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“Big Data, Little Data & Everything In Between”
A Complimentary Webinar From healthsystemCIO.com,
Sponsored By Optum
Your Line Will Be Silent Until Our Event Begins
Thank You!
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Housekeeping
• Moderator – Anthony Guerra, editor-in-chief, healthsystemCIO.com
• Ask A Question• We will be holding a Q&A session after the formal presentations.
• You may submit your questions at any time by clicking on the QA panel located in the lower right corner of your screen, type in your questions in the text field and hit send.
• Please keep the send to default as “All Panelists.”
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Housekeeping
• Download the Deck • Go to: http://healthsystemcio.com/presentation/big-data-little-data-webinar.pdf
• Shortened link below appears on all slides.
• View the Archive• You will receive an email notification when our archive recording is ready.
• Separate registration is required.
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Agenda
• Daniel Morreale, VP/CIO, Riverside Health Care (12 minutes)
• Chuck Podesta, SVP/CIO, Fletcher Allen Healthcare (12 minutes)
• A Word From Our Sponsor: Rodney Cain, VP of Strategic Initiatives, Product Strategy, Optum (5 minutes)
• Q&A (20+ minutes)
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Big Data, Little Data & Everything In Between
Daniel Morreale, VP/CIO, Riverside Health Care
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Big Data, Really?
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Healthcare Does Not Know Big Data
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That’s Big Data
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That’s Big Data
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This Is Not Big Data
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Zeros In Bytes
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Just because there is a lot of data does not mean it is meaningful
Just because data is available does not mean it is useful
Just because the data is there does not mean we have the capacity to use it
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For The Community Hospital Is It About Big Data or Just Basic Analytics?
Big Data
Analytics
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Desire, Data and Doubt
• Big Data is the desire for new insights.
• Big Data bursts the limits of the dialogue.
• Big Data drives down doubt.
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Analytics
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Big Data is Predictive and Demands No Specific Result
Analytics is Retroactive and Seeks a Specific Answer
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I Want To Know
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The True Meaning of Data is That We Master Its Value
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Big Data, Little Data & Everything In Between
Chuck Podesta, SVP/CIO, Fletcher Allen Health Care
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Who We Are
• 562 Bed Academic Medical Center in Burlington, VT.• Vermont’s only Academic Medical Center and Tertiary Care Center• Serving over 1 Million people in VT and Northern New York• Affiliated with University of Vermont College of Medicine & College of
Nursing/Health Sciences• 850 Credentialed Providers and 280 Residents• 450 Employed Providers in University of Vermont Medical Group• Affiliation with Central Vermont Medical Center to create Fletcher Allen
Partners• Affiliation with Champlain Valley Physicians Hospital and ElizabethTown• OneCare LLC (ACO) – January 1, 2013
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OneCare Vermont NetworkStatewide ACO Provider Network• 2 Academic Medical Centers• 13 Community Hospitals• 1 Behavioral Health/Substance Abuse Facility• 2 Federally Qualified Health Centers• 5 Rural Health Clinics• 58 Private Practices
• 280 Primary Care Physicians across Network Participants
• Approximately 42,000 attributed Medicare beneficiaries
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Big Data – What We Know About The Whole
• Volume• More is better
• Timeliness or Velocity• You wouldn’t cross the road with a 5 min old snapshot of traffic
• Variety• From many sources both structured and unstructured
• 80% of the time is spent cleaning it up
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Little Data – What We Know About The Individual
• The Variety Part of Big Data
• One account
• One person
• One transaction
• One customer
• Nike, FitBit
• Tracks activity and sleep
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Big Data and Little Data – A Symbiotic Relationship
Big Data without Little Data Becomes big brother – Web Ads
Little Data without Big Data Becomes un-actionable
FitBit Example
Collects information on you but is not prescriptive
It cannot alone tell you what you should be doing based on the data collected
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Big and Little Data Working Together
• Netflix• Uses Hadoop to graph traffic patterns for all subscribers
• Uses Little Data to optimize video delivery for each subscriber
• Amazon• Analyzing shopper transactions
• Uses Little Data to personalize experience
• Banks• Analyzing billions of transactions to detect fraud
• Uses Little Data to suspend individual account
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Big Data Maturity in Healthcare
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ACOs - Big and Little Data Challenges in Healthcare
