Healthcare BI for Power UsersSeptember 13, 2012

About Perficient

Perficient is a leading information technology consulting firm serving clients

throughout North America.

We help clients implement business-driven technology solutions that integrate

business processes, improve worker productivity, increase customer loyalty and create

a more agile enterprise to better respond to new business opportunities.

Perficient Profile

Founded in 1997

Public, NASDAQ: PRFT

2011 Revenue of $260 million

Major market locations throughout North America— Atlanta, Austin, Charlotte, Chicago, Cincinnati, Cleveland,

Columbus, Dallas, Denver, Detroit, Fairfax, Houston, Indianapolis, Los Angeles, Minneapolis, New Orleans, Philadelphia, San Francisco, San Jose, Southern California,St. Louis and Toronto

Global delivery centers in China, Europe and India

2,000+ colleagues

Dedicated solution practices

87% repeat business rate

Alliance partnerships with major technology vendors

Multiple vendor/industry technology and growth awards

Perficient brings deep solutions expertise and offers a complete set of flexible services to help clients implement business-driven IT solutions

Our Solutions Expertise & Services

Business-Driven Solutions• Enterprise Portals• SOA and Business Process Mgmt• Business Intelligence• User-Centered Custom Applications• Interactive Design• CRM Solutions• Enterprise Performance Management• Customer Self-Service• eCommerce & Product Information

Management• Enterprise Content Management• Enterprise Resource Planning• Management Consulting• Industry-Specific Solutions• Mobile Technology• Security Assessments

Perficient Services End-to-End Solution Delivery IT Strategic Consulting IT Architecture Planning Business Process & Workflow

Consulting Usability and UI Consulting Custom Application Development Offshore Development Package Selection, Implementation

and Integration Architecture & Application Migrations Education Interactive Design

Our Speakers

Mike Jenkins• Health BI Practice Manager for Perficient• 25+ years of experience architecting, developing, and

implementing solutions for organizations in the US, Canada, Europe, and Asia.

• Experienced in healthcare, finance, defense, manufacturing, training, and retail industries.

• Some of Mike’s healthcare projects include: • Developing a core measures proactive monitoring system• Developing an eHealth strategy for a growing community hospital• Implementing transparent pricing and outcomes measurement

solutions• Automating clinical and administrative tasks through forms

automation• Connecting multiple healthcare systems through a common

patient portal• Developing an electronic medical record application.

Our Speakers

Michael Planchart• Enterprise Healthcare Architect for Perficient• 25+ years of experience architecting, developing, and

implementing healthcare solutions for organizations in the US, Latin America and Europe.

• Author of the IHE Radiology Framework Profile CXCAD • Some of Michael’s healthcare projects include:

• Development of an Electronic Health Care Record System for Enterprise Hospitals deployed throughout Latin America

• Microsoft Amalga integration architecture • Microsoft Amalga implementations at major Healthcare

Organizations in the US• Microsoft HealthVault Community Connect implementations at

major Healthcare Organizations in the US• Architect and Development of advanced radiology imaging

viewers applied to lung cancer detection

Today’s Agenda

• Introduction• What is the BI Maturity Model• Maturity Model Levels• Walkthrough each Level:

– Lacks, Wins and Uses– Data Sources– Case Studies or Examples

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BI Maturity Model

BI Maturity Model

EcosystemMindset

Enterprise

Department

Individual

BI Maturity Level 1 – Many Lacks, Few Uses

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Many Lacks:• Accessibility to data• Availability of departmental data and

information• Coherent and structured data• Common repositories• Common vocabularies• Data governance and stewardship• Extensibility and functionality• Quality and trust• Retention• Sponsorship and Stakeholders• Proper technology infrastructure

Few Uses:• Promoted by end-users• Small interested audience• Informal• Non-continuous• Typically ends abruptly

Level 1 – Unawareness

No significant wins!

BI Maturity Level 1 – Data Sources

Data Sources:• Application-based data• Desktop databases (e.g., Access, FoxPro)• Manual abstraction of documents• External sources (e.g., CMS, payers)• Reports from transactional systems• Spreadsheets (e.g., Excel, Visi-Calc)

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Level 1 – Unawareness

Common Tools:• Microsoft Excel• Microsoft Access• Crystal reports (basic)• Some OTS applications

BI Maturity Level 1 – Example

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Level 1 – UnawarenessA small community hospital in rural Ohio decided to expand its medical imaging services offerings beyond the limited radius of the town they were serving at the moment.

They had acquired a couple of high-tech Computer Aided Detection (CAD) products for lung cancer and mammography and they were certain that they would be able to provide better care to their at-risk patients and provide their radiologists with tools that would allow to increase their bandwidth thus resulting in more diagnostic readings.

But they ran into some challenges. The radiologists were complaining that they wouldn’t be able to handle more cases without getting tired and that would increase patient safety risks.

The people in charge of delivering the imaging services option didn’t have the data to challenge or confirm the radiologists assertions.

