Where Are We and Where Do We Need to Go? Understanding, sharing and, ultimately, improving performance measures is always the focus for Swedish.

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1 CUSTOMER SUCCESS STORY : Sharing Improves Caring (and Helps the Bottom Line, Too) FOUNDED: 1910 HEADQUARTERS: SEATTLE, WA $10M+ IN IMPROVED OPERATIONAL PROCESSES $750K SAVINGS IN PERSONNEL COSTS AVOIDED OR RE-DIRECTED $600K SAVINGS THROUGH ELIMINATION OF REDUNDANT ANALYTICS PLATFORMS (Swedish) needed to understand and communicate physician and hospital performance across a number of areas but traditional reporting solutions were cumbersome to implement and expensive to maintain. After implementing Tableau as its primary enterprise-wide analytics platform, the healthcare provider is driving improvements in quality care, improving patient experiences, and enjoying substantial savings through process improvements and improved efficiencies. Where Are We and Where Do We Need to Go? Understanding, sharing and, ultimately, improving performance measures is always the focus for Swedish. This ongoing effort has become an even higher priority as healthcare moves away from traditional fee-for-service models and transitions aggressively to value-based reimbursement models. Under these new models, organizations will face reduced payments if they miss targets for factors such as readmission rates, patient satisfaction and other performance measures. Swedish tracks and communicates an array of performance metrics, but it needed to find a way to do so more effectively and less expensively and to tie those efforts to driving organizationwide performance improvement. For example, historically Swedish tracked readmission rates, but the work was time consuming and resourceintensive, leading to substantial lag times between patient care and reporting. Different groups in the organization were using spreadsheets to gather and organize readmissions data, and it was very time consuming for analysts and managers. Collecting all the data and trying to get good reports took time away from more valuable tasks. Everyone from the CEO to the managers thought there was a better way to solve this problem, says David Delafield, CFO of Swedish Medical Group, a division of the Swedish organization. While Swedish sends patient experience surveys to more than 15 percent of its patients each year, the organization lacked a simple, centralized way to share the results with internal staff and physicians. We would get tens of thousands of survey responses, Delafield says. We shared the results, but it was very inconsistent. Everyone was looking at different things, and some didn t look at the results at all. As a result, it was

2 It s hard if people can t go to one spot for everything they need it makes it really difficult to align. difficult for Swedish providers and administrators to consistently move in the same direction on patient experience metrics. In addition to preparing for value-based reimbursement, Swedish wanted to improve other areas like operating room efficiency, physician engagement and financial performance. The Cost Would Expand Indefinitely Delafield, who has a finance and technology background, led a team tasked with selecting and implementing a platform to help Swedish understand and share performance metrics in order to drive improvements. The lack of actionable data was a big issue, says Delafield. We had no lineof-sight, visual way to look at things that were very important to the organization. It s hard if you have one technology platform for revenue data, another for quality, another for patient experience and people can t go to one spot for everything they need, Delafield says. It makes it really difficult to align. This fractured approach created a growing need for expensive analyst support. There were just too many random, custom reports which made it really difficult to coordinate efforts on key levers. Keeping overhead costs down is important so we wanted to find a relatively inexpensive but effective way to made data actionable for operators and physicians, says Delafield. With so much custom reporting the overhead cost would expand indefinitely if we didn t get control of it. Our analysts would fulfill a lot of ad hoc requests, which are all pretty similar but for different audiences, Delafield says. And they were doing it over and over again, which became very expensive and made it very difficult to get a line of sight to what was happening across the company. We Wanted Tableau to Be the Solution for the Company By late 2012, Swedish was looking at a few potential options to meet its shortand medium-term requirements: IBM, SAP and Tableau. We were very familiar with IBM and SAP; we knew what they could do, he says. But we also knew some of the issues that they couldn t address. And we wanted our solution to be accessible and effective for everyone in the organization, not just analysts. The Swedish analytics team experimented with building smaller views in Tableau 7, the most current version available at the time. We had done enough to know that we could build this integrated platform using Tableau, he says. We didn t want this solution to be a niche visual tool for analysts; we wanted Tableau to be the solution for the company. They initially had some concerns. We weren t sure about using Tableau Server with massive amounts of users and lots of data, he admits. But we ve been able to expand to more and more people with only a few issues and Tableau solves a lot of those. We re in the process of upgrading now.

