Enterprise Data Warehousing in Healthcare Build vs Buy considerations Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Prop©rie2t0a1ry3 aHnedalCthonCfaidtaelnytsiat l Proprwiewtawr.yheaanldthCcaotnafliydsetn.ctoiaml www.healthcatalyst.com

Context for this topic Assess Design Implement Test Deploy 1 Decision Should we build this EDW from scratch, or partner with a vendor to deliver this capability for the organization. Are those my only options? Assess Design Implement Test Deploy “Do we have the tools to use data to transform care delivery and streamline operations?” “Assessment of our current state indicates we need a different future state. What should that look like?” “Key to our future state will be an Enterprise Data Warehouse (EDW) to integrate data from multiple sources and facilitate Triple Aim reporting. Make it so.” “We will test our EDW to ensure it is meeting our expectations.” “We will roll out our EDW and analytic applications to a broad group of users, including clinicians, leaders, and administrators.” Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Agenda Examine the options Other Considerations About Health Catalyst® Building an EDW Buying an EDW Hybrid solution Other Considerations About Health Catalyst® Questions Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Poll Question Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics 4 © 2013 Health Catalyst Prop©rie2t0a1ry3 aHnedalCthonCfaidtaelnytsiat l Proprwiewtawr.yheaanldthCcaotnafliydsetn.ctoiaml www.healthcatalyst.com

Building an EDW Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics 5 © 2013 Health Catalyst Prop©rie2t0a1ry3 aHnedalCthonCfaidtaelnytsiat l Proprwiewtawr.yheaanldthCcaotnafliydsetn.ctoiaml www.healthcatalyst.com

What is an EDW? Metadata, Security, and Auditing Common, Linkable Identifiers FINANCIAL SOURCES (e.g. EPSi, Peoplesoft, Lawson) DEPARTMENTAL SOURCES (e.g. Apollo) Financial Source Marts Departmental Source Marts Asthma Administrative Source Marts Patient Source Marts Hospital Operations PATIENT SATISFACTION SOURCES (e.g. NRC Picker, Press Ganey) ADMINISTRATIVE SOURCES (e.g. API Time Tracking) Primary Care EMR Source Marts HR Source Mart EMR SOURCE (e.g. Epic, Cerner) Human Resources (e.g. PeopleSoft) Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Why choose to build an EDW? Benefits of a data warehouse: Performance Integration Ease of use Historically Dearth of proven solutions for healthcare Pioneers had to demonstrate value prior to funding Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Considerations: building an EDW Worst case scenario: project failure 50% of data warehouse projects fail Common among unsuccessful EDW builds: A solid business imperative is missing Executive sponsorship and engagement is missing Frontline users are not involved from start to finish Ongoing success is elusive Most healthcare IT groups not prepared to function like a software company Limited opportunities to learn lessons before funding is cut Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Pros/Cons: Building an EDW Building it yourself means infinite customization Getting “something” built yourself may be “good enough” (for now) Pride of authorship Cons Staffing Shortage of qualified resources Re-learning lessons “Skunkworks” projects can be culturally divisive Project management challenges Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Buying an EDW Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Prop©rie2t0a1ry3 aHnedalCthonCfaidtaelnytsiat l 10 Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics Proprwiewtawr.yheaanldthCcaotnafliydsetn.ctoiaml www.healthcatalyst.com

Why might someone buy an EDW? Developing well-engineered, custom software may not be your core competency Market offerings for healthcare data warehousing solutions are better than 10 years ago Support and maintenance agreement help ensure long term success Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Considerations: Buying an EDW Many of the same risks with any vendor relationship Evaluating an analytics vendor Completeness of vision Culture and values Total cost Ability to execute Where else have they had success? Will their approach work for my organization? Do they have expert resources? More information: How to evaluate a clinical analytics vendor Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Pros/Cons: Buying an EDW Shortest time to value Real world experience: what works best in practice An infusion of help Lower total cost of ownership Cons Initial cost Knowledge transfer Tradeoff between “perfect” and “extremely good” Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Poll Question Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Prop©rie2t0a1ry3 aHnedalCthonCfaidtaelnytsiat l Proprwiewtawr.yheaanldthCcaotnafliydsetn.ctoiaml www.healthcatalyst.com 14

Hybrid Build and Buy Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Prop©rie2t0a1ry3 aHnedalCthonCfaidtaelnytsiat l Proprwiewtawr.yheaanldthCcaotnafliydsetn.ctoiaml www.healthcatalyst.com 15