The IT department was tasked to assist them in gathering the data. The IT team leveraged the RIS in order to obtain the scheduling information and the PACS to extract the study information and reconcile these with the radiologists claims.

Once the management team had the data they were then able to work in harmony with the radiologists’ team and come up with creative solutions to the problems. They were able to increase their offerings and they were also able to identify that they would need one more radiologist in order to avoid over-working the existing ones.

Tools Used:• Microsoft Excel• Microsoft Access• Crystal reports (basic)• Some OTS applications to

extract data from the RIS and the PACS

BI Maturity Level 2 – Some Lacks, Some Uses

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Some Lacks:• Accessibility to data across departments• Availability of interdepartmental data• Coherent and Structured data• Data Governance and Stewardship• Enterprise –scale repositories• Common vocabularies across domains• Quality and trust beyond a department• Sponsorship

Level 2 – Tactical

Some Uses:• Promoted by IT Executives and end

users• Fairly interested audience• Typically implemented in the

financial or operational departments

• Some departmental formality• Some departmental metrics• Some departmental reporting

Wins:• Accessibility to data within a department• Some reporting tools• Some visualization tools

Big Win:BI is acknowledged as crucial for the enterprise

BI Maturity Level 2 – Data Sources

Data Sources:

• Desktop databases (e.g., Access, FoxPro)• Manual abstraction of documents• Report Generators (e.g., Crystal reports)• Reports from transactional systems • Source Systems (e.g., MEDITECH, Eclipsys, Epic)• Spreadsheets (e.g., Excel, Multiplan)• SQL Databases (e.g., SQL Server, MySQL)• Stove-piped applications data

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Level 2 – Tactical

Common Tools:• Microsoft Excel• Microsoft Access• SQL Server Reporting

Services• SQL Server Integration

Services• Proprietary BI (e.g., Eclipsys)

BI Maturity Level 2 – Example

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Level 2 – TacticalA large healthcare enterprise in the United States, has been growing organically and through acquisitions. The rate of growth is so fast that it is nearly impossible to merge processes together.

They have to deal with myriad EHRs and many other types of systems per facility. The average number of applications per facility is over 200, this number is typical across the industry.

Due to the pressure of the external forces that are transforming healthcare and in the best interest to stay ahead of the pack they have seriously considered Business Intelligence as the move forward strategy.

Their overwhelming size does not allow them to implement Health BI in a “Big-bang” style so they have decided to approach the endeavor tactically with the vision of reaching Level 4 within 5 – 7 years.

They are currently using some well-known tools to achieve this. They still haven’t laid out the foundation but they are able to report analytics at the finance and quality departments and for certain facilities and ancillaries.

The goals they seek to accomplish in the immediate future are the formation of a Data Governance structure. The next steps are the design and architecture of an Operational Data Store/Atomic Data Store that will be the first steps towards a solid Extract, Transform and Load (ETL) layer and a Trusted Data Layer (TDL).

Tools Used:• Industry standard SQL

Databases• SQL Server Integration

Services (SSIS)• SAP – Business objects• Eclipsys Clinical Analytics

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BI Maturity Level 3 – Fewer Lacks, More Uses

Fewer Lacks:• Accessibility to data across enterprise• Availability of enterprise data• Coherent and structured data• Enterprise-wide repositories• Common vocabularies across enterprise

Level 3 – Focused

More Uses:• Promoted by Business Units• Large interested audience• Formal Processes within BU• BU metrics• BU reporting• BU Analytics

Some Wins:• Some Data Governance and Stewardship• Availability of coherent departmental data• Some ETL and data aggregation (ODS, ADS)• Some trusted data layer• Some sponsorship• Some Master Data Management (e.g., EMPI)

Big Win:BI is being used across the enterprise

BI Maturity Level 3 – Focused

Data Sources:• Integration Services (e.g., SSIS)• Report Generators (e.g., SSRS)• Reports from stove-piped systems• Reports from transactional systems• SQL Databases (e.g., Oracle, SQL Server)• Basic Enterprise Data Warehouse• Enterprise Master Person Index• Source Systems

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Level 3 – Focused

Common Tools:• SQL Server Reporting

Services• SQL Server Integration

Services• Proprietary BI (e.g., Eclipsys)

BI Maturity Level 3 – Case Study

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Level 3 - FocusedTexas Children's Hospital is an internationally recognized full-care pediatric hospital located in the Texas Medical Center in Houston. One of the largest pediatric hospitals in the United States, Texas Children's Hospital (TCH) is dedicated to providing the finest possible pediatric patient care, education and research.

Nurse researchers, cardiology physicians and researchers created spreadsheets to manage their day-to-day activities – a practice which resulted in more than 450 spreadsheets along with various other disparate sources. These clinicians were responsible for providing outcomes and research reports for consumption by the medical and surgical groups that often used different approaches to data management. The complexity of this data management infrastructure began to manifest into several issues including loss of productivity, low quality of data, increased costs and inefficient use of time.

