Creating a Data-Driven Advantage in Healthcare

Transcription

1 Creating a Data-Driven Advantage in Healthcare 1.15 EB8581 HEALTHCARE

2 Table of Contents 3 What Would You Do If You Knew? 4 Amazing Outcomes Start Here 5 Time for a New Approach 5 From Insights to Action: The Data-Driven Transformation 6 The Analytics Advantage 8 Tap Into the Teradata Advantage 11 Managing Big Data When You Know More, You Can Do More Teradata has more than 30 years of experience working with business and government leaders, creating and implementing data-driven solutions with the flexibility and scalability to effectively handle changes now and in the future. Teradata solutions and applications transform big data sets into actionable knowledge and valuable insights. Teradata delivers complete, best-ofbreed solutions that include data platforms, discovery platforms, integrated data warehouses, analytics, and marketing applications. 2 CREATING A DATA-DRIVEN ADVANTAGE IN HEALTHCARE

3 What Would You Do If You Knew? Rapidly escalating costs, aging and deteriorating populations, shifting consumer expectations, new delivery and payment models, pricing transparency, technology changes, an explosion of data, regulatory compliance, fraud... there certainly is no shortage of challenges facing health plans and insurers. On top of these industry pressures are the seismic changes in the healthcare economy brought about by healthcare reform. The challenges in today s healthcare environment are unprecedented, and so are the opportunities to provide better care for individuals, better health for populations, and reduced per-capita costs. Taking full advantage of these opportunities is not possible without engaging the patient/member directly, especially as they demand more from their healthcare organizations. These ongoing and emerging pressures are forcing healthcare organizations (both payers and providers) to reassess how they manage their information assets and deploy advanced analytics. Every possible data point available must be leveraged to the fullest to understand changes in and to improve patient engagement, provider care practices, reimbursement and funding models, and cost controls without sacrificing outcomes. While data relating to claims, operations, products, care management, electronic health records, customer interactions, sales and marketing, and financial performance that stream into departmental and organization databases every day holds the answers, analytics unlocks them uncovering new questions that lead to new insights to make the right decisions at the right moment, empowering the actions that produce more amazing outcomes. 3 TERADATA.COM

4 Amazing Outcomes Start Here What if you could accurately predict the onset of disease and take appropriate action? 4 CREATING A DATA-DRIVEN ADVANTAGE IN HEALTHCARE

5 Entrenched legacy systems often inhibit analytics and business benefits, which have the healthcare sector lagging well behind other sectors in its use of business intelligence and predictive analytics, despite their remarkably sophisticated use in other industries. The extraordinary explosion of data in today s highly connected world combined with new technologies, such as Apache Hadoop, and cyber security issues add even more layers of complexity, making it necessary to align the appropriate technology with business requirements to understand, adapt to, and identify opportunity in this rapidly changing environment. The data deluge and the fact that most data resides in disparate systems spread across the enterprise are stretching the abilities of current IT infrastructures. The challenges go beyond just data availability. Competitive advantage comes from stitching together disparate data in siloed systems with customer interactions and then weaving together a comprehensive relationship understanding. Time for a New Approach Harnessing and analyzing massive data volumes that accumulate with breathtaking speed form the foundation for putting new data-driven insights to work, enabling consumer engagement, coordinated care, population management, and risk-finance transparency. A new approach does not mean starting from scratch. The goal is to leverage your existing ecosystem and capabilities, providing an integrated approach to harness all your internal and external data and embrace data reuse to speed time to market and improve operating expenses. Evolving the information management ecosystem will enable the ability to make vast amounts of external data relate to internal data to rapidly analyze information without IT intervention to drive action and results. Harnessing the power of clinical data and unstructured big data from consumer-based information will enable new opportunities for a variety of areas across the organization. Health systems and insurers that can identify high-cost patients and efficiently coordinate their care will gain market advantage as the industry shifts to value-based reimbursement models. From Insights to Action: The Data-Driven Transformation Data-driven organizations excel at capturing, accessing, and analyzing all forms of data to extract intelligence. Teradata helps the world s leading healthcare providers and insurers transform data into insights that lead to greater knowledge of customers, products, processes, trends, and opportunities. By pairing customized healthcare analytics with real-time business needs, Teradata empowers healthcare organizations to realize exceptional results across the enterprise. When data is treated as a strategic asset, organizations can transform to be analytics driven to use data to gain a competitive advantage. For providers and insurers, there s great wealth waiting to be tapped in a diverse range of data relating to claims, operations, products, care management, electronic health records, customer interactions, sales and marketing, financial performance, and the supply chain. Teradata in Healthcare Healthcare is an extremely complex industry, which makes healthcare analytics even more challenging. Executing on population analytics and deriving clinical insight from massive administrative data is extremely difficult to perform, let alone do it quickly. That s why many of the world s most successful healthcare organizations choose Teradata to lead their way to a better understanding of their operations and their customers from a single view, including: 3 of the top 4 health insurers The largest U.S. commercial health plan 10 leading Blue Cross Blue Shield plans 4 of the top pharmacy benefit managers 6 major U.S. state and Medicaid plans The largest U.S. hospital management company 7 leading European healthcare organizations 5 TERADATA.COM

