Before loading Big Data...

1. Before loading Big Data...

2. Healthcare Business Intelligence Maturity Model Scott Wanless June 2012

3. Agenda • Introduction • Tackle Maturity Before Tackling Big Data • Six Levels • What are the levels? • What benefit do I get at each level? • What is the impact on data usage at each level? • Getting Started Now • Assessing current level • Choosing appropriate level for the organization • Preparing your business, clinical and data people

4. Introduction Scott Wanless Healthcare Analytics Practice Director 920.585.9630 | scott.wanless@cipeconsulting.com CipeConsulting Group, LLC 22500 SE 64th Place | Suite 230 Issaquah WA | 98027 • Background: • Analytics strategist • Business analyst • Author • Speaker • Wilderness survival expert • Published works and presentations can be found: • Book.Business Intelligence and Analytics for Healthcare Organizations • Articles.BeyeNetwork (www.b-eye-network.com) Click on Healthcare channel. • Teaching.BeyeUniversity (www.beyeuniversity.com/topics/business-intelligence/) • Healthcare Data Warehouse Association • Patient Safety and Quality Healthcare • Continuing Care News • American Health Insurance Plans Coverage • Managed Healthcare Executive • DM Review • CIO Update • The Center for Business Innovation • HIMSS Oregon Chapter, HIMSS Washington Chapter • Healthcare Finance Management Association (HFMA) • Healthcare Business Intelligence Summit

5. Need for Healthcare BI Maturity Model • Big Compliance • Big Reform • Big Consolidation • Big Data • Big Cost Control Pressures • Big Operating Model Changes...clinical, financial and operational

6. Healthcare BI Maturity Model — Levels 1 = Risky and Costly Hazard 2 = Developing Asset Breakeven Point 3 = Self-Sustaining Producer 4 = Performance Driver Breakthrough Point 5 = Game Changer 6 = Industry Driver

7. Truck Metaphor 1 • = Risky and Costly Hazard • Old truck we had in college. It usually runs and we get a few hauling jobs. 2 • = Developing Asset • Decent truck. Managed routes. Hauling jobs just about cover costs. Breakeven Point 3 • = Self-Sustaining Producer • Specialized trucks. Methodology. Each job pays for itself and provides profit. 4 • = Performance Driver • Onboard electronics tells us best routes for efficient fuel and labor usage. Breakthrough Point 5 = Game Changer Container trailers let us be in land, sea and air freight business. 6 • = Industry Driver • Our skill gives us negotiating power, and we get consulting jobs.

8. Healthcare Analytics from Business Perspective 1 • = Risky and Costly Hazard • Ad hoc reporting, overworked staff, inconsistent calculations, lots of paper. 2 • = Developing Asset • Installed tools, learning mode, early governance structures, investing. Breakeven Point 3 • = Self-Sustaining Producer • Mature BI environment, specialized applications paying for the asset. 4 • = Performance Driver • Analytics tell us optimal decisions within current business and clinical model. Breakthrough Point 5 • = Game Changer • Shows us new business and clinical opportunities and how to get there. 6 = Industry Driver Negotiating power, clinical authority power, sought as industry beacon.

9. Healthcare Analytics from Data Perspective 1 = Risky and Costly Hazard Dusty data files, spreadsheets, three-ring binders, inconsistent definitions. 2 = Developing Asset Data marts and data warehouse, data governance and data quality formation. Breakeven Point 3 • = Self-Sustaining Producer • Data organized, integrated, managed by business for business. 4 = Performance Driver Big data is mined, prediction algorithms running, insights stored for trending. Breakthrough Point 5 = Game Changer Inbound external data used for evidence-based business and clinical decisions. 6 = Industry Driver Conclusions database used by partners to comply with us. Skills licensed out.

10. 1 2 3 4 5 6 Getting from Level to Level

11. Getting from Level to Level 1 2 3 4 5 6 Risky and Costly Hazard Developing Asset • Examples • EHR package reporting • Ad hoc reporting • Scattered data files • Spreadsheets galore • Overworked IT staff • Three-ring binders • Paper, paper, paper • Knowledge could walk out door at any time • Plus • The devil you know • Feels cheap • Steps to Next Level • Champion BI • Sponsor BI • Understand data as an asset. • Talk with peers at other organizations • Look at tools (front and back end) • Skill up in data warehousing • Minus • Harms patients • Drains profits • Slow, messy • Inconsistent • Locks in data silos

12. Getting from Level to Level cont’d 1 2 3 4 5 6 Developing Asset Self-Sustaining Producer Breakeven • Examples • Core measures reporting • Patient registries • Patient safety reporting • Dashboards • Scorecards • EDI transmissions • Beginnings of... • Data governance • Data stewardship • Data quality program • Plus • Building trust • Establishing processes • Learning the tools • Steps to Next Level • Build management structures, processes and methodologies • Think like a portfolio manager • Most important • Skill up and outin project and product management • Minus • Still dependent on outside funds • Significant effort to develop

13. Getting from Level to Level cont’d 1 2 3 4 5 6 Self-Sustaining Producer Performance Driver • Examples • Outcomes analysis • Clinical quality • Case management • Clinical guidelines • Patient safety • Public reporting • Cost control • Physician report cards • Project methodology • Service request process • Analytics marketing • Plus • Applications paying for self • Smoother processes • Steps to Next Level • Get comfortable with data-driven decisions • Invest in technology to handle big data • Most important • Skill up in tweaking algorithms, learning from models, etc. • Minus • Staff constraints • Must tell analytics capability what to show

14. Getting from Level to Level cont’d 1 2 3 4 5 6 Performance Driver Game Changer Breakthrough • Examples • Demand prediction • Smart staffing • Care model improvement • Epidemiology support • Claims analysis • Revenue cycle management • Reusable compliance • Value stream design • Statistical process control • Data mining • Predictive analytics • Big data (internal) • Plus • Data tells us optimal decisions and why • Steps to Next Level • Get comfortable with external data • Establish cross-organizational governance • Most important • Get out of the healthcare shell • Minus • Effort to tweak algorithms • Investments • New skillsets required

15. Getting from Level to Level cont’d 1 2 3 4 5 6 Game Changer Industry Driver • Examples • Claims prediction • ACO support • Strategic planning • New service lines • New patient groups • New clinical processes • Clinical trials support • Access and outreach • Personalized medicine • Big data (external) • Plus • Identifies new business and clinical opportunities • Steps to Next Level • Think of analytics capability as a business entity • Think like a teacher • Think like a venture capitalist • Think like an orator • Treat data blocks like assets • Minus • Trust in machine-derived conclusions • External data is a new world

16. Getting from Level to Level cont’d 1 2 3 4 5 6 Industry Driver • Examples • P4P negotiation • Care model design • Public measures design • Lean / Six Sigma • Prescriptive operations • Industry best practices • Category management • Plus • Power • Steps to Next Level • Next levels? • Minus • Exposing Competitive “Secrets”

17. Choosing a “Level” for Your Organization 1 = Risky and Costly Hazard Degree of Pain 2 = Developing Asset Breakeven Point 3 = Self-Sustaining Producer Desired Payoff 4 = Performance Driver Breakthrough Point 5 = Game Changer Size of Investment 6 = Industry Driver

18. Tackle BI Maturity Before Tackling Big Data

19. Thank you! Thoughts? Questions?