More Related Content More from Health Catalyst (20) A Health Catalyst Overview: Learn How A Data First Strategy Can Drive Increased Outcomes Improvements1. A Health Catalyst Overview:
Learn How A Data First Strategy Can
Drive Increased Outcomes Improvements
Greg Sill - Director of Solutions
Consulting, Health Catalyst
Jared Crapo - SVP of Corporate
Integration, Health Catalyst
2. © 2018
Health
Catalyst
A Population Health Story….
“Our health system has seen an
increase in the number of cancer
related surgeries and inpatient
admissions over the last year.
Traditionally, we have used our EMR
and claim data to analyze the care
for the patient, however, it is often
incomplete and not timely. How can
we collaborate and share information
to identify the at-risk patients and
increase the number and types of
pre-cancer screenings?”
2
5. © 2018
Health
Catalyst
Poll Question
5
What is the biggest barrier for your organization to provide more data
driven insights to clinicians?
1. Data sharing agreements — 25%
2. Technical hurdles — 32%
3. Too many competing priorities — 34%
4. We do this well — 9%
6. © 2018
Health
Catalyst
We believe when you elevate data as a
strategic asset
it enables significantly
better decision-making
and promotes
massive improvement
in health, cost, and experience outcomes.
6
7. © 2018
Health
Catalyst
Definition of Data Governance
7
Data governance refers to the plans, processes, and
principles that are proactively applied to ensure that a
community’s data is managed in such a way to maximize
the value of that data to that community.
9. © 2018
Health
Catalyst
Act
Capture
Integrate
Grant
Access
Deliver
Insight
Data
Utilization
Data Utilization
• Lack of contextual training
causes incorrect interpretation
/ conclusions
• Fear of loss of privacy
prevents appropriate
utilization for improvement
• Culture of data fiefdoms –
that’s “our” data
Data Quality
• Data capture is incomplete,
delayed or inaccurate
• Consolidating to a single EMR is
slow, expensive, and may not be
feasible
• Integrating data into fixed
models from different sources is
error prone
Data
Quality
Data
Literacy
Data Literacy
• Lack of data skills, knowledge
and attitudes
• Wrong mix of resources (e.g.
too many report writers not
enough analytic engineers)
• Lack of interoperability
Challenges
9
11. © 2018
Health
Catalyst
Data Governance Framework: The Four E’s
11
Act
Capture
Integrate
Grant
Access
Deliver
Insight
1. Elevate
Elevate the status of data
as a strategic asset of
your organization
What would make your
data a distinguishing
asset of your clinical and
business objectives?
2. Establish
Build your data
governance org
structure
Who are the best
individuals and
how should you
organize to realize
the vision?
3. Execute
Identify, prioritize and execute on
data governance improvements in
the data lifecycle
How do you ensure all are
equipped with data for better
decision-making – from the bedside
to the boardroom?
4. Extend
How do you
ensure your data
investments are
built to last?
Expand and extend
to create a data
centric culture
13. © 2018
Health
Catalyst
• Pick a “pool table” that is already a “trouble” for the organization
– Significant financial pressure or budget cuts
– Desire to increase standing in national rankings
– Poor Benchmark Score
• Show how more effectively managing the data lifecycle through better data
governance can benefit that “pool table” trouble
• Eventually show a better way to achieve the strategic mission of the organization
through data AND improvement governance
Elevate: Engagement
13
14. © 2018
Health
Catalyst
• After your people, your data is your organization’s most strategic asset
• How can you help your organization realize this truth?
1. Up to 1/3 of all costs in your organization are wasteful
2. Key Process Analysis – identify opportunities hidden within your
data
3. Pilot projects in key areas can help support adoption of a more
data driven strategy
Elevate Data as a Strategic Asset
14
15. © 2018
Health
Catalyst
Establish
• Data stewards are the owners of clinical and operational processes which
produce data (or lack thereof, or bad data) as a result of the current process.
• Have you identified your key processes?
• Which cost the most? How much less could they cost?
• Which processes currently produce the right data at the right time to effectively
manage them?
• How well is the clinical, financial, and experience data integrated about a
process?
“Organize everything around front-line value-added work processes.”
