Performance Optimisation for Healthcare Providers ... · PDF fileGeorge Eisenberger World Wide...
Transcript of Performance Optimisation for Healthcare Providers ... · PDF fileGeorge Eisenberger World Wide...
1 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Performance Optimisation for Healthcare ProvidersPerformance Analytics and Business Intelligence For Organisational Agility
George Eisenberger
World Wide Software Group Healthcare Architect
IBM Software Group
2 © 2009 IBM Corporation
Building a smarter planet: Healthcare
2 7/14/2009
Health Analytics an Emerging Focus
3 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Health Analytics a New Wave• Globally, healthcare organisations have made substantial investments in information
systems to improve quality and operations efficiency.
• These investments will continue but now these healthcare organisations need to begin to get value and intelligence from these investments.
• This is a wide open emerging market with no end to end solution leader today
3 7/14/2009
Clinical and Business Automation
(Transactional)
Clinical ProcessTransformation and Transactional Systems
USA
2002 2003 2004 2005 2006 2007 2008 2009 2010
Japan
UK
India
China
Health Analytics
Clinical and Business Optimisation
(Integrated Infrastructure and Analytics)
2011 2012
Growing Market (Large # of analytic applications)
Market Consolidation
4 © 2009 IBM Corporation
Building a smarter planet: Healthcare
PAYERPROVIDER
Includes HIIG, HIF, GTS/Integrated Communications, IT Governance, Hospital
Expansion & Construction, Security, Green, Virtualisation, IBM
Systems/Storage
Core SystemsModernisation
(Claims,Payments)
Clinical and Business
Transformation
Core Business Process
Effectiveness
Enterprise Health Analytics(Analytics and Business Performance)
Quality and Business Performance
Collaborative Care
Infrastructure Effectiveness and Efficiency
Cost Effectiveness, Operational Excellence
Content, Images, Records, Forms Lifecycle Management
Data Integration
Quality & PerformancePublic Reporting
Quality StandardsDrug / Patient Safety
Chronic Disease Management
QualityOutcomes
OperationalEfficiency
Data Management
Cost EffectivenessBusiness Process Optimisation
Business Value O
utcomes
Health Integration Framework(SOA, Data Management and Business Process Framewor k)
IBM Healthcare strategic priorities and solution focus
Patient, Physician and Member Services(incl. Patient Centered Medical Home,
Health Information Exchanges)
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Building a smarter planet: Healthcare
5 7/14/2009
Health Integration Framework
Industry Relevance
6 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Health Integration Framework – High Level
6 7/14/2009
IBM Health Integration Framework
Healthcare and Life Sciences Extensions
Key Software Group Products
Data and Process Models
Interfaces and Adapters
Tools
Portals and Portlets
Information Management Lotus Rational Tivoli WebSphere
IBM Services Assets and Delivery
IBM Solutions
Healthcare
Payer
Core Systems
Modernisation
Healthcare
Provider
Health
Analytics
Life
Sciences
Regulatory
Compliance
Business Partner Solutions
Healthcare
Payer
Claims
Adjudication
Healthcare
Provider
Clinical
Information
Systems
Life
Sciences
Drug Discovery
Optimisation
ISV Ecosystem
our healthcare provider, payer and life science solutions
Reference
Architectures
Initial focus on healthcare
provider and payer segments
7 © 2009 IBM Corporation
Building a smarter planet: Healthcare
• Provider and Payer Analytics• The aggregation and analysis of information across a healthcare enterprise, to improve
clinical, financial or administrative outcomes and results.
• Patient and Clinician e-Views• Using a portal-based user interface for the aggregation of information across a
healthcare enterprise, provider or payer, to create custom views depending on role and providing new services.
• Integrating the Healthcare Enterprise (HL7 ESB)• The integration, exchange, and sharing of information across a healthcare
organisation. This can involve the integration of multiple systems within a single hospital, or within an integrated delivery network.
• Health Information Exchange (HIE)• The exchange, sharing and usage of information across multiple healthcare
organisations, region, or community of interest.
