predictive analytics for healthcare organizations

Global Sponsor

Predictive Analytics for Healthcare Organizations

Tony JurekBalaji ApparsamyYasim KolathayilMorgann Carlon

30-Sept-2014

Introduction

3 Copyright © 2014 Deloitte Development LLC. All rights reserved.

Contents

Introduction and Kick Off 3

Importance of Analytics for Healthcare Organizations 6

Case Study: The Impacts of Analytics at BayCare 14

Enabling Analytics for ACOs 20

Summary – What Next 26

Q&A 29


Tony JurekDirectorDeloitte Consulting

Minneapolis

Tony is Director in the Information Management practice of Deloitte Consulting. Tony advises healthcare clients in the Business Analytics space

Role – Engagement Director

Balaji ApparsamyDirector, Data Management & Enterprise Web ApplicationsBayCare Health SystemClearwater, FL

Balaji provides strategic leadership and governance over long term data strategy to increase the competitive advantage for Baycare. Leadership over patient centric CRM solution to improve on patient engagement, care coordination to reduce care gaps and financial risks

Role - Director

Yasim KolathayilManagerDeloitte Consulting

Dallas

Yasim is a Manager in the Information Management practice of Deloitte Consulting. Yasim is currently focused on providing value to health care clients in the business intelligence (BI) and business analytics space.

Role – Program Manager

Team resumes

Morgann CarlonConsultantDeloitte Consulting

Minneapolis

Morgann is a Consultant in the Information Management practice of Deloitte Consulting. Morgann is currently focused on healthcare analytics strategies for her clients.

Role – Consultant

Importance of Analytics for Healthcare Organizations

What does “Analytics” Mean to You?


Healthcare organizations are experiencing the “perfect storm” at the intersection of changing demographics, technological innovation and governmental regulation.

Six Trends Shaping Healthcare

Healthcare Organizations

Demanding Demographics

Personalized health information Individualized risk

assessment Personal health records Genetic screening

Expanding Definitions of Health

Consumer health technologies Medical expense

management Direct-to-consumer tools

and decision support Genotypic diagnostics and

targeted therapeutic interventions

Rising Pressure in Policy, Politics, and Economics

Online platforms for collective action Focus on cost reduction

and improved health outcomes

Communities of interest become communities of action

Expanding Connectivity: Anytime, Anywhere

Mobile health Delivery of information and services Peer-to-peer health management Adherence support and self careSensing technologies Collection of biometric data

Increasing TransparencyTechnology shapes health behavior New technologies integrate

layers of data OTC diagnostics provide real-

time feedback Advancement of data analysisSimulations anticipate risk Patient self-care Public health preparedness

Converging RelationshipsOpen platforms for innovation Connects outsiders to

specific projects inside companies

Encourages cross-disciplinary and external collaboration

Streamlines expert sourcing


Analytics Can be a Game Charger for Healthcare Organizations

Take an Enterprise View

Use the Right Solutions for the Job

Leaders Need 360O Insight Focus on Excellence

Market Excellence Clinical Excellence Operational Excellence Financial Excellence

You can’t manage what you don’t measure – metrics that matter

Understand what separates areas to better bring them together

Start with the End in Mind

One-Size Does Not Fill All Focus on the Future

1-2 Yr. Target Maturities 2-3 Yr. Target Maturities 3-5 Yr. Target Maturities

Don’t “rip and replace” but “leverage and lift” the value of the systems you already have

Alignment across functions makes everyone successful

Not Everything Looks Like a Nail Focus on Value

Deloitte Products & IP Vendor Technologies Deloitte Advice and IC Partner Network

Solutions, not tools bring the pieces together and drive new insights

Align projects and partners with shared risk and shared reward


Key is understanding the two sides of Analytics

Predictive Analytics

Future facing

Trending

Pattern Analysis

Scoring to determine “Next Best Action”

Cohort Determination

Should also be insightful

Descriptive Analytics

Reporting

After the fact performance measuring

Static

Should be insightful

HINDSIGHT INSIGHT FORESIGHT


An 360o Enterprise-View of a Healthcare Organizations Challenges

Innovator

Foundation

HumanResources

Technology& Facilities

Accounting& Finance

Governance &Compliance

SupplyChain

Mergers &Acquisitions

PatientSatisfaction

Quality &Safety

MarketDemographics

Value-BasedCare

Alliances &Partnerships

Research &Development

Developed

Advanced

ClinicalMarket

Financial Operational

CEO

CFO

CMO

COO

Accounting & Finance• Close, Plan & Report• Cost Accounting & DSS• Revenue Cycle Performance

