2019 provider analytics market trends · 2019-04-04 · our team is united by a core belief that...

www.ChilmarkResearch.com

Brian MurphyDirector of Research

Presented April 2, 2019

2019 PROVIDER ANALYTICS MARKET TRENDS

Solutions and Tools for Healthcare Delivery

© 2019 Chilmark Research

Our team is united by a core belief that effective deployment and use of IT is

essential to modernizing care delivery and ultimately improving the patient

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OUR PURPOSE AND VALUES



Director of Research

Brian Murphy joined Chilmark Research as an industry analyst in August 2012 and brings a wealth of experience to the table. He is an outspoken advocate for true interoperability being the key to unlocking the potential of health IT and has centered the majority of his research efforts with Chilmark around this subject. He also currently heads research for the Analytics and Interoperability domains.

Brian has worked in the IT business for over 25 years, beginning his career in the field-sales organization of IBM. He then joined Yankee Group as an analyst, where he managed an enterprise software service and led research on the dynamics of the database market. Leaving Yankee, Brian joined Eclipsys prior to its acquisition by Allscripts in 2010. At Eclipsys, Brian worked with product managers to refine and harmonize value propositions in light of the organization’s broader goals.

Brian is a graduate of both Harvard College and Suffolk Law School. When not thinking about healthcare IT, he is a runner and armchair Boston historian.

BRIAN MURPHY

Report introduction

Technology landscape Mainstream analytics

Advanced analytics

Actionability

Vendor landscape General and special purpose applications

Vendor types

Vendor Ratings

Payer version coming soon…

Summary and Conclusions

AGENDA


Vendors supplying analytics and reporting to end-users in provider organizations Any purpose in the healthcare provider

enterprise

End-user functionality, 2 live customers, $1 million revenue

Types of vendors analyzed Claims analytics vendors

EHR vendors

Independent vendors

REPORT FOCUS


KEY TAKEWAYS

VBC is still primary business driver

Quality performance improvement

Cost and utilization reporting is not a differentiator

Reporting is the killer app

Strong demand for reports and dashboards

Today’s applications are pioneers

Analytics begets more analytics


Technology Landscape


MAINSTREAM AND ADVANCED ANALYTICS

Value-based Care aka PHM Tied to a payer contract

Quality, cost, and utilization performance

Hospital/clinic/office operations and patient flow

Safety analytics

Revenue cycle and payment analytics

Referrals and scheduling

Patient adherence

Budgets and HR

Supply chain and ERP

MAINSTREAM ANALYTICS USE CASES


MAINSTREAM ANALYTICS – VBC

Organization- and quality-centric

Metrics Clinical quality Risk buckets Costs and utilization Leakage

✲ Costs and Utilization✲ Maybe quality

Benchmarks

Users see: Standalone or embedded in EHR or care management application Tabular, graphic, or GIS-type displays Filters (variable across vendors)


MAINSTREAM ANALYTICS - DATA SOURCES

Aggregated EHR and claims data are the dominant data sources Will be important for some time

Consent, patient matching, semantic uniformity, and quality continue to challenge

Increasing number and variety of data sources Increasing number of organizations

Social determinants usage increasing

Vendors are pushing the idea of “data platforms” More automated way to ingest, transform, and load data

Many networks, data and transaction types are out-of-scope

AI and ML in ETL


MAINSTREAM PREDICTIONS

Readmission Proprietary and standardized

Utilization likelihood Inpatient hospitalization

ED visit

Adherence Likely to follow instructions

Proprietary

Prospective costs

Likely revenue consequences of quality performance


Technique Actual Use Potential Uses

Artificial Intelligence (AI) /Machine Learning (ML)

• Single purpose algorithms • Course of illness predictions• Data aggregation• Cohort Discovery

Natural Language Processing (NLP)

• Clinical documentation improvement

• Encounter coding assist• Registry reporting• Supplements analytics data stores

• Data aggregation• Cohort Discovery• Referrals analysis and optimization• Adherence optimization• Care pathway improvement

Big Data • Enhances existing ETL processes• Scale and efficiency advantages• Most customers don’t see it

• Smarter ETL• Better support for real-time data• Find, not navigate

ADVANCED ANALYTICS


ADVANCED ANALYTICS – WHAT COULD BE…

Course of illness

What interventions should I think about?

How effective will possible interventions be for this patient?

Will this patient adhere?

Will this patient experience care coordination lapses?

