Mobile Business Intelligence

1. Mobile Business Intelligence Maureen Lowe, Denise Matthews, Divyes Patel BlueCross BlueShield of Tennessee

2. Maureen Lowe Director, Client Reporting BlueCross BlueShield of Tennessee Phone: 423.535.4046 Email: Maureen_Lowe@bcbst.com • Responsible for providing information to drive benefit and clinical decision-making, analysis of medical cost drivers, existing service performance and clinical program outcomes as well as building collaborative relationships with customers and stakeholders • Over 25 years of experience in the health insurance industry across technical, clinical and operational segments • Most recently held the role of Federal Government Systems Manager for the BlueCross BlueShield of Tennessee Medicare Administrative Contractor implementation • Education • Bachelor’s Degree Biology, University of Tennessee at Chattanooga

3. Denise Matthews Program Manager, Medical Informatics BlueCross BlueShield of Tennessee Phone: 423.535.5602 Email: Denise_Matthews@bcbst.com • Responsible for planning, directing and ensuring the successful management, oversight and implementation of Medical Informatics’ projects • Over 17 years of healthcare experience in operations, government regulations, business development and project management • Prior to joining the Medical Informatics Division in 2011, acted as a the Program Director for BCBST’s Medicare subsidiary. • Education • Bachelor Degrees Sociology/Criminal Justice, University of Tennessee

4. Divyes Patel Manager, Rapid Application and Development BlueCross BlueShield of Tennessee Phone: 423.535.6260 Email: Divyes_Patel@bcbst.com • Responsible for building the Clinical DataMart and reporting & analytical reports and tools for the Medical Informatics department • Over 15 years of healthcare experience in reporting and informatics development • Prior to joining BCBST in 2011, worked for Ingenix Consulting leading a development team in building a Clinical Value Measurement Infrastructure using SAS to automate clinical ROI savings calculations for OptumHealth clinical programs • Instrumental in building an industry leading clinical reporting package that tracked clinical activity to their financial outcomes for OptumHealth and was a lead developer to build a clinical reporting DataMart for reporting and adhoc uses • Education • Bachelor Degrees Chemistry and Economics, University of Tennessee

5. Background Information • In 2011, BCBST Medical Informatics purchased Teradata to expand our strategic framework, data infrastructure, integrated clinical reporting and data mining environment • Teradata provides an infrastructure that supports large volumes of claims data, eligibility, pharmacy, biometrics, HRAs, third party data • In addition to expanding our infrastructure and reporting capabilities, BCBST wanted to leverage Teradata to support a mobile framework and strategy

6. Getting Started • Once the need for mobile capabilities was recognized, Medical Informatics began working with IS to identify potential vendors • As a starting point, IS reviewed Gartner's top quartile for mobile BI • In addition to reviewing new vendors, Medical Informatics assessed technology already in use by BCBST

7. RFPs vs. Proof of Concepts • The typical procurement strategy at BCBST is to issue RFPs to potential vendors: • Request a written response to a variety of questions/scenarios • Onsite presentation for the finalists • Due to the nature of mobile technology, we wanted to ensure the technology we selected would work in our environment: • Was our data structure adequate? • Do we have the right resources for mobile development/can our staff be trained? • How long would it take us to deploy once we selected the vendor? • Senior leadership made the decision to conduct Proof of Concepts (POCs) with a multiple vendors rather than issue RFPs

8. Elements of the Proof of Concepts • To determine the top two vendors for the POCs, we held brainstorming sessions with applicable vendors: • Provided high level business requirements to the vendor prior to the brainstorming session • Requested they present benefits of their platforms that were specific to our requirements • Encouraged participation by multiple levels of MI management to ensure we captured all possible ideas/suggestions • Based on the brainstorming sessions, MI selected two vendors to proceed to the POC round: • BCBST developed a Statement of Work (SOW) • Vendors were asked to price a 60 day on site work effort • Output of the POC would belong to BCBST

9. Elements of the Proof of Concepts, cont. • The Mobile BI Proof of Concept had five objectives: • Create a prototype of an externally facing iPad application with write back capability • Develop an internally facing provider dashboard • Exhibit/showcase adhoc capabilities within the tool • Ability to generate BCBST’s Financial and Clinical Insights Report (FCIR) using the tool • Showcase the ease of use of the tool • Other requirements of the Proof of Concept included: • Vendor personnel had to work onsite at BCBST using a BCBST provided asset • An executive status was required every two weeks • Project status meetings with the team conducted three days per week

10. Development of the Mobile Application • The mobile application was derived using data from five large, self-funded accounts (de-identified) • Key performance metrics from the BCBST Balanced Scorecard were used: • Financial Trend • Healthcare Utilization • Population Risk • Chronic Health Status • Member Engagement • Clinical Outcomes Due to the 60-day limitation, vendors were asked to focus on two areas and provide two-three levels of drilldown within each component

11. Mobile Application POC Demonstration

12. Development of the Provider Dashboard • The provider dashboard was developed using a data set that included all Tennessee physicians (25,000+) • We requested the vendors to develop the dashboard using the following domains: • Summary View • Performance View • Demographic View • Direct Cost and Utilization View • Risk Adjustment View • Quality and Patient Experience View • Indirect Cost and Steerage View Due to the 60-day limitation, vendors were asked to focus on three domains

13. Provider Dashboard POCDemonstration

14. Adhoc Capabilities within the Platform • The adhoc capability portion of the proof of concept was demonstrated/shown by using the data for the provider dashboard • We requested the vendors to showcase the following capability: • Ability to select report elements such as columns, measures, sort groups, filters and output formats that are customizable for each user • Automatic condition drill-thru • Ability to create any number of report combinations • Ensure “single version of the truth” • In addition to using the provider dashboard to demonstrate functionality, vendors were asked to hold a ½ day hands on session for our analysts

17. Report Capabilities within the Platform • The vendors demonstrated the ability to generate/automate reports by using BCBST’s Financial and Clinical Insights Report (FCIR) • We requested the vendors to showcase the following capability: • Ability to interact with the data in a secure, feature rich manner • Ability to perform in-depth analytics and enhanced analytics such as charting • Security, such as password protection • Collaboration, including the ability to export and email • Incorporation of MS office

20. Proof of Concept Vendor Evaluations • Vendors were evaluated using the following criteria and scoring:

21. Developing the BI Roadmap • BCBST engaged Claraview (a subsidiary of Teradata) to help develop the BI roadmap for Medical Informatics • Claraview assists in planning and deploying complicated BI projects using proven methodologies for solution delivery and BI program management • Claraview was asked to assist in the following areas: • BI platform selection/support • BI platform TCO evaluation • BI delivery and architecture roadmap

22. Developing the BI Roadmap Elements of the BI Roadmap 2-3 Year Roadmap for BI Delivery Business Needs Matrixed with Existing Data BI Platform Integration BI Roles and Responsibilities

23. BCBST’s long range BI roadmap is being finalized. • We expect to deliver the provider dashboard to internal users by December 2012. • We are working to have the mobile application to customers in the 1st quarter of 2013. • Key to BI success is having optimal data models! • Questions?