Presentation Transcript

1. The Healthcare Analytic Challenge

   November 1, 2013 Joe Turk, MBA, FHIMSS, CPHIMS Sr. Director, IT Business Development Cleveland Clinic
2. CMS Three-Part Aimsfor Healthcare Delivery System Improvement Better care for individuals through seamless coordinated health care Reduced costs through continuous improvement Better health for populations
3. Acute Care Reimbursement HistoryMedicare 1983 - Present 1965 - 1982 2014 - Future Timeframe All Inclusive Risk-based IPPS or DRG Reimbursement Models Cost +
4. Driving Health Care System Transformation Healthcare Delivery System 3.0 Healthcare DeliverySystem 2.0 Integrated Care Healthcare DeliverySystem 1.0 Accountable Care Patient / Person Care Centered Patient / Person centered health care Productive and informed interactions between family and provider Cost and quality transparency Accessible health care choices Aligned incentives for wellness Integrated networks with community resources Aligned reimbursement / cost Rapid deployment of best practices Patient and provider interaction Aligned care management eHealth capable eLearning resources Episodic Non-Integrated Care Transparent Accountable Cost and Quality Performance Outcome oriented Access and coverage Accountable Provider Networks designed around the patient Focus on care management and preventive care Patient-centered primary care medical homes EHR capable Improved care management Episodic Care Sick care focus Uncoordinated care High use of Emergency Care Multiple clinical records Fragmentation of care Lack integrated care network Lack quality and cost performance transparency Poorly coordinate chronic care management
5. Transformation of Payment Global Capitation Chronic disease specific bundle Post-AcuteCare Episode Bundling Acute Care Episode (ACE) Bundles Pay-for-performance/ gain-sharing Need to have capability to know: What form(s) of risk you want to take and how that varies by population/segment How to price each form of risk When to introduce into market What you need to successfully manage risk once mechanism in place
6. Fully eHealth Capable Advanced Care Management Capable Remote Bio-Metric Monitoring Capable Community Practice Translational ResearchSite Horizontally Integrated Deliver System Enabled by HIT Community Health Surveillance Interfaces Connected to Community Research Database Psycho/Social Evaluation and Intervention Patient eLearning Center Healthcare IT Ecosystem360˚ of Data
7. A perfect storm for Healthcare Big Data! REAL-TIME? VISUALIZATIONS? ADVANCEDANALYTICS? VARIETYOF DATA? LARGE DATA VOLUMES? Its true value should transform the business
8. Oh, but wait, it gets bigger!