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InfoSphere software

IBM InfoSphere Clinical Analytics

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InfoSphere software

Medicare Says It Won’t Cover Hospital Errors By ROBERT PEAR

WASHINGTON, Aug. 18 — In a significant policy change, Bush administration officials say that Medicare will no longer pay the extra costs of treating

preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars.

New York Times, August 19, 2007

Hospitals must report patient-satisfaction data or face a financial hit; for many it’s just

business as usual, for others it poses some challenges

By: Barbara Kirchheimer - Story posted: July 23, 2007 - 5:59 am EDT Modern Healthcare

Hospitals blitz airwaves with ad campaigns

Stiff competition as consumers gain more say in care

By Christopher Rowland, Globe Staff | February 21, 2007

In an escalating advertising blitz, hospitals in the Boston area are trying to attract patients by pitching such services as knee replacements, cancer treatments, and

liver transplants.

There are growing pressures on providers to report publicallyThere are growing pressures on providers to report publically

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Healthcare Provider Challenges

Healthcare Providers are faced with a growing number of challenges, including:

• Increased demand for care delivery with decreasing reimbursement

• Compliance monitoring on the increase

• Need to improve patient Safety and Outcomes

• Utilization of patient data (Longitudinal Patient Records) for Chronic Disease Profiling for better outcomes and reduced costs

• Provide data and analytical tools to a growing number of users within hospitals

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To be successful in the future, organizations will need to use clinical data to improve operational efficiency and outcomes

Financial & Ops Reporting Available today Standalone analysis

Clinical Data Analysis Calculate and benchmark

financial and clinical productivity measurements

Compliance monitoring Actionable analytics via

management Healthcare Intelligence Dashboard

Conduct data mining Safety and Outcomes Disease Cubes

Information Currently Accessible

Hidden Information

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InfoSphere software

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ORSystem

Micro ResultsHematologyChemistry

Results

Peri Op DocumentationOR Med Admin

Time

ED Admit TimeED DC Time

Medication NameDispense Order

MRN NameICD 10

EDSystem

PharmacySystem

RegistrationSystemLab System

ManualData

Capture

Analysis Create Report

Quality Department

Analysis Create Report

FinanceDepartment

Analysis Create Report

Operations Managers

Current strategies for reporting, analyzing and trending are costly and inefficient….

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ICA Provides a Comprehensive Informatics Strategy across the Organization vs. Point Products which are

Targeted at Specific Departments

CLINICALInformatics

RESEARCHInformatics

ADMINISTRATIVEInformatics

EnterpriseHealthcare Analytics

Point Solution

Point Solution

Point SolutionPoint Solution

Point Solution

Data NotValidated

Data NotValidated

InfoSphere ClinicalInfoSphere ClinicalAnalytics (ICA)Analytics (ICA)

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InfoSphere software

Solution Positioning

Clinical Analytics Development Platform

Single source of trusted administrative, clinical, and research information across the enterprise.

Fully customizable and extensible solution

Fully integrated analytics development platform

Solution is optimized for healthcare analytic reporting, ad hoc analysis and research

Solution is highly adaptive to local medical vocabulary - Standards mapping features allow for regional and national benchmarking

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A fully integrated solution Clinical Analytics + BI

Applications + Healthcare Intelligence Dashboard Server + Data Warehouse + Server

Solution’s unique features: Creates longitudinal record from

inpatient, outpatient, specialty and ambulatory care setting

Patient record De-Id and Re-Id 900+ procedures for data

cleansing and validation Medical vocabulary mapping MPI mapping Cohort record or encounter

search Analysis of whole organization

down to physician and patients

Clinical Analytics Solution:Analytics + Warehouse + B.I.

Balanced

Warehouse

InfoSphere

Clinical

Analytics

Infosphere Warehouse

Cognos or other

B.I.

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InfoSphere software

Delivers a cost-effective solution for patient & provider data analysis:

Standardization: Common data model, data validation, medical terminologies mapping, privacy compliant, etc.

Provides different views of patient data: Combines inpatient, outpatient, specialty care, ambulatory and financial data into a longitudinal patient record in a analyzable format.

Supports analysis of multiple organizational models: Enterprise organizations, regions, single facility, departments, individual physician and patients.

