3Contents Introduction and Kick Off 3 Importance of Analytics for Healthcare Organizations 6Case Study: The Impacts of Analytics at BayCare 14Enabling Analytics for ACOs 20Summary – What Next 26Q&A 29
4Team resumes Role – Engagement Director Role - Director Tony JurekDirectorDeloitte ConsultingMinneapolisTony is Director in the Information Management practice of Deloitte Consulting. Tony advises healthcare clients in the Business Analytics spaceBalaji ApparsamyDirector, Data Management & Enterprise Web ApplicationsBayCare Health System Clearwater, FLBalaji 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 risksRole – Program ManagerRole – ConsultantYasim KolathayilManagerDeloitte ConsultingDallasYasim 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 CarlonConsultantDeloitte ConsultingMinneapolisMorgann is a Consultant in the Information Management practice of Deloitte Consulting. Morgann is currently focused on healthcare analytics strategies for her clients.
5Importance of Analytics for Healthcare Organizations
7Six Trends Shaping Healthcare Healthcare organizations are experiencing the “perfect storm” at the intersection of changing demographics, technological innovation and governmental regulation.Expanding Definitions of HealthConsumer health technologiesMedical expense managementDirect-to-consumer tools and decision supportGenotypic diagnostics and targeted therapeutic interventionsRising Pressure in Policy,Politics, and EconomicsOnline platforms for collective actionFocus on cost reduction and improved health outcomesCommunities of interest become communities of actionDemanding DemographicsPersonalized health informationIndividualized risk assessmentPersonal health recordsGenetic screeningHealthcareOrganizationsConverging RelationshipsOpen platforms for innovationConnects outsiders to specific projects inside companiesEncourages cross-disciplinary and external collaborationStreamlines expert sourcingIncreasing TransparencyTechnology shapes health behaviorNew technologies integrate layers of dataOTC diagnostics provide real-time feedbackAdvancement of data analysisSimulations anticipate riskPatient self-carePublic health preparednessExpanding Connectivity:Anytime, AnywhereMobile healthDelivery of information and servicesPeer-to-peer health managementAdherence support and self careSensing technologiesCollection of biometric dataThe Result – More data from more sources creates new challenges and opportunities
8Analytics Can be a Game Charger for Healthcare Organizations Take an EnterpriseViewStart with theEnd in MindUse the Right Solutions for the JobLeaders Need 360O InsightFocus on ExcellenceMarket ExcellenceClinical ExcellenceOperational ExcellenceFinancial ExcellenceYou can’t manage what you don’t measure – metrics that matterUnderstand what separates areas to better bring them togetherOne-Size Does Not Fill AllFocus on the Future1-2 Yr. Target Maturities2-3 Yr. Target Maturities3-5 Yr. Target MaturitiesDon’t “rip and replace” but “leverage and lift” the value of the systems you already haveAlignment across functions makes everyone successfulNot Everything Looks Like a NailFocus on ValueDeloitte Products & IPVendor TechnologiesDeloitte Advice and ICPartner NetworkSolutions, not tools bring the pieces together and drive new insightsAlign projects and partners with shared risk and shared reward
9Key is understanding the two sides of Analytics Descriptive AnalyticsReportingAfter the fact performance measuringStaticShould be insightfulPredictive AnalyticsFuture facingTrendingPattern AnalysisScoring to determine “Next Best Action”Cohort DeterminationShould also be insightfulHindsightInsightforesight
11Deloitte 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 IssueImpactProduct PortfolioIntellectClinical ExcellenceSustainable MarginRevenue ExcellenceImprove business processes, clinical effectiveness and efficiency, patient safety, productivity to lower cost, while maintaining and improving qualityIsolate and quantify revenue leakageInsightValue Based Care/ Population Health ManagementImprove population health management and outcomesReduce unwarranted variationImprove care coordination and risk stratificationLeverage evidence based guidelines and best practicesMinerResearch ExcellenceReal World EvidenceImprove signal exploration and surveillanceSupport comparative effectiveness analyses, pharmacovigilance, and other use cases for R&D & outcomes analysisImprove clinical and translational research/medicineEnable personalized medicineTotal Cost IntellectHealth System IntellectSustainable Margin and Quality DashboardClinical IntellectClinical Care OptimizerReadmission OptimizerQuality OptimizerPerformance IntellectPI WorkbenchOperations OptimizerProcedure Cost AnalysisRevenue IntellectRevenue Financial AnalysisInsightProvider Performance ManagementPatient EngagementContracting and ReportingCare ManagementOutcomes MinerSignal ExplorationStatistically Nuanced AnalyticsComparative AnalyticsPrecision MinerBiomarker Hypothesis Generation & ValidationGene Based MatchingCohort IdentificationDescriptive AnalyticsDrug Exposure / Response AnalysisPopulation MinerResearch Knowledge Management