3 We re just starting this process but we re seeing a lot of improvement in many of these areas by making data simple and easily accessible for operators and physicians. It has been a companywide effort. Swedish began with a limited number of visualizations supported by a small team of analysts. It took them very little time to get up to speed on Tableau, says Delafield. The initial dashboards debuted to a small audience but demand quickly outpaced expansion plans. It was very organic and viral. We had a lot of s each week from people wanting to get access, says Delafield. Now we re to the point where we re bringing a lot of new users onto the platform each week and we know it s having a big impact around alignment and simplification. Our focus now will be on expanding views and answering new business questions. Physicians will drive a lot of the movement towards value based healthcare so the Swedish team is working really hard to engage physicians AVS wherever possible Swedish Ballard Primary Care PERFORMANCE GENE RAL OPERATIONS ClosedChart MyChart reporting platform, everyone is looking at a single version of the truth. I think this simplification, at low cost, is going to be a really important foundation for Swedish to meet strategic goals. Everyone operating room surgeons, medical directors, hospital administrators over time will funnel to this same spot, across the hospitals and the medical group, says Delafield. Everyone involved has done a great job. We re just starting this process but we re seeing a lot of improvement in many of these areas by making data simple and easily accessible for operators and physicians. It has been a company-wide effort, says Delafield. Primary Care Physician Scorecard Status / Target Practice (Avg / You) (Avg / You) % / % 6% (7 of 11) 93% (134 of 149) Achievement 10 / 97% 99% (1 of 11) 9% (1 of 149) Top 5% 62% / 5 5% (4 of 11) 52% (50 of 149) PROFILE In System Referral Rate (current month) % Physician Capacity (current month) % 12 Month Rolling The current team comprises three technical resources and three fulltime report developers. It s not a very large team to build what Swedish has created. It s been a significant value a great ROI and will allow us to retire most of the other reporting solutions across Swedish, Delafield says. Objective and Transparent Now that Swedish Medical Center is quickly moving towards using Tableau as its primary enterprise-wide performance analysis and PATIENT EXPERIENCE Total Unique Patients 1,657 Overall As sessment % Female 72% Likelihood of recommending (n=) 5% / 79% 76% PCP Patients 1,00 Pers onal Is sues % Female 7% Our sensitivity to patients ' needs (n=2) 79% / 71% 69% Access Age Demographics Courtesy of registration staff (n=) 7 / 74% 71% < 1 yrs Ease of scheduling appointments (n=9) 5% / 59% yrs 41% Care Provider yrs 33% Likelihood of recommending CP (n=90) 2% / 79% > 64 yrs 26% CP explanations of prob/c ondition (n=90) 3% / 77% 7% Moving Through Your Visit Payor Mix Information about delays (n=62) 67% / 6 53% Commercial 62% Wait time at clinic (n=3) 74% / 6 53% Medicare 35% Medicaid 1% CHRONIC CARE Self 1% Diabetes Other 2% Hba1c>9% (1/4) 3% / 15% 11% (3 of 11) 12% (23 of 125) LDL<100 (37/4) 77% / 5 7 (3 of 10) 5% (9 of 124) Top 15% Risk Adjustment BP<140/0 (27/4) 56% / 5 52% (3 of 15) 53% (54 of 127) Incentive Measure (41/4) 5% / 76% (5 of 11) 6% (32 of 126) Current Baseline Month CHD You LDL<100 (16/40) 4 / 7 39% (4 of 11) 42% (61 of 120) HCC BP<140/90 (33/40) 2% / 7 71% (3 of 11) 69% (22 of 123) RAF Hypertension BP>140/90 (24/1273) 2% / 2% 3% (4 of 12) 4% (33 of 137) HCC PREVENTATIVE CARE RAF Breast Cancer Screening (254/337) 75% / 67% (2 of 10) 63% (15 of 116) Top 15% Cervical Cancer Screening (357/49) 73% / 64% (4 of 11) 67% (33 of 119) Colorectal Cancer Screening (190/317) 59% / 6 % (1 of ) 43% (17 of 117) Top 15% PRODUCTION Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Total Visits ,369 Patients ,027 PCP Patients ,247 New Patients wr VU's ,054 Reporting Period: May 2013 Last Updated: 6/13/13 10:00 AM Providers can quickly see their performance on a variety of measures.