W. Edwards Deming
15
16. © 2018
Health
Catalyst
Value Producing Healthcare Delivery Processes
16
Comm
Care
Care
Process
Families
e.g.,
Endo-
crine
Disorders
CV
Care
Process
Families
e.g.,
Heart
Failure
W&C
Care
Process
Families
e.g.,
Pregnancy
GI
Care
Process
Families
e.g.,
Liver
Diseases
Resp-
iratory
Care
Process
Families
e.g.,
Chronic
Lwr Resp
Disorders
Neuro
Sciences
Care
Process
Families
e.g.,
Dorsop-
athies
Musculo-
skeletal
Care
Process
Families
e.g.,
Arthrop-
athies
Surgery
Care
Process
Families
e.g.,
Trauma
General
Med
Care
Process
Families
e.g.,
Infectious
Disease
Oncology
Care
Process
Families
e.g.,
Neo-
plasms
Mental
Health
Care
Process
Families
e.g.,
Mood
Disorders
Care Unit
Support
Services
Laboratory Services (anatomic path, clinical path, blood bank)
Clinic Services (primary care, med sub-specialty, chronic disease care mgmt, practice mgmt)
Acute Medical Services (ECU, ICU, CCU, NICU, PICU, med-surg)
Invasive Services (IP/OP surg, cath lab, IR, GI, L&D, rad onc, cysto, ECMO, CS)
Pharmacy Services (Rx pharmaceuticals, TPN, infusion therapy, drugs sold to patients)
Imaging Services (Dx radiology, US, nuclear, CT, MRI, Dx mammo, waveform imaging)
Financial Services (capital/leasing, rev cycle, med records, general accounting)
Rehabilitation Services (PT, occupational Tx, Speech Tx, cardiac rehab)
Clinical Supply Chain Services (equipment, supplies sold to pts, DME)
Hotel Services (plant, scheduling, registration, security, laundry, non-pt food, parking, grounds)
Overhead Services (hosp admin, clinical admin, IT/phones, HR, edu, risk mgmt, PR, research)
Ancillary
Support
Services
Non-
Clinical
Support
Services
Respiratory Services (vent mgmt, O2 Tx, chest PT, inhaled meds, inc spiro, hyperbaric O2 )
Patient Experience Services (nurses, doctors, environment, experiences, discharge)
Sub-acute/Post-acute Services (sub-acute, ∂ hosp, SNF, IRF, home health, hospice, LTC)
Research Services (design, cohort, IRB, grant app, grant mgmt, analysis, publication )
19. © 2018
Health
Catalyst
Data Governance Framework: The Four E’s
19
Act
Capture
Integrate
Grant
Access
Deliver
Insight
1. Elevate
Elevate the status of data
as a strategic asset of
your organization
What would make your
data a distinguishing
asset of your clinical and
business objectives?
2. Establish
Build your data
governance org
structure
Who are the best
individuals and
how should you
organize to realize
the vision?
3. Execute
Identify, prioritize and execute on
data governance improvements in
the data lifecycle
How do you ensure all are
equipped with data for better
decision-making – from the bedside
to the boardroom?
4. Extend
How do you
ensure your data
investments are
built to last?
Expand and extend
to create a data
centric culture
20. © 2018
Health
Catalyst
Execute: Capture
20
8%
Only 8% of data required
for the population health
and precision medicine
strategy resides in
today’s EMR/EHR.
Source: Alberta Innovates Health Solutions, Secondary
Data Use Project, March 2016
http://www.aihealthsolutions.ca/initiatives-partnerships/secondary-
use-data-project/presentations/
A
C
IG
D
21. © 2018
Health
Catalyst
Just Beginning: Digitization of Health
21
The Growing Ecosystem of Human Health Data
Healthcare
Encounter
Data
7x24
Biometric
Data
Consumer
Data
Genomic
&
Familial
Data
Social
Data
Outcomes
Data
A
C
IG
D
22. © 2018
Health
Catalyst
Imagine the Richness of the Picture
22 22
Healthcare
Encounter
Data
7x24
Biometric
Data
Consumer
Data
Genomic
&
Familial
Data
Social
Data
Outcomes
Data
What is your 1, 3, and 5 year strategic data acquisition plan?