6 What if you could influence member/patient behavior across multiple encounters? The Analytics Advantage Teradata helps enterprises know more about their customers and business so they can do more of what really matters, better and faster than any alternatives. By unlocking the potential in diverse data, Teradata empowers the healthcare industry with a number of new capabilities that impact many areas, including: Data-driven consumer engagement Data-driven finance and risk management Population health management Value-based reimbursement analytics Care coordination operations mhealth biometrics analytics Through these unique and powerful analytics, newfound knowledge can be applied in meaningful ways to deliver significant value in four primary areas: High quality, low cost coordinated care Coordinate patient care to facilitate the appropriate delivery of healthcare services. Communication and intervention strategies are based on the segmentation of patients/members and rules-based medical protocols to provide actionable alerts, address gaps in care, perform compliance analysis and tracking, and undertake predictive analysis of care utilization. Advanced analytics also enable valuation studies of program and communication effectiveness, and the ability to coordinate with care managers to ensure that patient education and follow-up care is rendered. Quality is emphasized in value-based reimbursement models. Both providers and insurers use actuarial science analytics to understand the profitability of bundled payments leveraging clinical data/charge detail. It also enables modeling the impact of cost-saving programs in bundled payments (e.g. treatment paths) and to track medical cost trends for newly insured members/patients to predict when utilization will become typical. 6 CREATING A DATA-DRIVEN ADVANTAGE IN HEALTHCARE

7 Consumer/Patient engagement to drive wellness/growth Influence consumers to make better healthcare choices for themselves and their families. Gaining a 360-degree view of each consumer and actionable insights enable better identification, segmentation, and targeting with personalized outreach using multiple channels to engage members and patients. Actionable analytics support a range of areas, including sales, marketing, care/ wellness management programs, gaps in care, and quality measurements. They provide the ability to leverage insights to know when a clinical outreach or marketing campaign will affect behavior change and enable the use of contact preference information to use the most effective channel of communication. Having the right personalized message, at the right time using a preferred channel will result in more cost-effective communication and marketing programs. Integrated finance/performance management Integrate general ledger data with clinical detail and business cost accounting data via an accounting hub to understand operational/departmental profitability segmented by patient/coverage type, as well as to optimize the supply chain to reduce inventory and improve performance. Improved population health Access and analyze information to be able to align reimbursement to outcome and meet meaningful use clinical quality measures. Collaboration between providers and the payer community is critical, which requires improved communication and coordination, resulting in fewer medical tests with less paperwork. Analytics also give providers the knowledge to understand the impact of their referral patterns to their patients/members, and the benefit impact. New Accountable Care Organization (ACO) and Patient Centered Medical Home (PCMH) models require insights and analytics to effectively manage consumer/patient populations. Teradata Framework for Creating a Next Generation Analytics Advantage HEALTHCARE ECOSYSTEM Claims, Administrative, Operational, Product and Actuarial Care Management, Electronic Health Records, Sensor Sales and Marketing, Customer Service Financial (ERP), Supply Chain Patient/Member Interactions mhealth Biometrics Analytics TERADATA CAPABILITIES Data Driven Consumer Engagement Care Coordination Operations When You Know More, You Can Do More Data Driven Finance, Risk Management Value Based Reimbursement Analytics Population Health Management DELIVERED VALUE Consumer Engagement Coordinated Care Population Health Risk-Finance Transparency 7 TERADATA.COM

