Enterprise Data An Untapped Asset for Succeeding as Healthcare Changes

Transcription

1 Enterprise Data An Untapped Asset for Succeeding as Healthcare Changes Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

2 What We ll Cover It s all about the data Why now? Begin with the end in mind And now a word from technology Keeping it clean EHR implementations and optimizations that consider data re use It s not the only game in town How to keep your hard won gains around data consistency and accuracy Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

3 Why Care about the Data: The World Is Evolving to Fee for Value Patient Centered Medical Homes Accountable Care Organizations Integrated Care Delivery Systems Hardwiring Performance and Payment through Clinical and Financial Data Value Based Purchasing Pay for Performance Incentives Shared Savings Programs Bundled Payments Capitated Contracts It starts with trusted data from your IT investments and the EHR is the largest Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

4 EHR Implementation and Optimization: What You Need to Consider Ambulatory Inpatient/OR PCMH PQRS MU EP TJC and others MU EH NSQIP SCIP Commercial Risk Contracts MSSP Leapfrog CMS Quality Reporting STS HEDIS Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

5 Meaningful Use Is the Foundation for Building Competency Around emeasures MU standards are the foundation Increased clinical granularity Reimbursement & regulatory driven and using EHR data for analysis and reporting Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

6 Considering Data Needs During Implementation (and Optimization) Cycles Data Governance Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

7 Anatomy of a Data Element: From Source to Re purpose Medicare Shared Savings Pilot Partnership for Patients that support focused initiatives Population Health Quality Metrics Cost & Margin Payer Analysis that are re purposed in analytics apps generate individual data elements Source systems ED Practice Mgmt EHR Patient Billing ADT Other Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

8 Synergy between Work Flow and Data Re use Implementation & Optimization Data Governance Standards & Best Practices Data Quality Content, workflow, configuration, training, communication EDW Aggregate, Calculate, Report, Analyze, Predict Performance Improvement Self service Super user Predictive algorithms Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

9 A Step wise Approach to Understanding What Data Is Important to You Data Discovery Steps 1. ID programs and contracts (and accountability for each) 2. Operational efficiencies analysis (i.e., process for managing contracts and programs) 3. ID all metrics (calculations) 4. Rationalize list of metrics based on calculations 5. ID data required for each metric 6. Rationalize data elements 7. ID source for each data element (i.e., source to target mapping) 8. Profile the source data 9. Identify gaps and deficiencies to drive remediation 10. Implement remediation activities/optimize 11. Inform, build, validate Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

10 Health Analytics Maturity Model Personalized medicine Clinical and business process optimization Quality and safety reporting Performance management Operational reporting Basics Value-based purchasing Risk-based contracts Foundational Competitive Metrics Data marts Segmented data governance MS Office Out-of-the-box transaction reports Population health management Comparative effectiveness research Dashboards/ Scorecards Data warehouse (enterprise view) Enterprise data governance Differentiating Text analytics Data mining (what is not known) Transforming Predict and personalize Managing and learning from information Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

11 Maturing Need for Measurement and Analytics Drives Increased Value from Data and Ongoing System Optimization Information Capability Analytics Hospital and physician emeasures Reporting Minimal data sources Analytics Platform Integrated quality and cost performance Statistical analysis Add l data sources Comparative effectiveness Modeling and forecasting Acquire clinical, financial, administrative data Personalized translational medicine Predictive Analytics Source Implement and optimize EHRs, other source data Value (trusted, normalized, transparent) Data Governance (definitions, standards, primary source) Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

12 And Now a Word from Technology Process Data governance structure Vision and guiding principles Policies and procedures People Competencies Collaboration Technology Data acquisition Data aggregation Information/knowledge presentation Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