4 We can see readmissions for the entire Swedish system, Providers can quickly see their performance on a variety of measures. Employees now have a clearer understanding of the metrics on which they are evaluated as well as the ability to compare their performance levels with those of their peers, both within the organization and even across the state and the nation. We re trying to make most key levers in the organization completely objective so Swedish can accurately measure performance and have a certain amount of accountability,, says Delafield. Where possible we want decisions to be very data-driven. We can see readmissions for the entire Swedish system, says Delafield. The Swedish readmissions dashboard is built to be automated and match national definitions. The team that works on readmissions can focus on moving the rate down and not on collecting data. Employees can also see patient experience survey results in Tableau, helping them to understand how they are perceived by patients. We have taken 35,000 survey results, and put them in one spot, Delafield says. The providers can see what patients are saying about them, specifically, or about their clinic in addition to how they rank against their peers internally and externally. Combining this platform with operational teams has allowed Swedish to see significant movement on patient experience. These simple, consistent views tie into operations and help to drive change, he says. Swedish has been able to freeze analyst hiring as well, converting several existing analysts into Tableau power users to build the views used on Vantage. We were able to stop the expansion of hiring more and more report writers to build every possible report that you can build. Delafield estimates that once fully implemented this will save Swedish approximately $750,000 each year. Monthly Trend of Heart Failure (HF) Readmission Rate Readmission Rate Swedish has easy, at-a-glance views of its readmission rates.

5 Overall, Tableau has helped us capture efficiencies and process improvements that we estimate to be valued at tens of millions of dollars. And the analysts are happier working in Tableau, too. Oh, they love it. Solving key business problems and working with end users on what a visual interaction might look like? It s a gratifying place to be. He also says that the analysts appreciate that once a visualization is finished, it can be refreshed automatically as the data updates. Once you do it once and automate it, it s done. You never have to do it again for the company, and everyone is looking at that one thing, Delafield says. Swedish has seen a great deal of value from the insight is has gained from its Tableau implementation. Overall, Tableau has helped us capture efficiencies and process improvements that we estimate to be valued at tens of millions of dollars, says Delafield. Taking the Next Step Both the Swedish organization and the analytics group have gained positive exposure from their successful use of Tableau. This implementation has helped us put a strong foundation in place to move in the direction we need to move, says Delafield. It has really helped the whole company catch up in the reporting and analytics space. Overall, Delafield sees Tableau as part of the Swedish journey towards business transformation and, ultimately, more efficiently serving the needs of the patients and communities it serves. Just about everyone in healthcare has or is going to have an Electronic Medical Record. We re trying to take the next step, which is working on using data to understand our performance and using that understanding to drive movement toward achieving our strategic goals. Eventually, we hope this platform will help us improve not only our internal performance but potentially change the way that we interact with our customers, the patients, he says. Tableau has helped to improve our operations. And we re a good-sized system, so it s pretty exciting. Press Ganey Scores Medical Group Service Line Medical Group Monthly trend line (below) is for th e question: Likelihood of recommending Site/F acility Swedis h Greenlake Primary Care Monthly Trend by Question Provider All Date Option Discharge / Service Date Received Date Date Range 4/1/2012 to 4/30/ % 75% Target = 3.5% 2.5% Age All values Specialty Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 Responses Sex All Now providers can hear and react to patient feedback. tableausoftware.com Copyright Tableau Software, Inc All rights reserved. Tableau Software, the Tableau Software logo, and Visual Analysis for Databases are either registered trademarks or trademarks of Tableau Software, Incorporated. Other company or product names may be the trademarks of their respective owners.