• EHR Data is Typically 100% Proprietary• Little data not easily usable outside the system it was first created in
• 80% unstructured
• Combining Little Data with Big Data Requires an HIE Strategy• Multiple EHRs in play
• Claims Data Lagging• Remember Velocity
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Data Governance
• Data Integration Management Group (DIMG)• Representation from Quality, Finance, EHR, Planning, Research
• Create inventory of source data
• Create pathways to link disparate data sources and normalize it
• Institute best practices regarding MDM
• Develop policies to govern release, use, and disposal of data
• Evaluate resources, infrastructure and tools
• Publish a report inventory
• Common nomenclature for data terms, definitions, and calculations
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ACO - Combining Big Data with Little Data
Patient Registries
Real-time Alerts with Retrospective Review
Risk Stratification and Predictive Modeling
Cost effective interventions
Care Management
Identify care gaps and alert
Network Performance
Identify providers using the most resources
Identify providers following evidence based guidelines
CMS 33
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OneCare Vermont “BigData” Roadmap
1/1/2013 7/1/2013 2014+
Phase IACO Business Intelligence
Phase IIClinical Process Workbench
Phase IIIPopulation HIE
ACO Data Trust and Reporting
• Attributed Beneficiary File
• Population Claims File
• ACO Provider/Participant
File
• 33 Quality Measure File
(unpopulated repository)
• Standard Reports
• Ad hoc query and custom
report capability
• Multi-level performance
benchmarking by region
Advanced Clinical Capabilities
• Interface with HIE for clinical
elements
• Automated calculation of
applicable quality measures
• Patient registries for disease
state, risk level, and shared
decision making opportunity
• Population/panel care
management workbench and
workflow support
Population Informatics
• Integrated with point-of-care
EHRs
• Architecture and process for
access to full patient-centered
encounter and clinical results from
all members
• Predictive Analytics
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Big Data, Little Data & Everything In Between
Rodney Cain
VP, Product Strategy, Health Information Exchange,
Optum
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Figuring out where you are,and where you need to go
Managing population health is a unanimously applauded goal. But, in practice, it means a lot of different things. And it’s hard to do it successfully.
• Talk about your system’s approach to population health management.
• How do you balance cost vs. quality?
• Where have you been able to make the biggest impact? Why?
• What hurdles still lie ahead?
• What do you need to clear the hurdle?
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Does higher spending buy better quality?Generally not.
• A key policy question is whether spending on health care
tends to buy better quality outcomes.
• And, conversely, is better quality associated with lower costs?
• No, not in general.
• We examined different measures of quality for the Medicare
and commercially insured populations and find no relationship
between the level of spending and quality of care in a
community.
• Correlation is virtually zero (ρ = -0.06)
Quality of Care, Commercially Insured
Per
-cap
ita
cost
What’s the secret behind these high-performing communities? Data from UnitedHealth Group commercial claims as analyzed by Optum Communities = Hospital Referral
Regions, as defined by Dartmouth Health Atlas
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What differentiates cost and quality?
Communities with higher costs have
• Poor health behaviors
• Integration ? -- mixed
Communities with lower costs have
• Greater social capital: education, literacy,
charitable organizations
• More economic resources, employment
• Better-aligned incentives; accountable care
Communities with higher quality have
• Higher social capital
• Stronger incentives and alignment
• Perhaps more advanced HIT adoption
Communities with lower quality
• Poor health behaviors
• Less incentive alignment
Co
sts
Qu
alit
y
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Navigating the journey from providing care to managing healthWith in-depth payer and provider expertise, Optumhelps navigate compliance, reimbursement and reform requirements that span the health care system.
Providing Care
Quality
Patient Satisfaction
Cost
Managing Health
Patient AccessMedical
NecessityReimbursement
Clinical CareCoding and
Documentation
Financial and
Clinical Analytics
Population
Health
Management
Care Delivery
Model
Aligned Incentives
We drive financial performance, enable compliance, and deliver health intelligence for the health care provider community, increasing quality and patient satisfaction while lowering cost.
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Q&AClick on the QA panel located in the lower right corner of your screen, type in your questions in the text field and hit send. Please keep the
send to default as “All Panelists.”
Download Today’s Slide Deck @ http://healthsystemcio.com/presentation/big-data-little-data-
webinar.pdf
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Thank You!• You will receive an email notification when our archive recording is
ready. (Separate registration is required)
• Questions/Comments – Anthony Guerra [email protected]
• Thanks to our sponsor, Optum!
Go to www.healthsystemCIO.com/webinars to view our upcoming schedule, and see archived events.