13 Technology Options EDW Approach COTS (commercial off the shelf) Semi custom Delivery Data Model ETL Presentation Layer SaaS Premised Included as part of the application Pre defined with option for local extensions Included as part of application Customer must make data available to the application Can leverage ETL from other implementations but typically modified for specific customer Cloud based options will have more pre packaged options Included as part of the application; might have some flexibility in formatting Developed for the organization; might leverage templates designed for the specific data model Custom Premised Proprietary to the organization Hybrid Premised Cloudbased Cloudbased Pre defined Built from scratch to support the proprietary model Combination of prepackaged and site specific Built from scratch for the organization Leverages analytics from COTS applications and amends with site specific analytics and dashboards Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

14 Data Source & Analytic Tools: Sample Current State Data Sources Data Repositories Analytic Tools Epic Hyperion Trendstar BO Crystal Rpts Access Excel Lawson Crimson Trendstar Hyperion Trendstar Verisk EDW R SPSS Etc. Humedica Truven SAS Tableau Truven Crimson Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

15 Data Source & Analytic Tools: Potential Future State Data Sources Data Repositories Tools/ Apps EHR EDW Analysis/ reports tools* Claims ODS Statistical analysis Pop Health Cost Accounting Dashboards ERP Finance Financial Reporting *Note: Excel may still be used for ad hoc analysis Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

16 Iterative Rollout Based on Organizational Priorities (an example) Data governance decision process Prioritized analytic needs drive subsequent work 1 Service line reporting Define requirements Profile data 2 3 Physician scorecards Population health Develop ETL Populate EDW and build data marts Build templates and dashboards Quality assurance Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

17 Keeping It Clean: The Role of Data Governance to here consistently and accurately. Medicare Shared Savings Pilot Partnership for Patients Population Health Quality Metrics Cost & Margin Payer Analysis Source Systems ED Practice Mgmt EHR Patient Billing ADT Other Data governance makes sure data gets from here Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

18 What Is Data Governance? the discipline of formally organizing and managing data and information assets across an organization from a business, technical, and administrative perspective for the purpose of managing data as an asset, driving information quality, and optimizing data outcomes that enhances decision making. Encore, A Quintiles Company, definition derived from practical application of the Data Governance Institute definition and other industry leaders, such as IBM Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

19 Business Drivers for Adopting Data Governance Foundational for organizing and managing data and information assets across the healthcare enterprise Improves information quality and optimizes data usage that in turn supports ongoing clinical and business decisions Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

20 What Is a Data Governance Program? Data Governance is the orchestration of people, process, and technology to enable an organization to leverage data as an enterprise asset. The core objectives of a governance program are: Building governance infrastructure, technology, and supporting organization Defining processes and business rules for ongoing governance Developing common and standard data domain definitions Developing architecture practices and standards Monitoring and improving data quality Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

21 Recommendations Organizational Characteristics Best Practice Approach to Identify the Right Data Governance Model Data governance models for comparable healthcare organizations and other cross industry standardized models Managed as a corporate asset and differentiator Efficient, inclusive and collaborative Process Data Guiding Principles People Tools Market Skills Culture Recommendations and conclusions for the initial data governance model Encore, A Quintiles Company. No unauthorized copying or distribution permitted. Amount of change management required Trained resources Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

22 Data Governance Models Federated Centralized executive leadership Operations group by service line/function SMEs represent service line/function Centralized Centralized executive leadership Centralized operations group representing organization SMEs represent service line/function AND organization Hybrid Centralized executive leadership Temporary projectbased operations group Temporary projectbased working groups (SMEs) Excludes departments that are not common across all entities Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.

23 Identifying Opportunities for Action Integrating clinical, administrative, and financial data across care settings Enabling cost of care and outcomes insights Quality, safety, productivity, and cost Evidence based medicine and outcomes Population management Define a plan now for how to harness the untapped value in the data across your enterprise Build the skills, processes, and enabling technology that turn data into information that can be used to drive new levels of performance Include data capture requirements in EHR implementations and upgrades Encore, A Quintiles Company. No unauthorized copying or distribution permitted Encore, A Quintiles Company. No unauthorized copying or distribution permitted.