Mergers & Acquisitions• Strategy & Growth• Valuation & Pricing• Post-Merger Integration

Governance & Compliance• Governance & Controls• Security & Privacy• ICD-10• Tax Optimization

Alliances & Partnerships• Joint Ventures• Physician Integration• Strategic Affiliations

Market Demographics• Sizing & Segmentation• Brand & Identity• Access & Pricing

Research and Development• Project & Trials Management• Applied Research• Translational Research

Quality & Safety• Clinical Effectiveness• Perioperative Care• EHSS & HITS

Patient Satisfaction• Environment & Setting• Clinical Integration• Mobile Health

Human Resources• HR Transformation• Bus. Model Transformation• Compensation Alignment

Supply Chain• Sourcing & Procurement• Logistics & Distribution• Demand Management

Value Based CarePopulation ManagementCare CoordinationDisease Management

Technology & Facilities• Infrastructure & Architecture• HIT and ERP Shared Services• Real Estate & Facilities

Re-Admissions Analytics


Our balanced product portfolio is designed to impact key issues in healthcare, while maximizing value, aligning with the core business, maintaining a competitive position, and enabling innovation.

Deloitte Health Analytics Product Portfolio

Market Issue Impact Product Portfolio

Intellect

Clinical Excellence

Sustainable Margin

Revenue Excellence

Improve business processes, clinical effectiveness and efficiency, patient safety, productivity to lower cost, while maintaining and improving quality

Isolate and quantify revenue leakage

Insight

Value Based Care/ Population Health Management

Improve population health management and outcomes

Reduce unwarranted variation

Improve care coordination and risk stratification

Leverage evidence based guidelines and best practices

Miner

Research Excellence

Real World Evidence

Improve signal exploration and surveillance

Support comparative effectiveness analyses, pharmacovigilance, and other use cases for R&D & outcomes analysis

Improve clinical and translational research/medicine

Enable personalized medicine

Total Cost IntellectHealth System Intellect

Sustainable Margin and

Quality Dashboard

Clinical Intellect Clinical Care Optimizer Readmission Optimizer Quality Optimizer

Performance Intellect PI Workbench Operations Optimizer

Procedure Cost Analysis

Revenue Intellect

Revenue Financial Analysis

Insight

Provider Performance Management

Patient Engagement

Contracting and Reporting

Care Management

Outcomes Miner

Signal Exploration

Statistically Nuanced Analytics

Comparative Analytics

Precision Miner

Biomarker Hypothesis Generation &

Validation

Gene Based MatchingCohort Identification

Descriptive Analytics

Drug Exposure / Response Analysis

Population Miner

Research Knowledge Management


A powerful combination of capabilities to help meet the demands of the information driven healthcare environment

Oracle Enterprise Healthcare Analytics + Deloitte Analytic Applications

Exception Management System

Metadata Delivery

AllSources

Source Data

ExtractOHADI: WIL

Business Rules

Source Dependent

OHADI: Interface tables > HDWF, business rules,

MDM, and metadata management

Source Independent

MPIUnit of

Measure

Master Data Management & Other Services

De – identification

NLP

Security

Exec

Clinician

Researcher

ClinicalFinancial

AdministrativeResearch

OracleEHA Apps

OBI-EE/Java

ConvergeHealthBy Deloitte

Apps

EHA HealthcareData Model

…

Ad Hoc Query

OLAP

Data Mining

Reporting

“Real” Time

Conformed Data Mart (HCD)

CustomApplications

Validation, Standardization, and

Transformation

HDWF3NF EDW

OHADI: HDWF > Applications

MDM, Conformance,

Metric Definition, Benchmarks, etc.

Master Data Interface (MDI)

MDM: Term.

Master Data

Interface Tables

MDM Loaders MDM

ETL

OHADI: Application

Toolkit

Applications: Reports,

Dashboards, Scorecards, etc.

Case Study: Impacts of Analytics at BayCare


Introduction

BayCare Health System is a leading community-based health system in the Tampa Bay area. Composed of a network of 11 not-for-profit hospitals, outpatient facilities and services such as imaging, lab, behavioral health and home health care, BayCare provides expert medical care throughout a patient's lifetime.

