Dale will take a slide deck previously prepared in 2006, from a lecture entitled, "The Power of an Enterprise Data Warehouse in Clinical Decision Support", presented to several informatics masters classes at Northwestern University and the University of Victoria. He won’t change anything about the slide deck, including the content and the old school graphics. The concept with this webinar is to give a “time capsule” perspective on past thinking and contrast that against current thoughts and trends in the market. Some of the information will be laughably wrong and naive, and some of the information will still be relevant. The hope is, by regularly reviewing our past, we will better inform our future.
Introduction to Population Health Analytics, Predictive Analytics, Big Data a...Frank Wang
UNH HCAD 6635 Healthcare Analytics Session 12, the last session of Health Information Analytics. Details of the topics of this session will be covered in HCAD 6637 "Advanced Analytics and Health Data Mining"
The Analytic System: Finding Patterns in the DataHealth Catalyst
Dr. Haughom set the stage for this upcoming discussion in his previous webinar, explaining the key components of an effective analytical system that enables self-exploration and learning. In this session Attendees will learn:
How the distinction between random variation and assignable cause variation is critically important to patient care
Creation and application of Statistical Process Control (SPC) charts to:
Monitor process variation over time
Differentiate between assignable cause and random cause variation
Assess effectiveness of change on a given process
Achieve and maintain process stability
How implementing inlier management and creating a collaborative environment will drive continuous improvement
How to identify patterns in data using a live demonstration of advanced analytical tools.
Data Mining in Healthcare: How Health Systems Can Improve Quality and Reduce...Health Catalyst
This is the complete 4-part series demonstrating real-world examples of the power of data mining in healthcare. Effective data mining requires a three-system approach: the analytics system (including an EDW), the content system (and systematically applying evidence-based best practices to care delivery), and the deployment system (driving change management throughout the organization and implementing a dedicated team structure). Here, we also show organizations with successful data-mining-application in critical areas such as: tracking fee-for-service and value-based payer contracts, population health management initiatives involving primary care reporting, and reducing hospital readmissions. Having the data and tools to use data mining and predict trends is giving these health systems a big advantage.
Predictive Analytics: It's The Intervention That MattersHealth Catalyst
In this two-part webinar, get the detailed knowledge you need to make informed decisions about adopting predictive analytics in healthcare so you can separate today's hype from reality. In part 1, you'll learn key learnings from Dale Sanders including 1) our fixation on predictive analytics in readmissions, 2) the common trap of predictions without interventions, 3) the common misconceptions of correlations verses causation, 4) examples of predictions without algorithms, and 5) the importance of putting the basics first.
In part 2, you'll hear from industry expert David Crockett, PhD in a "graduate level" crash course cover key concepts such as machine learning, algorithms, feature selection, classification, tools and more.
EHR Implementation project: Addressing problems with the current EHR system in Star Health and proferring Hypothetic solutions.
Case study of YNHHS EHR implementation strategy.
Interoperability is one of the most critical issues facing the health care industry today. A universal exchange language is needed to assist health care providers in sharing health information in order to coordinate diagnosis and treatment, while maintaining privacy and security of personal data. Health Information Exchanges (HIE) allow for the movement of clinical data between disparate systems; they enable providers to electronically share health records through a network. This presentation provides an overview of HIE and the Meaningful Use requirement related to the exchange of clinical information as well as information about standards of exchange and the recommended "next steps" for providers.
Three Approaches to Predictive Analytics in HealthcareHealth Catalyst
Predictive analytics in healthcare must be timely, role-specific, and actionable to be successful. There are also three common types of healthcare predictive analytics: Risk scores (risk stratification using CMS-HCC or other models), What-if scenarios (simulations of specific outcomes given a certain combination of events, and Geo-spatial analytics (mapping a geographical location’s patient disease burden). The common thread in all of these is the element of action, or specifically, the intervention that really matters in healthcare predictive analytics.
Introduction to Population Health Analytics, Predictive Analytics, Big Data a...Frank Wang
UNH HCAD 6635 Healthcare Analytics Session 12, the last session of Health Information Analytics. Details of the topics of this session will be covered in HCAD 6637 "Advanced Analytics and Health Data Mining"
The Analytic System: Finding Patterns in the DataHealth Catalyst
Dr. Haughom set the stage for this upcoming discussion in his previous webinar, explaining the key components of an effective analytical system that enables self-exploration and learning. In this session Attendees will learn:
How the distinction between random variation and assignable cause variation is critically important to patient care
Creation and application of Statistical Process Control (SPC) charts to:
Monitor process variation over time
Differentiate between assignable cause and random cause variation
Assess effectiveness of change on a given process
Achieve and maintain process stability
How implementing inlier management and creating a collaborative environment will drive continuous improvement
How to identify patterns in data using a live demonstration of advanced analytical tools.
Data Mining in Healthcare: How Health Systems Can Improve Quality and Reduce...Health Catalyst
This is the complete 4-part series demonstrating real-world examples of the power of data mining in healthcare. Effective data mining requires a three-system approach: the analytics system (including an EDW), the content system (and systematically applying evidence-based best practices to care delivery), and the deployment system (driving change management throughout the organization and implementing a dedicated team structure). Here, we also show organizations with successful data-mining-application in critical areas such as: tracking fee-for-service and value-based payer contracts, population health management initiatives involving primary care reporting, and reducing hospital readmissions. Having the data and tools to use data mining and predict trends is giving these health systems a big advantage.
Predictive Analytics: It's The Intervention That MattersHealth Catalyst
In this two-part webinar, get the detailed knowledge you need to make informed decisions about adopting predictive analytics in healthcare so you can separate today's hype from reality. In part 1, you'll learn key learnings from Dale Sanders including 1) our fixation on predictive analytics in readmissions, 2) the common trap of predictions without interventions, 3) the common misconceptions of correlations verses causation, 4) examples of predictions without algorithms, and 5) the importance of putting the basics first.
In part 2, you'll hear from industry expert David Crockett, PhD in a "graduate level" crash course cover key concepts such as machine learning, algorithms, feature selection, classification, tools and more.
EHR Implementation project: Addressing problems with the current EHR system in Star Health and proferring Hypothetic solutions.
Case study of YNHHS EHR implementation strategy.
Interoperability is one of the most critical issues facing the health care industry today. A universal exchange language is needed to assist health care providers in sharing health information in order to coordinate diagnosis and treatment, while maintaining privacy and security of personal data. Health Information Exchanges (HIE) allow for the movement of clinical data between disparate systems; they enable providers to electronically share health records through a network. This presentation provides an overview of HIE and the Meaningful Use requirement related to the exchange of clinical information as well as information about standards of exchange and the recommended "next steps" for providers.
Three Approaches to Predictive Analytics in HealthcareHealth Catalyst
Predictive analytics in healthcare must be timely, role-specific, and actionable to be successful. There are also three common types of healthcare predictive analytics: Risk scores (risk stratification using CMS-HCC or other models), What-if scenarios (simulations of specific outcomes given a certain combination of events, and Geo-spatial analytics (mapping a geographical location’s patient disease burden). The common thread in all of these is the element of action, or specifically, the intervention that really matters in healthcare predictive analytics.
In this webinar, Dale Sanders will provide a pragmatic, step-by-step, and measurable roadmap for the adoption of analytics in healthcare-- a roadmap that organizations can use to plot their strategy and evaluate vendors; and that vendors can use to develop their products. Attendees will have a chance to learn about:
1) The details of his eight-level model, 2) A brief introduction to the HIMSS/IIA DELTA Model, 3) The importance of permanent organizational teams to sustain improvements from analytic investments, 4) The process of curating and maturing data governance, and 5) The coordination of a data acquisition strategy with payment and reimbursement strategies
Railhealth Electronic Medical Record encompasses the information and capabilities required to support healthcare service delivery. This presentation gives you the information regarding the features, objectives and the benefits what doctor gets by using our EMR.
