infosphere software 1 ibm infosphere clinical analytics
TRANSCRIPT
1
InfoSphere software
IBM InfoSphere Clinical Analytics
2
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
2
33
3
InfoSphere software
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
3
4
InfoSphere software
4
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
5
InfoSphere software
5
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….
6
InfoSphere software
6
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)
7
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
7
8
InfoSphere software
8
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.
9
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
9
10
InfoSphere software
10
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)
11
InfoSphere software
11
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
12
InfoSphere software
12
InfoSphere Clinical Analytics
ICA
Server PlatformServer Platform
InfoSphereWarehouseInfoSphereWarehouse
Cognos (orOther B.I.)Cognos (orOther B.I.)
DashboardDashboard
13
InfoSphere software
13
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
14
InfoSphere software
14
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
15
InfoSphere software
15
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
16
InfoSphere software
16
ICA is Easily Extensible
“Site Specific” Metadata
17
InfoSphere software
17
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
18
InfoSphere software
18
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
19
InfoSphere software
19
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
20
InfoSphere software
20
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
21
InfoSphere software
21
Main Dashboard
Drill-down tocompliance by surgery type
InfoSphere ClinicalInfoSphere ClinicalAnalyticsAnalytics
22
InfoSphere software
22
Compliance Monitoring with Actionable Analytics Drill-down(System – Facility – Provider – Patients)
23
InfoSphere software
23
For Further Information
External URL http://www-01.ibm.com/software/data/infosphere/clinical-analytics