The Growing Ecosystem of Human Health Data
A
C
IG
D
23. © 2018
Health
Catalyst
Execute: Integrate
“Definition: The health data convergence hub is the orchestration platform
that brings together data from across the consumer/citizen/patient health and
wellness continuum and prepares the data for delivery to downstream
consumption platforms, applications, analytics and "things." It automates the
ingestion of data — both structured and unstructured — from all identified
and permissioned sources; provides tracking and traceability; and manages
identity, compliance and security. It may process algorithms and deliver the
output to the correct modality.”
Laura Craft, Vi Shaffer, “Gartner: Hype Cycle for Healthcare Providers, 2017”
Gartner: Health Data Convergence Hub
23
A
C
IG
D
24. © 2018
Health
Catalyst
Expanding the Patient View
24
Historical and Analytical
Insights
Data in the
Moment
• Chief Complaint
• Observations
• Labs
• Diagnosis
• Procedures
• Medications
• Clinical History
• “Patients like me”
• Risk Prediction Models
• Cost Estimates
• Gaps in Care
• Patient Registries
A
C
IG
D
25. © 2018
Health
Catalyst
Data Operating System (DOS™)
25
Right Time
From event to
insight quickly
Operational
analytics
Real-time data
pipeline, FHIR
Right Insights
Predictive
Prescriptive
Quality &
performance
metrics
SQL Algorithms,
machine
learning models
Right Place
At point of care
In the workflow
Unsupervised
outcomes
EMR closed
loop, Excel,
Analytics portal
Right Delivery
Analytic
accelerators
Software modules
Mobile
Create-your-own
apps
Open APIs,
app platform,
fabric services
Right Data
Multiple
integrated data
sources
External data
sources
Socioeconomic,
personal device
data, Big Data
A
C
IG
D
26. © 2018
Health
Catalyst
Data Access Polarity
Data Protection Data Sharing
26
Symptoms of Extreme
• Legitimate data request denied
• IT approves data access requests
• 2 month process to get access
Symptoms of Extreme
• Data breach
• Inappropriate data useEvidence of Balance
Streamlined approvals
Consistent auditing
Appropriate use of data
A
C
IG
D
27. © 2018
Health
Catalyst
Execute: Deliver Insight and Act
We believe if you get the
Right Information, to the
Right Audience, at the
Right Granularity, at the
Right Time, in the
Right Visualization/Modality
you produce the Right Action,
to improve outcomes.
27
A
C
IG
D
28. © 2018
Health
Catalyst
Data Governance Framework: The Four E’s
28
Act
Capture
Integrate
Grant
Access
Deliver
Insight
1. Elevate
Elevate the status of data
as a strategic asset of
your organization
What would make your
data a distinguishing
asset of your clinical and
business objectives?
2. Establish
Build your data
governance org
structure
Who are the best
individuals and
how should you
organize to realize
the vision?
3. Execute
Identify, prioritize and execute on
data governance improvements in
the data lifecycle
How do you ensure all are
equipped with data for better
decision-making – from the bedside
to the boardroom?
4. Extend
How do you
ensure your data
investments are
built to last?
Expand and extend
to create a data
centric culture
30. © 2018
Health
Catalyst
Poll Question
30
How would you rate the maturity of your organization’s data centric
culture?
1. Limited – Data is a luxury and only the biggest decisions are data driven.
— 26%
2. Developing – We have a strategy in place and early adopters have
demonstrated success. — 44%
3. Established – Broad, but uneven, adoption. Some pockets of excellence,
some areas of concern. — 28%
4. Pervasive – Almost everyone has timely access to the data related to their
work, and the skills to apply that data to improve the work they do. — 2%
31. © 2018
Health
Catalyst
Evaluate data skills, knowledge and attitudes
Evaluate mix of resources
• Data Scientist
• Outcomes Analysts
• Analytics Engineers
• Data Stewards
• Report Writers
• Super Users / Data Evangelists
Leadership Literacy Evaluation
• Understand Signal vs Noise
• Control Charts, Variation
Data Literacy Assessment
31
32. © 2018
Health
Catalyst
Analytic Literacy Progression
32
Answering anticipated questions. Single vended
system. Tells what happened.