With more than 280 access points conveniently located throughout Tampa Bay, BayCare connects patients to a complete range of preventive, diagnostic and treatment services for any health care need. In 2013, BayCare provided $243.5 million in community benefit, which includes $110.8 million in traditional charity care


Readmissions

Common Causes Lack of coordination of care between settings Estimated high volume related to social issues Lack of compliance with prescribed therapy

Prevention Readmission flag on EMR Standard discharge procedure and patient education Discharge phone calls and follow up Improved patient experience

Identification of consistent process (or lack of it) to capture data that causes potential readmission, and make it available at the right time, right place for right people

ProcessPeople

Technology


Readmissions - ImpactReduction of readmission is a spectrum of process, that leads to the transformation of providing care to the patients

Patients One fifth of the Medicare patients are readmitted within 30 days Huge cost impact on unplanned readmissions within 30 days

Hospitals Reductions in reimbursements Penalties and risks due readmission trends Three fourth of the readmissions are preventable

Fee for Service

Value based(PHM)


BayCare Strategy

Financial

EMRPharmacy

Clinical

HIE

Predictive Outcomes

Population Management

Dashboard

KPI

Scorecards

Analytics

EDW

DM&ACapabilities

DataCreation

DataStorage

DataMovement

DataUsage

DataRetirement

DG

Financial Sustainability

Labs

Registration

Digitization Integration Data CollectionAnalytics & Predictive Modeling

Act on Data


2014 Accomplishments

Standard method to identify patients at High Risk for Readmission

Implemented Interdisciplinary Plan of care

EMR ‘task’ to Case Manager and Social Worker when patient identified as

High Risk for Readmission

Monitor Home Care admits and Pilot rollouts

Next stage

Transition of Care Management Process model

Ongoing monitor and improvements

Beginning of the journey, in the right direction

Enabling Analytics for ACOs


Analytics can address the critical needs of ACOs

Critical ACO needs

1. Integrated Patient Care management

• Access to a holistic 360 degree view of patient data and analyze data overtime to identify trends and spot gaps in care coordination and delivery

• Use predictive modeling techniques and solutions to prevent adverse events and readmissions

5. Technology adoption

• Creation of sophisticated technology platform allowing for longitudinal view of patients and more practice of evidence based medicine

• Analytics system focus on acquiring clinical data and facilitating a care management workflow

3. Population Health Management

• Enables risk stratification and can identify the subpopulations that are most at risk

• Summarize and explain population level outcomes data to budget for the healthcare expenses of a defined population

2. Accountability and Organizational Effectiveness

• Defines shared accountability among the ACO leadership to provide collaborative care

• Measures organizational effectives and key capabilities across excellence areas enables organizational savings and growth opportunities.

How analytics can help ACOs address these critical needs

4. Safety and Quality Reporting Compliance

• Enables ACOs to measure the quality and compliance metrics for CMS shared savings

• Reporting capabilities and detailed metrics are required to operate, manage and measure an ACO

1. Integrated Patient Care management

2. Accountability and Organizational Effectiveness

3. Population Health Management

4. Safety and Quality Reporting Compliance

5. Technology adoption


Analytics enables a 360 degree view of patient and spot gaps in care coordination and delivery

Integrated care coordination by ACO

• Success of Member Education• Patient Education/Outreach

Participation• Patient Channel

Responsiveness• Young Adult Health Care Survey

(YAHCS)

• Member Insurance Affiliation• Dual Eligibility• Employer Affiliation• YTD Total Medicare Membership

Growth• Termed Group Count

• Communication with Nurses• Communication with Doctors• Call Center - Hold Time• Responsiveness of Hospital Staff

• Medication Reconciliation• 30 Day Post Discharge Physician

Visit • Measure of Processes of Care

(MPOC-28)• Plans Of Care Compliance

Proactive Plan of Care and Follow-

up

Patient/ Care Giver

Experience

Patient Engagement

Patient/ Membership

Analysis

Sample metrics to measure patient engagement, satisfaction, plan of care and membership analysis

Improved patient engagement and care coordination


Analytics enables shared accountability among the ACO leadership to provide collaborative care

CMOAt Risk Population

Evidence Based Medicine/ Gaps in Care

Patient SafetyPopulation Health Management

Proactive Plan of Care and Follow-up

Quality Improvement

Patient Engagement

Patient Satisfaction

Preventive Health

Healthcare home effectiveness

Practitioner Satisfaction

COOOperational EfficiencyOrganizational AnalysisTransitions and CommunicationReimbursementSecurity and PrivacyCost of CarePractitioner SatisfactionProvider UtilizationPatient/Membership AnalysisPatient SafetyQuality ImprovementSupply Utilization MeasuresPurchasing & Contract Compliance MeasuresInventory Management Measures