8 Tap Into the Teradata Advantage Teradata s healthcare solutions are built upon the world s leading analytic data platform ecosystem, marketing and analytic applications, and consulting services. Our integrated solutions are engineered to analyze massive amounts of data in microseconds, yet designed for everyday use by the broadest constituency of business users. Professional Services Best practice advice from Teradata experts who have completed 30+ years of successful implementations, including proven data models and vetted processes. Services include business consulting, architecture and implementation, and optimization and management. Analytic Data Platform Ecosystem The world s most scalable analytics platform for structured, multi-structured, and big data analytics through integrated and shared data environments (Integrated Data Warehouse) and the integrated Teradata Aster Discovery Platform. The discovery platform makes it faster and easier for a wider group of users to generate powerful, high impact business insights from big data. Rapid discovery analytics deliver iterative exploration using a variety of analytic techniques to support dynamic decision making. The Teradata Unified Data Architecture is a comprehensive enterprise approach that seamlessly integrates multiple technologies into a cohesive and hybrid architecture for all types of data, data processing, and analytic needs. Teradata Unified Data Architecture for Healthcare TERADATA UNIFIED DATA ARCHITECTURE Business Conceptual View ERP MOVE MANAGE ACCESS Marketing Marketing Executives Claims INTEGRATED DATA WAREHOUSE Applications Operational Systems CRM Images Audio and Visual EHR Text Web and Social DATA PLATFORM Fast Data Loading and Availability Filtering and Processing Deep History: Online Archival Business Intelligence Predictive Analytics Operational Intelligence DISCOVERY PLATFORM Data Discovery Fast-Fail Hypothesis Testing Path, Graph, Time-series Analysis Pattern Detection Business Intelligence Data Mining Math and Stats Languages Customers Partners Frontline Workers Business Analysts Data Scientists Engineers SOURCES ANALYTIC TOOLS & APPS USERS The Teradata Unified Data Architecture allows healthcare organizations to capture, deploy, support, manage, and seamlessly access all their data. 8 CREATING A DATA-DRIVEN ADVANTAGE IN HEALTHCARE

9 Marketing and Analytic Applications Build stronger consumer engagement and experiences, and boost revenue by consolidating every element of your datadriven marketing and communication programs including processes, resources, campaign financials, performance analytics, and even digital messaging templates in a single application, on-premise, or in the cloud. Data Models Most organizations have a large number of healthcare information system applications, and a variety of hardware and software environments where healthcare information is delivered. Standardizing the representation of data across these applications and, even more importantly, across the organization offers many benefits. The Teradata Healthcare Data Model (HCDM) makes data integration considerably more efficient by serving as a blueprint for how data moves and interrelates within an organization. It helps create an ideal framework for a wide range of knowledge applications, launch new lines of business, support new payment models, and meet evolving government mandates The Teradata HCDM contains Value-Based Reimbursement: Patient to Discharge Analysis Improves Quality while Reducing Costs With reimbursements tied to quality, a large hospital wanted to identify factors that influence and improve the patient flow process from admission to transfer to discharge (i.e., ED, clinicians, patient flow, diagnosis, treatment protocols, discharge planning, facilities, etc.). The hospital used path, pattern, and graph analysis to identify all procedures, treatments, and healthcare providers that interact with the patient. These advanced analytics led to enhanced patient flow, improved quality and outcomes with lower costs, and the ability to identify treatment improvement opportunities to decrease morbidity and mortality. 9 TERADATA.COM