How to Evaluate Emerging Healthcare Technology with Innovative AnalyticsHealth Catalyst
As healthcare systems are pressured to cut costs and still provide high-quality care, they will need to look across the care continuum for answers, reduce variation in care, and look to emerging technologies. This article walks through how to evaluate the safety and effectiveness and of emerging healthcare technology and prioritize high-impact improvement projects using a robust data analytics platform. Topics covered include:
The importance of identifying variation in innovation.
Ways to improve outcomes and decrease costs.
The value of an analytics platform.
The reliable information that produce sparks for innovation.
Identifying and evaluating emerging healthcare technology.
Knowing what data to use.
The difference between efficacy and effectiveness in evaluation of emerging healthcare technology.
Understanding Risk Stratification, Comorbidities, and the Future of HealthcareHealth Catalyst
Risk stratification is essential to effective population health management. To know which patients require what level of care, a platform for separating patients into high-risk, low-risk, and rising-risk is necessary. Several methods for stratifying a population by risk include: Hierarchical Condition Categories (HCCs), Adjusted Clinical Groups (ACG), Elder Risk Assessment (ERA), Chronic Comorbidity Count (CCC), Minnesota Tiering, and Charlson Comorbidity Measure. At Health Catalyst, we use an analytics application called the Risk Model Analyzer to stratify patients into risk categories. This becomes a powerful tool for filtering populations to find higher-risk patients.
In this presentation, you’ll learn all about electronic health records (EHRs), what types of data they can store, what their benefits are and why they are needed for achieving Meaningful Use.
Looking for more info? The last slide has a list of resources for you to continue learning about EHRs.
Precision Medicine: Four Trends Make It PossibleHealth Catalyst
When realized, the promise of precision medicine (to specifically tailor treatment to each individual) stands to transform healthcare for the better by delivering more effective, appropriate care. To date, to achieve precision medicine, health systems have faced financial, data management, and interoperability barriers. Current trends in healthcare, however, will give researchers and clinicians the quality and breadth of health data, biological information, and technical sophistication to overcome the challenges to achieving precision medicine.
Four notable trends in healthcare will bolster to growth of precision medicine in the coming years:
Decision support methods harness the power of the human genome.
Healthcare leverages big data analytics and machine learning.
Reimbursement methods incentivize health systems to keep patients well.
Emerging tools enable more data, more interoperability.
Interoperability in Healthcare Data: A Life-Saving AdvantageHealth Catalyst
When health system clinicians make care decisions based on their organization’s EHR data alone, they’re only using a small portion of patient health information. Additional data sources—such as health information exchanges (HIEs) and patient-generated and -reported data—round out the full picture of an individual’s health and healthcare needs. This comprehensive insight enables critical, and sometimes life-saving, treatment and health management choices.
To leverage the data from beyond the four walls of a health system and combine it with clinical, financial, and operational EHR data, organizations need an interoperable platform approach to health data. The Health Catalyst® Data Operating System (DOS™), for example, combines, manages, and leverages disparate forms of health data for a complete view of the patient and more accurate insights into the best care decisions.
Dr Sanjoy Sanyal wrote this article when he was doing his Masters in Royal College of Surgeons of Edinburgh, University of Bath, United Kingdom.
It traces the origin of the term and discipline called 'Medical Informatics'; describes its evolution and mentions its current healthcare applicability and academic status.
It is fundamental towards understanding today's Information Explosion and its digital implications in all work atmospheres.
Today Dr Sanjoy Sanyal is Professor and Course Director of Neuroscience and FCM-III in Caribbean.
By leveraging Big Data, the healthcare industry has an incredible potential to improve lives. This session will give examples of how data volume, velocity and variety is transforming the “art” of a doctor to the science of care. It will describe how the use of machine learning and massive amount of data will drive the new Consumer Drive healthcare movement.
Bahmni started from a rural hospital in India three years back and is now being deployed in many countries. In this talk I share our motivation, approach and strategy of making and scaling Bahmni via implementations. I will also cover key technologies, features and roadmap of Bahmni.
Designing Machine Learning Driven Clinical Decision Support ToolsQian Yang
CHI'16 Paper Presented by Qian Yang from Carnegie Mellon University. The presentation describes a field study investigating how to design better machine-learning-driven systems in support of better LVAD (left-ventricular assist device, the "heart pump") implant decision.
Organizations are looking to solve their data challenges and enable quick image access without completely re-engineering their archives. ResolutionMD has the capability to connect multiple IT systems including PACS, VNA and the EMR. See why Intermountain Healthcare chose our enterprise-wide image viewer to solve their data dilemma, download the guide at http://offers.calgaryscientific.com/image-enable-your-enterprise
Visit http://www.calgaryscientific.com/contact/ to get in touch with us.
In this webinar, Dale Sanders will provide a pragmatic, step-by-step, and measurable roadmap for the adoption of analytics in healthcare-- a roadmap that organizations can use to plot their strategy and evaluate vendors; and that vendors can use to develop their products. Attendees will have a chance to learn about:
1) The details of his eight-level model, 2) A brief introduction to the HIMSS/IIA DELTA Model, 3) The importance of permanent organizational teams to sustain improvements from analytic investments, 4) The process of curating and maturing data governance, and 5) The coordination of a data acquisition strategy with payment and reimbursement strategies
Railhealth Electronic Medical Record encompasses the information and capabilities required to support healthcare service delivery. This presentation gives you the information regarding the features, objectives and the benefits what doctor gets by using our EMR.
How to Evaluate Emerging Healthcare Technology with Innovative AnalyticsHealth Catalyst
As healthcare systems are pressured to cut costs and still provide high-quality care, they will need to look across the care continuum for answers, reduce variation in care, and look to emerging technologies. This article walks through how to evaluate the safety and effectiveness and of emerging healthcare technology and prioritize high-impact improvement projects using a robust data analytics platform. Topics covered include:
The importance of identifying variation in innovation.
Ways to improve outcomes and decrease costs.
The value of an analytics platform.
The reliable information that produce sparks for innovation.
Identifying and evaluating emerging healthcare technology.
Knowing what data to use.
The difference between efficacy and effectiveness in evaluation of emerging healthcare technology.
Understanding Risk Stratification, Comorbidities, and the Future of HealthcareHealth Catalyst
Risk stratification is essential to effective population health management. To know which patients require what level of care, a platform for separating patients into high-risk, low-risk, and rising-risk is necessary. Several methods for stratifying a population by risk include: Hierarchical Condition Categories (HCCs), Adjusted Clinical Groups (ACG), Elder Risk Assessment (ERA), Chronic Comorbidity Count (CCC), Minnesota Tiering, and Charlson Comorbidity Measure. At Health Catalyst, we use an analytics application called the Risk Model Analyzer to stratify patients into risk categories. This becomes a powerful tool for filtering populations to find higher-risk patients.
In this presentation, you’ll learn all about electronic health records (EHRs), what types of data they can store, what their benefits are and why they are needed for achieving Meaningful Use.
Looking for more info? The last slide has a list of resources for you to continue learning about EHRs.
Precision Medicine: Four Trends Make It PossibleHealth Catalyst
When realized, the promise of precision medicine (to specifically tailor treatment to each individual) stands to transform healthcare for the better by delivering more effective, appropriate care. To date, to achieve precision medicine, health systems have faced financial, data management, and interoperability barriers. Current trends in healthcare, however, will give researchers and clinicians the quality and breadth of health data, biological information, and technical sophistication to overcome the challenges to achieving precision medicine.
Four notable trends in healthcare will bolster to growth of precision medicine in the coming years:
Decision support methods harness the power of the human genome.
Healthcare leverages big data analytics and machine learning.
Reimbursement methods incentivize health systems to keep patients well.
Emerging tools enable more data, more interoperability.
Interoperability in Healthcare Data: A Life-Saving AdvantageHealth Catalyst
When health system clinicians make care decisions based on their organization’s EHR data alone, they’re only using a small portion of patient health information. Additional data sources—such as health information exchanges (HIEs) and patient-generated and -reported data—round out the full picture of an individual’s health and healthcare needs. This comprehensive insight enables critical, and sometimes life-saving, treatment and health management choices.
