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Healthcare BI and Analytics including Master Data Management, Targeted Analytics, Governance, Enterprise Data Strategy, and Data Assessment

10 Benefits of Enterprise Information Management in Healthcare

This month, we completed an interview with our healthcare analytics strategist, Juliette Silver. We wanted to understand how enterprise information management strategies can specifically optimize business performance, reduce costs, mitigate risks and improve quality of care.

From the interview, I take away at least 10 major benefits to establishing and leveraging an enterprise information management strategy in healthcare settings:

EIMAn EIM strategy can:

  1. Help manage access to enterprise information in a secure, HIPAA-compliant manner.
  2. Allow healthcare professionals to turn mountains of data into real-time decisions.
  3. Help focus people, process, policies, frameworks and foundational technologies toward how to best leverage enterprise data.
  4. Set forth the framework that will be used to provide the information delivery capability,whether the information is in the form of data (structured or unstructured) or unstructured content, or a combination of both.
  5. Help an organization respond to evolving regulatory requirements and reimbursement models.
  6. Define the information management model that will be used to harmonize the delivery of both content and data specific to a healthcare organization’s goals and objectives.
  7. Ensure the delivery of information in the form of a trustworthy source that can be interpreted, used and managed consistently across the enterprise.
  8. Give a clinician or healthcare knowledge worker the access they need to the many sources or types of information from which to make decisions.
  9. Ensure information is timely, accurate, valid, verified and generally fit for purpose.
  10. Produce a more holistic view of the patient, derived from structured data stored in an electronic health record and other clinical systems, as well as unstructured information or content made available in some of the forms previously stated.

Read the full interview here.

The Three G’s of Mapping….Is Healthcare a Leader?

Ok, it’s true.  I’m a closet geek.   I think no one knows how much I love maps. (Lesli Adams, my colleague at Perficient, often describes herself as a geek so this is homage to her).  There are so many different kinds of maps, so which ones do I favor, you ask?  I think the best maps are the three “G’s”,

  1. geospatial,
  2. genomic and
  3. geocaching.

Let me show you how all of these have relevance to healthcare:

Let’s start with geospatial. 

shutterstock_56289301I am fascinated by the heat maps of disease prevalence, patient engagement and demographics that have started to electrify Healthcare.  Duane Schafer, Director of Microsoft Business Intelligence for Perficient, recently revealed a great demo at HIMSS, based on Population Health statistics from ProHealth in Wisconsin.  Using basic tools from the Microsoft stack, Duane was able to visually map important population health statistics from ProHealth and present that data in a way that entices the viewer to explore deeper.  It allows the organization to see, at a glance, major population demographics in their region.  This can then be combined with additional analytics to determine trending of disease in the area, frequencies of patient visits to the Emergency Departments over time and correlations of missed appointments to care gaps in specific chronic disease management.   Geospatial mapping even hit the news recently when a contamination at Lake Champlain caused concern about the risk of spreading disease and therefore assisted with facilitating a rapid Public Health response in this  situation. Of course, there are many more examples but you get the idea. Read the rest of this post »

Population Health: Informatics for Clinical Decision Flow & Costs

At the Fourteenth Population Health Colloquium in Philadelphia, Perficient’s own Lesli Adams, MPA, took the stage with Sanjay Udoshi, MD and Brady Davis to present “Shared Accountability: How Informatics and Data for Clinical Decision Workflow engages Consumers on the Quality/Cost Equation.”  This Mini Summit presentation was sponsored by Oracle Health Sciences and Perficient.   The kick-off of the presentation was fun because it introduced the speakers as a business analyst geek (Lesli), an innovation and strategy guy (Brady) and a doc in the box (Dr. Udoshi). The presentation was targeted at the opportunities for quality improvement and cost control including wellness and chronic disease care gaps.  At the risk of seeming biased, this presentation was one of the more practical, down to earth approaches at this week’s Colloquium event.