Measures outcomes through custom data
models populated from multiple sources.
Highlights gaps between current state and
best practices.
Coupling of technical expertise and
domain knowledge. Illuminates the ‘why’
behind results. Discovers new paths for
future improvements.
Reactive
Descriptive
PrescriptiveAnalyticComplexity
Technical Skill + Contextual Understanding
33. © 2018
Health
Catalyst
Don’t try to fix it all at once
• Focus data quality efforts on the areas you have improvement initiatives
• Ignore the rest
Don’t wait to start improvement until the data is perfect
• Fix operational/clinical process variation AND data system variation at the same
time
Don’t be afraid to stop before you are done
• Directionally correct vs perfect
• Aim defines the system
Data Centric Culture: Quality
33
34. © 2018
Health
Catalyst
Data Centric Culture: Utilization
Recruit Change Agents
34
"In times of change, learners inherit the future,
while the learned find themselves beautifully
equipped to deal with a world that no longer
exists."
Eric Hoffer
35. © 2018
Health
Catalyst
Data Centric Culture: Utilization
Change Agents are usually early adopters
35
Innovators
Early
adopters
Early
majority
Laggards
(never adopters)
* Adapted from Rogers, E. Diffusion of Innovations. New York, NY: 1995.
Late
majority
Innovators -
Recruit innovators
to re-design care
delivery processes
TheChasm
Early adopters - Recruit early adopters to chair
improvement and to lead implementation at each site
(key individuals who can rally support)
36. © 2018
Health
Catalyst
Data Centric Culture: Utilization
• You need both willing and able leaders
• Identify those wanting to lead permanent improvement efforts
• Allow those not wishing to lead to participate in the selection process
• Executive leadership can select from top recommendations the most open
minded leaders and give them decision rights
• Involvement in the selection process leads to better adoption later
Select early adopter leaders
36
37. © 2018
Health
Catalyst
Data Governance Framework: The Four E’s
37
Act
Capture
Integrate
Grant
Access
Deliver
Insight
1. Elevate
Elevate the status of data
as a strategic asset of
your organization
What would make your
data a distinguishing
asset of your clinical and
business objectives?
2. Establish
Build your data
governance org
structure
Who are the best
individuals and
how should you
organize to realize
the vision?
3. Execute
Identify, prioritize and execute on
data governance improvements in
the data lifecycle
How do you ensure all are
equipped with data for better
decision-making – from the bedside
to the boardroom?
4. Extend
How do you
ensure your data
investments are
built to last?
Expand and extend
to create a data
centric culture
38. © 2018
Health
Catalyst
We believe when you elevate data as a
strategic asset
it enables significantly
better decision-making
and promotes
massive improvement
in health, cost, and experience outcomes.
38
40. © 2018
Health
Catalyst
Data, People and Process
40
At-Risk Cohort
Gaps in Screening
Last Encounter
Predictive Probability
Quality Metrics
Preventative Screening
Patient Education
Community Outreach
Physician Training
Best Practices
41. © 2018
Health
Catalyst
Community Care Demo
Community Care
The application is aimed at Primary Care Clinical
Program leaders, primary care providers and care
coordinators working in ambulatory settings, quality
improvement teams, and staff responsible for reports
related to the organization’s status as an Accountable
Care Organization (ACO). The application focuses on
providing data to help organizations review population
health; compare their performance to national
benchmarking standards for specific measures;
identify opportunities for costs savings, and help
practices track, monitor, and meet the needs of high-
risk patients.
• 8 percent relative improvement in diabetes HgbA1c
poor control (reverse measure = lower is better).
• 25 percent relative improvement in the number of
patients with diabetes receiving eye exams.
• 1.4 percent relative improvement in the
documentation of current medications in the
medical record.
• Community Care Success Story
42. © 2018
Health
Catalyst
Community Success
42
90th Percentile performance
for tobacco and clinical depression
screening and planning
80th Percentile performance
for flu immunization, blood
pressure and future fall risk
screenings
Made significant contributions to
Medicare savings and has been
recognized as the fourth best
ACO in the nation, saving over
$21 million in 2016
43. © 2018
Health
Catalyst
… Back to Our Story
Through linking the data in the
moment with the analytic insights,
providers can better serve their
patients.