7 7/14/2009
HIF Solution Focus
8 © 2009 IBM Corporation
Building a smarter planet: Healthcare
IBM’s Foundation Tools and Runtime Landscape
BUSINESS AND TECHNICAL METADATA
INDUSTRY CONTENT
MDM
WORKBENCH
DATASTAGE / QUALITYSTAGE INFOSPHERE WAREHOUSE
RATIONAL DATA
ARCHITECT FASTTRACK
METADATA
WORKBENCH
BUSINESS
GLOSSARY
INFORMATION
ANALYZER
InfoSphere Foundation Tools
MDM SERVERS
Core measures / Workbench
Quality Reporting
Patient Safety
Dashboard
Diabetes Management
Operations and KPI
Dashboard
User Interface
Cognos BI
DB2 and Balanced Warehouse
Data Layer
WebSphere Application/Portal ServerWebSphere Portlet Factory
Clinical Systems
DataIntegrationLevel
BI Level
GBSSWG Services
InfoSphereCDW
Metadata
BusinessGlossary
Datastage
QualityStage
WSTX+HL7
Adapters
Siemens GP Apps McKesson
Governance
Analytics for patient throughput and access
Identify, track, analyse report by disease for population studies
Track, analyse, report adverse drug events, other events
IBM has assembled a strong base of capabilities an d partners to create end-to-end, differentiated offerings around Enterprise Healthca re Analytics
9 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Health Care Industry Data Models and Architecture
10 © 2009 IBM Corporation
Building a smarter planet: Healthcare
� Fully integrated Dev. Platform� Server + Clinical Data Warehouse
+Solution Templates + Tools + Dashboard
� Solution’s unique features:� Create longitudinal record from
inpatient, outpatient, specialty and ambulatory care setting
� Patient record De-Id and Re-Id � Data validation 900+ Programs � Medical vocabulary mapping� MPI mapping� Cohort screening� Analysis of whole organisation down
to physician and patients
IBM Clinical Data Warehouse (CDW) Platform
BalancedWarehouse
Server
Clinical DataWarehouse
InfosphereWarehouse
Edition
CognosData Mining& Analytics
11 © 2009 IBM Corporation
Building a smarter planet: Healthcare
IBM Clinical Data Warehouse Delivers
• The Value Proposition:– A full feature clinical analytics development platform that is uniquely
available for on-premise installation and can be in a production state within weeks. It is designed to meet a wide array of clinical and operational needs while integrating seamlessly into a provider’s healthcare IT environment.
• CDW Clinical Solution Templates: – Fast deployment of powerful, clinical ad-hoc query environments– Rapid development of disease profile solutions that provide population
based analysis with the ability to drill through to the patient or encounter detail
– The ability to turn information into actionable insights for Physicians, Medical Directors and Patient Quality advocates
12 © 2009 IBM Corporation
Building a smarter planet: Healthcare
The Value of Enterprise Healthcare Analytics with the IBM Clinical Data Warehouse
• Start with proven technology – The value of mass customisation
• Obtain additional value from your considerable CIS investment bycreating a corporate data asset
• Population-level analysis, not just survey data ties process changes to patient outcomes
• Support evidence-based practices
• Provide new tools to providers to improve treatment
• Monitor and manage operations on a more timely basis: Operational in as little as 16 weeks
13 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Mapping –
Validation -
Norm
alization
Data Sources
Consolidate Clinical Data AcrossEntire Organisation Into‘Single Enterprise Trust’
Disease Cubes
Hospital
Hospital
Clinic
Clinic
Analysis
Operations
Sep
arat
e S
yste
ms
& S
iloed
Dat
aHealthcare Analytics Architecture
C3 C2 C1
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C3 C2 C1
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A
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AC3 C2 C1
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C3 C2 C1
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C3 C2 C1
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C3 C2 C1
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AC3 C2 C1
X
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C3 C2 C1
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Analytic E
nvironment
IBM / CDW
LocalVocabulary
Dashboard
PatientSafety
OutcomesAnalysis
Quality Improvement
PhysicianPerformance
QualityImprovement
Car
e &
Ops
Im
prov
emen
t
ComplianceMonitoring
C3 C2 C1
X
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Y
X
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Y
X
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A
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C3 C2 C1
X
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A
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AC3 C2 C1
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NormalisedVocabulary
MEDITECH
14 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Enterprise Analysis Use CasesDomains Use Case Subject Areas
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
CDW
15 © 2009 IBM Corporation
Building a smarter planet: Healthcare
15
OLAP
Delivery of trusted information through IBM CDW