Which SNF should I discharge this patient to?


AVAILABILITY OF APPLICATIONS - INPATIENT


Acute Care Critical Care ED Ambulatory Surgical Lab Pharmacy RadiologyMedical

Records

Admission

Discharge

Benchmarks

Budgets

Care Management

Clinical Quality

Cohort Discovery

Costs

G/L Costs

Risk

Network Analytics

Predictions

Registries

Revenue Cycle

Safety

Self-service Analytics

Supply Chain

Utilization

AVAILABILITY OF APPLICATIONS - AMBULATORY


Primary CareSpecialty

Care

Reference

LabPharmacies

Imaging

CenterUrgent Care

Ambulatory

Surgical

Center

SNF Home HealthBilling and

Office

User Style Build ConsumePersonal Action

Program Action

Developers √ √

Analysts √ √

Miners √ √ √

Scanners √ √ √

Sippers √ √

ACTIONABILITY - ENGAGEMENT INTENSITY AND USAGE


Printed

• Morning huddle

• Reports

• Facesheets

Reports

• PDF

• Static

• Clickable

• Summary and/or detail

Dashboards

• Summary to detail

• Web apps in portal

Window at chart open

• Separate app linked to patient

In EHR

• On facesheet page

• CDS

ACTIONABILITY – FROM COMPUTER TO BRAIN


Electronic Health Information (eHI) Export Open-ended requirement

Definition of EHI could be anything, including data in these applications

Will affect providers and vendors

API Conditions of Certification Narrower set of data (USCDI)

Could affect you if you have or had certified HIT

Comments due to ONC by May 3, 2019 Extension possible???

PROPOSED INFORMATION BLOCKING RULE


Vendor Landscape and Offerings


VENDOR TYPES AND VENDORS PROFILED


VENDOR APPLICATION PORTFOLIOS


Special Purpose• VBC or P4P focus• Organized by program• Quality lens• Integration with care

management

General Purpose•Multiple use cases•More extensive data catalogs•More filters•Supports deeper analysis and segmentation

Strong presence in existing EHR customer base One throat to choke

Similar technology approach

Viable product offerings in all analytics domains Most strive to be one-stop analytic shop

Consolidating diverse reporting application on a single analytics platform

All experience competitive encroachment

Closest to day-to-day workflow

Limited complementary services

EHR VENDORS


Many excel at data aggregation and quality

More to prove than EHR vendors Faster implementations than EHR vendors

Out in front of market demand

Some attrition over time and the strong persist

Strongest offerings for VBC Quality and coding gaps

Increasing emphasis on in-EHR integration

Integrated care management

More limited product catalog than EHR vendors

Deeper focus on causation

INDEPENDENT VENDORS


Health plan is primary customer HEDIS quality measures

Deep exploration of claims data

Cross-community perspective on costs and utilization

Quality and cost control Emphasis on Star ratings, cost of care

Outsourced UM/DM/CM services Call centers, care navigators, care managers

Providers reluctant to adopt

PAYER-ORIENTED VENDORS


Vendor Ratings


Clinical and Claims Data Contribution

Other Data Contribution

Analyst and Developer Support

Scope of Applications

Benchmarks

Care Management

Clinical Quality

Cohort Discovery

Registries

Healthcare Costs

Risk

Network Analytics

Predictions

Utilization

Operations

User Support

Self-Service Analytics

Application Design

PRODUCT CAPABILITIES CRITERIA


MARKET EXECUTION CRITERIAMarket Vision

Extensibility and Engagement

Complimentary Services

Momentum (growth in clients)

ANALYTICS CONCLUSIONS

Improving applications

Care coordination analytics missing Care coordination needs will only increase

Providers will need more visibility into details of referrals and scheduling

Metric proliferation and reporting burden increasing despite harmonization

Modeling is rudimentary

Limited visibility into profitability

Payer Analytics Market Trends Report coming this summer…


http://go.chilmarkresearch.com/2019-healthcare-analytics-market-trends-report-interest

Additional Questions?

Feel free to contact Brian directly with any additional questions or inquiries: [email protected]

Stay tuned: Slides and recording will be distributed before the end of the week, so please be on the lookout for that notification.

Thank You for Attending


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To acquire a copy of the report, please follow this link:

https://chilmark.co/2019Analytics

https://chilmark.co/2019Analytics

2019 provider analytics market trends · 2019-04-04 · our team is united by a core belief that...

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