To leverage the data from beyond the four walls of a health system and combine it with clinical, financial, and operational EHR data, organizations need an interoperable platform approach to health data. The Health Catalyst® Data Operating System (DOS™), for example, combines, manages, and leverages disparate forms of health data for a complete view of the patient and more accurate insights into the best care decisions.
Dr Sanjoy Sanyal wrote this article when he was doing his Masters in Royal College of Surgeons of Edinburgh, University of Bath, United Kingdom.
It traces the origin of the term and discipline called 'Medical Informatics'; describes its evolution and mentions its current healthcare applicability and academic status.
It is fundamental towards understanding today's Information Explosion and its digital implications in all work atmospheres.
Today Dr Sanjoy Sanyal is Professor and Course Director of Neuroscience and FCM-III in Caribbean.
By leveraging Big Data, the healthcare industry has an incredible potential to improve lives. This session will give examples of how data volume, velocity and variety is transforming the “art” of a doctor to the science of care. It will describe how the use of machine learning and massive amount of data will drive the new Consumer Drive healthcare movement.
Bahmni started from a rural hospital in India three years back and is now being deployed in many countries. In this talk I share our motivation, approach and strategy of making and scaling Bahmni via implementations. I will also cover key technologies, features and roadmap of Bahmni.
Designing Machine Learning Driven Clinical Decision Support ToolsQian Yang
CHI'16 Paper Presented by Qian Yang from Carnegie Mellon University. The presentation describes a field study investigating how to design better machine-learning-driven systems in support of better LVAD (left-ventricular assist device, the "heart pump") implant decision.
Organizations are looking to solve their data challenges and enable quick image access without completely re-engineering their archives. ResolutionMD has the capability to connect multiple IT systems including PACS, VNA and the EMR. See why Intermountain Healthcare chose our enterprise-wide image viewer to solve their data dilemma, download the guide at http://offers.calgaryscientific.com/image-enable-your-enterprise
Visit http://www.calgaryscientific.com/contact/ to get in touch with us.
Intermountain Healthcare Streamlines Stroke Notifications and Improves Patien...xMatters Inc
Intermountain Healthcare was already a leader in TeleHealth
response time for stroke victims. Its 5 minute median time to
first response was far below the national average. But with the
new notification service in partnership with xMatters, Intermountain Healthcare has reduced the overall time to connect the on-call neurologist to the requesting emergency doctors to less than 3 minutes from the time of initial request.
Health IT Summit in Houston 2014 - Presentation "Improving Healthcare through Data and Analytics” with Katherina Holzhauser, Assistant Vice President, IS Commercialization, Intermountain Healthcare
Case Study “Analytics Strategies to Improve Quality & Outcomes”
Trevor Strome, MSc, PMP
Analytics Lead
WRHA Emergency Program
Assistant Professor, Department of Emergency Medicine
University of Manitoba
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
Comparison of excess radiological risk of building materials and industrial b...Zoltan Sas, PhD
To get an insight into the radiological features of potentially reusable by-products can be reused in building materials industry a review of the reported scientific data is necessary. This study is based on the continuously growing database of the By-BM (H2020-MSCA-IF-2015) project (By-products for Building Materials). Currently, the By-BM database contains individual data of about 431 by-products and 1095 building and raw materials. It was found that in case of the construction materials the natural isotope content varied widely (Ra-226: <dl-27851 /><dl-906 /><dl-17922 /><dl-1350 /><DL-3001 Bq/kg). The average Ra-226, Th-232 and K-40 content of reported by-products were 2.52, 2.35 and 0.39 times higher than the building materials respectively. The gamma exposure of bulk building products was calculated according to IAEA Specific Safety Guide No. SSG-32 and European Commission Radiation Protection 112 based I-index (EU BSS). It was found that in most cases the I-index without density consideration provides a significant overestimation in excess effective dose.
Data Driven Clinical Quality and Decision SupportDale Sanders
From a lecture about the use of data warehousing, analytics, and point of care clinical decision support to improve the quality and reduce the cost of healthcare.
The Next Generation ACO Model team hosted an open door forum on Tuesday, February 28, 2017. During this open door forum Model team members provided a deep dive presentation examining details of financial aspects relating to the model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Improving Patient Safety and Quality Through Culture, Clinical Analytics, Evi...Health Catalyst
According to the Centers of Disease Control (CDC), an estimated 70,000 patients die each year from hospital-associated infections (HAIs): contrast the CDC statistic with the fact that only 35,000 people die each year in the U.S. from motor vehicle accidents. Learn key best practices in patient safety and quality including: patient safety as a team sport, the added challenges of healthcare being the most complex, adaptive system, and how culture, analytics, and content contribute to improve outcomes and lower costs.
The next wave of the Internet will connect machines and devices together into functioning, intelligent systems. This "Internet of Things" (IoT) will change every industry, every job, and every home. How will it impact medicine? When?
This webinar will reveal how the Internet of Things is changing medicine today by examining real applications of advanced networking technology. The applications include from 911 dispatch, EMS transport, imaging, surgery, ICU interoperability, patient safety, hospital integration, and treatment. We will discuss critical needs: finding the right data, delivering high-fidelity waveforms, integrating large hospital systems, ensuring EMR accuracy, and guarding sensitive information.
The CMS Innovation Center held a Medicare Diabetes Prevention Program webinar on August 9, 2016 from 12:00 – 1:00p.m. EDT. This webinar provided an overview of the proposal in calendar year 2017 Medicare Physician Fee Schedule.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The seminar is about Data warehousing, in here we are gonna discuss about what is data warehousing, comparison b/w database and data warehouse, different data warehouse models.about Data mart, and disadvantages of data warehousing.
As the author of “Big Data in Healthcare Hype and Hope,” Dr. Feldman has interviewed over 180 emerging tech and healthcare companies, always asking, “How can your new approach help patients?” Her research shows that data, as an enabling tool, has the power to give us critical new insights into not only what causes disease, but what comprises normal. Despite this promise, few patients have reaped the benefits of personalized medicine. A panel of leading big data innovators will discuss the evolving health data ecosystem and how big data is being leveraged for research, discovery, clinical trials, genomics, and cancer care. Case studies and real-life examples of what’s working, what’s not working, and how we can help speed up progress to get patients the right care at the right time will be explored and debated.
• Bonnie Feldman, DDS, MBA - Chief Growth Officer, @DrBonnie360
• Colin Hill - CEO, GNS Healthcare
• Jonathan Hirsch - Founder & President, Syapse
• Andrew Kasarskis, PhD - Co-Director, Icahn Institute for Genomics & Multiscale Biology; Associate Professor, Genetics & Genomic Studies, Icaahn School of Medicine at Mt. Sinai
• William King - CEO, Zephyr Health
New York eHealth Collaborative Digital Health Conference
November 18, 2014
Precise Patient Registries for Clinical Research and Population ManagementDale Sanders
Patient registries have evolved from external, mandatory reporting databases to playing a critical role in internal clinical research, clinical quality, cost reduction, and population health management. This slide deck describes how to design those precise registries.
> Definition of RWD
> RWD - Big Data Characteristics
> Sources of RWD
> Important Stakeholders
> Benefits of RWD
> Why Data Sharing is Important?
> Benefits of Data Sharing
> Who Benefits?
> Ultimate Goals
> Case Studies
> Challenges
> Data Privacy Scenario
> Data Security in India
> Regulatory Perspectives Around RWD
> How to Encourage Data Sharing?
Advanced Laboratory Analytics — A Disruptive Solution for Health SystemsViewics
As US healthcare systems grapple with the recent upheavals in care payment and delivery, they are turning to advanced analytics as their “central nervous systems” for driving care and financial performance.
Laboratory information — spanning chemistry, pathology, microbiology and molecular testing, for example — is among the best sources of data for these advanced analytics, including clinician decision support, predictive analytics, population health management, and personalized medicine. When strategically harnessed and integrated to create a patient-centric lab data lake, laboratory information can form an affordable yet competitively powerful advanced analytics solution well suited for many health systems — i.e., a disruptive option.
