ksa ge bi summit 082607

GE Healthcare Summit

Jason Oliveira, MBAPrincipal

Kurt Salmon AssociatesAugust 26, 2007

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About Us – Me

Twenty-three year healthcare IT professional career

Principal in the Health Services Division of KSA – Business Intelligence practice leader

Served as the Chair of the HIMSS Data Warehousing and Data Mining Special Interest Group (SIG).

Prior to joining KSA, the manager of decision support systems for Columbia-Presbyterian Medical Center in New York

Prior to Columbia, senior designer of a 11 hospital data warehouse and patient cost accounting system for NYC Health and Hospitals

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About Us - HSD

HEALTH SERVICES DIVISION

• Merger Implementation and Consolidation Planning

• Patient Flow Planning/Modeling

• Utilization and Capacity Analysis

• Market Modeling/Forecasting

• Master Planning• Functional/Space

Programming• Operations planning

Facilities Planning

Information Technology• Strategic IT Planning • System Selection/Contract Negotiation• Business Intelligence• Implementation Oversight • Readiness Assessment• IT Process Improvement• Infrastructure

• Interim Leadership• Regulatory Preparedness• Outsourcing Evaluation• Technology Planning for New

Facilities• RHIO Planning and Development• Consumer Health Automation

Planning

• Strategic Planning/Implementation

• Market Evaluation• Governance/Management

Issues

• Clinical Service/Business Line Planning

• Merger/Acquisition Analysis

• Integration

Strategy Development and Implementation

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• Alameda County Medical Center• Catholic Healthcare West• San Mateo County• Santa Clara Valley Health and Hospital System• Stanford Hospital and Clinics• UCSF Medical Center

• North Ottawa Community Hospital• St. Joseph’s Mercy Medical Center• Trinity Health

• PROMINA Health System• South Fulton Medical Center• University Healthcare, Inc.• WellStar Health System

• Mountain States Health Alliance

• University of Kentucky

• St. Luke’s Regional Medical Center

• Saint Francis PHO• Saint Raphael Healthcare System• Yale New Haven Health System• Yale School of Medicine

• Bloomington Hospital and Healthcare System• Deaconess Hospital, Inc.• The Methodist Hospitals, Inc.

• Johns Hopkins Medicine

• Albert Einstein Healthcare Network• Children’s Hospital of Pittsburgh

• Flagler Hospital• H. Lee Moffitt Cancer Center• Memorial Medical Center of Jacksonville• Mount Sinai Medical Center, Miami

• Community Health Partners (HMIS)• EMH Regional Healthcare System• Lake Hospital System• OhioHealth System• The Ohio State University Medical Center

• Peace Health

• Jewish Hospital of St. Louis

• Columbia/St. Mary’s• ProHealth Care, Inc.

• Elmhurst Memorial Health Care.• Ingalls Health System• Wheaton Franciscan Services, Inc.

• Duke University Medical Center • Gaston Memorial Hospital

• Cedars-Sinai Health System• Children’s Hospital and Health System• City of Hope Medical Center• LA County Health Services• Riverside County Health Services Agency• St. Joseph Health System• UCLA Medical Center

• Covenant Health System

• Louisiana State University Health Services

• Atlantic Health System• Hackensack University Medical Center• Newton Memorial Hospital• Pascack Valley Hospital• Robert Wood Johnson University Hospital• Saint Barnabas Health Care System• Valley Health System

• Baylor College of Medicine• The Methodist Hospital• Texas Children’s Hospital• University Health System

• Baptist Hospitals and Health System• St. Joseph’s Hospital and Medical Center

• HealthEast Care System• HealthPartners• North Memorial Hospital• WESTHealth

• Alegent Health

• Prairie Lakes Health System

• McGill University Health Centre

• Lifespan Health Corporation (RI and MA)

• Harvard Vanguard Medical Associates• Massachusetts General Hospital• New England Medical Center

• Hospital For Special Surgery• Maimonides Medical Center• MedAllies/THINC• Montefiore Medical Center• Mount Sinai Medical Center• New York Presbyterian Hospital• North Shore LIJ Health System• NYU Medical Center/School of Medicine• St. Francis Mercy Corporation• Strong Memorial Hospital/University of Rochester• Unity Health System• Weill Medical College of Cornell University• Winthrop University Hospital

• The Children's Hospital, Denver

About Us - HSD

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Topics

Got BI? What’s next?

The performance measurement movement

BI to the rescue

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Got BI?

Siemens Invision

Lawson

Patient Management / Patient Accounting

Enterprise Resources / Administrative

Clinical / Ancillary

GE / ORMIS

IDX PM

Siemens Soarian

Cerner PharmNet

GE EMR

Kronos

WebCIS

Proteomic

Gentiva Home Health

Data Capture

Canopy

GEACHR /

Payroll

Charge Capture

Siemens DSS

Faculty Practice

Data Mart(s)

Diabetes

Cancer

Public Health

ORYX Measures

Eclipsys / TSI DSS

Supply Chain DM

HR Analytics UHC CDBP&A Analytical

Application

Pediatrics

Surgery

Genomics

Revenue Cycle

Strategic Planning

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The Performance Measurement Movement

The Institute of Medicine Reports brought an old problem into a new slick and heavily marketed light for the public.

Avoid Getting It Wrong

Getting It Right . . . Consistently

Patient-Centric, Coordinated Care

98,000 Patients Killed!

