Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Never mind the data, show me the outcome

1,812 views

Published on

Presented by Dr Penelope Jane O'Hara, Managing Director, Accenture Analytics, Accenture at ISS Seminar: Outcome-based Analytics on 23 August 2013

Published in: Technology, Business
  • Be the first to comment

  • Be the first to like this

Never mind the data, show me the outcome

  1. 1. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture.Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. Insight Driven Health Never mind the data – show me the outcomes Dr Penny O’Hara August 2013
  2. 2. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. The cost of healthcare is being driven globally by an aging, less fit population, affected by chronic and more complex disease states. 2 Lifestyle Diseases • Osteoporosis • Stroke • Depresssion • Obesity • Chronic Kidney Disease • Atherosclerosis • Chronic liver disease • Cirrhosis • Type 2 diabetes Aging Populations Increased Incidence of Chronic Disease Decreasing Fitness of Populations Increasing Patient Complexity Increasing Costs
  3. 3. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. Limited /Silo’ed Data & Analytics Current Situation Niche Analytic Models Cost + Clinical Triggers Mostly Claims Based Data Short-Term Patient Focus Complex Benefit Plans Contentious Outcomes Repeatable ROI Proof Economic Incentive Mismatch Health Behavior Change Measurement Traditionalism & Inertia Road Blocks Target State EHR/Integrated Analytics Integrated Impact & ROI Prediction Behavioral Triggers Integrated Claims & Clinical Data Longitudinal Patient Focus (3–5 year) Consumer Optimized with Incentives Evidence Base Medicine (EBM/CER) Analytic insights are needed help overcome inertia and drive meaningful change 3
  4. 4. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. Readmission Prediction, Safety Risk Actuarial, Financial Forecasts Genomics; Fraud & Abuse Treatment Option Evaluation, Resource Utilization Predictive Analytics (the “so what”…and the “now what”) Future orientated and source of competitive advantage Biosurveillance, Adverse Drug Warning Disease Management, Daily staffing Clinical Analysis, Top Performers Patient Satisfaction, Quality Metrics Descriptive Analytics (the “what”) “Rearview mirror” – provides foundation and insight Sources: Davenport, Thomas H and Jeanne G. Harris, Competing on Analytics; The New Science of Winning, Harvard Business School Publishing Corporation 2007. 4 The power of shifting healthcare analytics from describing what happened to creating accurate predictions will not only deliver new insights but improve patient outcomes
  5. 5. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. Improvedpatientoutcomes Optimization Predictive Modeling Forecasting/ extrapolation Statistical analysis Alerts Query/drill down Ad hoc reports Standard Reports “What’s the best that can happen?” “What will happen next?” “What if these trends continue?” “Why is this happening?” “What actions are needed?” “What exactly is the problem?” “How many, how often, where?” “What happened?” Descriptive Analytics (the “what”) Sophistication of Intelligence Predictive Analytics (the “so what”) …..and cover both descriptive as well as predictive analytics to drive improved patient outcomes
  6. 6. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. The data needed to empower robust health analytics is distributed throughout the ecosystem Patients PMP Suppliers Public & Private Payers Providers Supply Chain Data Industry Intelligence Data Benchmarking Data Market Research Data Treatment & Rx Claims & Payment Data Clinical Outcomes Data Leading Practices Data Program Effectiveness Data Population/ Disease Data Drug Safety Data Drug Efficacy Data Medical Device Efficacy Clinical Trial Data Leading Practices Data Market Research Data Prescription Data Lab Data Radiological Data Product Utilization Data Treatment Protocol Data Admissions Data Physician Profile Data Benchmarking Data EBM Data Clinical Research Data Epidemiological Data Patient Profile Data Market Research Data Genomics Data Clinical Trial Data Other basic research Optimize Revenue Control Cost 6