L. Eleanor J. Herriman, MD, MBA, Chief Medical Informatics Officer of Viewics, explains why laboratory data should be a core strategic component for achieving success in value-based healthcare.
Healthcare Analytics Adoption Model -- UpdatedHealth Catalyst
The Healthcare Analytics Adoption Model is the result of a collaboration of healthcare industry veterans over the last 15 years. The model borrows lessons learned from the HIMSS EMR Adoption Model, and describes an analogous approach for assessing the adoption of analytics in healthcare.
The Healthcare Analytics Adoption Model provides:
1) A framework for evaluating the industry’s adoption of analytics
2) A roadmap for organizations to measure their own progress toward analytic adoption
3) A framework for evaluating vendor products
This Analytics Adoption Model will enable healthcare organizations to fully understand and leverage the capabilities of analytics and so achieve the ultimate goal that has eluded most provider organizations – that of improving the quality of care while lowering costs and enhancing clinician and patient satisfaction.
Precise Patient Registries: The Foundation for Clinical Research & Population...Health Catalyst
Join Dale Sanders as he shares his experience in developing disease registries, the history of patient registries, and the current design patterns in data engineering to create highly precise registries to support clinical research and population health management.
Topics:
*How the definition of the term “patient registry" has evolved from being associated with a federal- or state-mandated reporting requirement to a hospital or health system’s own population of patients, including device registries, drug registries, and procedure registries.
*Why engaging certain populations via group registries allows them to better understand their conditions and reach out for support from others who share their condition.
*Several untapped benefits of registries for disease and quality management.
*When to utilize patient registries to guide decision-making and drive change, especially at the point of care.
*Which of the critical steps to building a disease registry is most important.
*The keys to winning organizational support in order to implement a successful registry initiative.
*Precise patient registries play a significant role in the management of a broad variety of healthcare processes, including chronic diseases and conditions, as well as clinical research.
Understanding how registries are currently built vs. how they should be built is critical to the future of healthcare outcomes improvement, cost reduction, and translational research.
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
The implementation and on-going enhancement of the eHealth Saskatchewan Clinical Portal to complement existing systems to support improved health care province-wide through electronic access to important clinical information.
Better Health
Kevin Kidney
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Unlock the Secrets to Optimizing Ambulatory Operations Efficiency and Change ...Health Catalyst
Today’s healthcare leaders are seeking technology solutions to optimize efficiencies and improve patient care. However, without effective change management and strategies in place, healthcare leaders struggle to strategically improve patient flow, space, to strategically improve patient flow, space, and schedule management, and implement daily huddles. The role of technology in supporting operational efficiency and change management initiatives is inevitable.
During this webinar, attendees will learn how to optimize Ambulatory Operational Efficiencies and Change Management. Attendees will also learn about the importance of visual management boards in enhancing clinic performance and insights into effective change management approaches.
Patient expectations are rising, and organizations are continuously being asked to do more with less.
Additionally, the convergence of several significant emerging market and policy trends, economic uncertainty, labor force shortages, and the end of the COVID-19 public health emergency has created a unique set of challenges for healthcare organizations.
Attend this timely webinar to learn about new trends and their impact on key healthcare issues, such as patient engagement, migration to value-based care, analytics adoption, the use of alternative care sites, and data governance and management challenges.
During this webinar, we will discuss the complexities of AI, trends, and platforms in the industry. Dive deep into understanding the true essence of AI, exploring its potential, real-world use cases, and common misconceptions. Gain valuable insights into the latest technology trends impacting healthcare and discover strategies for maximizing ROI in your technology investments.
Explore the profound impact of data literacy on healthcare organizations and how it shapes the utilization of data and technology for transformative outcomes. Understand the top technology priorities for healthcare organizations and learn how to navigate the digital landscape effectively. Furthermore, simplify industry jargon by defining common data elements, fostering clearer communication and collaboration across stakeholders.
Finally, uncover the transformative potentials of platforms in healthcare and how they can revolutionize scalability, interoperability, and innovation within your organization. Don't miss this opportunity to gain invaluable insights from industry experts and stay ahead in the ever-evolving healthcare landscape. Reserve your spot now for an enlightening journey into the future of healthcare technology!
Three Keys to a Successful Margin: Charges, Costs, and LaborHealth Catalyst
How can cost management and complete charge capture protect and enhance the margin?
In this webinar, we will look at 2024 margin pressures likely to impact your organization’s financial resiliency. This presentation will also share how organizations can move from Fee-for-Service to Value; bringing Cost to the forefront.
2024 CPT® Updates (Professional Services Focused) - Part 3Health Catalyst
Each year the CPT code set undergoes significant changes. Physicians and their office staff need to be aware of the changes in order to ensure a smooth transition into 2024. Join us for a discussion of the new, deleted and revised CPT codes and associated guidelines for 2024. This presentation will focus on the changes to the CPT dataset and the associated work RVU value changes that impact professional service reporting.
During this complimentary webinar, we will empower you to correctly apply the new and revised codes and discuss the rationale behind this year’s changes. You will leave with an understanding of the financial implications of the changes on your practice.
2024 CPT® Code Updates (HIM Focused) - Part 2Health Catalyst
Each year the CPT code set and the HCPCS code set undergo significant changes, and your coding staff needs to be aware of the changes in order to ensure a smooth transition into 2024. Join us for a discussion of the new, deleted and revised CPT codes and associated guidelines for 2024. This is part two in a three-part series.
During these complimentary webinars, we will empower you to correctly apply the new and revised codes and discuss the rationale behind this year’s changes. This presentation will be geared towards hospital staff with a focus on the surgical section of the CPT book in addition to surgical Category III codes.
2024 CPT® Code Updates (CDM Focused) - Part 1Health Catalyst
Each year the CPT and the HCPCS code sets undergo significant changes, and your staff needs to be aware of the changes in order to ensure a smooth transition into 2024. Join us for a discussion of the new, deleted, and revised CPT codes and associated guidelines for 2024. This is part one in a three-part series, with a CDM focus.
During these complimentary webinars, we will empower you to correctly apply the new and revised codes and discuss the rationale behind this year’s changes. This presentation will be geared towards hospital staff with a focus on the non-surgical sections of the CPT book.
What’s Next for Hospital Price Transparency in 2024 and BeyondHealth Catalyst
The Centers for Medicare & Medicaid Services (CMS) published updates to the hospital price transparency requirements in the CY 2024 Outpatient Prospective Payment System (OPPS) Final Rule. The updates will be phased in over the next 14 months and include several significant changes including the use of a CMS-mandated template, a requirement for an affirmation statement from the hospital, and several new data elements. Join us to discover what changes are scheduled for implementation in 2024 and 2025 and how they’ll impact your facility.
During this complimentary 60-minute webinar, we’ll analyze the key provisions of the Price Transparency regulations and provide insights to help you prepare for the upcoming changes.
Automated Patient Reported Outcomes (PROs) for Hip & Knee ReplacementHealth Catalyst
What was once voluntary reporting will soon be made mandatory with penalties.
On July 1, 2024, all health systems will be required to collect Patient Reported Outcome Measures (PROM) as part of the Centers for Medicare & Medicaid Services (CMS) regulation for the following measures:
Hospital-Level, Risk Standardized Patient-Reported Outcomes Performance Measure (PRO-PM) Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA)
Hospital-Level Risk-Standardized Complication Rate (RSCR) Following Elective Primary THA/TKA
Are you equipped to handle these new requirements?
Mandatory data collection begins April 1, 2024, and failure to submit timely data can result in a 25 percent reduction in payments by Medicare.
Attend this webinar to learn how mobile engagement can empower your organization to meet this requirement.
2024 Medicare Physician Fee Schedule (MPFS) Final Rule UpdatesHealth Catalyst
According to the Centers for Medicare & Medicaid Services (CMS), the calendar year (CY) 2024 MPFS final rule was created to advance health equity and improve access to affordable healthcare. This webinar will cover the major policy updates of the MPFS final rule including updates to the telehealth services policy and remote monitoring services and enrollment of MFTs and MHCs as Medicare providers. The conversation will also cover policy changes on split (or shared) evaluation and management (E/M) visits, and the Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging.