Why do I believe that? Well, I felt that many of the attendees at the Colloquium were seeking real how-to knowledge.  Not that the big healthcare organization’s experience in implementing population health management aren’t valuable insights, but there was a lot of buzz about whether population health management can be done in a cost effective manner, and this presentation addressed the type of informatics required to change traditional approaches.  The first step was to outline the process in a slide called Population Health Management 101.  The key concept was moving paper processes for care management to a digital platform to analyze and manage costs, see figure 1.

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Figure 1. Population Health Management 101

 

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Figure 2. Re-engineering Clinical Care

 

The second idea was to re-engineer clinical care to identify and manage care gaps.  The first step is to identify the key populations to be managed, then determine the key Goals for that population, and finally to manage addressing the gaps in care or Action Arms (Figure 2).  Note that different populations have unique goals but subsequently could have common Action Arms.  To address creating the care gaps and related Action Arms, the healthcare organization has to have a strategic vision for these target populations and combine that with the right tactical tools, namely informatics.  The challenge of creating these informatics isn’t simply addressed with technology tools, but requires several key steps including:

  • Structured Data Capture vs Natural Language Processing (NLP)
  • Diagnosis Naming Conventions
  • Establishing the Digital “Gold” Standard”
  • Influencing the Problem List
  • HCCs and Chronic Disease Management
  • Best Practice Alerting and Health Maintenance Modifiers
  • Guideline Based Bundles and Closing Care Gaps

Addressing Care Gaps is very practical advice for healthcare organizations seeking to really manage populations. Creating informatics solutions that support closing preventive, chronic and restorative care gaps will drive health care value for patients and health plans alike.  Creating these informatics requires data mining, process re-engineering and the ability to extract data from modern electronic health record systems.  Building patient-centric plans of care based on this process will need to be supported through proactive outreach as well.  The key is applying technology tools in novel ways to enhance shared decision-making between the clinician and patient.

Lesli Adams outlined what I see as the key factor to population health management: cost management.  The integration of clinical information and financial data is key to cost management and often this data resides in silo’ed or separate software applications.  The ability to manage costs by having standardized pathways, then examine costs at a Patient Level will lead to better decision-making and more cost effective care.  Putting the disciplines in place to examine physician variability against the standardized pathways is the enforcement technique to bring costs under control.  When organizations commit to collecting and cleaning this level of costing information, then profitability reports by service line, DRG and Physician become reliable tools for key decisions about operations.  One of the highlights of the presentation was micro-costing examples to highlight the key decision points for clinicians.

Lesli Adams will be presenting at the Oracle Industry Connect event on Tuesday and Wednesday, March 25-26 in Boston.  For more information on Perficient’s informatics offerings, especially related to Population Health Management, please contact us.

How ProHealth is Innovating Population Health Management Webinar

The process of effectively managing population health while consistently measuring and reporting its outcomes can be a challenge for healthcare providers.

How ProHealth Care is Innovating Population Health ManagementWe will be having a conversation with Christine Bessler, CIO and VP of Information Technology at ProHealth Care and Juliet Silver, Director of Healthcare Advisory Services at Perficient on Wednesday, March 26. We will be discussing some of these issues as well as how ProHealth Care was the first healthcare system to produce reports and data out of Epic’s Cogito data warehouse in a production environment.

During the session, Christine will be answering the following questions:

  • How did they deliver clinically integrated insights to 460 physicians
  • How access to analytics allows their physicians to easily see which patients need important health screenings or care interventions, setting the stage for enhanced preventive care and better management of chronic diseases.
  • How ProHealth Care’ developed their strategy to integrate data from Epic with information from other EMRs and data sources to deliver clinically integrated BI
  • How ProHealth Care is positioning itself to deliver against an advanced self-service BI capability in the future.

Juliet will share insight into the methodology applied to establish data governance as a discipline at ProHealth Care, and how the Business Intelligence Competency Center came to be.

