
First surgery in 2750 BC
Developed tools - forceps, surgical needles
Life changing innovations – antibiotics, vaccines, heart stents
Watson/Crick – Described structure of DNA (1/2 century ago)
Sequencing of the Genome (a decade ago)
… Fast forward to today …
Health Care has been slow on the adoption of IT
That may be changing with the introduction of electronic records
In our country, contorversies surrounding privacy and appropriate use
persist
Source: Economist, April 18

U.S. Health Care Facts
We spend more for health care than the citizens of any other country
59% of Americans have health insurance through an employer
Cost is the primary reason for being uninsured
71% of workers in private industry have access to health insurance
through their employer
Health care spending rises with age; < 25 yrs spend $704 out-of-pocket,
> 75 yrs spend $4,210.
Health share of GDP in the United States is around 16%; almost $2
trillion and rising.
The United States is the only wealthy, industrialized nation that does
not provide universal health care.
Source: American Health; Demographics & Spending of Health Care Consumers, 2nd Edition

More Health Care Facts
Medical errors account for more deaths than breast cancer, AIDS and
motorcycle accidents
U.S. has highest Health Care costs per capita in the world
Healthcare is 10-15 yrs behind business in adoption of IT
By 2015, 15% of the population will be receiving Medicare benefits
In 2020, one in five Americans will be on Medicare
42.5 million Americans are enrolled in Medicare
By 2016, 54.5 million Americans will be enrolled
In 2025, 72.5 million Americans will be Medicare recipients

Perfect Storm?
Top MIT Researcher holding 500 patents says, “like chemistry before it,
biology is moving from a world of alchemy and ignorance to becoming a
predictable, repeatable science”
An IBM Scientist said, “it’s the transformation of biology into an
information science from a discovery science”
World wide trends
Rich world becoming older and sicker
Poor world becoming wealthier and fatter
Technology can help
Control overspending in the rich world
Manage under-provisioning in the poor world
Source: Economist, April 18

What is “Value” in Health Care?
Value is the health outcomes per dollar spent in providing services.
Outcomes are multidimensional, and include not only survival but extent of
recovery or disability, errors, complications, recovery time, recurrences,
and other aspects of the patient’s health experience.
Outcomes (and costs) can only be measured and understood effectively for
a medical condition, not for a physician group or a hospital overall. Value
(outcomes and costs) can only be reliably measured over the full cycle of
care, rather than for a discrete procedure or intervention (e.g., drugs,
hospital stays, tests).
Measuring and reporting outcomes and costs in a piecemeal fashion, as is
the practice today, only encourages poorly coordinated care and cost
shifting.

Health IT Deployment Coordination
Health Care Industry
Breakthroughs
Biosurveillance Consumer Chronic Care Electronic Health
Empowerment Records
Industry Transformation
Standards
Technology Industry
Harmonization
Coordination of Policies,
Infrastructure
Compliance
Certification Resources, and Priorities
Office of the National Coordinator
NHIN -Health IT Policy Council
-Federal Health Arch.
Privacy / Security The Community
-Workgroups
Health IT
Adoption
Consumer Value 15
Source: http://www.hhs.gov/healthit/community/background/

National Health Information Network (NHIN)
Source: HHS/National Alliance for Health Information Technology

Information Flow – Interoperability
National Health Information Network (NHIN)
Regional Health
Health Information Health Information Information Organization
Exchange (HIE) Organization (HIO) (RHIO)
The electronic movement of An organization that A health information
health-related information oversees and governs the organization that brings
among organizations exchange of health-related together health
according to nationally information among stakeholders within a
recognized standards. organizations according to defined geographic area
nationally recognized and governs health
standards. information exchange
among them for the purpose
of improving health and
care in that community.
Source: HHS/National Alliance for Health Information Technology; http://www.hhs.gov/healthit/ahic/materials/06_08/ce/muir_files/textonly/index.html

Information Flow – Digitization
Patient Records
Electronic Medical Records (EMR) Electronic Health Records (EHR) Patient Health Record (PHR)
An electronic record of health- An electronic record of health- An electronic record of health-
related information on an related information on an related information on an
individual that can be created, individual that conforms to individual that conforms to
gathered, managed, and nationally recognized nationally recognized
consulted by authorized interoperability standards and interoperability standards that
clinicians and staff within one that can be created, managed, can be drawn from multiple
health care organization. and consulted by authorized sources while being managed,
clinicians and staff across more shared, and controlled by the
than one health care individual.
organization.
Source: HHS/National Alliance for Health Information Technology

RAND HIT EMR Study
U.S. health care is a very large and inefficient
information enterprise -- it still operates mostly with
paper
U.S. healthcare system could save lives as well as
$162 billion annually with widespread use of
healthcare information technology (HIT)
RAND uncovered potential cost savings related to:
Increased efficiencies ($77 billion)
Reduced adverse drug events ($4 billion)
Improved health quality via prevention and disease management ($81 billion)

Business Intelligence - Evolution
Powerful
Analytics,
BPM
Dashboards,
Scorecards
Level of Sophistication
Customizable Customizable
Analytical Analytical
Applications Applications
Exploration Exploration Exploration
Data Data Data Data
Mining Mining Mining Mining
Multi- Multi- Multi- Multi- Multi-
dimensional dimensional dimensional dimensional dimensional
Analysis Analysis Analysis Analysis Analysis
(OLAP) (OLAP) (OLAP) (OLAP) (OLAP)
Queries, Queries, Queries, Queries, Queries, Queries,
Reports and Reports and Reports and Reports and Reports and Reports and
EIS EIS EIS EIS EIS EIS
Mid Early Mid Late Early Today
1980s 1990s 1990s 1990s 2000s

Health Care Futures
Evidence based Medicine RFID
EHR/EMR/PHR Surgery Checklists
Computerized Physician Order
Entry (CPOE)
Genomics
Medical imaging
Medical diagnostics
Operations streamlining
Patient monitoring systems
Telehealth

Thank you
If you have questions, suggestions, feedback, please contact:
Bharat Chitnavis, Director, Business Intelligence and Analytics
Email: Bharat@Chitnavis.com or Call: (602)625-1918
Smith Hanley Consulting Group | http://www.SmithHanleyConsulting.com