Foundations for Clinical and Healthcare Business Intelligence

1. Foundations forClinical and HealthcareBusiness Intelligence eMids Business Intelligence Conference Nashville, Tennessee James E. Gaston, FHIMSS Sr. Dir. of Clinical & Business Intelligence HIMSS and HIMSS Analytics James.Gaston@HIMSSAnalytics.org Twitter @JamesEGaston MAY 2012

2. Agenda • HIMSS and HIMSS Analytics • Orienteering • Clinical Intelligence First Steps • Practical Application • Pulling It All Together

3. www.HIMSS.org HIMSS Vision Advancing the best use of information and management systems for the betterment of healthcare. HIMSS Mission Lead healthcare transformation through the effective use of health information technology.

4. www.HIMSSAnalytics.org

5. Print, Digital, iTunes…all available http://marketplace.himss.org/ http://www.ebooks.himss.org/ http://www.apple.com/itunes/

6. OrienteeringClinical & BusinessIntelligence

7. Orienteering Business intelligence (BI) mainly refers to computer-based techniques used in identifying, extracting, and analyzing business data, such as sales revenue by products and/or departments, or by associated costs and incomes. Business Intelligence supports business decision-making. http://en.wikipedia.org/wiki/Business_intelligence

8. Orienteering Clinical Intelligence (CI) mainly refers to computer-based techniques used in identifying, extracting, and analyzing healthcare data, such as lab results, medical histories, or medical records, to support a healthcare related decision. ClinicalIntelligencesupports healthcare decision-making.

9. Orienteering C&BI as defined by leading healthcare organizations… “Mining clinical data with an eye towards patient care” “Access to key information to make care or business decisions that result in the best outcome for the patients and the business” “To use currently available and create new data sources to drive all aspects of running an organization” “Supporting clinical excellence” “Maximizing the quality of care and minimizing the cost”

10. Clinical Intelligence First Steps

11. Clinical Intelligence First Steps

12. Clinical Intelligence First Steps • Meaningful use Drivers • Improve quality, safety, efficiency, and reduce health disparities • Engage patients and family • Improve care coordination, and population and public health • Maintain privacy and security of patient health information 2011 - 2012 2013 - 2014 2015 + http://www.healthit.gov/

13. Clinical Intelligence First Steps CI is about exposing the clinical decision process, turning a “gut feeling” or intuition into a revealed process that is informed, defensible and consistent • In the moment of the care decision • Banner Health physicians have access to patient EMR and are prompted upon a visit to provide diagnosis related care • Retrospectively examining the circumstances (data) • Geisinger uses their patient data warehouse to identify “care gaps” and push them to clinicians for review

14. PracticalApplication

15. Practical Application - BIDMC John D. Halamka, MD, MS Chief Information Officer of Beth Israel Deaconess Med. Center Chief Information Officer at Harvard Medical School Chairman of the New England Healthcare Exchange Network Co-Chair of the HIT Standards Committee Harvard Medical School full professor Practicing Emergency Physician http://geekdoctor.blogspot.com “Healthcare CIOs should implement applications which filter data so that it becomes information, transform information into knowledge, and ultimately provide clinicians with wisdom based on that knowledge at the exact time they need it.” Ten-year-old John Halamka winning the Science Fair in 4th grade with his home-built Van De Graff generator in 1972.

16. Practical Application - BIDMC http://geekdoctor.blogspot.com/2007/11/data-information-knowledge-and-wisdom.html

17. Practical ApplicationBanner health Network Payment Model + Delivery Model Alignment Transitioning to a “Value based methodology”for physician reimbursement • Physicians spend more time with patients • New payment codes incentivize physicians • “Holistic” approach to care, including behavioral & social health Practical Application • Find patients that have not recently had a visit and arrange it • Ensure proper post acute care follow-up • Generate care plans, engage care managers • ActiveHealth technology provides registry, risk assessment

18. Practical Application Atrius Health “We also adopted a relatively unique concept in that we wanted to take care of all of our patients exactly the same, no matter what their funding mechanisms were.” Dr. Gene Lindsey, CEO of Atrius Health The ACO Shared Savings application process - FierceHealthcare, http://www.fiercehealthcare.com/special-reports/atrius-ceo-interview-inside-pioneer-aco/aco-shared-savings-application-process#ixzz1ywZVYK58 , 2/24/2012

19. Practical Application Atrius Health Multi-pronged Care Strategy Core Strategy Components • Hospital strategy • Post-acute stay facility strategy • Home care strategy • Geriatric care model design Practical Application • Define “patient care expectations” with “Preferred Partners” • Expect all care to be delivered as defined in agreement • Monitor, benchmark and manage using CI & BI reporting

20. Practical ApplicationCommon Themes “You just can’t over communicate what you are trying to achieve…the ongoing communication, not just the printed stuff, but the conversations and dialog, are where it happens” Mr. Chuck Lehn, SVP and CEO of Banner Health Network “Compensation is being based on, in part, your quality scores, or your patient satisfaction scores, or the size of the panel of patients you care for as opposed to just the numbers of visits you generated.” Dr. Rick Lopez, Chief Physician Executive of Atrius Health

21. Practical Application Recommendations • C&BI should be positioned to enable and support and organizations mission and vision • Engage senior level support • C&BI is an active and engaging process, not a technology or application solution • Ensure physicians have a leadership role and a stake in the process • Establish strong data governance and communication

22. Pulling it All Together Create the foundation, data and environment forClinical Intelligence & Healthcare Business Intelligence

23. Foundations for Clinical and Healthcare Business Intelligence Healthcare BI Summit Minneapolis, Minnesota Information Management Symposium 2012 Nashville, Tennessee James E. Gaston, FHIMSS Sr. Dir. of Clinical & Business Intelligence HIMSS and HIMSS Analytics James.Gaston@HIMSSAnalytics.org Twitter @JamesEGaston