• Unlocking data from– Databases– Repositories– Spreadsheets– Application silos – Sensor Networks
• Bringing it all together in a meaningful way– Information Integration – ETL, CDC, Replication, Federation
• Improving its Quality– Cleansing, standardising, enriching, semantic reconciliation– Controlled Vocabularies
• Getting to one version of the truth– Master Data Management (EMPI), Data Warehouse
• Delivering it where needed– Information Integration, Business Dashboards, SOA
SOURCE SYSTEMS
DATAMARTS
INFORMATION INTEGRATION
WAREHOUSE
REPORTS
MASTERDATA
Dashboards
CIS
HR
GL/AR
CDW
EMPI
16 © 2009 IBM Corporation
Building a smarter planet: Healthcare
High Level Data Model for Clinical & Operational Data
PatientCharacteristics� Age� Gender� Race� Geography
ICD-9/CPT� Diagnosis� Procedure� DRG (inpatient)� Date/time
stamp� Encounter link
Pharmacy� Days Supply� Refill #� Ordering MD� Dose/Strength� Route� NDC
Laboratory� Orders & Results� Microbiology
Encounter� Admit info� Discharge info� CCR� Dept, Facility ID� CPT Codes
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� UB Data� 1500 Data� 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� Department
Pathology
Clinical Data Model
C3C2C1
X
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Y
X
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Y
X
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C3C2C1
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C3C2C1
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EMR� Problem list� Med list� Allergies� Chief complaint
Imaging studies
17 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Emerging Healthcare Analytics Requires Longitudinal Patient-Centric Data Combining Primary and Acute Care
Primary Care(Physician
Office, Pharmacy)
Acute Care(Emergency,
Inpatient, Outpatient)
TimeA Patient’s Longitudinal Medical Record
18 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Evidence-based Analysis Supporting Improvements to Financial and Clinical Performance
• Practice Pattern Analysis– Analyses physician practice patterns. Conduct comparative analysis
to identify performance best practices
• Clinical Cost Decision Support– Measures and views clinical performance across multiple
perspectives to optimise resource utilisation, cost effectiveness, and evidence-based decision-making
• Early Disease/Condition Management– Uses predictive modeling techniques to identify high-risk patients and
to proactively intervene and optimise care across populations
19 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Example Provider Analytic Use Cases
• Patient Demographics Analysis• Patient Readmission Analysis• Disease Management: clinical alert creation• Chronic Disease Management: personal diabetes report card• Chronic Disease Management: self care patient reminders• Chronic Care Education Program: patient referrals• Patient Safety: adverse drug events• Outcomes Analysis: best practice identification• Treatment Strategies • Regulatory Analytics & Compliance• Quality Improvement: Analysis & Reporting• National Comparative Benchmarking• Episode Analysis: Program Evaluation• Physician Performance: MD profile/scorecard• Pay for Performance• Financials by Disease or Service• Resource Utilisation• LOB Revenue Analysis
20 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Actionable Analytics for Management
Valley Community Hospital
Powered by:
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Building a smarter planet: Healthcare
21 7/14/2009
Ability to see how Cross River Diabetes Clinic is trending on all NCQA measures can be displayed as well
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Building a smarter planet: Healthcare
Sample Dashboard
7/14/2009
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Building a smarter planet: Healthcare
Top 10 Procedures Performed
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Building a smarter planet: Healthcare
Health Care Provider Reference Architecture
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25 © 2009 IBM Corporation
Building a smarter planet: Healthcare
A Progress Report:Leveraging the Web Presence with Clinical and Patie nt Portals
Tony Bosselait
World Wide Software Group Healthcare Executive
Chief Technology Officer
IBM Software Group
26 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Integrating silos of information across healthcare is critical to better patient care and improved performance/satisfaction
Laboratory
Radiology
PharmacyClinical records
EMR
Financial
27 © 2009 IBM Corporation
Building a smarter planet: Healthcare
United States Hospital EMR Adoption Progress – 03/2009
Organisations
further
along
are
doing
more
Integration
(not less)
28 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Value expected by surveyed Clinicians:
29 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Clinical Care Systems
Lab/Medical Records Systems
Imaging Systems
Patient Admin Systems
Financial & HR Systems
Collaboration, e-mail
e-learning - CME
Patient enabled Systems
Content (articles, manuals...)