CMIO

Technology Adoption

Security and Privacy

Evidence Based Medicine/ Gaps in Care

CFOCost of CareFinancial PerformanceFinancial RiskMarket ShareRegulatory RiskReimbursementPatient/Membership AnalysisPurchasing & Contract Compliance Measures

CMO

CFO

CO

O

CM

IO

Key

Cap

abili

ties

Key

Cap

abili

ties

CEO

CEO

ACO

DashboardsExecutive Management Information System (EMIS)

Revenue Cycle

Note: The capabilities that are in bold are shared across the excellence areas


Analytics enables ACOs to budget for the healthcare expenses of a defined population

• Does clinician have the capability to evaluate health risks based on year over year comparing assessments?

• Is clinician auto notified of new or conflicting info requiring resolution?

• Can analytics deconstruct the patient groups to examine and manage population sub groups?

• Comprehensive understanding of patient health/risk

• Consumer health segmentation• Patient cohort identification & Stratification• Epidemic monitoring

• What are the cost drivers, at risk individuals in the population?• Can analytics make predictions for given patient groups to offer

most effective intervention?• Can the at-risk patients be prioritized and offer tailored

interventions?

• Track population trends• Clinical campaign management & targeted

outreach• Chronic disease management• Risk-pool stratification• Shared decision making

• Are the at risk patients receiving timely care?• Is physician receiving real time patient and population data at

point of care?• Does the clinician have access to decision making tools to

provide best possible care?

• Improved patient health status• Improved patient satisfaction• Personalized patient care• Evidence based intervention• Enables use of social media

• Does ACOs have tools to measure outcomes and patient satisfaction to compare against national and local benchmarks?

• Does the conclusions make sense?• Does ACOs have access to scorecard to understand and

improve performance?

• Improved patient outcomes• Financial reporting• Risk and regulation compliance• Quality & compliance reporting• Clinical performance management• Reimbursement reporting

Health Assessment

Risk Stratification

Impact Evaluation and

Outcomes Measurement

Patient-Centered

Intervention

Population HealthManagement Objectives

Key Questions Analytics Impact


Reporting capabilities and detailed metrics are required to operate, manage and measure an ACO

Accountable Care MetricsACO Reports

Regulatory Metrics

• Outcomes Metrics• Guidelines Metrics• Efficiency Metrics• Clinical Process Metrics

Payer Metrics• Payer Mandated Metrics• Outcomes Metrics• Physician Metrics• Process Metrics• Claims for Reimbursement

MetricsACO

Reporting capabilities are required to collect and submit quality and safety data to CMS and private payers.

Reports will provide valuable information allowing ACOs to track performance and identify areas for improvement.


Sophisticated analytics platform enables longitudinal view of patients and practice of evidence based medicine

Connectivity, Security and InteroperabilityConnects to all the data producers, provides access to data consumers, and validates access rights.

Core Applications and Workflow / AutomationOrchestrates the execution of activities the constitute the care continuum, gathering contextual information from both the transactional systems as well as the data-warehouse.

Data Integration and ManagementRetrieve data from the data producers, in both structured and unstructured form, and transform it to align with core application data requirements as well as end user analytical needs.

Physician/Patient EngagementKey interfaces for both patients and physicians to facilitate their interactions with the VBC system, leveraging workflow & analytics to enhance engagement and satisfaction for both these stakeholders.

Data Analytics and ContentUsing self-actualizing trends and business solution specific heuristics analyzes transactional data and creates enriched information. Data delivery occurs via screen-reports and services/API.

Physician / Patient Engagement

Data Integration & Management

Core Applications & Workflow / Automation

Data Analytics & Content

12 3

4 5

What Next


Unprecedented Market Changes Are Creating New Challenges for Healthcare Providers

Transparency in cost & quality

Shift from volume to value (e.g., P4P, risk sharing)

Heightened consumer expectations on value, simplicity, and transparency

Ubiquitous technology adoption (e.g. Web, Mobile, Social) combined with always-on consumers

Rise in government programs (e.g., Medicare, Medicaid, Duals, and HIX)

Heightened regulatory oversight

Realignment of relationships and scope of services across healthcare industry

Risk shifts from Health Plans to Providers

Players are seeking new ways to create and deliver value (e.g., disintermediation of traditional players)

The evolution occurring in the industry is driven primarily by four macro-drivers:

These macro trends make it imperative for industry leading provider organizations to adapt to change enabled by their best in class people and processes

HC Delivery


The Unified Data Platform – Oracle and Deloitte

Level 2 View –

Data Source/Producers

Data Consumers

Data Brokering

Data Ingestion/Enrichment

Data Collection

Where do investments in technologies like Oracle EHA, and Deloitte’s Analytical Applications fit in this future view?