12Oracle Enterprise Healthcare Analytics + Deloitte Analytic Applications A powerful combination of capabilities to help meet the demands of the information driven healthcare environmentSecurityMetadata DeliveryException Management SystemBusiness RulesOracleEHA AppsConformed Data Mart (HCD)OBI-EE/JavaSourceDataExtractOHADI:ApplicationToolkitReportingAllSourcesInterfaceTablesOHADI: WILEHA HealthcareData ModelConvergeHealthBy DeloitteAppsExecAd Hoc QueryValidation, Standardization, and TransformationClinicalFinancialAdministrativeResearchOLAPClinicianData MiningCustomApplicationsMaster DataInterface (MDI)MDM: Term.MPIUnit of Measure…NLPDe – identificationMasterDataMDM LoadersMaster Data Management & Other Services“Real” TimeResearcherMDMETLOHADI: Interface tables > HDWF, business rules, MDM, and metadata managementSource IndependentOHADI: HDWF > ApplicationsMDM, Conformance, Metric Definition, Benchmarks, etc.Source DependentHDWF3NF EDWApplications: Reports, Dashboards, Scorecards, etc.
14IntroductionBayCare 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
15ReadmissionsIdentification 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 peopleCommon CausesLack of coordination of care between settingsEstimated high volume related to social issuesLack of compliance with prescribed therapyPreventionReadmission flag on EMRStandard discharge procedure and patient educationDischarge phone calls and follow upImproved patient experiencePeopleProcessTechnology
16Readmissions - ImpactReduction of readmission is a spectrum of process, that leads to the transformation of providing care to the patientsPatientsOne fifth of the Medicare patients are readmitted within 30 daysHuge cost impact on unplanned readmissions within 30 daysHospitalsReductions in reimbursementsPenalties and risks due readmission trendsThree fourth of the readmissions are preventableFee for ServiceValue based(PHM)
182014 Accomplishments Beginning of the journey, in the right direction Standard method to identify patients at High Risk for ReadmissionImplemented Interdisciplinary Plan of careEMR ‘task’ to Case Manager and Social Worker when patient identified as High Risk for ReadmissionMonitor Home Care admits and Pilot rolloutsNext stageTransition of Care Management Process modelOngoing monitor and improvements
20Analytics can address the critical needs of ACOs 1. Integrated Patient Care management2. Accountability and Organizational Effectiveness3. Population Health Management4. Safety and Quality Reporting Compliance5. Technology adoptionCritical ACO needsIntegrated Patient Care managementAccess to a holistic 360 degree view of patient data and analyze data overtime to identify trends and spot gaps in care coordination and deliveryUse predictive modeling techniques and solutions to prevent adverse events and readmissions5. Technology adoptionCreation of sophisticated technology platform allowing for longitudinal view of patients and more practice of evidence based medicineAnalytics system focus on acquiring clinical data and facilitating a care management workflowPopulation Health ManagementEnables risk stratification and can identify the subpopulations that are most at riskSummarize and explain population level outcomes data to budget for the healthcare expenses of a defined populationAccountability and Organizational EffectivenessDefines shared accountability among the ACO leadership to provide collaborative careMeasures organizational effectives and key capabilities across excellence areas enables organizational savings and growth opportunities.How analytics can help ACOs address these critical needsSafety and Quality Reporting ComplianceEnables ACOs to measure the quality and compliance metrics for CMS shared savingsReporting capabilities and detailed metrics are required to operate, manage and measure an ACO