“To Err is Human” IOM (2000)

“Crossing the Quality Chasm” IOM (2001)

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RAND Study: Quality of Health Care Often Not Optimal

Doctors provide appropriate health care only about half the time

Percentage of time

Alcohol dependenceHip fracturePeptic ulcer

DiabetesLow back painPrenatal careBreast cancer

Cataracts

11%

23%33%

45%69%

73%76%

79%

E. McGlynn, S. Asch, J. Adams, et al., The Quality of Health Care Delivered to Adults in the United States, N Engl J Med, June 26, 2003, MA Medical Society

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Transparency • ONC Strategic Framework

• HealthGrades

• CMS Hospital Compare

Improvement• IHI 5 Million lives

• AHRQ

• DOQ-IT

Accreditation• TJC ORYX (Core Measures)

• NCQA HEDIS

Pay for Performance• CMS / Premier Hospital Quality

Incentive Demonstration

• Bridges to Excellence

• CMS IPPS – 2005 Deficit Reduction Act

Quality as Marketing

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ConsumerismTransparency

P4P

Patient SafetyQualityImprovement

DEVISINGSTRATEGY

BIFOUNDATION

MANAGINGSTRATEGY

Sharing Learning

Innovation

Disease ManagementQuality Management

Operational EfficiencyRevenue Enhancement

High Performing Organization


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How can BI Help?

Independent of the perceived value of these performance measurement systems as

drivers of desirable change, the reality is that they are here; they affect the bottom line; and

they are now an operational reality, and burden, to provider organizations.

Independent of the perceived value of these performance measurement systems as

drivers of desirable change, the reality is that they are here; they affect the bottom line; and

they are now an operational reality, and burden, to provider organizations.

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Performance Management Infrastructure

MEASURE & MONITOR

KPI, Dashboards, Benchmarks,

Reporting

EVALUATESix Sigma, Root Cause Analysis,

Fishbone

IMPROVE PROCESSESSimplify, Align, Interconnect, Standardize, Stabilize, Train

Data Management

Methodology

Decision Support

Skilled People

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Data ManagementMethodology

Decision SupportSkilled People

This is BI

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Performance Methodologies

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Performance Methodologies

Six Sigma

Balanced Scorecard

CQI

Lean Thinking

Malcolm Baldridge Pillars

Management by Objective (MBO)

ISO 9000

Etc.

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Challenges and Barriers

Multiple, duplicative, and conflicting measurement systems

Data, data everywhere – not a measure in sight

Healthcare Information Technology is not helping performance management today

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This is BI

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Data Management – Today’s Reality

Data mart explosion

Spreadmarts

Information quality

Sparse clinical data capture

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Health Data Model Health Data Model

Medical Vocabulary Medical Vocabulary

Identifiers Identifiers

Medical Knowledge Medical Knowledge

Clin

ical

O

pera

tions

Perform

ance M

easuresSignificant data barriers remain in achieving insight into clinical

processes.

Significant data barriers remain in achieving insight into clinical processes.

Data Management – Today’s Reality

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Enterprise Information Management

Data Definition standardization

Natural Language Processing

Data Integration Centers of Excellence

Virtual Data Warehousing

Data Management – Future State

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This is BI

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Decision Support – Today’s Reality

BI toolset explosion

Analytical applications deployed in silos - by department, funding, and politics

Lack of skill sets – lack of training

No single unified view

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Decision Support – Future State

Corporate Data Warehouse(s)

ERP CIS PMExcel HR

Performance Measures, Scorecards, Reports, Analyses, AlertsPerformance Measures, Scorecards, Reports, Analyses, Alerts

Goals & Objectives

Peer Benchmarks

Targets

Goals & Objectives

Peer Benchmarks

Targets

Planning Cycle Management

Financial Consolidation

Compliance Reporting

Planning Cycle Management

Financial Consolidation

Compliance Reporting

Revenue CycleRevenue Cycle Financial Management

Financial Management Research Research

Clinical Management

Clinical Management

Revenue Modeling

Revenue Cycle

ContractManagement

Price Modeling

Revenue Modeling

Revenue Cycle

ContractManagement

Price Modeling

Cost Accounting

Budgeting

Forecasting

Product Line Management

Cost Accounting

Budgeting

Forecasting

Product Line Management

Data Management Foundation

Planning

Monitoring

Taking Action

EMR.G/L

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This is BI

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Finance Decision Support

Budgeting, Cost Accounting, P&L,

Business Planning, Revenue Modeling

Research CentersCancer, Cardiology, CF, Diabetes, et al.

Health Information Management (HIM)Abstracting, Billing Abstracting, Case

Finding

Information ServicesData Integration

Ad-Hoc Reporting,CIS /CDR queries

NursingKey Statistics, Nursing

Informatics

Medical InformaticsService Line Initiatives,

Clinical analysis

?

Knowledge workers typically must navigate a complex organization of support resources to gain access to information and analytical support. Is this optimal?

Knowledge workers typically must navigate a complex organization of support resources to gain access to information and analytical support. Is this optimal?

Performance Improvement / Safety

Public Reporting, Performance Measures,

Patient Satisfaction, Custom DBs, Data

Consolidation

BioInformaticsGenomix, Proteomcs, research data analysis

PharmacyPharmacy informatics,

costs, inventory

User

User

User

User

User

Physician AssociatesFaculty Plan Productivity,

Revenue Analysis, PI Studies

Skilled People – Today’s Reality

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Skilled People – Future State

BI Governance

Knowledge management function… Knowledge Management Officer anyone?

BI Competency Center

Corporate University

Self-Service

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Thank You!

Jason Oliveira212.508.8311

[email protected]