Installs once, use many times: Serves multiple stakeholders from a single validated healthcare data warehouse – quality, research, clinicians, nurses, business operations

The Value of a Solution vs. a Build Approach Are Many

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The Value of Enterprise Healthcare Analytics

Get additional value from your considerable CIS investment by creating a corporate data asset

Monitor and manage on a more timely basis Population-level analysis, not just survey data ties process changes to

patient outcomes Identify new revenue opportunities & cost controls Validate effectiveness of evidence-based practices Provide new tools to providers to improve treatment Reduce cost of patient recruitment for clinical research Operational deployment in as little as 16 weeks (single hospital with one data

source)

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Enterprise Analysis Use Cases Domains Example Use Cases

Exploratory Analysis Exploratory Analysis

Cohort IdentificationCohort Identification

Patient Flow / Capacity ManagementPatient Flow / Capacity Management

Service Line MeasurementService Line Measurement

Business AnalysisBusiness Analysis

Identify Variations in Healthcare DeliveryIdentify Variations in Healthcare Delivery

Quality & Best PracticesQuality & Best Practices

Outcomes Management; e.g. Diabetes, surgicalOutcomes Management; e.g. Diabetes, surgical

Safety & SurveillanceSafety & Surveillance

Clinical Trial Study Design Clinical Trial Study Design

Patient RecruitmentPatient Recruitment

Clinical Use Cases

Clinical Use Cases

Business Use CasesBusiness

Use Cases

Research Use CasesResearch

Use Cases

InfoSphereInfoSphereClinical Clinical AnalyticsAnalytics

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InfoSphere software

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InfoSphere Clinical Analytics

ICA

Server PlatformServer Platform

InfoSphereWarehouseInfoSphereWarehouse

Cognos (orOther B.I.)Cognos (orOther B.I.)

DashboardDashboard

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Ma

pp

ing

– V

alid

atio

n -

No

rma

lizatio

n M

ap

pin

g –

Va

lida

tion

- N

orm

aliza

tion

Data Sources

Consolidate Clinical Data AcrossEntire Organization Into

‘Central Source of Truth’

Disease Cubes

Hospital

Hospital

Clinic

Clinic

Analysis

Operations

Sep

arat

e S

yste

ms

& S

iloed

Dat

a

Healthcare Analytics ArchitectureHealthcare Analytics Architecture

An

alytic E

nviro

nm

ent

An

alytic E

nviro

nm

ent

InfoSphere Clinical AnalyticsInfoSphere Clinical Analytics

LocalVocabulary

LocalVocabulary

Dash

bo

ard D

ashb

oard

PatientSafety

OutcomesAnalysis

Quality Improvement

PhysicianPerformance

QualityImprovement

Car

e &

Op

s

Imp

rove

men

t

ComplianceMonitoring

NormalizedVocabulary

NormalizedVocabulary

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ICA

Data Model

PrivacyCompliant

Re-ID Patients

Vocabulary Mapping

Identity Mgmt

DiseaseProfiles

Data CleansingDe-ID Patients

Clinical Query

ResearchData Export

Common PatientIdentification

Inpatient &Outpatient

Ambulatory

ICA– Integrated, Ready to Use Features

Pathology Analytics

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High Level Data Model Clinical & Operational Data

PatientCharacteristics Age Gender History Geography

ICD-10/CPT Diagnosis Procedure DRG123 (inpatient) Date/time stamp Encounter link

Pharmacy Days Supply Refill # Ordering MD Dose/Strength Route Drug Code

Laboratory Orders &

Results Microbiology

Encounter Admit info Discharge info

Provider Specialty/Sub Admit/Attend Cons/Order Prescribing Procedural

Insurance All Payers Plan ID

Medical Devices Mfg. Name Model, type Serial number Implant date

Financial CCR Dept CPT Codes Facility ID

G/L and HR Productive FTE

Nursing Notes Height, weight Blood pressure Temp., HR, RR

Facility Details Inpatient Outpatient Geography Urban/Rural Dept, # Beds

Pathology

Clinical Data Model

EMR Problem list Med list Allergies Chief complaint

Imaging Studies

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ICA is Easily Extensible

“Site Specific” Metadata

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Custom Analytics

Core Analytic Services

Diabetes view

-x- view

CV view

Routine reports, withcomparative data Physician feedback reports Selected care processes

and patient populations Selected quality and

performance indicators

“Community”collaboration portal Web-based exploratory

analysis, with comparative data at every level

Selected care processes and patient populations

Network with colleagues,share best practices, andfoster improvement

Download comparativedata for local analysis Selected care processes

and patient populations

Data extracts or cubes foradditional care processes orpatient populations

Operational/revenue analysis Registry reporting (external) Adverse event ID, analysis Individual and comparative

analyses

InfoSphereClinical

Analytics

Elements of InfoSphere Clinical Analytics (consolidated)

Access to own data Extract standardized data

for internal analysis Query and analysis tools Re-identify patients for

clinical studies Re-identify providers for

performance improvementstudies

ICA

Hospitals

DBFDBFHIS

DBFDBFPMS

DBFDBFEMR

On-site System

ICA

ICA

ICA

SourceSystems

Fullyde-identified

data

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INV_1500

INV_1500_CLAIM

INV_1500_DET

INV_1500_DX

INV_1500_PMT_ADJ

INV_UB

INV_UB_CLAIM

INV_UB_DET

INV_UB_DET_DX

INV_UB_DX

INV_UB_PMT_ADJ

INV_UB_PROC

InfoSphere Clinical AnalyticsSample Implementation Timeline

Typical Single Hospital – Single Source (16 Wks)

