Health Care EA Presentation

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A case study for a health care provider for a strategic plan on enterprise architecture.

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Health Care EA Presentation

  1. 1. HCGlobalCase Study<br />…an architectural approach for business growth and patient well being.<br />Bill Wimsatt, Enterprise Architect<br />
  2. 2. State of the Healthcare Industry<br />Cost of Healthcare is increasing annually - US spends ~17% of GDP<br />Aging population placing intense pressure on system<br />Extremely mobile world population sets stage for pandemic possibilities<br />Increasing regulation<br />
  3. 3. Healthcare Environment Struggles<br />Incentive System<br />Vs <br />Payment Systems<br />Community Practice<br />Vs <br />Hospital<br />
  4. 4. HCGlobalBusiness Goals<br />Modernize for growth and for intra/inter-organizational interoperability<br />Develop a care model that is patient-centric<br />Become premier Cancer diagnostic and treatment center<br />Increase specializations through mergers<br />
  5. 5. HCGlobalIT Goals<br />IT Modernization with SOA<br />Improve customer experience with PHR<br />Create world class data intelligence and reporting<br />Standardize/Improve exchanges with CCD HL7<br />IT Plan for business growth<br />Comply with HIPPA<br />Physician portal<br />
  6. 6. Leading edge capability<br />Aligned to some best practices<br />No capability<br />Aligned to most best practices<br />First generation effort<br />Assess – Plan - Execute<br />HCGlobalmaylargely achieve the targeted future state by the end of 2013 and must focus on driving business benefits from the capabilities. Core Data capabilities are required to enable key business capabilities. <br />Data Access<br />Service Delivery Model<br />PMRI<br />Infr. Simp.<br />
  7. 7. HCGlobalManaged Care<br />Harmonize Application Infrastructure<br />Exploit Internet & Web 2.0<br />MDM & EDW/BI<br /><ul><li>Improve patient care and reduce medical risks
  8. 8. Improve efficiencyby reducing redundant care activities
  9. 9. Support consumer directed health information management
  10. 10. Comply with regulations
  11. 11. Enhance operational productivity and efficiency</li></ul>ROI<br />
  12. 12. HCGlobalManaged Care<br />Harmonize Application Infrastructure<br />Exploit Internet & Web 2.0<br />MDM & EDW/BI<br /><ul><li>Improve patient care and reduce medical risks
  13. 13. Improve efficiencyby reducing redundant care activities
  14. 14. Support consumer directed health information management
  15. 15. Comply with regulations
  16. 16. Enhance operational productivity and efficiency</li></ul>ROI<br />
  17. 17. Interoperability Framework<br />Contracts<br />Sales<br />Service<br />Marketing<br />Contracts<br />Sales<br />Service<br />Healthcare Financial Apps<br />Healthcare Clinical Apps<br />Healthcare Administrative Apps<br />Order Management<br />Supply Chain<br />Internet Procurement<br />Financials<br />Human Resources<br />Projects<br />Order Management<br />Supply Chain<br />Internet Procurement<br />Financials<br />Human Resources<br />Projects<br />Oracle E-Business Platform<br />Oracle E-Business Platform<br />Harmonized Platform<br />Enterprise Integration<br />Common Language<br />Future Investment<br />
  18. 18. Service Bus<br />Health Information Exchange<br />Electronic <br />Health Record<br />Personal<br />Health Record<br />Pharmacy<br />Laboratory<br />Viewer/<br />Portal<br />Hospital /<br />Clinic<br />Radiology /<br />Imaging<br />Public Health<br />2.84<br />SERVICE DELIVERY<br />DATA ACCESS APPLICATIONS<br />Public Health Provider<br />Patient<br />Lab Clinician<br />Physician/Nurse<br />Radiologist<br />Pharmacist<br />POINT OF SERVICE<br />APPLICATIONS<br />Health Information Exchange<br />l<br />ICD-10<br />HIPAA5010<br />Analysis Services<br /><ul><li> Reporting
  19. 19. Analytics
  20. 20. Data Warehouse</li></ul>Patient Information Services<br /><ul><li> Record Location & Management
  21. 21. Entity Identification
  22. 22. Distributed Data Access (CRUD)
  23. 23. Indexing
  24. 24. Replication
  25. 25. Workflow & Business Rules</li></ul>Terminology Service<br />Infrastructure Services<br /><ul><li> Security & Privacy
  26. 26. Provider/Patient Registries
  27. 27. Communications
  28. 28. Medical device integration</li></ul>Public Health Services<br /><ul><li> Outbreak Management
  29. 29. Detection & Notification
  30. 30. Visualization</li></ul>Interoperability Services<br /><ul><li> Data Interchange
  31. 31. Legacy System Adapters
  32. 32. Simulator</li></ul>Service Library<br />Common Services<br />
  33. 33. Interoperability<br />Providers<br />Patients<br />Administrators<br />Researchers<br />NewApplications<br />Point of CareAppliances<br />Internet<br />HL7 IFEngine<br />BusinessIntelligence<br />DataMining<br />DataAccess<br />Registries<br />Data Warehouse<br />Healthcare Transaction Base<br />ClinicalDataRepository<br />Messaging Services<br />Person Services<br />Terminology Management<br />Security and Auditing<br />ExternalWarehouse<br />Clinical Trial<br />System (OC)<br />Clinical<br />Information<br />Systems<br />Laboratory<br />Information<br />Systems<br />
