Business Intelligence – Decision Support Through Better Data Management

1. “Of all the transformations reshaping American Healthcare, none is more profound than the shift towards payment for value” - HFMA’s Value Project Phase 2 Business Intelligence – Decision Support Through Better Data Management Thursday, March 29, 2012

2. "Do not go where the path may lead; go instead where there is no path and leave a trail."- Ralph Waldo Emerson Hospitals are steeped in tradition of creating new clinical pathways There is no clear path of achieving sound financial results under reform The traditional methods for sustaining hospital margins, managing costs, and quality are no longer completely valid Significant new data is needed to evaluate a course of action for future success Moving from volume to value changes everything

3. HFMA Value Project

4. The Need for Better Data Key challenge is managing data chaos Simplify Data Integration Manage Financial Risk and Incentive Improve Quality Increase Efficiency

5. Metric Focus Too many metrics with lack of focus on organizational goals Align enterprise resources to establish clear set of goals Integration of clinical financial and operational data – extended enterprise Enable action not just reporting Cross functional weekly meetings on outcomes and future direction Improving care Improving health of populations Reducing per capita costs

6. Current Market Trends Providers' Perceptions: Business Intelligence and Analytics in Healthcare - 2/1/2012 Sponsored by: Billions Health Data and Porter Research

7. Priorities of Business Intelligence Almost three-quarters (71%) of providers ranked business intelligence as a high priority initiative (importance of 4 or 5) within their organizations Providers' Perceptions: Business Intelligence and Analytics in Healthcare - 2/1/2012 Sponsored by: Billions Health Data and Porter Research

8. Benefits of BI Technology Bars represent ratings of 4 or 5 on a scale of 1 (not significant) to 5 (Significant) “Predict Patient Behavior and Outcomes” and “Competitive Differentiator” not charted Providers' Perceptions: Business Intelligence and Analytics in Healthcare - 2/1/2012 Sponsored by: Billions Health Data and Porter Research

9. Current State of BI Deployments • Two trends emerged in the study: • Project focused; BI technology was deployed either as a part of “solution initiatives” or on a “project-by-project basis for data warehousing” • Facilities are “standard on several core BI vendors” and many are “decentralizing and deployed at the department level” (i.e. Quality, Finance, etc.) Providers' Perceptions: Business Intelligence and Analytics in Healthcare - 2/1/2012 Sponsored by: Billions Health Data and Porter Research

10. Moving Towards – Enterprise BI Strategy • Organizations are moving towards an enterprise Bi strategy: • Half (47%) of providers have been moving towards an enterprise BI strategy in the past 24 months or less. • A quarter (23% are planning to develop an enterprise strategy. Providers' Perceptions: Business Intelligence and Analytics in Healthcare - 2/1/2012 Sponsored by: Billions Health Data and Porter Research

11. Payment Cuts in Healthcare Reform • Nearly $200 billion in upcoming Medicare reimbursement cuts over 10 years. • Combined, payment cuts to hospitals could amount to 15% of total inpatient Medicare reimbursement. • Independent Payment Advisory Board to recommend cost reductions starting in 2020. Source: PNC Healthcare Advisory Services - 2011

12. Potential Opportunities for Cost Savings in US Healthcare Industry from use of BI $ 220 Bn Source: http://bi-insight.systechusa.com/tag/bi/

13. What is Business Intelligence? • Business intelligence (def’n) - Business intelligence (BI) is a broad category of applications and technologies for gathering, storing, analyzing, and providing access to data to help users make better business decisions. • Gives you the ability to transform clinical, financial, and operational data into discrete but somewhat meaningful actionable information. INSIGHTACTION

14. What is Enterprise BI? • Enterprise Business Intelligence is able to create integrated reports from disparate databases to see a complete/meaningful picture of the business enterprise. In healthcare, that may include: • EHR data • Billing data • Scheduling data • HR costs and allocations • Purchasing costs and assignment to services • Other meaningful sources of data

