Build vs. Buy a Healthcare Enterprise Data Warehouse: Which is Best for You?
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Transcript of Build vs. Buy a Healthcare Enterprise Data Warehouse: Which is Best for You?
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Enterprise Data Warehousing in HealthcareBuild vs Buy considerations
www.healthcatalyst.com
Context for this topic
Assess Design Implement Test
Deploy
“Do we have the tools to use data to transform care
delivery and streamline operations?”
“Assessment of our current state indicates we need a
different future state. What should that look like?”
“Key to our future state will be an Enterprise Data Warehouse (EDW) to integrate data from multiple sources and facilitate Triple Aim reporting. Make it so.”
“We will test our EDW to ensure it is meeting our expectations.”
“We will roll out our EDW and analytic applications to a broad group of users, including clinicians, leaders, and administrators.”
DecisionShould we build this EDW from scratch, or partner with a vendor to deliver this capability for the organization. Are those my only options?
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Agenda
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● Examine the options– Building an EDW
– Buying an EDW
– Hybrid solution
● Other Considerations
● About Health Catalyst
● Questions
Poll Question
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Building an EDW
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What is an EDW?Metadata, Security, and Auditing
Common, Linkable Identifiers
Financial Source Marts
Administrative Source Marts
Departmental Source Marts
Patient Source Marts
EMRSource Marts
HRSource Mart
Hospital Operations
Primary Care
Asthma
FINANCIAL SOURCES(e.g. EPSi, Peoplesoft, Lawson)
ADMINISTRATIVE SOURCES(e.g. API Time Tracking)
EMR SOURCE(e.g. Epic, Cerner)
DEPARTMENTAL SOURCES(e.g. Apollo)
PATIENT SATISFACTION SOURCES
(e.g. NRC Picker, Press Ganey)
Human Resources (e.g. PeopleSoft)
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Why choose to build an EDW?
Benefits of a data warehouse:● Performance
● Integration
● Ease of use
Historically● Dearth of proven solutions for healthcare
● Pioneers had to demonstrate value prior to funding
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Considerations: building an EDW
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Worst case scenario: project failure● 50% of data warehouse projects fail
Common among unsuccessful EDW builds:● A solid business imperative is missing● Executive sponsorship and engagement is missing● Frontline users are not involved from start to finish
Ongoing success is elusive● Most healthcare IT groups not prepared to function like a
software company● Limited opportunities to learn lessons before funding is
cut
Pros/Cons: Building an EDW
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Pros● Building it yourself means infinite customization● Getting “something” built yourself may be “good enough”
(for now)● Pride of authorship
Cons● Staffing● Shortage of qualified resources● Re-learning lessons● “Skunkworks” projects can be culturally divisive● Project management challenges
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Buying an EDW
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Why might someone buy an EDW?
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Developing well-engineered, custom software maynot be your core competency
Market offerings for healthcare data warehousing solutions are better than 10 years ago
Support and maintenance agreement help ensurelong term success
Considerations: Buying an EDW
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Many of the same risks with any vendor relationship
Evaluating an analytics vendor● Completeness of vision● Culture and values● Total cost● Ability to execute
– Where else have they had success?
– Will their approach work for my organization?
– Do they have expert resources?
More information:● How to evaluate a clinical analytics vendor
Pros/Cons: Buying an EDW
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Pros● Shortest time to value
● Real world experience: what works best in practice
● An infusion of help
● Lower total cost of ownership
Cons● Initial cost
● Knowledge transfer
● Tradeoff between “perfect” and “extremely good”
Poll Question
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Hybrid Build and Buy
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Buying AND Building an EDW
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In practice, more like “Buy and Extend”● Leverage a vendor partner for some components
● Develop, using internal resources, others
Examples:● Select a vendor to:
– Implement the data warehouse
– Integrate several high priority data sources
● Leverage internal resources to:– Integrate additional data sources
– Develop additional analytic applications
– Integrate data from the warehouse into operational processes
Why choose to build AND buy?