Christine Bessler will answer these questions and more during our free webinar on March 26th at 1:00pm CT.

To register for the webinar click here.

 

What will it take to decrease nursing home readmissions? #HIMSS14

HIE, clinical data, quality measures, financial and claims data along with healthcare analytics – what does it take to decrease readmission rates in nursing homes?

There is so much attention these days on making the most of all of the clinical and financial data regarding healthcare, hospital readmission costs and reimbursement, but do we really know what changes can or will make a difference?

It has been a long time since I have done bedside nursing, but I can remember how often I would have one or more patients assigned to me who had come from a skilled nursing facility, long-term care facility or “nursing home.”

home_care_nursingThe American Health Care Association (AHCA), the largest association representing skilled nursing care centers in the country, reports that every year, nearly 2 million Medicare beneficiaries are readmitted to the hospital within 30 days of being discharged, at a cost of $17.5 billion. Of readmissions, one fourth are skilled nursing care patients, receiving post-acute care (recuperative or rehabilitative services).

According to the recent Office of Inspector General (OIG), Medicare Nursing Home Resident Hospitalization Rates Merit Additional Monitoring report, in Fiscal Year 2011, one quarter (24.8%) of Medicare residents in nursing homes were transferred to hospitals for inpatient admissions, at a cost of $14.3 billion for the hospitalizations. The hospitalizations were required for a wide range of conditions with septicemia the most common. While the majority (67.8%) were transferred to hospitals only once, 20% transferred two times, 7.2% transferred three times, and the remaining 5% transferred four or more times. Of the Medicare costs for hospitalizations in FY2011, care for a nursing home resident cost an average of $11,255 per hospitalization, which is 33.2% higher than the average Medicare hospitalization ($8,447). Read the rest of this post »

Why business intelligence isn’t the end game for health analytics

A few years ago, I transplanted my family from the south to Washington DC.  I love the Capital, for its history, its influence, but we quickly realized we had left Mayberry and arrived on Jupiter.  Horns honked and people moved around briskly.  Maybe it was us – our naiveté — or maybe it was the community we had arrived in.  But we quickly realized: “If you order french fries, you get french fries.” And only french fries. Months of dining out were spent, only to find that our presumed “condiments” were not standard with our order.  We would have to ask for them and specify the quantity.  French Fries and 2 ketchups, please.

Careful.Well I clicked my heels three times and eventually moved us back to our Mayberry.  It’s been three years and my son and I will still giggle together when we order french fries and see someone going out of his or her way to offer ketchup.  And when we say “Yes, Please”, we get several packets.

Consulting in Healthcare is no different. We’ve grown accustomed to the “build to spec” approach.  You get exactly what you asked for.

I’m thankful to be a part of Perficient and the Oracle Healthcare Business Intelligence team.  We share a common philosophy – understand what the customer wants to achieve, coach and advise available options, design and deliver a solution that fulfills their NOW problem and simultaneously prepared them for the next 5 years.  It’s not just a report – it’s Healthcare Analytics. Read the rest of this post »

Balancing clinical effectiveness with profitability – #HIMSS14

A former boss of mine, who happened to be the CFO of a large academic medical center, used to say the phrase “no margin, no mission”  all the time.  I’m not sure I really took the time to understand it at that point in time, but I have since then, “grown up”.  My understanding of the intricacies of determining true profitability is now burdened by the awareness of how many different business transactions occur in the hospital setting and how hard it really is to capture each correlated business transaction at the same point in time.  

ON THE (1)Still, producing a monthly income statement is one thing, and there is certainly no shortage of guidance whether considering GAAP or public sector fund management reporting requirements, but how do we merge the clinical effectiveness discussion with the finance and accounting discussion? 