Data IngestionHL7 MLLP FHIR DICOM CDA

Web Services

...

ODBC

JDBC

FTP SFTP

SSH

...

Web Services

ODBC

JDBC

FTP SFTP

SSH

...

Replication Services

Routing Change Data Capture Exception Channel Structural Validation ...

Master Data Hub

Patient Merge Patient Unmerge Lookup Validation ...

Transformation Services

Structural Normalization

ConsolidationData Manipulation /

DerivationBusiness

Tranformation...

Bulk Load Services

Data Authentication Job Metrics Internal Transport Load ...

Metadata Hub

Impact Analysis PurgingData Tagging

(Social/Unstructured)Customizing ...

Common Services

Logging System Monitoring System Caching Data Privacy ...

...

Data Collection

ODBC JDBCFTP

SFTPSSH ...

ODBC

FTPSFTP

...

ODBC SSHFTP

SFTP...

Non Relational

Relational

Master Data

Metadata

Person Location Codes ...

Standards

...

Elements Business Rules Value Sets Lineage

Data Warehouse

Person Event Allergies Medication Lab Results

Clinical Notes Surgery Disease ...

Data Mart

Person Event Allergies Medication Lab Results

Clinical Notes Surgery Disease ...

Operational Data

Patient Event Clinical Notes Lab Results ...

Images Genomics Logs Social Media Voice

…

Virtualization

Security

Orchestration

Data Brokering

Registration Services

Events Routing (Channel) Services

Event Processing Services

In Memory Management

In Memory Analytics Machine LearningReal time Decision

Making

Business Services/Rules

Data Consistency/Parallel Persistence

...

Synchronous Read-Through

Synchronous Write-Out

Asynchronous Write-Behind

Asynchronous Event Listener

Subscriptions Notifications

Coarse Grain Fine Grain

Semantic / Federated View

In Memory StrorageDistributed Processing

Adapter Service

Adapter Service

Adapter Service

Adapter Service

...Adapter Service

Adapter Service

Adapter Service

Adapter Service

Adapter Service

...Adapter Service

Adapter Service

Adapter Service

Adapter Service

Adapter Service

...

Adapter Service

Adapter Service

Adapter Service

Adapter Service

Adapter Service

...

Adapter Service

Data Creation

ODBC JDBC FTP SFTP SSH ...Web

Services

Structured Data

Internal

External

Semi or Unstructured Data

Internal

External

Electronic Medical Record

Financials Lab Orders/Results Pharmaceuticals ...

Extramural Lab – Orders/Results

National Demographics

Electronic Medical Record

...

Device Data

Sys Logs

Call Notes / Logs

Behavioral Assessments

Treatment Plans

Clinical Notes

Images

Clinical Knowledge

Mobile Formatted Data

...

Device Data

Clinical Notes

Mobile Formatted Data

Voice

Treatment Plans

...

Social Media Images

Data Consumption

External Services

Analytics

Data Services

Vendor HubsHIEs

...

Predictive Analytics

Internal Open APIs

Affiliate Information Sharing

BI/Operational Reporting

Internal Data Sharing

Knowledge Delivery

Data Visualization

…

External Open APIs

...

ODBC

FTPSFTP

SSH

...

HL7 MLLP FHIR DICOM CDAWeb

ServicesXDS (HIE)ODBC JDBC FTP SSH ...

Web Services

ODBC

JDBC

FTP SFTP

SSH

...

Oracle- HDM- DBMS

Oracle- MDM- ODI- Data Quality

ConvergeHealth by Deloitte

ConvergeHealth by Deloitte

Oracle - OBIEE

Oracle - OBIEE

Healthcare organizations should enable advanced analytics to provide integrated patient care

predictive analytics for healthcare organizations

Documents

deloitte development

importance of analytics

health care clients

predictive analytics

impacts of analytics

baycare14enabling analytics

healthcare clients

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