Healthcare Delivery Reimagined: Patient Flow and Care Coordination Analytics
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Transcript of Healthcare Delivery Reimagined: Patient Flow and Care Coordination Analytics
Copyright © 2015 Splunk Inc.
Data Informed Healthcare Delivery
Process Improvement
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Agenda
Problem Background and MotivationProcess Analytics Solution OverviewSolution Features and Benefits: ExecutiveSolution Features and Benefits: Operations UserSolution Features and Benefits: Informatics UserProduct Demonstration
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Information Flow in Care Delivery: Spaghetti
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002133/
Requires complex cross domain coordination
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And Flow is Care Condition Specific
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Current picture of My Visit
Source: HIMSS Presentation, capturing patient flow value stream
Algorithmsforinnovation.org
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National Average Wait Time for Specialist Visit
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Underlying Problem AreasExamples
Process variations that reduces efficiency without improving outcomeMismatch of supply and demand: Nurse Staffing, Patient Scheduling, Beds, Operating Room, Emergency DepartmentBest Practices/Checklist hard to implement
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Event Type Event ID Attributes (Timestamp, Department, Resource)
Registration 4798668 02/06/2015 14:00 A John
Lab 4798669 02/06/2015 14:00 B Pete
Consultation 4798670 04/06/2015 11:00 C Rose
Medication Order
4798671 04/06/2015 12:00 C Pete
Medication Dispense
4798672 04/06/2015 10:00 D John
Transport 4798673 04/06/2015 15:00 E Pete
Billing 5798670 03/06/2015 14:00 F Pete
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Good News: Increasing Healthcare Digitization-Flows are Captured in Events
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Virtual
Physical
Cloud
Healthcare Data is Time Oriented and Diverse
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EHR Systems
WebServices
Developers
App Support
Telecoms
Networking
Desktops
Servers
Security
Devices
StorageMessaging
Patient Surveys
clickstream
HIE
PatientNetworks
Healthcare Apps IT Systems and Med Devices Patient Generated Data
MedicalDevices
CDR Mobile
PHI Access Audit Logs
HL7 Messaging
Sensors
Departmental and
HomegrownApplications
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Goal With Splunk: From Spaghetti To LasagnaReduce Unwarranted Variations
Source: processmining.org
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Real Time Diverse Data Integration
End to End Process Discovery and KPI visibility
Detect and Monitor Process Anomaly and Bottlenecks
Predict, Recommend, and Forecast
Using Process Analytics: Improvement Method + Real Time Data Analytics
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Patient Flow Data Sources Examples
Health Event Data:
Application Event Logs
HL7 Messages and Logs
Web Logs
Device Data:
RTLS Asset Tracking
Patient Tracking (optional non-US)
Medical Device Logs
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Future State My Visit Enabled by Process Analytics
Source: HIMSS Presentation, capturing patient flow value stream
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Anticipated Improvements and MeasurementsAnticipated Improvement Opportunities
Prediction of Resource Requirements next hour/day/week
Identify Over provision of low or non value added activity
Find low utilization of expensive clinicians, operating room, devices, supplies, and clinic space.
Discover use of clinicians for less skilled activities
Identify routine care delivered in expensive settings
Detect long waiting time and delays because of lack of cross functional coordination
KPI to ImproveTime for patient waiting for an inpatient bed ER Wait Time
Cycle time of discharge order received to room clean and ready. Waiting time for scheduled surgery
Reduction in inventory and equipment capex/opex
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Traditional Process Analysis Vs. Splunk ApproachSplunk ApproachDiscover actual behavior of people, organization, and machines and relate to modeled behavior.
Correlate millions of ad-hoc events showing how reality is different from perceptions, opinions, and beliefs.
Provide clue for standardization, reduce unwarranted variations, and better prepare to handle ad-hoc events.
Traditional ApproachBased on the opinion of the expert.
Assemble an appropriate team and to organize process modeling sessions. The knowledge of the team members is used to build an adequate process model.
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Why Now? Shift in The Payment System and Care Delivery Models
New Care Delivery Models: Accountable Care
Organizations, Mergers, Acquisition, and Partnerships.
Shift of Payment Systems: fee for service to fee for quality.
Margins are thinner, infection penalty, readmission penalty.