What's Next for OPPS: A Look at the 2024 Final RuleHealth Catalyst
During this webinar, we’ll analyze the key provisions of the OPPS final rule and identify the significant changes for the coming year to help prepare your staff for compliance with the 2024 Medicare outpatient billing guidelines.
Insight into the 2024 ICD-10 PCS Updates - Part 2Health Catalyst
Prepare for mandatory ICD-10 PCS diagnosis code updates, which take effect on October 1, 2023. By attending this 60-minute educational session, medical coders and healthcare professionals will gain a comprehensive understanding of the changes to the 2024 ICD-10 procedure codes and their guidelines, enabling accurate and compliant coding for optimal billing and reimbursement.
Vitalware Insight Into the 2024 ICD10 CM Updates.pdfHealth Catalyst
Prepare for mandatory ICD-10 CM diagnosis code updates, which take effect on October 1, 2023. By attending this 60-minute educational session, medical coders and healthcare professionals will gain a comprehensive understanding of the changes to the 2024 ICD-10 diagnosis codes and their guidelines, along with major complication or comorbidity (MCC), complication or comorbidity (CC), and Medicare Severity Diagnosis Related Groups (MS-DRGs) classification changes. With this information, professionals can ensure accurate and compliant diagnosis coding for optimal billing and reimbursement.
Driving Value: Boosting Clinical Registry Value Using ARMUS SolutionsHealth Catalyst
Many hospitals today face a perfect storm of operational and financial challenges. With increasing competition from outpatient facilities and rising care costs negatively impacting budgets, now is the time to boost your clinical registry’s value. However, collecting and analyzing data can be time-consuming and costly without the right tools. During this webinar, we will share insights and best practices for increasing the value of registry participation and how it’s possible to reduce costs while improving outcomes using the ARMUS Product Suite.
Tech-Enabled Managed Services: Not Your Average OutsourcingHealth Catalyst
During this webinar you'll learn the following:
The importance of optimizing performance, reducing labor costs and sourcing talent given current market challenges.
Highlighting the need for a balanced approach to cost reduction.
How to reap the benefits of outsourcing (cost cutting, expertise, etc) while protecting yourself from the collateral damage that often comes with them.
This webinar will provide an in-depth review of the CPT/HCPCS code set changes that will be effective on July 1, 2023. The review will include additions and deletions to the CPT/HCPCS code set, revisions of code descriptors, payment changes, and rationale behind the changes.
How Managing Chronic Conditions Is Streamlined with Digital TechnologyHealth Catalyst
Chronic conditions across the United States are prevalent and continue to rise. Managing one or more chronic diseases can be very challenging for patients who may be overwhelmed or confused about their care plan and may not have access to the resources they need. At the same time, care teams are overburdened, making it difficult to provide the support these patients require to stay as healthy as possible. A new approach to chronic condition management leverages technology to enable organizations to scale high-quality care, identify gaps in care, provide personalized support, and monitor patients on an ongoing basis. Such streamlined management will result in better outcomes, reduced costs, and more satisfied patients.
COVID-19: After the Public Health Emergency EndsHealth Catalyst
In this fast-paced webinar, we will discuss the impact of the end of the public health emergency (PHE), including upcoming changes to the different flexibilities allowed during the PHE and the timeline for when these flexibilities will end. We’ll also cover coding changes and reimbursement updates.
Automated Medication Compliance Tools for the Provider and PatientHealth Catalyst
When it comes to sustaining patient health outcomes, compliance and adherence to medication regimens are critically important, especially as providers manage patients with complex care needs and multiple medications. But, with provider burnout and staffing shortages at an all-time high, an efficient solution is critical. The use of automated medication management workflows to decrease provider burnout, while improving both medication compliance and patient engagement, is the way forward.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Trauma Outpatient Center is a comprehensive facility dedicated to addressing mental health challenges and providing medication-assisted treatment. We offer a diverse range of services aimed at assisting individuals in overcoming addiction, mental health disorders, and related obstacles. Our team consists of seasoned professionals who are both experienced and compassionate, committed to delivering the highest standard of care to our clients. By utilizing evidence-based treatment methods, we strive to help our clients achieve their goals and lead healthier, more fulfilling lives.
Our mission is to provide a safe and supportive environment where our clients can receive the highest quality of care. We are dedicated to assisting our clients in reaching their objectives and improving their overall well-being. We prioritize our clients' needs and individualize treatment plans to ensure they receive tailored care. Our approach is rooted in evidence-based practices proven effective in treating addiction and mental health disorders.
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Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
For those battling kidney disease and exploring treatment options, understanding when to consider a kidney transplant is crucial. This guide aims to provide valuable insights into the circumstances under which a kidney transplant at the renowned Hiranandani Hospital may be the most appropriate course of action. By addressing the key indicators and factors involved, we hope to empower patients and their families to make informed decisions about their kidney care journey.
This document is designed as an introductory to medical students,nursing students,midwives or other healthcare trainees to improve their understanding about how health system in Sri Lanka cares children health.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Looking Back on Clinical Decision Support and Data Warehousing
1. Culturally-Driven Process Improvement
Enabled By Technology
Guest Lecture for Health Information Science
HINF 551
University of Victoria
May 2008
Clinical Decision Support
and Data Warehousing
Dale Sanders
312-695-8618
dsanders@nmff.org
2. 2
• Complex, life-critical, time-critical computerized decision support
• It all boils down to managing false positives and false negatives, then
optimizing your intervention and response
My background
US Air Force
Command,
Control,
Communications,
Computers &
Intelligence (C4I)
Officer
TRW/National
Security Agency
• START Treaty
• Nuclear Non-
proliferation
• US nuclear
weapons threat
reduction
Director of Medical
Informatics, LDS
Hospital/Intermountain
Healthcare
CIO,
Northwestern
CIO, Cayman Islands
National Health System
Product
Development,
Health Catalyst
20161983
Reagan/Gorbachev
Summits
Nuclear Warfare
Planning and
Execution–
NEACP &
Looking Glass
3. 3
Acknowledgements & Thanks
Robert Jenders, MD, MS
Associate Professor, Dept of Medicine, Cedars-Sinai Medical
Center & UCLA
Co-chair, HL7 Clinical Decision Support TC & Arden Syntax SIG
R. Matthew Sailors, PhD
Assistant Professor, Dept of Surgery, UT-Houston
Co-chair, HL7 Clinical Decision Support TC & Arden Syntax SIG
Clinical Decision Support and Arden Syntax
4. Overview
• Patient information systems trends & concepts
• Enterprise Data Warehouse (EDW)
– Basic Terms and Concepts
– Case Study Examples
– Intermountain Healthcare
– Northwestern University
• Clinical Decision Support
5. 5
Information Systems:
The Three Perspectives
Transaction Systems:
Collecting data that
supports analytics &
efficient workflow
Analytic Systems:
Aggregating and exposing
data to improve workflow
Knowledge Systems:
Organizing, sharing,
and linking
information
• Query and reporting tools
• Enterprise data warehouses
• Benchmarking data
• Document imaging
• Videoconferencing
• Collaboration tools
• Intranets/Internet access
• Search engines
• EMR’s
• Billing systems
• GL systems
• HR systems
• Scheduling systems
• Inventory management systems
Goal
Measurement
Goal
achievement
Goal
Achievement
Designed to support
6. 6
Patient Information
Systems Trends
Transportability and Interoperability
– Information moves with the patient
Real-time alerts and reminders
– Drug-drug and drug-allergy interactions
Data-driven treatment planning
Disease management at the point-of-care
Payer-driven data collection
– Pay for Performance (P4P)
Quality of care reporting
Transparency of cost is coming
7. 7
Health consumerism movement
– Demands for improved and more transparent
information access
– Demands for more security and privacy
– The “credit report” phenomenon
Computerized patient records
– Legislation and state and federal initiatives are
supporting investment in collaborative software
Regional health information networks are receiving
funding
– For collaborative clinical information sharing and for
pay-for-performance initiatives
Patient Information
Systems Trends
8. 8
Patient Care Data “Customers”
Patient Care Data
Financial
HIS Coding (HDM)
A/R Management
Standard Costing
Materials Management
Case Mix
Clinical
Patient Safety
Clinical Programs
Clinical Support Services
Case Mix
Accreditation/Regulatory
JCAHO, NCQA, HEDIS
HIPAA, EMTALA, OSHA, CLIA
Third-party Payers
Claims information
Utilization management
Case management
9. 9
Meaningful,
maintainable point-of-care
clinical decision support
•Registration
•Scheduling
•Accts Receivable
•Patient/payer billing
•Reporting
•HIPAA claims,
eligibility, remittance
•Benefit plan tracking
•Co-pay tracking
•Referral management
•COB
•Risk management
•Patient education
•Encounter
documentation
•Charge capture
•Diagnostic coding
•ePrescribing
•Allergy alerts
•D-D interactions
•Medical history
•Messaging & real time
collaboration
•Patient portal
• Self-scheduling
• Self-registration
• Account management
• Results & history
• Rx refills
• Credit card payment
•Lab interfaces
•Payer/clearinghouse interfaces (HIPAA)
•Integrated orders
•Integrated results
•ePrescribing
•Patient education
•Clinical references within context
•Affiliated referring partners
Business Intelligence/”Pay for Performance” Metrics
Workflow & Handoff Between Clinical and Business Processes
Core
Best Practices Reminders Meaningful Alerts
Advantage Differentiator Off The Edge
Regional/External Entities
Functional Framework:
Electronic Health Record
Leading Edge
• Rare & difficult
• The next frontier
10. The Future EHR User Interface
• Patient specific data
– Much like current EHRs
– “Tell me about this patient.”