  34. 34. HCGlobalManaged Care<br />Harmonize Application Infrastructure<br />Exploit Internet & Web 2.0<br />MDM & EDW/BI<br /><ul><li>Improve patient care and reduce medical risks
  35. 35. Improve efficiencyby reducing redundant care activities
  36. 36. Support consumer directed health information management
  37. 37. Comply with regulations
  38. 38. Enhance operational productivity and efficiency</li></ul>ROI<br />
  39. 39. Blueprint Summary – Core Data Objectives and Scope<br />The goal is to build baseline competencies and functionality that will positionHCGlobalto develop enhanced capabilities.<br />PMICore Data<br />
  40. 40. Patients vs Patience<br />Do we know the patient?<br />What ‘view’ of the patient are you allowed to see?<br />Is this the correct patient?<br />What other information do we know about the patient?<br />What can we do with this patient information?<br />How do we get to theother informationabout the patient?<br />How do we keep the patient information in-sync?<br />Patient ID: The ‘Foundation’ of Interoperability<br />
  41. 41. Interoperability Starts with Patient Identification<br />P&C policyholder data<br />Debbie Dozier -Becker<br />9146 E VIA DEL SOL<br />NETOWN, CA 45883<br />Local identifier<br />12/19/61 – 727<br />Trusted systemof record<br />Claims and billing data<br />Debbie Becker<br />9146 VIA DEL SOL<br />NETOWN, CA 45883<br />480-473-3486<br />5555-55-1234<br />Debbie Becker<br />NULL<br />5555-55-1234<br />Local identifier<br />DBECKER1234<br />Debbie Dozier<br />NEED INFO<br />5555-55-1234<br />Local identifier<br />12345ABCDE<br />1: 12/19/61 – 727<br />2: DBECKER1234<br />3: 12345ABCDE<br />4: HOSPABC98765<br />5: BECKER4807343486<br />Commercial policyholder data<br />Debbie Becker<br />9146 E VILLA DEL SOL<br />NETOWN, CA 45885<br />Local identifier<br />HOSPABC98765<br />Web self service data<br />Debbie Becker<br />9146 VIA DEL SOL<br />480-473-3486<br />Local identifier<br />BECKER4804733486<br />Patient Master<br />Derive & standardize data for efficiency<br />Find all potential matches<br />Use sophisticated probabilistic statistics to compare many attributes & score records<br />
  42. 42. HCGlobalData Warehouse<br /><ul><li>Data Throughput is no longer 30-60 day window
  43. 43. Transaction Time Window (RT/NRT)
  44. 44. Cost of Money
  45. 45. Need to bill at time of discharge
  46. 46. Comprehensive Data Environment
  47. 47. Care Team – Medical Records – Finance
  48. 48. Real Time ICD-10 coding
  49. 49. Payment method (Insurance Plan) may dictate care path</li></li></ul><li>HCGlobalManaged Care<br />Harmonize Application Infrastructure<br />Exploit Internet & Web 2.0<br />MDM & EDW/BI<br /><ul><li>Improve patient care and reduce medical risks
  50. 50. Improve efficiencyby reducing redundant care activities
  51. 51. Support consumer directed health information management
  52. 52. Comply with regulations
  53. 53. Enhance operational productivity and efficiency</li></ul>ROI<br />
  54. 54. Healthcare 2.0 Architecture<br />18<br />Provider, Payer, Purchaser Applications<br />Collaborate<br />Communicate<br />Devices<br />
  55. 55. Platform for Innovation<br />Patient Care<br />Treatment<br />P4P<br />Research<br />Profitability/Efficiency<br />Innovation<br />Innovation<br />Time in Market<br />"If automakers were paid by the bolt, cars would be brimming with bolts," Harvard Medical School professor Jeff Levin-Scherz, April 2010 Harvard Business Review<br />Advanced Data Research with 11g RDF<br />Collaboration<br />Structured & Unstructured Content Access<br />
  56. 56. Moving Beyond Standard BI & Statiscal Analysis<br />Patient “has manifestation” spinal injury<br />Procedure “has associated anatomic” cell tissue damage<br />Procedure “decreases” recovery time<br />Extreme lateral interbody infusion (XLIF)<br />Minimizes tissue damage<br />Decreases recovery time<br />Std. Insurers “experimental procedure” – accepted use<br />Nuvasive “provides” XLIF products<br />University Research<br />Insurance Industry Datastore<br />Medical Technology Database<br />
  57. 57. HCGlobal<br />Harmonize Application Infrastructure<br />Exploit Internet & Web 2.0<br />MDM & EDW/BI<br /><ul><li>Improve patient care and reduce medical risks
  58. 58. Improve efficiencyby reducing redundant care activities
  59. 59. Support consumer directed health information management
  60. 60. Comply with regulations
  61. 61. Enhance operational productivity and efficiency</li></ul>ROI<br />
  62. 62. Systemic Approach to Business Value<br />Financial<br />Hospital Bed Days<br />Headcount productivity<br />Colon Cancer Screening<br />Capital equipment cost avoidance<br />Costs per ED Visit<br />Cost per Prescription<br />Generic Prescribing<br />Non Financial<br />Customer satisfaction<br />Intellectual property risk reduction<br />Product development agility<br />Regulatory compliance<br />
  63. 63. Structure for Maintaining & Monitoring Portfolio<br />18 %<br />50 %<br />27 %<br />
  64. 64. Communication<br />
  65. 65. Thank You<br />Bill Wimsatt<br />Enterprise Architect<br />waw@1783.com<br />

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