1. Predictive Analytics for Healthcare Organizations
Tony Jurek
Balaji Apparsamy
Yasim Kolathayil
Morgann Carlon
30-Sept-2014

2. Introduction

3. 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

4. Team resumes Role – Engagement Director Role - Director
Tony Jurek
Director
Deloitte Consulting
Minneapolis
Tony is Director in the Information Management practice of Deloitte Consulting. Tony advises healthcare clients in the Business Analytics space
Balaji Apparsamy
Director, Data Management & Enterprise Web Applications
BayCare Health System Clearwater, 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 – Program Manager
Role – Consultant
Yasim Kolathayil
Manager
Deloitte 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.
Morgann Carlon
Consultant
Deloitte 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.

5. Importance of Analytics for Healthcare Organizations

6. What does “Analytics” Mean to You?

7. Six Trends Shaping Healthcare
Healthcare organizations are experiencing the “perfect storm” at the intersection of changing demographics, technological innovation and governmental regulation.
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
Demanding Demographics
Personalized health information
Individualized risk assessment
Personal health records
Genetic screening
Healthcare
Organizations
Converging Relationships
Open platforms for innovation
Connects outsiders to specific projects inside companies
Encourages cross-disciplinary and external collaboration
Streamlines expert sourcing
Increasing Transparency
Technology shapes health behavior
New technologies integrate layers of data
OTC diagnostics provide real-time feedback
Advancement of data analysis
Simulations anticipate risk
Patient self-care
Public health preparedness
Expanding Connectivity:
Anytime, Anywhere
Mobile health
Delivery of information and services
Peer-to-peer health management
Adherence support and self care
Sensing technologies
Collection of biometric data
The Result – More data from more sources creates new challenges and opportunities

8. Analytics Can be a Game Charger for Healthcare Organizations
Take an Enterprise
View
Start with the
End in Mind
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
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

9. Key is understanding the two sides of Analytics
Descriptive Analytics
Reporting
After the fact performance measuring
Static
Should be insightful
Predictive Analytics
Future facing
Trending
Pattern Analysis
Scoring to determine “Next Best Action”
Cohort Determination
Should also be insightful
Hindsight
Insight
foresight

10. An 360o Enterprise-View of a Healthcare Organizations Challenges
Value Based Care
Population Management
Care Coordination
Disease Management
Re-Admissions Analytics
Market Demographics
Sizing & Segmentation
Brand & Identity
Access & Pricing
Research and Development
Project & Trials Management
Applied Research
Translational Research
Innovator
Foundation
Human
Resources
Technology
& Facilities
Accounting
& Finance
Governance &
Compliance
Supply
Chain
Mergers &
Acquisitions
Patient
Satisfaction
Quality &
Safety
Market
Demographics
Value-Based
Care
Alliances &
Partnerships
Research &
Development
Developed
Advanced
Clinical
Financial
Operational
CEO
CFO
CMO
COO
Quality & Safety
Clinical Effectiveness
Perioperative Care
EHSS & HITS
Alliances & Partnerships
Joint Ventures
Physician Integration
Strategic Affiliations
Mergers & Acquisitions
Strategy & Growth
Valuation & Pricing
Post-Merger Integration
Patient Satisfaction
Environment & Setting
Clinical Integration
Mobile Health
Accounting & Finance
Close, Plan & Report
Cost Accounting & DSS
Revenue Cycle Performance
Human Resources
HR Transformation
Bus. Model Transformation
Compensation Alignment
Governance & Compliance
Governance & Controls
Security & Privacy
ICD-10
Tax Optimization
Supply Chain
Sourcing & Procurement
Logistics & Distribution
Demand Management
Technology & Facilities
Infrastructure & Architecture
HIT and ERP Shared Services
Real Estate & Facilities

11. Deloitte Health Analytics Product Portfolio
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.
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 Intellect
Health 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 Matching
Cohort Identification
Descriptive Analytics
Drug Exposure / Response Analysis
Population Miner
Research Knowledge Management

12. Oracle Enterprise Healthcare Analytics + Deloitte Analytic Applications
A powerful combination of capabilities to help meet the demands of the information driven healthcare environment
Security
Metadata Delivery
Exception Management System
Business Rules
Oracle
EHA Apps
Conformed Data Mart (HCD)
OBI-EE/Java
Source
Data
Extract
OHADI:
Application
Toolkit
Reporting
All
Sources
Interface
Tables
OHADI: WIL
EHA Healthcare
Data Model
ConvergeHealth
By Deloitte
Apps
Exec
Ad Hoc Query
Validation, Standardization, and Transformation
Clinical
Financial
Administrative
Research
OLAP
Clinician
Data Mining
Custom
Applications
Master Data
Interface (MDI)
MDM: Term.
MPI
Unit of Measure …
NLP
De – identification
Master
Data
MDM Loaders
Master Data Management & Other Services
“Real” Time
Researcher
MDM
ETL
OHADI: Interface tables > HDWF, business rules, MDM, and metadata management
Source Independent
OHADI: HDWF > Applications
MDM, Conformance, Metric Definition, Benchmarks, etc.
Source Dependent
HDWF
3NF EDW
Applications: Reports, Dashboards, Scorecards, etc.