In my view, these two areas converge at the decision support team who have been supporting contract management and costing activities for decades.  Perficient views the costing activity as an enabler for business to deliver strategic advice, moving away from low value transactional activities, through increased focus on:

  • cost reduction and ability to support the introduction of new products/services or new markets
  • understanding spend according to the value a function or activity creates
  • promoting transparency with a wider view to cost data to allow management to better understand spend through driver-based information on “cause of cost”.

Read the rest of this post »

A healthcare treasure map leading to a single data warehouse

I’ve waited 20 years for my Treasure Map.  Yes, a map with hidden passages, remote islands and an “X” to mark the spot.  As kids, some of us hunted in our yards looking for buried treasures.  Kids today use smart phone apps for activities like “Geocaching” to explore public and urban spaces.  What do we use in Healthcare?

The single place to put a healthcareMany of us desire a chest full of clinical outcomes, protocol conformity, activity based costing, provider scorecard, genomic studies, Pharmacogenomic markers, Adverse Event analysis, and coordination of care analytics.

But lately, we have been lost – adrift at sea, hopping from one raft to another, and from one stranded island to the next more barren island.  We’ve bought point solutions that offered the holy grail for a niche activity, all while knowing the vendor or the quick fix would evaporate before we had achieved broad-based adoption.

Oh, I’ve been there – tasked with implementing the pet project for a clinical director or department chair.  I’ve no sooner got the data in and one cycle of analysis out, than the provider champion would change their focus and the solution implemented didn’t transfer to the next project. (Sigh.) Read the rest of this post »

Manage health system costs with insightful analytics – #HIMSS14

Healthcare systems must be able to provide timely and accurate financial information for decision making and planning. Many hospitals and health systems are targeting hefty reductions in their operating budgets to maintain financially viable without interrupting investments in facility, information technology and other areas needed to remain competitive.  This cost management culture requires organizations to fully understand and ensure transparency exists for key performance indicators that drive consumption and reflect service line profitability.

PRODUCT NAMEWhether it is supplies, labor or productivity or clinical effectiveness, the quality/cost/value equation requires the organization to truly understand their data.  This includes not only considering the right product at the right place, but also applying a broader perspective on clinical evidence for resources used and approaches employed.

A hospital can’t just make across-the-board financial target reduction a sustainable approach. Perhaps a place to start would be to identify opportunities to reduce variation in care delivery by standardizing clinical processes.

But how do we understand cost of care?  There are “experts” within the organization for sure, but a better approach would be to couple these experts with technology that enables us to understand the fully burdened margin by service, by patient or by procedure.  Costing software technology and spreadsheets have been around for a while; we must now transform these systems to leverage clinical and financial / administrative data to create transparent costing models that tell us about profitability across service lines, patients and encounters.

Read the rest of this post »

Agile Forecast Planning for Healthcare Providers – #HIMSS14

In today’s rapidly evolving healthcare environment, provider organizations must be able to identify financial performance gaps continuously and quickly change course when needed.   As we discussed in my blog:  Elevating the Role of Finance within the Hospital, this requires a partnership with operations to ensure that the correct metrics are correlated within the budget process, but being agile is also influenced by the mechanism the hospital uses for budgeting.

A rolling forecast model can replace orThe use of a rolling forecast to replace or supplement the annual budget process

What is a rolling forecast?  The rolling forecast is usually a quarterly budget with a two to three year horizon that keeps a close eye on the organization trajectory.  Typically the forecast budget is not prepared at the department level but may instead focus on divisions or even at a hospital level.  Global budget drivers and assumptions will typically be the same as the annual budget but those unique to a department or division may not be line itemed.

The forecast is built using historical trends, current conditions and future assumptions for budget drivers.  Some forecasts may be primarily driven by revenue drivers with expenses flowing from ratios defined to the model.  The forecast feedback process fosters the partnership between finance and operations to allow the healthcare organization to course-correct sooner and reinforce the cause effect relationships that effect reality.   Some organizations use the rolling forecast process in conjunction with the annual budget and others have moved to using the forecast only.