21Integrated care coordination by ACO Analytics enables a 360 degree view of patient and spot gaps in care coordination and deliverySample metrics to measure patient engagement, satisfaction, plan of care and membership analysisIntegrated care coordination by ACOProactive Plan of Care and Follow-upPatient/ Care Giver ExperiencePatient EngagementPatient/ Membership AnalysisMedication Reconciliation30 Day Post Discharge Physician VisitMeasure of Processes of Care (MPOC-28)Plans Of Care ComplianceCommunication with NursesCommunication with DoctorsCall Center - Hold TimeResponsiveness of Hospital StaffMember Insurance AffiliationDual EligibilityEmployer AffiliationYTD Total Medicare Membership GrowthTermed Group CountSuccess of Member EducationPatient Education/Outreach ParticipationPatient Channel ResponsivenessYoung Adult Health Care Survey (YAHCS)Improved patient engagement and care coordination
22Analytics enables shared accountability among the ACO leadership to provide collaborative care Key CapabilitiesCMOAt Risk PopulationEvidence Based Medicine/ Gaps in CarePatient SafetyPopulation Health ManagementProactive Plan of Care and Follow-upQuality ImprovementPatient EngagementPatient SatisfactionPreventive HealthHealthcare home effectivenessPractitioner SatisfactionCEOACODashboardsExecutive Management Information System (EMIS)Revenue CycleCOOOperational EfficiencyOrganizational AnalysisTransitions and CommunicationReimbursementSecurity and PrivacyCost of CarePractitioner SatisfactionProvider UtilizationPatient/Membership AnalysisPatient SafetyQuality ImprovementSupply Utilization MeasuresPurchasing & Contract Compliance MeasuresInventory Management MeasuresKey CapabilitiesCMOCFOCOOCMIOCEOCFOCost of CareFinancial PerformanceFinancial RiskMarket ShareRegulatory RiskReimbursementPatient/Membership AnalysisPurchasing & Contract Compliance MeasuresCMIOTechnology AdoptionSecurity and PrivacyEvidence Based Medicine/ Gaps in CareNote: The capabilities that are in bold are shared across the excellence areasNote: The capabilities that are in bold are shared across the excellence areas
23Management Objectives Analytics enables ACOs to budget for the healthcare expenses of a defined populationPopulation HealthManagement ObjectivesKey QuestionsAnalytics ImpactDoes 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/riskConsumer health segmentationPatient cohort identification & StratificationEpidemic monitoringHealth AssessmentWhat 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 trendsClinical campaign management & targeted outreachChronic disease managementRisk-pool stratificationShared decision makingRisk StratificationAre 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 statusImproved patient satisfactionPersonalized patient careEvidence based interventionEnables use of social mediaPatient- Centered InterventionDoes 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 outcomesFinancial reportingRisk and regulation complianceQuality & compliance reportingClinical performance managementReimbursement reportingImpact Evaluation and Outcomes Measurement
24Accountable Care Metrics Reporting capabilities and detailed metrics are required to operate, manage and measure an ACOReports will provide valuable information allowing ACOs to track performance and identify areas for improvement. Regulatory MetricsOutcomes MetricsGuidelines MetricsEfficiency MetricsClinical Process MetricsPayer MetricsPayer Mandated MetricsOutcomes MetricsPhysician MetricsProcess MetricsClaims for Reimbursement MetricsACOACO ReportsAccountable Care MetricsReporting capabilities are required to collect and submit quality and safety data to CMS and private payers.
25Sophisticated analytics platform enables longitudinal view of patients and practice of evidence based medicinePhysician / Patient EngagementData Integration & ManagementCore Applications & Workflow / AutomationData Analytics & Content12345Connectivity, 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.
27Unprecedented 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 transparencyUbiquitous technology adoption (e.g. Web, Mobile, Social) combined with always-on consumersTransparency in cost & qualityShift from volume to value (e.g., P4P, risk sharing)HC DeliveryRealignment of relationships and scope of services across healthcare industryRisk shifts from Health Plans to ProvidersPlayers 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 oversightThese macro trends make it imperative for industry leading provider organizations to adapt to change enabled by their best in class people and processes
28The 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 DeloitteLevel 2 View –Data Source/ProducersData ConsumersData BrokeringData Ingestion/EnrichmentData CollectionOracleHDMDBMSOracle - OBIEEOracle - OBIEEConvergeHealth by DeloitteOracleMDMODIData Quality
29Healthcare organizations should enable advanced analytics to provide integrated patient care