Aging Populations, new population with insurance:
more demand on constrained resources
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Why Now? Increased Patient Participation
More Choices- new entrants in the market- Wal-Mart,
Walgreens, CVS
Patient’s skin in the game: Highly deductible plans,
sharing of costs
Availability of Patient Portals, Online
Communities, and Consumer tools- Mobile, Sensors, Home Health
Increased Transparency on cost and quality data
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Business Value of Process Analytics
Increase Staff Productivity, reduce error, optimize time
1Reduce cost
without outcome tradeoff
2 3Improve patient
outcome, experience, and
engagement
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Executive
Solution Features and Benefits
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Process KPI Dashboards• Waiting Times/Delays at Highly Utilized Flow Steps• Current Bed Capacity• Current Imaging Frequency• Current discharge to bed readiness time
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Visualize Patient Flow
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Visualize Asset Flow
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Business Benefits
Process Flows and real time Capacity and Time Metrics
1Comparison
Data- by min, hour, days, months etc.
2 3Make data
informed time critical
operational decisions
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Clinical Operations
Solution Features and Benefits
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Finding and Troubleshooting Bottlenecks
Utilization Management KPI temporal view
Visualize flow and frequency
Visualize Entity RelationsEx: relations among conditions and procedures
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Automatic Notifications: Actionable Alerting
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Business Benefits
Monitoring for Joint
Commission and other best
practices
1Detect trends, anomalies, and inconsistencies
and troubleshoot
2 3Make data
informed time critical
operational decisions
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Informatics
Solution Features and Benefits
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Real World Business Questions, Improvement Opportunities, feedbacks
Data Collection Data Preparation
Exploratory Visualization, Statistics and Machine Learning
Communication, VisualizationReports, Findings
Evaluation
Knowledge Discovery, developing and evaluating Knowledge, Rules, and KPI
Decision Support Product
Think of the Process/Walk in the Patients’ shoes
Process Mining Platform
Pre Mortem Data :Real Time Monitoring, Anomaly Detection , and Predictions
CaseManagement
Anomaly Detection,
Linkage, Correlations/
Patterns
AlertsPredictive
Modeling/Model
Maintenance
Data Warehouse
New Events
Standard Reports/Que
ries
Data Archival
Rules System
Process Data Mining Core Engine
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Analytics PlatformIntegrate Untapped Data: Any Source, Type, Volume, Velocity
Healthcare Apps Data/HL7 Events
Healthcare Apps Audit Logs
Medical Device (PACS)/RFID Metadata (logs)
Patient Generated Data
Hadoop Clusters Relational Database No SQL Data StoreSplunk Clusters
Explore Visualize Dashboard ShareAnalyze Monitor and alert
External Applications Integration
(SDK, REST API)
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Application Development Platform
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Business Benefits
Diverse Data Integration
and Enrichments
1Tools for process
discovery and visualizations
2 3Make real time
knowledge available to
operations and executives
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Splunk ResourcesSearch Tutorial: http://docs.splunk.com/Documentation/Splunk/latest/SearchTutorial/WelcometotheSearchTutorialTraining Videos: http://www.splunk.com/view/educa3on-videos/SP-CAAAGB6Splunk Docs: http://docs.splunk.com/Documentation/Splunkbase Apps & Answers: http://apps.splunk.com/
http://answers.splunk.com/Splunk Wiki: http://wiki.splunk.com/ Developers: http://dev.splunk.com/
Exploring Splunk Book: http://www.splunk.com/goto/book
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Interactive, cut/paste examples from popular source repositories: D3, GitHub, jQuery
Splunk 6.x Dashboard Examples Apphttps://splunkbase.splunk.com/app/1603
Custom SimpleXML Extensions Apphttps://splunkbase.splunk.com/app/1772
Splunk Web Framework Toolkit Apphttps://splunkbase.splunk.com/app/1613
Machine Learning Toolkit:
https://splunkbase.splunk.com/app/2890/
Example Advanced Visualizations and Machine Learning Toolkit
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http://dev.splunk.com/view/python-sdk/SP-CAAAEU2
http://dev.splunk.com/sdks
http://dev.splunk.com/restapi
REST API, SDKs, and Custom Search Command
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Thank YouAdrish SannyasiHealthcare Solution ArchitectSplunk, [email protected]