CPOE
People Finding - expertise
Examples of clinical & patient information needs:
Patient View Clinician View
Consumer View Employee View
Pre –
Admissio
n
FormsFind a Dr.
& Schedule
Bill Payment
Change
Demographics
View
Appointments
Common
Portal
Clinical Systems Access
HR Self Service
Secure
Chat
QualityDashboards
Get
Results
JobInfo
Get Medical
Info
CE/CME
Learning
30 © 2009 IBM Corporation
Building a smarter planet: Healthcare
PORTALPLATFORM
[Why] A Single Portal Platform and Framework [Borrowed from Trillium:]
PatientsPatients ProvidersProviders
EmployeesEmployees
Portal software connects all stakeholders enabling communication, collaboration, process efficiency, orchestration and workflow opti misation and information
sharing.
90 % of content & multipleportlets re-used
50 % of development time
Resourcingincremental from originalinvestments
31 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Other Examples of Healthcare Portals
Memorial HealthSystem
Duke MedicalUniv. of TexasCancer Therapy &Research Center
Mayo Clinic
Richardson RegionalMedical Center
CatholicHealthcareWest
OttawaHospital
TrilliumHealthCentre
32 © 2009 IBM Corporation
Building a smarter planet: Healthcare
An Enterprise Portal for Patients, Employees and Physicians
Enterprise Portal Framework
Common Infrastructure
Enterprise Portal FrameworkEnterprise Portal Framework
Common InfrastructureCommon Infrastructure
PatientsPatientsPatients EmployeesEmployeesEmployees PhysiciansPhysiciansPhysicians
33 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Demonstration of the Clinical Portal:
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Building a smarter planet: Healthcare
General Practitioner (Hospitalist) Census View
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General Practitioner (Hospitalist) Portal Page
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Building a smarter planet: Healthcare
Surgeon’s view – same portlets - personalised
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Proactive Alert View – Core Measures example
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Building a smarter planet: Healthcare
Obstacles to Portal Implementations
Source: Healthcare Informatics Feb 2009
39 © 2009 IBM Corporation
Building a smarter planet: Healthcare
Key to success: Use ‘Launch and learn’ to maximise benefits:S
trat
egic
Bus
ines
s an
dT
echn
olog
ical
Val
ue
Time
PHASE n
SolutionMicro Design
Build
Pilot
Deploy &Improve
Extended PortalSolution
Micro Design
Build
Pilot
Deploy &Improve
Extended Portal
SolutionMicro Design
Build
Pilot
Deploy &Improve
Extended Portal
SolutionMacro / Micro
Design
Build
Pilot
Deploy &Improve
Basic Portal
InitiateAssessment &
Strategy
Phase 1 Implementation• Bills on line• Payment• Scheduling
Phase 1 Phase 2 Phase 3
Phase 2 Implementation• Labs• PHR
Example Approach: Multi-Phase, Iterative Rollout Strategy
Physicians Nurses Employees Patients…
“Never eat more than you can lift”
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40 7/14/2009
Thank You
Q & A