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Best of both worlds● Rapid implementation
● As customizable as a purely “build” solution
● Higher potential for return on investment
Mitigates risk● Benefit from the lessons your vendor has learned
● Infusion of resources to help deploy and train
Other considerations
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Potential pitfalls for any data warehouse project● “Boil-the-ocean syndrome”
● Seeking governance “perfection”
● Rigid architecture
Insights● Original article
● Comparing data warehouse architectures for Healthcare
Other Resources● Healthcare Data Warehousing Association (HDWA)
● The Data Warehousing Institute (TDWI)● Health Catalyst Knowledge Center
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About Health Catalyst
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Health Catalyst ProfileIntegrated Delivery Systems
Community Hospitals
Academic Medical Centers
Children’s Hospitals
Patients Impacted
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Hospitals& Clinics
25M 1400
Founded 2008
Employees 140
HQ Salt Lake City, UT
What does Health Catalyst offer?
Late-Binding™Data Warehouse Platform
Data Warehouse, Architecture, Metadata Management, Security, and
Auditing
Analytic ApplicationsKey Process Analysis, Dashboards, Advanced
Analytics
ServicesInstallation Services,
Clinical Improvement Services
Integrates Disparate Data
Apply Evidence and Standardize
Change Processand Behavior
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Application Families
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Reduce Healthcare Labor Costs byusing an EDW and Analytics“The work our organization is doing with the Health Catalyst team pushes the envelope of what it means to have near real-time data at our fingertips to make operational decisions. Their technology and processes put us on track to understand the potential upstream and downstream financial impact of even the smallest decision.”
~ Director Clinical Planning and Financial Management
Objective
• Manage labor costs by allocating resources appropriately to the demand for services
• Eliminate the need to manually pull and consolidate reports on a monthly basis for a 3rd party point solution
• Enable business and unit managers to better track and manage performance by providing more timely information
Health Catalyst Solution
• Late-Binding™ DataWarehouse
• Labor Productivity Advanced Application Module
• Installation Services
• Improvement Services
Results to date
• Estimated 2% reduction in total salaries and benefits to date
• 66% percent increase in the speed of data availability
• Estimated NPV of $425K over a 4-year period from automated data integration
• 500% increase in the number of managers using data to drive decisions © 2013 Health Catalyst
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How to Reduce Heart FailureReadmissions
• Late-BindingTM data warehouse that enables faster time-to-value
• Integration of clinical, patient satisfaction and financial data to establish baseline, ongoing and balance measures
• Discovery, Foundational and Advanced HF applications including cohort finder, registry and evidence- based clinical content
• Healthcare analytic visualization including gauges and trend lines for at-a-glance view
• Seasonally adjusted rate reduction of 21% in 30- day and 14% in 90-day readmissions
• 2X increase in the number of phone calls made to patients within 48 hours of discharge
• Average of 63 % increase in physician medication reconciliation within 48 hours of discharge
• Follow-up appointment intervention baseline and balance measures established
“Our data is now accessible to stakeholders throughout the organization, including clinical teams who can use it to drive improvements in care processes, care quality and patient outcomes”
~ Director of Clinical & Business Analytics
Objective Health Catalyst Solution Results to date
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• Define Heart Failure (HF) baseline measures for 30 and 90-day readmissions rates
• Implement evidence- based practice interventions to drive HF readmission rate reductions
• Establish balance metrics including ED visits, observation days and patient satisfaction
• Develop sustaining processes for evaluating readmission rates to ensure continuous process improvement
Questions and AnswersAdditional Information
• See us at HIMSS 2014 booth #6076
• Call 801.708.6800 to request a meeting
• Listen to two clients speak:– “Improving Outcomes with
an Innovative Approach to Population Health Analytics”
» Stanford Hospital & Clinics
» Yohan Vetteth, Pravene Nath, MD
» Date/Time: Thursday, 2/27, 12 PM
» Location: Room 304A, Session #229
– “Blending Clinical and Financial Data to Drive the Value Equation”
» Texas Children’s Hospital
» Charles Macias, MD» Date/Time:
Wednesday, 2/26, 1 PM» Location: Room 304A,
Session #191
• Follow us on Twitter– @healthcatalyst
Explore our site: www.healthcatalyst.com
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