Perficient created a data warehousing solution using Microsoft SQL Server as a backend with web/Windows-based data collection tools. This data was collected, extracted and transformed using complex workflows to produce a single system of record using SQL Server Integration Services, SQL Server, .NET and Microsoft Office suite.

This baseline system quickly processes 100,000 rows of data from multiple systems resulting in a business benefit of cost avoidance hours and new visibility to patient outcomes and research data by providing the users with a trusted single source for data needs.

Further information can be obtained here: http://www.perficient.com/About/Case-Studies/2011/Texas-Childrens-Hospital

Tools Used:• Microsoft SQL Server• SQL Server Integration

Services (SSIS)• Microsoft Office Suite• .NET

BI Maturity Level 4 – Few Lacks, Many Uses

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Many Uses:• Promoted by C-Level• Very large interested audience• Very Formal• Enterprise metrics• Predictive Analytics and Modeling

Few Lacks:• Accessibility to data across departments• Availability of interdepartmental data• Coherent and structured data• Enterprise-wide repositories• Common vocabularies across enterprise

Level 4 – Strategic

Wins:• Enterprise Data Governance and Stewardship• Master Data Management• BI is used daily to manage the business• Enterprise data aggregation (ODS, ADS)• Enterprise Data Warehouse• Trusted Data Layer• Sponsorship

Big Win:BI is a key part of the enterprise

BI Maturity Level 4 – Strategic

Data Sources:• Enterprise Data Warehouse• Information Delivery Applications• Enterprise SQL Databases (e.g., Oracle,

IBM)

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Level 4 – Strategic

Common Tools:• SAP – Business Objects• IBM Cognos• Oracle OBIEE• SQL Server Reporting

Services• SQL Server Integration

Services

BI Maturity Level 4 – Example

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Level 4 - Strategic

Tools Used:• Microsoft SQL Server• SQL Server Integration

Services (SSIS)• SQL Server Reporting

Services• Microsoft Amalga• SharePoint 2010• PowerPivot

Another Children's Hospital in Texas made the strategic decision to connect it’s Emergency Department with it’s community provider network to improve it’s delivery of services and thus save patient lives by having the right information at the right time, and near real time, at the point of care.

In order to achieve this they had to aggregate the data of their patients into a common repository supported by Microsoft Amalga which acted as an ODS/ADS. Data that was originated at the community physician office was sent to the ODS via CCD documents that were also aggregated and atomized in the ADS.

The use case would allow the emergency physicians to immediately view all the clinical relevant information of the patient.

BI Maturity Level 5–No Lacks, Infinite Possibilities

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No Lacks!

Level 5 – Pervasive

Infinite Possibilities:• Corporate sponsored• Corporate audience• Analytics Embedded in

Processes• Clinical Intelligence• Decision Support Systems• Population Health

Management

Wins:• Pervasive access to enterprise data• Availability of enterprise data• Enterprise master data management• Enterprise-wide repositories• Common vocabularies across enterprise• Pervasive Data Governance and Stewardship• Availability of coherent enterprise data• A very happy and healthy organization!

Big Win:BI is shared outside the enterprise

BI Maturity Level 5 – Pervasive

Data Sources:• Enterprise Data Warehouse• Information Delivery Applications• Enterprise SQL Databases (e.g., Oracle,

IBM)• Artificial Intelligence processing of

unstructured data

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Level 5 – Pervasive

Common Tools:• SAP – Business Objects• IBM Cognos• IBM Watson• Oracle OBIEE• SQL Server Reporting

Services• SQL Server Integration

Services

BI Maturity Level 5 – Example

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Level 5 - PervasiveAchieving level 5 is not an easy task. Although some payers have been able to initiate level 5 maturity most healthcare provider organizations fall below this level.

Blue Cross / Blue Shield of Kansas City was able to create an enterprise business intelligence strategy and a data governance model in order to integrate 20 major mission critical source systems in order to better serve their member patients.

They decided that information had to be enterprise-wide accessible, reliable and accurate. Their information was trapped in silos. They then created the Data Integrated Health Management Platform.

They were able to bring in outsourced disease management applications and helping them save millions of dollars a year.

With their Enterprise Data Warehouse they were also able to deploy a self-service business intelligence reporting application to large employer group customers and brokers with which they could access and perform their own online analytics. Data was exposed to almost 5000 physician offices.

Other noteworthy organizations that have achieved high-levels of maturity are:

• Kaiser Permanente• Mayo Clinic• Healthcare Partners

Questions and Answers

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Questions

Thank You!Mike Jenkins

mike.jenkins@perficient.comOn Twitter: @TechnologyChef

Michael Planchartmichael.planchart@perficient.com

On Twitter: @theEHRGuy

Get in Touch with Perficient

• On Twitter: @Perficient_HC• Our Healthcare Blog:

blogs.perficient.com/healthcare/• To register for the second webinar:

www.perficient.com/Webinars• To download the Health BI White Paper:

www.perficient.com/WhitePapers