• Disease management data
– “Tell me about managing patients like this.”
• Treatment options data
– “Tell me about my options for treating this patient.”
– “Tell me about the most common tests and medications ordered for patients like this.”
• Cost of care data
– “Tell me about how much these treatment options cost.”
• Clinical outcomes data
– “Tell me how satisfied patients were with these treatment options.”
10
14. 14
Multiple, Collaborative Organizations
EDW
A single data perspective
on the patient care process
Diagnostic systems
•Lab System
•Radiology
•Imaging
•Pathology
•Cardiology
•Others
Diagnosis
Registration &
Scheduling
Patient
Perception
Orders &
Procedures
Results &
Outcomes
Billing &
Accounts
Receivable
Claims
Processing
Encounter
Documentation
•ADT System
•Master Patient Index
Pharmacy Electronic
Medical Record
Surveys•Diagnostics
•Pharmacy
Billing and AR
System
Claims Processing
System
Diagnostic systems
•Lab System
•Radiology
•Imaging
•Pathology
•Cardiology
•Others
Diagnostic systems
•Lab System
•Radiology
•Imaging
•Pathology
•Cardiology
•Others
Diagnosis
Registration &
Scheduling
Patient
Perception
Orders &
Procedures
Results &
Outcomes
Billing &
Accounts
Receivable
Claims
Processing
Encounter
Documentation
•ADT System
•Master Patient Index
Pharmacy Electronic
Medical Record
Surveys•Diagnostics
•Pharmacy
Billing and AR
System
Claims Processing
System
Diagnosis
Registration &
Scheduling
Patient
Perception
Orders &
Procedures
Results &
Outcomes
Billing &
Accounts
Receivable
Claims
Processing
Encounter
Documentation
•ADT System
•Master Patient Index
•ADT System
•Master Patient Index
PharmacyPharmacy Electronic
Medical Record
Electronic
Medical Record
SurveysSurveys•Diagnostics
•Pharmacy
•Diagnostics
•Pharmacy
Billing and AR
System
Billing and AR
System
Claims Processing
System
Claims Processing
System
Diagnostic systems
•Lab System
•Radiology
•Imaging
•Pathology
•Cardiology
•Others
Diagnosis
Registration &
Scheduling
Patient
Perception
Orders &
Procedures
Results &
Outcomes
Billing &
Accounts
Receivable
Claims
Processing
Encounter
Documentation
•ADT System
•Master Patient Index
Pharmacy Electronic
Medical Record
Surveys•Diagnostics
•Pharmacy
Billing and AR
System
Claims Processing
System
Diagnostic systems
•Lab System
•Radiology
•Imaging
•Pathology
•Cardiology
•Others
Diagnostic systems
•Lab System
•Radiology
•Imaging
•Pathology
•Cardiology
•Others
Diagnosis
Registration &
Scheduling
Patient
Perception
Orders &
Procedures
Results &
Outcomes
Billing &
Accounts
Receivable
Claims
Processing
Encounter
Documentation
•ADT System
•Master Patient Index
Pharmacy Electronic
Medical Record
Surveys•Diagnostics
•Pharmacy
Billing and AR
System
Claims Processing
System
Diagnosis
Registration &
Scheduling
Patient
Perception
Orders &
Procedures
Results &
Outcomes
Billing &
Accounts
Receivable
Claims
Processing
Encounter
Documentation
•ADT System
•Master Patient Index
•ADT System
•Master Patient Index
PharmacyPharmacy Electronic
Medical Record
Electronic
Medical Record
SurveysSurveys•Diagnostics
•Pharmacy
•Diagnostics
•Pharmacy
Billing and AR
System
Billing and AR
System
Claims Processing
System
Claims Processing
System
Diagnostic systems
•Lab System
•Radiology
•Imaging
•Pathology
•Cardiology
•Others
Diagnosis
Registration &
Scheduling
Patient
Perception
Orders &
Procedures
Results &
Outcomes
Billing &
Accounts
Receivable
Claims
Processing
Encounter
Documentation
•ADT System
•Master Patient Index
Pharmacy Electronic
Medical Record
Surveys•Diagnostics
•Pharmacy
Billing and AR
System
Claims Processing
System
Diagnostic systems
•Lab System
•Radiology
•Imaging
•Pathology
•Cardiology
•Others
Diagnostic systems
•Lab System
•Radiology
•Imaging
•Pathology
•Cardiology
•Others
Diagnosis
Registration &
Scheduling
Patient
Perception
Orders &
Procedures
Results &
Outcomes
Billing &
Accounts
Receivable
Claims
Processing
Encounter
Documentation
•ADT System
•Master Patient Index
Pharmacy Electronic
Medical Record
Surveys•Diagnostics
•Pharmacy
Billing and AR
System
Claims Processing
System
Diagnosis
Registration &
Scheduling
Patient
Perception
Orders &
Procedures
Results &
Outcomes
Billing &
Accounts
Receivable
Claims
Processing
Encounter
Documentation
•ADT System
•Master Patient Index
•ADT System
•Master Patient Index
PharmacyPharmacy Electronic
Medical Record
Electronic
Medical Record
SurveysSurveys•Diagnostics
•Pharmacy
•Diagnostics
•Pharmacy
Billing and AR
System
Billing and AR
System
Claims Processing
System
Claims Processing
System
Hospital X
Hospital Y
Physician Office Z
15. Sanders’ Hierarchy of Analytic Maturity
• Basic business reporting
– Financial and Human Resources
• Legal compliance reporting
– As required by state and federal law
– Cancer Registry, mortality rates, et al
• Professional accreditation reporting
– Joint Commission, Society of Thoracic Surgeons, et al
• Quality of care reporting
– Physician Quality Reporting Initiative, Leap Frog, et al
• Patient Relationship Management (PRM)
– Borrowing from Customer Relationship Management in retail
– Tailored to the entire context of the patient
– Simpler, faster patient satisfaction and outcomes feedback
– Clinical “Loose Ends”
• Real-time analytic fusion
– Blending patient specific data with general patient type data
– “Other physicians who saw patients like this, ordered these medications and tests.”
15
Increasing Maturity
16. Healthcare Analytics Adoption Model
Level 8
Personalized Medicine
& Prescriptive Analytics
Tailoring patient care based on population outcomes and
genetic data. Fee-for-quality rewards health maintenance.