Data sharing requires
collaboration and governance.
44. © 2018
Health
Catalyst
Healthcare Analytics Summit 18
Sept. 11-13, Salt Lake, Grand America Hotel
TOBY COSGROVE, MD
former CEO and President of
Cleveland Clinic (2004-2017),
who as a cardiac surgeon
performed more than 22,000
operations and holds 30 patents
for medical innovations
KIM GOODSELL
the actualized ‘genomified,’ quantified,
digitalized “patient of the future," her debut at
the 2014 Future of Genomic Medicine
conference made headline news
announcing— “The patient from the future,
here today”
DANIEL KRAFT, MD
a Stanford and Harvard trained physician-
scientist, inventor, entrepreneur, and
innovator, Kraft is the Founder and Chair of
Exponential Medicine, a program that
explores convergent, rapidly developing
technologies and their potential in
biomedicine and healthcare
BRENT JAMES, MD
former Chief Quality Officer at
Intermountain Healthcare - known
internationally for his work in
clinical quality improvement,
patient safety, and the
infrastructure that underlies
successful improvement efforts
PENNY WHEELER, MD
President and Chief Executive
Officer of Allina Health,
returns a second time as one
of the most popular HAS
speakers ever
MARC RANDOLF
Co-founder of Netflix, Marc will
share the Netflixed story: how a
scrappy Silicon Valley startup
brought down Blockbuster and
the lessons that could be
applicable to healthcare
JILL HOGGARD GREEN
PhD, RN, Chief Operating Officer – Mission
Health and President – Mission Hospital,
and recently named to the 2017 Becker’s
Healthcare list of the country’s top Women
Hospital and Health System Leaders to
Know
ROBERT WACHTER, MD
global leader in healthcare safety,
quality, policy, IT; Chair of the
Department of Medicine, University of
California, San Francisco; best-selling
author, “The Digital Doctor: Hope, Hype
and Harm at the Dawn of Medicine’s
Computer Age”
More highlights
4 Digital Innovators (Keynotes)
AI Showcase (10 walkabout case studies)
Digitizing the Patient Showcase (10-12 stations)
28 Educational, Case Study, and Technical Breakouts
24 Analytics Walkabout Projects
More Networking (Introducing “Brain Date”)
CME Accreditation For Clinicians
5-Star Grand America Hotel Experience
96 Total Presentations
National keynotes
Employer
Innovation
Scott
Schreeve
MD, CEO, Crossover Health
Payer
Innovation
Kevin
Sears
Executive Director of Marketing
and Network Services, Cleveland
Clinic
Biosensor
Innovation
John
Rogers
PhD, Founding Director, Center
Bio-Integrated Electronics,
Northwestern University
Pricing
Innovation
Gene
Thompson
Project Director, Health City
Cayman Islands
45. © 2018
Health
Catalyst
Have you ever asked yourself, “Why can’t I convince my patient to take her prescriptions?” New York Times bestselling
author, Gretchen Rubin, developed The Four Tendencies to help answer this question and more. Join Gretchen and
Health Catalyst co-founder, Tom Burton, to explore how these tendencies apply to healthcare, and learn how
understanding them can help you to be more productive in your work and easily navigate confrontations.
Wednesday, September 19
1:00-2:00 PM EST
By attending this webinar you will gain:
• Knowledge of the four tendencies: the upholder, the questioner, the obliger, and the rebel
• An understanding of how these tendencies can affect behavior in a healthcare setting
• Practical tips for working with superiors, colleagues, and patients that fall into different tendencies
• Insight into why people choose to act and why they don’t act
• The ability to make better decisions, be less stressed and generally be more effective in your work once you
understand your own tendency
The Four Tendencies for Healthcare Professionals
45
GRETCHEN RUBIN
Author, The Four Tendencies
TOM BURTON
Co-founder, Health Catalyst
Gretchen Rubin photo credit: Sam Interrante
Editor's Notes Suspension of Disbelief