Going Beyond the EMR for Data-driven Insights in Healthcare


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Join Dr. Marcie Stoshak-Chavez, MD, FACEP, Director of Healthcare Strategic Advisory Services at Perficient and Mr. J.D. Whitlock, Director of Clinical & Business Intelligence at Catholic Health Partners to learn how analytics is being used to measure and monitor performance and provide service-line directors and financial administrators with reporting and analysis that enhances clinical care processes and business operations.

Learn how clinicians and administrators armed with the data-driven insights from the EMR and beyond can:

Derive meaningful insights for care delivery by analyzing clinical, financial and operational data
Collaborate more effectively and improve quality of care by securely sharing insights among providers
Meaningfully measure and understand performance across key Federally mandated measures and take prescribed action
Stay on top of shifts in regulatory policy that impact reimbursements and quality requirements

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  • SPEAKER NOTES: Industry challenges and opportunitiesCost of treating chronic diseasesShortages of “experienced” IT and clinical resourcesManaging the shift in healthcare fro Inpatient centric to a more affordable community based precision care modelRequires new approaches for identifying patients, providers the EMPI centric functions as well as a solid foundation for any MDM strategy (if polling question floats, then here is where I will insert a comment about a single vendor is not the total solution for addressing the EMPI or MDM Issues)
  • These questions address Triple Aim initiatives including improving population health, reducing costs and improving the patient experience.
  • SPEAKER NOTES: Where MDM impacts HealthcareSegue way from Insights to improve business with Big data to where MDM impacts HCPlaces where data existsOperational impactsBusiness of providing high quality healthcare with cost accountability
  • SPEAKER NOTES:Before you can jump into Big Data and taking advantage of the analytics you can gain from Big Data, you need to understand your organization’s data at the core level. Your ‘Master Data.’ This slide gives some examples of what Master Data is. Master Data is really the core information in an organization that is used to make critical decisions and it is what a lot of business processes are designed around.The problem many organizations are facing, is that this high value data (customer data, product data, patient data) – and relationships in the data are the most central to running business, but the data is often very poor quality – inaccurate, incomplete, missing or duplicated – and thus the business processes that depend on those data can be inefficient, ineffective, and costly or increase business risk. That is important to remember when you are talking to customers about Master Data. Since business processes are designed around their data, you need to engage business people with that. The key isn’t to talk about speeds and feeds you can load data with. The key is to engage business people in a discussion about the effectiveness of key processes and explore that with your prospects. And this applies to all industries.Healthcare – patient registration is a classic example, especially across multiple clinics, hospitals, labs. But we really would like to stress that the EMPI is really just one domain that can be implemented. Outside of the EMPI, there are Provider, Location, and Facility domains that the InfoSphere product can also support. MDM in healthcare is expanding, and the InfoSphere product can support it!
  • Going Beyond the EMR for Data-driven Insights in Healthcare

    1. 1. Going Beyond the EMR for Data-Driven Insights in Healthcare August 7, 2013
    2. 2. AGENDA IBM • 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-MD Strategic Healthcare Advisor Sri Srinivasan VP Healthcare Information Management JD Whitlock Director of Clinical & Business Intelligence http://www.linkedin.com/in/jdwhitlock Marcie.Stoshak-ChavezMD@perficient.com
    3. 3. Healthcare Challenges
    4. 4. 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
    5. 5. 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?
    6. 6. Transforming Data into Healthcare Insights Population Management We identified & recommended vaccination for patients at risk for meningitis within hours of the outbreak. Intervention The patient’s BP and sugar levels spiked, I need to communicate with her and direct her to treatment. Patient Engagement My reports show a decline in satisfaction based on sentiments expressed on our member portals and social networking sites. Care Management We reduced readmission rates by assigning a care manager to heart patients with no emergency contact on file. Health Economics I 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, E MR Notes Customer Sentiment Devices
    7. 7. 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?
    8. 8. Analytics at the Point of Care
    9. 9. 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
    10. 10. The Rapidly Changing Healthcare Landscape Commercial r e g u l a t o r y Operational Personalized Healthcare Value Based Purchasing Bundled Payments Meaningful Use Mobile Health T r i p l e A i m
    11. 11. 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 Medicine Predictive Analytics
    12. 12. Clinical Analytics for Providers
    13. 13. 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
    14. 14. 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
    15. 15. ID At-Risk Patients and Adjust Care with Insight into Clinical and Factors EMR Doctor’s notes, dictation Mobile Health Email, Apps Insurance Claims, DRG, eligib ility Events Weather, local events, disease outbreaks Monitors/ Sensors At 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 New Capability Outcomes Improved health outcomes Prescriptive care Reduced costs and readmissions Communities Patients like me Retailers Groceries, prescriptions, OTC drugs Research Genomics, environm ental
    16. 16. Trends for Analytics in Healthcare?
    17. 17. Analytics at Work in Healthcare
    18. 18. • 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
    19. 19. 20 CHP Population Health Management Tools Claims Physicians Value Analytics Team Care Coordinators Explorys (Clinical Quality Dashboards) Epic 2012 Multiple Data Sources InforMed (Risk Profiling) PremierConnect EDW
    20. 20. 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
    21. 21. 22 PremierConnect Data Model Powered by: “Big Data” Data Warehouse Appliance PremierConnect CHP Data Sources … Stored in … Viewable via … Claims Quality Clinical Operations Revenue Supply Chain Enterprise Business Intelligence Suite Powered by: Dashboards “Drillable” Interactive Reports “Self-Service” BI Tools Ad-hoc Reports
    22. 22. 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
    23. 23. 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-MD Strategic Healthcare Advisor Sri Srinivasan VP Healthcare Information Management JD Whitlock Director of Clinical & Business Intelligence http://www.linkedin.com/in/jdwhitlock Marcie.Stoshak-ChavezMD@perficient.com
    24. 24. Thank you for your time and attention today. Please visit us at Perficient.com