13. Case Study: Impacts of Analytics at BayCare

14. 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 $ million in traditional charity care

15. Readmissions
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
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
People
Process
Technology

16. Readmissions - Impact
Reduction 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)

17. Analytics & Predictive Modeling
BayCare Strategy
Digitization
Integration
Data Collection
Analytics & Predictive Modeling
Act on Data
Financial Sustainability
Pharmacy
EMR
Scorecards
EDW
Analytics
Financial
HIE
DM&A Capabilities
Data Creation
Data Storage
Data Movement
Data Usage
Data Retirement DG
Population Management
Labs
KPI
Registration
Clinical
Dashboard
Predictive Outcomes

18. 2014 Accomplishments Beginning of the journey, in the right direction
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

19. Enabling Analytics for ACOs

20. Analytics can address the critical needs of ACOs
1. Integrated Patient Care management
2. Accountability and Organizational Effectiveness
3. Population Health Management
4. Safety and Quality Reporting Compliance
5. Technology adoption
Critical ACO needs
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
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
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
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

21. Integrated care coordination by ACO
Analytics enables a 360 degree view of patient and spot gaps in care coordination and delivery
Sample metrics to measure patient engagement, satisfaction, plan of care and membership analysis
Integrated care coordination by ACO
Proactive Plan of Care and Follow-up
Patient/ Care Giver Experience
Patient Engagement
Patient/ Membership Analysis
Medication Reconciliation
30 Day Post Discharge Physician Visit
Measure of Processes of Care (MPOC-28)
Plans Of Care Compliance
Communication with Nurses
Communication with Doctors
Call Center - Hold Time
Responsiveness of Hospital Staff
Member Insurance Affiliation
Dual Eligibility
Employer Affiliation
YTD Total Medicare Membership Growth
Termed Group Count
Success of Member Education
Patient Education/Outreach Participation
Patient Channel Responsiveness
Young Adult Health Care Survey (YAHCS)
Improved patient engagement and care coordination

22. Analytics enables shared accountability among the ACO leadership to provide collaborative care
Key Capabilities
CMO
At Risk Population
Evidence Based Medicine/ Gaps in Care
Patient Safety
Population Health Management
Proactive Plan of Care and Follow-up
Quality Improvement
Patient Engagement
Patient Satisfaction
Preventive Health
Healthcare home effectiveness
Practitioner Satisfaction
CEO
ACO
Dashboards
Executive Management Information System (EMIS)
Revenue Cycle
COO
Operational Efficiency
Organizational Analysis
Transitions and Communication
Reimbursement
Security and Privacy
Cost of Care
Practitioner Satisfaction
Provider Utilization
Patient/Membership Analysis
Patient Safety
Quality Improvement
Supply Utilization Measures
Purchasing & Contract Compliance Measures
Inventory Management Measures
Key Capabilities
CMO
CFO
COO
CMIO
CEO
CFO
Cost of Care
Financial Performance
Financial Risk
Market Share
Regulatory Risk
Reimbursement
Patient/Membership Analysis
Purchasing & Contract Compliance Measures
CMIO
Technology Adoption
Security and Privacy
Evidence Based Medicine/ Gaps in Care
Note: The capabilities that are in bold are shared across the excellence areas
Note: The capabilities that are in bold are shared across the excellence areas

23. Management Objectives
Analytics enables ACOs to budget for the healthcare expenses of a defined population
Population Health
Management Objectives
Key Questions
Analytics Impact
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
Health Assessment
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
Risk Stratification
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
Patient- Centered Intervention
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
Impact Evaluation and Outcomes Measurement

24. Accountable Care Metrics
Reporting capabilities and detailed metrics are required to operate, manage and measure an ACO
Reports will provide valuable information allowing ACOs to track performance and identify areas for improvement. 
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 Metrics
ACO
ACO Reports
Accountable Care Metrics
Reporting capabilities are required to collect and submit quality and safety data to CMS and private payers.

25. Sophisticated analytics platform enables longitudinal view of patients and practice of evidence based medicine
Physician / Patient Engagement
Data Integration & Management
Core Applications & Workflow / Automation
Data Analytics & Content 1 2 3 4 5
Connectivity, Security and Interoperability
Connects to all the data producers, provides access to data consumers, and validates access rights.
Core Applications and Workflow / Automation
Orchestrates 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 Management
Retrieve 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 Engagement
Key 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 Content
Using self-actualizing trends and business solution specific heuristics analyzes transactional data and creates enriched information. Data delivery occurs via screen-reports and services/API.

26. What Next

27. Unprecedented Market Changes Are Creating New Challenges for Healthcare Providers
The evolution occurring in the industry is driven primarily by four macro-drivers:
Heightened consumer expectations on value, simplicity, and transparency
Ubiquitous technology adoption (e.g. Web, Mobile, Social) combined with always-on consumers
Transparency in cost & quality
Shift from volume to value (e.g., P4P, risk sharing)
HC Delivery
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)
Rise in government programs (e.g., Medicare, Medicaid, Duals, and HIX)
Heightened regulatory oversight
These macro trends make it imperative for industry leading provider organizations to adapt to change enabled by their best in class people and processes

28. The Unified Data Platform – Oracle and Deloitte
Where do investments in technologies like Oracle EHA, and Deloitte’s Analytical Applications fit in this future view?
ConvergeHealth by Deloitte
Level 2 View –
Data Source/Producers
Data Consumers
Data Brokering
Data Ingestion/Enrichment
Data Collection
Oracle
HDM
DBMS
Oracle - OBIEE
Oracle - OBIEE
ConvergeHealth by Deloitte
Oracle
MDM
ODI
Data Quality

29. Healthcare organizations should enable advanced analytics to provide integrated patient care

30. Q&A