  7. 7. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. Statistical models trained on a broad set of profile parameters for each individual allow us to derive per- patient risk scores Very high High – Medium 0 20 80 100 Claims & Clinical data history Patient profiles Predictive Models Model-specific risk-score Low Member Data Inpatient/Hospital data Outpatient/GP Data Data on care procedures Rx/Pharma data Others (e.g. rehab, ...) Datacleansing&Aggregation 250-1000 predictive parameters form per-patient profile Hospital admission risk (LOH) Financial risk Disease specific risks: Diabetes, CHF/CAD, COPD/ Asthma, etc.  Socio-demographic  Chronic conditions & ICD-groups  Medication  Inpatient/Outpatient visits  Costs  Med. Procedures  Coaching Feedback Identified target population for intervention 7
  8. 8. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. In La Fe, Valencia, 17% of patients drive around 60% of the total health expenditure. A Health Management system reduced hospital contacts considerably Proactive patient care: In La Fe, Spain, a Health Management program helped to reduce the strain on health system from patients with chronic diseases Case Management High complexity patients Case Management / Disease Management High risk patients Selt-treatment Patients with moderate risk Healthy Living & Prevention Patients with low risk 7% Hospital stays (days) 8% Hospital Admissions 33% Visits to Emergency 7% Hospital stays (days) 24% Hospital Admissions 27% Visits to Emergency 64% Hospital stays (days) 53% Hospital Admissions 16% Visits to Emergency 22.5% Hospital stays (days) 15% Hospital Admissions 24% Visits to Emergency 8 La Fe Activity Results
  9. 9. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. A large proportion of the increased expenditure is in the inpatient setting Source: Basque Country Health Department 2009 9 1.0% 3.5% 31.4% 23.0% 13,6% 27,4% 35% 25% 15% 12% 8% 5% 23.383 80.186 720.644 527.441 311.862 628.303 6,3% 12,4% 27% 36% 35% 2,5%6,7%7,6% 4%11,7%11,4% 20,6% 17,7% 4% 30,7% 19% 20,6% 7% 17,5% 24% 27,5% 11% 2,6%
  10. 10. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. Something had to change – we developed an approach to identify patients AND to operationally improve outcomes 10
  11. 11. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. We predicted which patients were approaching their ‘Intense Years’ of health resource consumption (*) Source: Roger Halliday, Department of Health for England Number of Hospital Days Before Integrated Case Management After Integrated Case Management -4 Years -3 Years -2 Years -1 Year Intense Year +1 Year +2 Years +3 Years +4 Years +5 Years 11
  12. 12. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. The Case Management Model is a capability that coordinates health services provisioning and helps patients navigate the system 12
  13. 13. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. Australia: Convergence of PCEHR & mHealth 13 The National eHealth Record System and Mobile Gateway (e.g. consumer-entered medications via an NPS mobile application) eHealth Record Functions 8 Copyright © 2011 Accenture All Rights Reserved. 14 New Documents sent to the PCEHR since the Shared Health Summary Medication Summary 08-Nov-2008ConsumerEntered Medication Case Study – National Prescribing Service: • Consumer based application to track medicines (brand, strength ,dosage) • Keep photos of medicines, packaging and dispense labels • Track schedule of medicines taken /not taken • Set medicine alerts and reminders • Track changes to medicines using a change log Value Proposition: • Identification & authentication • Ability to view and upload medicines directly to their eHealth record using a mobile device. • A more complete picture of current medications– hence better care.
  14. 14. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. Whole Community Health: The North West London Integrated Care Model Local Multi-Disciplinary Groups… …working in a Multi-Disciplinary System Patient registry Risk stratification Clinical protocols & care packages Case conference Performance review    Care plans Care delivery Improve the quality of patient care for patients with diabetes and the elderly Group Mental Health Specialist Sub-Group Social care Specialist Acute Specialist Aligned Incentives through an innovative financial model Information sharing to access and analyse data in a timely fashion Joint Governance through IMB with a shared performance and evaluation framework Organisation and culture development Patient, user and carer engagement and involvement Community matron Practice Social care worker District nurse Community Mental Health Practice nurse GP 1 2 3 4 5 6 7 Source: :NHS North West London ICP business-case-amended-final
  15. 15. Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. Thank You

×