Presented by: Rich Temple, National Practice Director - IT Strategy, Beacon Partners

1. Business Intelligence (BI) in Healthcare Building the Roadmap to Realize the Fullest Potential of BI to Transform Your Organization Presented by: Rich Temple, National Practice Director - IT Strategy, Beacon Partners June 3, 2013

2. Why the particular interest now? Business case / ROI opportunities in BI How to avoid historical pitfalls How to achieve true transformation through BI Building the BI roadmap Dialogue / Q&A Agenda

3. Providers having to do more with less • Affordable Care Act (ACA) reimbursement carrots and sticks • Value-Based Purchasing (VBP) • Tighter enforcement of regulatory mandates New healthcare business models eating into traditional sources of revenue • ACOs • Bundled payment • Penalties for sub-par quality or excess re-admissions Why The Particular Interest Now ?

4. Areas of Tangible ROI Utilizing BI

5. Potential mergers/acquisitions, clinical integration, minimizing risk arising from the Affordable Care Act, ACOs, PCMHs, etc. • Predictive modeling / “what-if” analyses • Regression analysis: gauging the impact of one variable on another when analyzing outcomes Coordination of care (clinical resource utilization, physician profiling, LOS) Organization alignment: Hospital-Hospital & Hospital-Physician Service line management Achieving economies of scale Strategy Development and Implementation

6. Improved productivity and staffing ED optimization • “Door-to-doc” tracking • ED wait times • ED turnaround time (optimizes revenue and patient satisfaction!) IP discharge tracking Improve patient flow Track OR utilization and start times Improved Operational Efficiency

7. Emergency Department OperationsReal Time Bed, Patient and Doctor Status, ED Wait Trends ** Information Builders Confidential **

8. ED Optimization – “Door-to-Doc” Tracking BEFORE 30-minute “door-to-doc program” AFTER 30-minute “door-to-doc program” • Each bubble represents a physician – larger bubbles mean larger numbers of patients seen by the physician • X-axis is door-to-MSE time for each physician • Y-axis is MSE-to-disposition time for each physician • Graphs were posted to the doctors – each doctor knew their own color

9. Overall monitoring of census and visit volume Revenue cycle optimization Cost reduction strategies (including unit of service costs) Identifying winning and losing service offerings • Are there particular outliers (e.g., doctors using a particular expensive implant) that are unnecessarily driving up costs? Monitoring and improving profitability Reducing administrative overhead Supply chain management (unit costs, inventory management, group purchasing) Better Financial Performance

10. Information Builders Healthcare Solutions Hospital Clinical Operations Management Dashboard

11. Ongoing compliance with clinical best practices Coordination of care (clinical resource utilization, case mgt., physician profiling, LOS) ACO / PCMH / PQRS / CQM reporting – detailed dive and targeted interventions Population management Patient return to the ED within x hours/days Readmissions Hospital-Acquired Infections Improved Quality and Clinical Outcomes

12. Compliance with Clinical Policies Following this type of model, large portions of “chart reviews” can be done automatically and nearly real-time!

13. Going Deeper – Real-Time Compliance Monitoring

14. Sample ACO / Population Management Dashboard

15. Zeroing in on problem areas around MU requirements, Clinical Quality Measures (CQMs) or Physician Quality Reporting System requirements • Broken by doctor, by unit, by time of day… anything ACOs • Physicians whose quality or productivity may be putting the ACO at risk • Population management initiatives • Targeting interventions before they require huge and expensive interventions • Reimbursement modeling (ICD-10 a notable example) Some Profound Needs – Today!

16. Much at stake in terms of the long-term viability of the provider organization • Need to tightly control their quality indicators as well as key performance indicators on the financial side As healthcare organizations become more complex, these measurements become increasingly challenging and increasingly critical Quality and Reimbursement

17. BI’s Checkered History – How to Avoid Pitfalls

18. “Nice-to-have” vs. “Must have” - competing priorities Integrating disparate data across systems Lack of an enterprise perspective Seen as an IT project / lack of focus on end-user needs Lack of overall buy-in from leaders and line staff to the organizational BI vision Usability – effective optimization of workflows Data governance and “sources of truth” Underestimating impact on hardware, network and connectivity infrastructures Where Has BI Encountered Challenges?