Level 7
Clinical Risk Intervention
& Predictive Analytics
Organizational processes for intervention are supported
with predictive risk models. Fee-for-quality includes fixed
per capita payment.
Level 6
Population Health Management
& Suggestive Analytics
Tailoring patient care based upon population metrics. Fee-
for-quality includes bundled per case payment.
Level 5 Waste & Care Variability Reduction
Reducing variability in care processes. Focusing on
internal optimization and waste reduction.
Level 4 Automated External Reporting
Efficient, consistent production of reports & adaptability to
changing requirements.
Level 3 Automated Internal Reporting
Efficient, consistent production of reports & widespread
availability in the organization.
Level 2
Standardized Vocabulary
& Patient Registries
Relating and organizing the core data content.
Level 1 Enterprise Data Warehouse Collecting and integrating the core data content.
Level 0 Fragmented Point Solutions
Inefficient, inconsistent versions of the truth. Cumbersome
internal and external reporting.
16
18. 18
Examples of Clinical Goals
• Decrease the total number of
nulliparous elective inductions with
a Bishop Score <10 by 50%
• Keep the variable cost increase of
deliveries without complications
resulting in normal newborns to
5.73% for 2003
• For all adult patients with diabetes,
increase the percent of patients with
LDL less than 100 to >=45.5%.
(Currently 44.5%)
• Measured glucose values will be
between 60 and 155 mg/dl 80% of
the time for all ICU patients
• 100% compliance to post-surgery
radiation therapy protocols for
breast cancer cases with >4
positive nodes and tumor size
>=5cm
• Compliance with the timing of
administration of Pre-surgical
Prophylactic Antibiotic Usage will
exceed 91%
• For patients being treated for
depression, increase the
percentage continuing on
prescribed antidepressant for 6
months after filling first prescription
to >=44.6%
25. 25
Structured vs. Unstructured Data
Representation of Human
Experience & Knowledge
ComputableAnalyticValue
• Text
• Video
• Recorded
Audio
• Structured,
discrete data
• Face-to-Face
Audio
27. 27
Case Study
• Primary Care: Diabetes
– Motive: Improved long-term management of diabetes patients
– RAND Study 2002: “64% of diabetic patients receive inadequate care.”
– Integrates five disparate data sources
– Lab
– Problem list
– Insurance claims: CPT’s and pharmacy
– In-patient pharmacy
– Hospital ICD-9
– This one hits home
– Winner
– National Exemplary Practice Award 2002
– American Association of Health Plans
28. Measure Goal
HbA1c (test at least 2 times a
year)
<7.0%
Blood Pressure
(check at each office visit)
<130/80 mm
Hg
LDL Cholesterol
(test at least every 2 years)
<100 mg/dL
Triglycerides
(test at least every 2 years)
<150 mg/dL
Foot Exam (perform at least
annually)
normal
Urine Microalbumin/Creatinine
Ratio (test at least annually)
<30
Dilated Eye Exam (check
annually,
or every 2 years if well
controlled)
normal
Diabetes CPM:
Key Indicators
28
36. Case Study
• Labor and Delivery - Elective Inductions
– Continue to educate physicians and patients on the safe
and efficacious practice of elective labor induction.
– To maintain at ≤5% elective deliveries that do not meet
strict criteria (39 weeks gestation) developed by the
Intermountain Obstetrical Development Team.
– To measure clinical outcomes of care and report
quarterly by provider.
36
40. Data Loaded to Date
Metric Value
Number of Rows 3,173,632,200
Terabytes 2.2
Truckloads 1,233
Complete works of Shakespeare 252,483
41. 41
Early Adopters and Value of the EDW
Customer Analytic Use
NUgene Relating genomic data and clinical profiles for phenotyping high risk
diseases such as diabetes and asthma
Neurosurgery A summary of new patients, encounters and diagnoses from the
EDW is import daily into MDAnalyze, a Neurosurgery outcomes
database
Alan Peaceman, MD Creation of a perinatal patient registry for studying clinical quality
outcomes; BMI relationships to complications
Bill Grobman, MD Statistics of deliveries at NMH in preparation for a grant proposal
Dana Gossett, MD Application of Systemic Inflammatory Response Syndrome (SIRS)
criteria to pregnant and postpartum women with infectious
complications
Andrew Naidech, MD First adopter of the Research Patient Data Aggregator for use in
research and clinical quality assessment of subarachnoid
hemorrhage, intracerebral hemorrhage, and stroke patients
NMH Process Improvement A DMAIC project aimed at improving the quality of care for patients
seen with bone fractures at NMH. Used the EDW to help narrow
and speed their search for bone fracture patients using a query of
text-based Radiology reports.
42. 42
Specific Research Example
For the last year for the women who deliver, provide…
• mean age and standard deviation
• percent between 18-34, inclusive
• ethnic breakdown, at least by white, black, latino
• % smokers
• % singletons (i.e. no twins or triplets)
• % who receive their prenatal care with an NMH doc
• mean BMI and standard deviation
• % BMI < 19
• % BMI 19 - 29.9
• % BMI > 29.9
• % who start prenatal care in the first trimester
Rapid turnaround (<2 days) to meet a grant submission deadline…
43. 43
Other Examples
• How many patients were prescribed an NSAID and who also had a lab
value which indicated reduced renal function (lab result of GFR < 50 or
Creatinine > 1.5)?
– Answer: 725 out of 16214 in calendar year 2007
• What percentage of patients diagnosed with multiple myeloma in
remission over age 18 were prescribed bisphosphonates in the past 12
months?
– Answer: 18%
• How many patients who have had 1 or more low LVEF (<40) measurements in
our outpatient echo system (Xcelera) and who have received a low LVEF
measurement within the last 180 days and who have not seen one of the
following doctors in a Northwestern clinic office visit within the last 120 days?
– 'KADISH, ALAN H.'
– 'GOLDBERGER, JEFFREY J.'
– 'PASSMAN, ROD S.'
– 'DENES, PABLO'
– 'JACOBSON, JASON‘
– Answer: 309
44. Changes in quality measures during the first 3 months of the study
MEASURE Satisfied (%)
Sept 301, 2007
Satisfied (%)
Dec 31, 2007
Satisfied (%)
April 30, 2008
Coronary Heart Disease
Beta blocker in MI 0.89 0.91 0.91
Antiplatelet drug 0.90 0.89 0.91
Lipid lowering drug 0.88 0.88 0.89
ACE inhibitor/ARB in DM or LVSD 0.84 0.84 0.85
Heart Failure
ACE inhibitor/ARB in LVSD 0.86 0.87 0.85
Anticoagulation in atrial fibrillation 0.63 0.64 0.72
Beta blocker in LVSD 0.83 0.84 0.85
Hypertension control 0.76 0.75 0.76
Diabetes Mellitus
Blood pressure management 0.60 0.60 0.63
HbA1c control ( < 8) 0.63 0.65 0.64
LDL control 0.51 0.51 0.52
Aspirin for primary prevention 0.76 0.77 0.83
Nephropathy screening/management 0.81 0.82 0.83
Examples
45. Prevention
Screening mammography 0.79 0.80 0.84
Cervical cancer screening 0.80 0.81 0.80
CRC screening 0.49 0.48 0.47
Pneumococcal vaccination 0.49 0.52 0.54
Osteoporosis screening or
therapy
0.76 0.79 0.82
Changes in quality measures during the first 3 months of the study
MEASURE Satisfied
(%)
Sept
301,
2007
Satisfied
(%)
Dec 31,
2007
Satisfied
(%)
April 30,
2008
49. Why Didn’t the Patient
Follow the Protocol?
• 167 patient reasons for not following advice for
preventive service
– 9 have resulted in patient having service
• 2 patients unable to afford medication
• 14 patients refused medication
– 0 have started medication
50. Why Didn’t the Physician
Follow the Protocol?