Read the rest of this post »

The Role of Finance Within the Hospital has Elevated – #HIMSS14

Performance monitoring within the hospital can be accomplished through strategic partnerships between finance and operations.  These partnerships serve the organization well and lead to financial steadiness.  Let’s examine how this might work.

Data-driven decision making has (3)A recent case study within the November issue of HFMA Magazine explores how Mary Lanning Healthcare in Nebraska showcased how data-driven decision making has elevated the role of the hospital finance department from a back-office operational function to a more strategic, advisory one. The article goes on to discuss how finance can strategically deliver data that drive informed business decisions that support sound strategic and tactical planning and execution.

Mary Lanning is a 183-bed acute care facility which offers 29 medical specialties. Embracing data-driven decision making requires agile thinking to pinpoint and respond to the short-term and long-term needs of the organization. This shift requires finance to transcend from the typical focus on aggregating data to a value added analytic team that could provide greater visibility into changes in variables and assumptions.

Read the rest of this post »

Can you predict my future? Predictive analytics at #HIMSS14

While my interest is always in the convergence of technology like the Internet of Things and healthcare IT, the role of sensors in managing health and wellness is just exploding. 

“The most popular device functionality in the wearable tech market is heart rate monitoring, with nearly 12 million such devices shipped in 2013. Pedometers and activity trackers accounted for a combined 16 million shipments over the same period.” (According to a report released Thursday by ABI Research)

- Source: New report shows smartwatches and AR glasses have their work cut out.

the role of analytics, especially healthcare analytics, should be to inform, encourage and drive healthcare consumers to improve our behaviors or decisions without being intrusive.

“The role of analytics, especially healthcare analytics, should be to inform, encourage and drive healthcare consumers to improve our behaviors or decisions without being intrusive.”

You can’t turn anywhere without reading about the latest running gadgets, fitness bands, Bluetooth blood pressure cuffs, etc.  In the inevitable rush to wearable computing, one key idea can get lost: what are we doing with all of that data? 

The data produced by these devices and sensors has to be interpreted and turned into information that is actionable.  The fitness band that looks at your goal of 10,000 steps, sees that you are at 8,000 steps right after dinner and encourages you for one final walk around the neighborhood, will ultimately win out over all others.  In order to pull off that trick, we need analytics and, sometimes, predictive analytics.

Just as the sensors are working in the background without us even taking notice, the role of analytics, especially healthcare analytics, should be to inform, encourage and drive healthcare consumers to improve our behaviors or decisions without being intrusive.  The goal of healthcare analytics or informatics should be to create an environment for the healthcare consumer that makes life better, easier and more enjoyable.

An example is when the running app sees your pace slowing down towards the end of a run, then it kicks in a song with a faster pace to help you finish strong.  Today those apps require you to recognize that situation and take action of pressing a button.  It’s all there but it’s not automated.  What we need is that invisible intelligence that recognizes the situation and then takes action to assist us.

The Role of AnalyticsAt HIMSS 2014, we will be seeing this jump in interest in predictive analytics as it applies to healthcare, especially two distinct types of predictive analytics.

  1. One type is the traditional forecasting model of advanced analytics that trends past information to predict future states.
  2. The second type of predictive analytics is statistical models that encompass multiple feeds or variables to predict a future outcome.  This modeling is rapidly moving past the arena of data scientists who create the models and is moving more within the grasp of smart business analysts.  These models can predict your longevity based on multiple factors like your BMI, blood sugar readings for diabetics and other factors from your medical history.

Of course, we want to be able to predict health outcomes, especially when faced with several choices for changing our behaviors or lifestyle.  It will be exciting to see how healthcare application vendors are addressing this important next step in analytics.

The use of predictive analytics could really change the nature of a patient engagement with your doctor.  How will we react when we see the outcome of our current lifestyle?  Will we shut off Netflix bingeing and head to the gym? See you at HIMSS 2014 to find out!  Stop by Perficient’s booth #2035 and tell us what you found out!

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