IBM COGNOS in Healthcare

Michael LangtonManaging Director

Natalija PavicAccount Manager

AGENDA• Healthcare Challenges• Discuss Account and Visit Website• Business Analytics for Healthcare Overview• Dashboards, Data Visualization• DEMO• Healthcare Performance Management,

Workforce Planning• Summary of Benefits• Watson• Next Steps

Healthcare Challenges

• Pay for Performance metrics – Readmission penalties before 30 days fee– Overstaying patients put strain on the system– Ambulance diversions lower quality of care

• Medicare/Medicaid/HMO set prices and fee schedules for certain procedures

• US Law require hospitals to provide care even to those not able to pay– Therefore cost is distributed to those able to

pay

What will be important?

• Currently using: – Anvita Health to monitor patient experience and

quality of care with sophisticated reporting– Peoplesoft (Oracle) for financial systems but seeking

Accounting Director with advanced “excel” skills

• Might Need:– Performance Management for cost optimization and

workforce management– Dashboards/Scorecards to visualize KPIs– Predictive Analytics for patient demographic analysis

and remission analysis

WEBSITE VISIT

Business Analytics Overview• Track and monitor revenues, margins, and operational

performance• Analyze results, identify trends, detect patterns and

predict outcomes• Model the impact of business decisions to improve

financial processes• Monitor quality initiatives and care programs• Support pay for performance goals and initiatives• Gain an enterprise-wide view of performance against

organizational goals, key performance indicators (KPIs) and strategic objectives

• Quickly adjust plans to meet financial objectives and support profitable growth

Human resources… optimize resource allocation and workforce planning to improve service levels and optimize cost?

Doctors and patients... could collaborate and track recovery with treatment compliance and disease management with quick alerts if patients miss or skip treatment?

Executive leaders… had a clear view of organizational performance and were alerted to patient quality issues before they became a problem?

Finance... could reduce operating costs, perform dynamic budgeting and forecasting, and improve overall accountability

Decision Support... could reduce wait times for patients?

Healthcare providers are turning to analytics to deliver smarter outcomes

What if …

• Typical Hospital has more than 50 data sources

• Most are best of breed solutions, this creates many data silos

• “Excel Hell”

• Leverage and extend the investment in the Hospital Information Systems (Meditech, etc.)

Healthcare Complications and Challenges

Healthcare increasingly will use analytics to drive clinical and operational improvements to meet business challenges

Predictive Analytics

Decision support analytics

Data integration;

data warehouse

Transaction

reporting

Ad-hoc Reporting

Standard Reporting

Alerts

Query/Drill-down

Simulation

Forecasting

Optimization

Predictive Modeling

• Basic reporting tools

• Spreadsheets

• Applications’ report modules

• Financial/operational dashboards

• Clinical data repositories

• Departmental data marts Current analytics level

• Enterprise analytics

• Evidence-based medicine

• Clinical outcomes analytics

• Successful ALC patients

• Readmission probability

• Patient, member behavior

2010 2010-2014

2011-2014

2012-2015

Healthcare Performance Management

1. What is happening? A gauge of the most critical indicators for your organization

2. Why is it happening? The ability to dig deeper into current issues to understand what led to the results

3. What should we be doing? The ability to set plans, allocate resources, monitor them and adapt

4. What is likely to happen in the future? Being able to monitor and analyze current and past performance to proactively address evolving trends and predict outcomes

Business Analytics solutions help optimize decision making

Quality directorClinician

.

Business analystExecutiveFinance officerMedical officer

Messagesources

Relationalsources

Applicationsources

OLAPsources

Modern and legacy sources

Smartphone PowerPoint Browser TabletExcel Email

Dashboards Scorecards Reports Queries Analysis Networkanalytics

Predictivemodeling

Planning/ budgeting

IBM Business Analytics software—independent, service-oriented architecture (SOA)-based platform

Unstructured data

Ambulatory systems

Human resourcesClinical systems

Scheduling

Claims management

Financial systems

Call center Supply chain

Risk management Contracts

Access from

Deliver insight to

?

Opportunities for Analytics in Healthcare

What-if Analysis

Driver Based Planning

Workforce/Labour Planning

Planning Transparency

Planning KPI’s & Variances

Planning/Forecasting/Budgeting

Tracking Variances in Financial/Operational/HR Performance

Personal Analytics

Slicing & Dicing

Dashboards

Data Security

Dashboards• Monitor revenues and margin performance by service line,

by department, by facility and at the enterprise level

• Measure performance against strategic institutional initiatives

• Monitor quality across multiple locations and service lines

• Track financial goals in terms of growth, profitability, key controllable expenses and return on net assets

• Aggregate profitability and operational data from multiple silos across the organization to deliver dashboards and scorecards to care providers and management

DEMO TIME

Performance Management • Develop long-range, financial, cost center and headcount plans,

forecasts and budgets• Create driver-based models for expense planning based upon

patient days, visits ,units of service, procedure and more• Create operational plans for facilities, clinics and service lines• Plan for adjustments based on projected demographic and/or

environmental influences (e.g. market competition, changes in referral patterns, changes in reimbursement rates, etc.) that impact volume and dollar projections

• Gain consensus and consolidate top-down and bottom-up operational plans with financial plans

• Increase accountability across the organization through a high-participating planning process

• Support timely updates of forecasts to address changing market influences, new initiatives and competitive factors

• Manage and consolidate plans via integrated workflows

Workforce Planning

• Pay for Performance Funding Model

• 80% of Healthcare costs are in Payroll

• Workforce Planning is critical to optimizing resources and is very intensely manual (should be driver based)

• Includes BI/TM1/SPSS and Mobile

• Service line and departmental reporting, analysis, dashboards and scorecards let service-line directors and operational staff see at a glance how individual clinics, ambulatory centers, departments and/or service lines are performing

• Marketing departments can identify service areas to target to more efficiently serve the community and enhance operational performance

• Initiative planning lets you perform what-if analysis and plan marketing initiatives by service, by specialty, by market or practice

• Service line P&L calculation and forecasting can be created dynamically from revenue, balance sheet and cost information to provide profitability insights

Improve Profitability

Summary of Benefits• Tying performance targets

to events, trends and risk factors

• Shorter planning cycles• Focusing on achievement of

specific tactics and initiatives

• Critical business ratios to gain understanding

• Continuous planning• Rolling forecasts

Summary of Benefits• Reduce costs

– Identify, implement and monitor operational process efficiencies to drive down operating cost

• Improve care quality– Optimize and align clinical processes to improve quality, patent

safety and clinical outcomes

• Promote transparency and access– Provide cost and quality information to purchasers, consumers and

regulators to drive accountability, collaboration and equitable access to care

• Drive sustainable and profitable growth– Support the organizational mission by ensuring market

competitiveness and leveraging capacity and capabilities to expand into new markets, partnerships, products and services

ONE MORE THING

WATSON

AVAILABLE FOR FREE

WHAT IS WATSON?

• Smart analytics artificial intelligence

• Natural Language Capabilities Evidence Based Learning Hypothesis Generation

• For querying massive unstructured text data using natural speech

• Healthcare applications in patient diagnosis and solving complex problems

Next Steps• Business Analytics Projects? Plans? Pains?

• Target Finance, Administrative, Decision Support Departments

• Questions to ask: – How do you manage costs?– What affects profitability within your organization? – How do you forecast/budget?– How long does it take you to plan? – Could your financial costing/quality system be improved? – Do you run into staff shortages/overages? – How do you do your workforce planning?

QUESTIONS?