Buying AND Building an EDW In practice, more like “Buy and Extend” Leverage a vendor partner for some components Develop, using internal resources, others Examples: Select a vendor to: Implement the data warehouse Integrate several high priority data sources Leverage internal resources to: Integrate additional data sources Develop additional analytic applications Integrate data from the warehouse into operational processes Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Why choose to build AND buy? Best of both worlds Rapid implementation As customizable as a purely “build” solution Higher potential for return on investment Mitigates risk Benefit from the lessons your vendor has learned Infusion of resources to help deploy and train Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Other considerations Potential pitfalls for any data warehouse project “Boil-the-ocean syndrome” Seeking governance “perfection” Rigid architecture Insights Original article Comparing data warehouse architectures for Healthcare Other Resources Healthcare Data Warehousing Association (HDWA) The Data Warehousing Institute (TDWI) Health Catalyst Knowledge Center Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

About Health Catalyst Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Prop©rie2t0a1ry3 aHnedalCthonCfaidtaelnytsiat l 19 Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics Proprwiewtawr.yheaanldthCcaotnafliydsetn.ctoiaml www.healthcatalyst.com

Health Catalyst Profile Integrated Delivery Systems Patients Impacted Hospitals & Clinics 25M 1400 Community Hospitals Academic Medical Centers Founded 2008 Employees 140 HQ Salt Lake City, UT Children’s Hospitals Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

What does Health Catalyst offer? Services Installation Services, Clinical Improvement Services Change Process and Behavior Analytic Applications Key Process Analysis, Dashboards, Advanced Analytics Apply Evidence and Standardize Late-Binding™ Data Warehouse Platform Data Warehouse, Architecture, Metadata Management, Security, and Auditing Integrates Disparate Data Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Application Families Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Reduce Healthcare Labor Costs by using an EDW and Analytics “The work our organization is doing with the Health Catalyst team pushes the envelope of what it means to have near real-time data at our fingertips to make operational decisions. Their technology and processes put us on track to understand the potential upstream and downstream financial impact of even the smallest decision.” ~ Director Clinical Planning and Financial Management Objective Health Catalyst Solution Results to date Manage labor costs by allocating resources appropriately to the demand for services Eliminate the need to manually pull and consolidate reports on a monthly basis for a 3rd party point solution Enable business and unit managers to better track and manage performance by providing more timely information Late-Binding™ Data Warehouse Labor Productivity Advanced Application Module Installation Services Improvement Services Estimated 2% reduction in total salaries and benefits to date 66% percent increase in the speed of data availability Estimated NPV of $425K over a 4-year period from automated data integration 500% increase in the number of managers using data to drive decisions Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

How to Reduce Heart Failure Readmissions “Our data is now accessible to stakeholders throughout the organization, including clinical teams who can use it to drive improvements in care processes, care quality and patient outcomes” ~ Director of Clinical & Business Analytics Objective Health Catalyst Solution Results to date Define Heart Failure (HF) baseline measures for 30 and 90-day readmissions rates Implement evidence- based practice interventions to drive HF readmission rate reductions Establish balance metrics including ED visits, observation days and patient satisfaction Develop sustaining processes for evaluating readmission rates to ensure continuous process improvement Late-BindingTM data warehouse that enables faster time-to-value Integration of clinical, patient satisfaction and financial data to establish baseline, ongoing and balance measures Discovery, Foundational and Advanced HF applications including cohort finder, registry and evidence- based clinical content Healthcare analytic visualization including gauges and trend lines for at-a-glance view Seasonally adjusted rate reduction of 21% in 30- day and 14% in 90-day readmissions 2X increase in the number of phone calls made to patients within 48 hours of discharge Average of 63 % increase in physician medication reconciliation within 48 hours of discharge Follow-up appointment intervention baseline and balance measures established Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com

Questions and Answers Additional Information See us at HIMSS 2014 booth #6076 Call 801.708.6800 to request a meeting Listen to two clients speak: – “Improving Outcomes with an Innovative Approach to Population Health Analytics” » Stanford Hospital & Clinics » Yohan Vetteth, Pravene Nath, MD » Date/Time: Thursday, 2/27, 12 PM » Location: Room 304A, Session #229 – “Blending Clinical and Financial Data to Drive the Value Equation” » Texas Children’s Hospital » Charles Macias, MD » Date/Time: Wednesday, 2/26, 1 PM » Location: Room 304A, Session #191 Follow us on Twitter @healthcatalyst #HCDatawarehouse Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics © 2013 Health Catalyst Proprietary and Confidential www.healthcatalyst.com