• 147 cases in which medical exceptions or modifiers
were given
– 132 appropriate on initial review
– 5 discussed with another reviewer and judged
appropriate
– 4 discussed with another reviewer and judged
inappropriate: feedback given
– 6 reviewed with peer reviewer and expert and
recommended change in management
52. 52
Clinical DSS Structure
Point-of-Care DSS
– Alerts, reminders
Retrospective
– What happened?
Prospective
– What will happen?
53. 53
Where Does It Appear?
Organization of Data
– “checklist effect”
Stand-Alone Expert Systems
– often require redundant data entry
Data Repository: Mining
CDSS Integrated into Workflow
– push information to the clinician at the point
of care
– examples: EMR, CPOE
54. 54
The Revolutions in CDSS
Phase 1: Quality and safety of care
– What is “good care”?
– Did we provide good care?
– Barely entering this phase now
Phase 2: Economics of care
– What does good care cost?
– Did we provide good care at the most effective cost?
Phase 3: Genomics of care
– What are the genomic influences on good care?
– Did we provide personalized, tailored care?
55. 55
Key Architectural Elements
Data capture/display/storage
– EMR
– central data repository
Controlled, structured vocabulary
Knowledge representation (e.g., Arden)
Knowledge acquisition
Clinical event monitor: integrate the pieces
for many different uses (clinical, research,
administrative)
56. 56
Foundation and Rationale for
Decision Support Models
Mathematics, mathematical models and
decision making
Probability and statistics (Bayesian models)
Rule-based decision-making
– IF the patient has symptoms A or B or C
THEN
– Prescribe medication X and treatment Y and
schedule next visit for T weeks
Data-driven models
– Looks for patterns within a test set of data
and then generalize
57. 57
Justification for CDSS:
Medical Errors
Estimated annual mortality:
Air travel deaths 300
AIDS 16,500
Breast cancer 43,000
Highway fatalities 43,500
Preventable medical errors 44,000 -
(1 jet crash/day) 98,000
Costs of Preventable Medical Errors:
$29 billion/year overall
1999 Institute of Medicine (IOM) Report
58. 58
Definitions: What is an error?
Error of execution: Failure of an action to be
completed as planned
Error of planning: Use of a wrong plan to achieve an
aim
Adverse event: An injury caused by medical
management (and not the result of the patient’s
condition)
Preventable adverse event: An adverse event
attributable to error
Negligent adverse event: A preventable adverse event
that satisfies criteria for malpractice
59. 59
Errors in Medicine
Hospital admissions: 2.9% (UT/CO, 1992) -
3.7% (NY, 1984) have an adverse event
Proportion of preventable adverse events: 53%
(CO/UT) - 58% (NY)
Extrapolate to USA (33.6M admissions in
1997): 44,000 - 98,000 deaths
60. 60
Errors in Medicine
Types of adverse events (Harvard
Medical Practice Study, 1991):
– drug complications: 19%
– wound infections: 14%
– technical complications: 13%
50% associated with operations
61. 61
Clinical DSS: The Impact
Examined randomized and nonrandomized
controlled trials that evaluated the effect of a
CDSS compared with care provided without a
CDSS on practitioner performance or patient
outcomes.
CDSS improved practitioner performance in
62 (64%) of the 97 studies
JAMA. 2005;293:1223-1238.
62. 62
Case Studies:
Examples of CDSS Effectiveness
Perioperative Antibiotic Administration
– intervention: reminder re timing and type of abx
– period: 1988 - 1994
– result: perioperative wound infections dec 1.8% ->
0.9%
– avg # doses: 19 -> 5.3
– overall antibiotic cost (constant $) per treated
patient: $123 -> $52
Pestotnik SL, Classen DC, Evans RS, Burke JP. Implementing antibiotic practice
guidelines through computer-assisted decision support: clinical and financial
outcomes. Ann Intern Med 1996;124(10):884-90.
64. 64
Examples (continued)
Reminders of Redundant Test Ordering
– intervention: reminder of recent lab result
– result: reduction in hospital charges (13%)
– Tierney WM, Miller ME, Overhage JM et al. Physician inpatient order writing on
microcomputer workstations. Effects on resource utilization.
JAMA 1993;269(3):379-83.
Preventive Health Reminders in HIV
– intervention: reminders to perform screening tests or
vaccination (e.g., pap smear, HBV)
– result: sig decreased time to documentation (median = 11 vs
52 days)
– Safran C, Rind DM, Davis RB et al. Guidelines for management of HIV infection with
computer-based patient's record. Lancet 1995;346(8971):341-6.
65. 65
Examples (continued)
Systematic review
– 68 studies
– 66% of 65 studies showed benefit on physician
performance
• 9/15 drug dosing
• 1/5 diagnostic aids
• 14/19 preventive care
• 19/26 other
– 6/14 studies showed benefit on patient outcome
Hunt DL, Haynes RB, Hanna SE et al. Effects of computer-based clinical
decision support systems on physician performance and patient outcomes:
a systematic review. JAMA 1998;280(15):1339-46.
66. 66
Other CDSS Success Stories
Point-of-Care Decision Support
– Bilirubin Management in neonates
– Ventilator Management in ARDS
– Coumadin Management
– Glucose Management in the ICU
– Antibiotic Assistant
– Infectious Disease Monitoring
68. 68
Goals of AI
Study the thought processes of humans to
better understand the complexity of
human intelligence
Create computer systems which achieve
human levels of reasoning
69. 69
Knowledge Representation Formalisms:
Their Role
Express policies (institutional, national, international)
in computable format
Formulate interventions in medical practice
Make local variations in guidelines
Provide “intelligence” to a clinical expert system
71. 71
Roots of Medical AI
MYCIN (late 1070s)
– Shortliffe, et al, at Stanford
– 1970s, infectious disease and antibiotic
therapies
– Rules-based
PUFF (early 1980s)
– Based on MYCIN
– Pulmonary data interpretation
72. 72
Roots of Medical AI
APACHE (1981)
– http://www.cerner.com/public/Cerner_3.asp?id=3562
– Point of care in ICU
73. 73
Computers Are Good At…
Computational functions - add, subtract,
multiply, divide, compare
– The most familiar
Symbolic reasoning
Pattern recognition
74. 74
The Arden Syntax
A symbolic language for encoding medical knowledge
Adopted by HL7 and ANSI in 1999
Used to develop Medical Logic Modules (MLMs)
Each MLM can make a single medical decision
– MLMs can be chained
Can be used for variety of clinical decision support
functions
– E.g., alerting physicians of potential kidney failure
75. 75
Arden Syntax: Assessment
Incorporated into several vendors’ products
Growing number of installation sites
Facile for simple alerts/reminders
May not be sufficiently expressive for complex
guidelines
76. 76
Support for Arden Syntax
Institutions
Cedars-Sinai Medical Center
Software Vendors
Eclipsys/Healthvision
McKesson
Siemens
Knowledge Vendors
Micromedex
77. 77
Arden Syntax - History
HELP
LDS Hospital
Salt Lake City, UT
CARE
Regenstrief Institute
Indianapolis, IN
Arden Syntax
1989
78. 78
Arden Syntax - Rationale
Arden Syntax arose from the need to make medical
knowledge available for decision making at the point
of care.
Allow knowledge sharing within and between
institutions
Make medical knowledge and logic explicit
Standardize the way medical knowledge is integrated
into hospital information systems
79. 79
Pattern Recognition
Objects, events or processes are described by their
qualitative features, logical, and computational
relationships
Examples
– Computer matches pattern found in a new x-ray to
other cases to determine diagnosis
– Searching text for context-based key words
• Spam filters
80. 80
Wikipedia
Based on either a priori knowledge or on
statistical information extracted from the
patterns
Sensor
Feature
Extraction
Classification
Engine
Training Set
Real Data
81. 81
Other AI Methods
Genetic algorithms
– Selection, recombination, mutation
Search algorithms
Constraint-based problem solving
– When conditions in variables are met,
then execute
Frame-based reasoning
84. 84
In Summary
Enterprise Data Warehouses and
Electronic Medical Records work hand-
in-hand to address Clinical Decision
Support
Artificial Intelligence has yet to prove
itself scalable beyond informatics
research projects