19. Integrating Disparate Data Sources – Where was THIS?

20. How to Deploy BI to Provide Organizational Transformation

21. Enterprise-Wide Vision

22. Leadership comes together to identify organization-wide vision Identify benefits to the organization • Need for detailed data to survive and thrive • Unambiguous data sources of truth Commit the time and resources necessary to ensure success Identify non-IT project sponsors Begin process of identifying subject-area workgroups to help identify needs and explore ideal BI solutions. Lay Groundwork For Success Immediately

23. Early in the process to get everyone thinking in an aligned manner Some likely agenda items: • Why Analytics is So Critical Today • What’s Possible with Analytics – Some Sample Use Cases • Current and Planned Strategic Initiatives • Current State of Analytics • Desired Future State and How Do We Get There? • What are the likely challenges in getting there? • Next Steps in Moving Forward Leadership “Whiteboarding” Session

24. Communicate, communicate, communicate… to EVERYBODY Commitment to soliciting feedback from EVERYBODY at all steps in the process Reinforce that BI is now an essential component of long-term survival for the organization BI is not “Big Brother” – but rather a way to allow everyone to achieve clinical and financial excellence Engage leadership in ongoing report-outs, town halls and ongoing electronic communications • Use Marketing as a major tool to accomplish this Start Messaging Campaign on Day One

25. High-Level Education on BI Concepts • Alerts • Trending over time • Scorecards • Benchmarks • Predictive modeling • Textual searching and analyses • Customized dashboards • Access rights • Drill-downs • Data governance • Filters • Data validation/normalization

26. Data governance • Who owns what data and how is it to be rendered • Duplicative, potentially conflicting data across multiple systems Data validation / normalization Data visualization Begin the process of identifying and prioritizing BI “use cases” Address Basic BI Concepts from Day One

27. Building the BI Roadmap

28. It is all-too-tempting to start the heavy lifting of data mapping and code building to populate a data warehouse right away Resist the urge to do this (except at a general level for predictable data needs) • Analogous to getting directions from Mapquest without knowing where you’re going First Define the Destination

29. BI cannot be effectively deployed on a department-by-department basis • Too many disparate systems • Inability to validate specific sources of truth To build a BI Roadmap, stakeholders need to be brought together to begin identifying: • The overarching vision for BI in the organization • Current-state reporting capabilities and gaps based on current internal needs and regulatory requirements • Future needs based on downstream mandates (ACA, ICD-10, collaborative arrangements with other providers, etc.) • What is possible with BI Developing an Enterprise BI Roadmap

30. Provide the resources to design, build, validate, deploy, and maintain the BI infrastructure Establish a formal governance structure for the project Assurance that workflows across the enterprise are restructured to fully utilize the new BI tools Leadership meetings should have the BI tools as their agreed-upon basis for metrics • Be prepared to embark on true organizational transformation to have meetings and accountability be based on agreed-upon data points from the BI tool Developing an Enterprise BI Roadmap

31. Interview both leaders and line staff Ask about current-state pain points and perceived needs to optimally perform tasks Partner operational leadership, IT staff, and analytics staff so that communication challenges can be bridged immediately Consciously seek to build enthusiasm and involvement among all stakeholders • You want all stakeholders to feel as though it is their system and they have a stake in its success Engage Stakeholders Directly

32. Attempt to inventory all “use cases” (specific types of reports that stakeholders indicate will help them perform their duties most effectively) Have operations, IT and analytics team members work collaboratively to complete worksheets that speak to details about each use case Engage Stakeholders Directly

33. Engage Stakeholders Directly

34. Begin the process of establishing how a data warehouse will be designed and what the likely hardware/storage/connectivity requirements will be for this Don’t go TOO far down this road • Much of what will be designed will be directly impacted by your engagement of stakeholders, but … • Begin the process so you can have some sense of estimated costs, staging logistics and what will need to procured In Parallel to Outreach Efforts

35. Prepare high-level implementation plans to lock down resources and prepare the organization for what will need to be done and when Again, don’t go TOO far down this road • Your discovery process will have a profound impact on what your implementation plan will look like In Parallel to Outreach Efforts

36. Steering Committee to review information gleaned from the discovery process Roadmap to be driven by specific end-user use cases Based on need and technical challenge, prioritize when use cases will be deployed and offer modifications as needed Process in place where alternate suggestions can be offered Governance structure that can review and sign off on the BI Roadmap PITCH THE BI ROADMAP to the entire organization Offer opportunities for last-minute revision based on end-user feedback Putting the Pieces Together

37. NOT an IT project!!! IT does play a major role in deploying and maintaining, but the project must be sponsored and overseen at the highest (non-IT) levels of the organization Make sure all necessary staff is dedicated to this effort Solicit input aggressively but take a hard line that people have to use the system when it is fully ready for deployment Final Thought

38. And Let the Journey Begin!

39. Dialogue / Q & A

40. Rich TempleNational Practice Director – IT Strategy Beacon Partnersrtemple@beaconpartners.com