10 Right Time, Right Channel Consumer Engagement with Personalized Clinical and Marketing Outreach A major health plan needed an automated, repeatable process for clinical outreach to improve HEDIS and CMS MA quality metrics, as well as the ability to use digital communication channels to reach members at the right time, through the right channel with the right message. Using propensity and predictive scoring and Teradata data-driven engagement capabilities, the health plan was able to personalize reminders and gaps in care alerts via or text message based on lifestyle personas. The health plan manages collateral using built-in workflow and audit-trail capabilities. With timely, reliable, and relevant insights into consumer needs and preferences, the plan increased CMS MA membership by 40 percent and improved its HEDIS and CMS MA quality metrics. 10 CREATING A DATA-DRIVEN ADVANTAGE IN HEALTHCARE

11 the data architecture specifications that represent an integrated, stable, and flexible healthcare data environment. The architecture supports the advancement of healthcare data integration for healthcare insurers, providers, managed care organizations, pharmacy benefit managers (PBMs), healthcare data administrators, vendors, and consultants. These groups share a common goal of simplifying and defining a standard representation of healthcare data. The Teradata HCDM is designed to support all major industry data standards, and will continue to support evolutionary growth as new industry requirements are identified or recognized. Managing Big Data Organizations across all industries have more data than ever before, and the volume of data continues to grow exponentially. The potential of big data lies in tapping into tremendous amounts of transactional data (e.g. structured) and digital data (e.g. multi-structured). Healthcare providers and insurers are looking for costeffective ways to capture the value of the big data avalanche extraneous data and new data types that were previously often discarded due to cost, scale, or processing limitations. Apache Hadoop has emerged as the cost-effective, next-generation data management platform to capture, refine, explore, and integrate multistructure data within the enterprise. The Teradata Portfolio for Hadoop is a flexible suite of products and services that integrates Hadoop into a Teradata environment and across a broader enterprise architecture, while taking advantage of world-class Teradata service and support. For more information, contact your Teradata representative or visit Teradata.com/healthcare. Different by Design From the very beginning, Teradata has focused on helping businesses use data analytics to make the best decisions and make a difference in their world, and that focus makes us unique in the industry. Teradata solutions are designed differently to analyze information better and faster. The pursuit of knowledge is our passion, and no company is more passionate about datadriven analytics than Teradata. It began when we introduced Teradata Database the world s first parallel database designed to analyze data rather than simply store it. And it continues in our commitment to lead the industry with new innovations and new technology a commitment that has consistently earned Teradata some of the industry s highest accolades: Gartner Magic Quadrant Leader Data Warehouse Database Management Systems Multichannel Campaign Management Integrated Marketing Management Marketing Resource Management Forrester Wave EDW Platforms Teradata provides the most scalable, flexible, cloud-capable Enterprise Data Warehouse in today s market. Forrester Wave : Big Data Hadoop Solutions Leader Forrester notes Teradata creates a unique, high-performance Hadoop appliance that few other vendors can match. 11 TERADATA.COM

12 10000 Innovation Drive, Dayton, OH Teradata.com Unified Data Architecture is a trademark and Teradata and the Teradata logo are registered trademarks of Teradata Corporation and/or its affiliates in the U.S. and worldwide. Apache is a trademark and Hadoop is a registered trademark of the Apache Software Foundation. Teradata continually improves products as new technologies and components become available. Teradata, therefore, reserves the right to change specifications without prior notice. All features, functions, and operations described herein may not be marketed in all parts of the world. Consult your Teradata representative or Teradata.com for more information. Copyright 2015 by Teradata Corporation All Rights Reserved. Produced in U.S.A EB CREATING A DATA-DRIVEN ADVANTAGE IN HEALTHCARE