ORG

PARTICIPANT

PARTICIPANT_ORG

FACILITY

DEPT_UNIT

PROV

INS_PAYOR

PATIENT

ENCOUNTER

LAB_ORD

LAB_RESULT

MAR

MEDICAL_DEV

NRS_NOTE

OR_CASE

OR_PROC

OR_RX

PATIENT_INS

PATIENT_LOC

PATIENT_RISK

PATIENT_VITAL

PROBLEM_LIST

PROV_NOTE

RAD_ORD

RAD_ORD_DX

RAD_PROC

RAD_PROC_DX

RAD_PROC_SUP_DEV

RX_HOSP_DISPENSE

RX_HOSP_ORD

RX_RETAIL_FILL

RX_RETAIL_PRESCRB

ICA Patient Information,

9 Tables (20%)

ICA Clinical Information,

23 Tables (53%)

Single Vocabulary/

Catalog

ICA Finance Information,

12 Tables (27%)

ICA - 16 Week Implementation Proposed

Discovery 60% Week 1-9

60%

30%

Implementation 30% Week 10-14

Identify vocabularies, plan maps

Data element mappings

Vocabulary / Lookup mapping

Analytics framework & measures tailoring

Prepare load scripts

Load, Validate Year 1 to source & ICAReconcile outliers in Year 1 data

Load, Validate Year 2 to source & ICA

Reconcile outliers in Year 2 data

30% Implement operational procedures

Training, turnover

Operational 10% Week 15-16

ICA Go-LiveDashboard Delivery

Single SourceApplication

Or Data Warehouse

1 Hospital/Clinic Feed

An

aly

tics D

iscovery

an

d M

easu

res

Delivery

Live

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InfoSphere Clinical Analytics - Sample Implementation

Timeline Typical Multiple Hospital – Multiple Source

IDX

Catalog Two

Medipac

CatalogThree

13 Hospital Feeds

Cerner

CatalogOne

Professional Billing

ADT, EHR

ADT, Lab ORD/OBX

ADT, Rx

ICA, MPI

Inbound only

Unique MRN for all source systems

INV_1500

INV_1500_CLAIM

INV_1500_DET

INV_1500_DX

INV_1500_PMT_ADJ

INV_UB

INV_UB_CLAIM

INV_UB_DET

INV_UB_DET_DX

INV_UB_DX

INV_UB_PMT_ADJ

INV_UB_PROC

ORG

PARTICIPANT

PARTICIPANT_ORG

FACILITY

DEPT_UNIT

PROV

INS_PAYOR

PATIENT

ENCOUNTER

LAB_ORD

LAB_RESULT

MAR

MEDICAL_DEV

NRS_NOTE

OR_CASE

OR_PROC

OR_RX

PATIENT_INS

PATIENT_LOC

PATIENT_RISK

PATIENT_VITAL

PROBLEM_LIST

PROV_NOTE

RAD_ORD

RAD_ORD_DX

RAD_PROC

RAD_PROC_DX

RAD_PROC_SUP_DEV

RX_HOSP_DISPENSE

RX_HOSP_ORD

RX_RETAIL_FILL

RX_RETAIL_PRESCRB

ICA Patient Information, 9 Tables (20%)

ICA Clinical Information, 23 Tables (53%)

ICA Finance Information, 12 Tables (27%)

Outpatient

Multiple Databases and Catalogs

eGate Interface

Site Statistics 1.6m Patients 94 Satellite Clinics 13 Hospitals 700+ Physicians 1,767 Beds Cerner System ICA Master Patient

Index (MPI) implemented (system did not implement Cerner EMPI)

ICA Provided Consolidated Warehouse and Analytics

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Healthcare Analytics StrategyKey Quality Measures Comparative performance data for

selected indicators Advance view for externally visible

measures Monitor trends over time

Opportunity Analysis Look across the organization to find

opportunities for improvement

Variation—is it real? Consider internal variance in light of

variation within comparative data

What’s causing it? Distinguish true process–outcome

relationships from “noise”

How to improve? Encourage creative thinking, rapid

hypothesis testing Measure impact of process changes Monitor to sustain improvement

Das

hb

oar

dE

xplo

rato

ry A

nal

ysi

s

ICA

Cognos

Central Source of Truth No Copy Analytics Actionable Analysis

Clinical Query

Excel / Other

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Main Dashboard

Drill-down tocompliance by surgery type

InfoSphere ClinicalInfoSphere ClinicalAnalyticsAnalytics

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Compliance Monitoring with Actionable Analytics Drill-down(System – Facility – Provider – Patients)

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For Further Information

External URL http://www-01.ibm.com/software/data/infosphere/clinical-analytics