15. Enterprise Business Intelligence Framework 1. Acquire raw data 2. Organize, define and Integrate data 3. Analyze and act Data Warehouse Financial Actionable information and Trend Analysis Financial Analysis Performance Analysis Regulatory Reporting Operational Clinical Source: http://bi-insight.systechusa.com/tag/bi/

16. Key Components of BI

17. Drill Down - Graphically

18. Drill Down – Pivot Functionality

19. Drill Through – Detail Level

20. Meaningful Use Data Management Benchmark Diabetes Patients: LDL <100 and % of Patients with No LDL Test

21. Meaningful Use Data Management Diabetic Patients that had an A1C Test or A1C >9

22. Business Intelligence - Actionable

23. Data Integration and Data Definitions • This is the real challenge • Customer or vendor must provide metadata definitions but vendors like PNC will guide process (you are not alone) • Data integration is handled by populating an enterprise database and helping develop new workflow/data capture approaches to link data

24. Key Hurdles in Healthcare BI • Capital • Limited IT and Administrative resources • ICD10 & 5010 • ACOs • Pay for Performance • Meaningful Use • Volume vs. Value • Clinical Quality and Outcomes Measures • Assimilating Employed Physicians

25. Ways to Beat Hurdles in BI • Hosted/SaaS solution by Trusted Organization • No Capital through subscription/hosted models • Assure integrity of off-site Data Security • Low IT involvement is expected • Look for available Dashboards Library (fast tracking startup) • Look for available talented analysts and report writers • Quick ROI – opportunities identified early • Look for access to experienced/successful project engineers

26. Wow Report Samples / Talking points • Hospital & Physician Revenue cycle pathway and KPIs • Denial pattern analysis highlighting changes in payer behavior and/or contract deviance • Clinical performance data linked to meaningful use and quality metrics • Scorecards that compare actual performance to external and internal benchmarks associated with performance alerts

27. Claims KPIs

28. Clinical Data KPIs

29. Patient Care KPIs

30. KPIs and Dashboards Need basic set for industry benchmarking Need custom set for local needs Must be meaningful and allow quick assessment of appropriate responses to address issues Must generate trust from the end users

31. Ad Hoc Reporting • Usually created from questions raised from Dashboards and Scorecards • Can become future dashboards • Often provides the data for project ROI • Used to monitor specific projects or short term objectives • Ultimate tool to build trust

32. Goal - Predicting and Avoiding Preventable Readmissions an Example What are the population and DRG sources of readmission? What are the co-morbidities associated with DRG sources? Is there a risk stratification model what are the indicators? Who are the physicians? What was the hospital length of stay? What are the nursing homes sending patients and what are the reasons?

33. ROI Quotes for BI • “Last year's IDC study, "The Financial Impact of Business Analytics," reinforces that organizations who implemented analytic applications have realized returns ranging from 17 percent to more than 2,000 percent with a median return on investment (ROI) of 112 percent.” • “Industry studies have repeatedly demonstrated that business intelligence (BI) initiatives are among the IT investments that yield the highest returns.” (Information Management) • “You are going to make some changes that will not make some people happy. You will begin to hit some interference pretty quick.”--Rick Schooler, vice president and CIO, Orlando Health, on the inevitable pushback across enterprise analytics efforts that supplant proprietary data sources. • “Information is the fuel that powers change. We are simultaneously awash in information and bereft of it. So, how do we use data effectively without overwhelming people?"--Bernadette Loftus, M.D., associate executive director for the Mid-Atlantic States, Permanente Medical Group • “Data aggregation isn’t the focus, data agreement is. Get the people who need to agree on definitions in a room and get to work.”--Tom Davenport, author, Analytics at Work: Smarter Decisions, Better Results, stressing a big challenge to successful use of analytics. 

34. Summary Future Business needs require robust enterprise analytics Look for easy to use products that provide the data most meaningful to you Not necessary to incur capital costs and protracted implementation times Scare analyst resources may invite you to look for a partner over just a vendor If outsourcing, be sure data is in the most secure/affordable environment