FOUNDATIONS FOR
CLINICAL AND
HEALTHCARE
BUSINESS INTELLIGENCE
James E. Gaston, FHIMSS
eMids Business Intelligence Conference
Sr. Dir. of Clinical & Business Intelligence
HIMSS and HIMSS Analytics
James.Gaston@HIMSSAnalytics.org
Twitter @JamesEGaston
Nashville, Tennessee
MAY 2012
AGENDA
 HIMSS and HIMSS Analytics
 Orienteering
 Clinical Intelligence First Steps
 Practical Application
 Pulling It All Together
WWW.HIMSS.ORG
HIMSS Vision
Advancing the best use of information and management systems
for the betterment of healthcare.
HIMSS Mission
Lead healthcare transformation through the effective use of
health information technology.
WWW.HIMSSANALYTICS.ORG
Print, Digital, iTunes…all available
http://marketplace.himss.org/
http://www.ebooks.himss.org/
http://www.apple.com/itunes/
ORIENTEERING
CLINICAL & BUSINESS
INTELLIGENCE
ORIENTEERING
Business intelligence (BI) mainly refers to
computer-based techniques used in
identifying, extracting, and analyzing business
data, such as sales revenue by products
and/or departments, or by associated costs
and incomes.
Business Intelligence supports business
decision-making.
http://en.wikipedia.org/wiki/Business_intelligence
ORIENTEERING
Clinical Intelligence (CI) mainly refers to
computer-based techniques used in identifying,
extracting, and analyzing healthcare data, such
as lab results, medical histories, or medical
records, to support a healthcare related
decision.
Clinical Intelligence supports healthcare decisionmaking.
ORIENTEERING
C&BI as defined by leading healthcare organizations…
“Mining clinical data with an eye towards patient care”
“Access to key information to make care or business
decisions that result in the best outcome for the patients
and the business”
“To use currently available and create new data sources to
drive all aspects of running an organization”
“Supporting clinical excellence”
“Maximizing the quality of care and minimizing the cost”
CLINICAL INTELLIGENCE
FIRST STEPS
CLINICAL INTELLIGENCE FIRST STEPS
Patient or
Population
Associated
Information
Opportunity
for
Clinical
Intelligence
CLINICAL INTELLIGENCE FIRST STEPS
Meaningful use Drivers
•
•
•
•
Improve quality, safety, efficiency, and reduce health disparities
Engage patients and family
Improve care coordination, and population and public health
Maintain privacy and security of patient health information
2011 - 2012
Prepare
• Data
Capture
and
Sharing
http://www.healthit.gov/
2013 - 2014
Process
• Advanced
Clinical
Processes
2015 +
Measure
• Improved
Outcomes
CLINICAL INTELLIGENCE FIRST STEPS
CI is about exposing the clinical decision process,
turning a “gut feeling” or intuition into a revealed
process that is informed, defensible and consistent
• In the moment of the care decision
» Banner Health physicians have access to patient EMR and are
prompted upon a visit to provide diagnosis related care
• Retrospectively examining the circumstances (data)
» Geisinger uses their patient data warehouse to identify “care gaps”
and push them to clinicians for review
PRACTICAL
APPLICATION
PRACTICAL APPLICATION - BIDMC
John D. Halamka, MD, MS
Chief Information Officer of Beth Israel Deaconess Med. Center
Chief Information Officer at Harvard Medical School
Chairman of the New England Healthcare Exchange Network
Co-Chair of the HIT Standards Committee
Harvard Medical School full professor
Practicing Emergency Physician
http://geekdoctor.blogspot.com
Ten-year-old John Halamka winning the
Science Fair in 4th grade with his home-built
Van De Graff generator in 1972.
“Healthcare CIOs should implement applications which
filter data so that it becomes information, transform
information into knowledge, and ultimately provide
clinicians with wisdom based on that knowledge at the
exact time they need it.”
PRACTICAL APPLICATION - BIDMC
http://geekdoctor.blogspot.com/2007/11/data-information-knowledge-and-wisdom.html
PRACTICAL APPLICATION
BANNER HEALTH NETWORK
Payment Model + Delivery Model Alignment
Transitioning to a “Value based methodology”
for physician reimbursement
Physicians spend more time with patients
New payment codes incentivize physicians
“Holistic” approach to care, including behavioral & social health
Practical Application
Find patients that have not recently had a visit and arrange it
Ensure proper post acute care follow-up
Generate care plans, engage care managers
ActiveHealth technology provides registry, risk assessment
PRACTICAL APPLICATION
ATRIUS HEALTH
“We also adopted a relatively unique
concept in that we wanted to take care of all
of our patients exactly the same, no matter
what their funding mechanisms were.”
Dr. Gene Lindsey, CEO of Atrius Health
The ACO Shared Savings application process - FierceHealthcare, http://www.fiercehealthcare.com/special-reports/atrius-ceointerview-inside-pioneer-aco/aco-shared-savings-application-process#ixzz1ywZVYK58 , 2/24/2012
PRACTICAL APPLICATION
ATRIUS HEALTH
Multi-pronged Care Strategy
Core Strategy Components
Hospital strategy
Post-acute stay facility strategy
Home care strategy
Geriatric care model design
Practical Application
Define “patient care expectations” with “Preferred Partners”
Expect all care to be delivered as defined in agreement
Monitor, benchmark and manage using CI & BI reporting
PRACTICAL APPLICATION
COMMON THEMES
“You just can’t over communicate what you are trying to
achieve…the ongoing communication, not just the printed
stuff, but the conversations and dialog, are where it happens”
Mr. Chuck Lehn, SVP and CEO of Banner Health Network
“Compensation is being based on, in part, your quality
scores, or your patient satisfaction scores, or the size of the
panel of patients you care for as opposed to just the
numbers of visits you generated.”
Dr. Rick Lopez, Chief Physician Executive of Atrius Health
PRACTICAL APPLICATION
Recommendations
C&BI should be positioned to enable and support
and organizations mission and vision
Engage senior level support
C&BI is an active and engaging process, not a
technology or application solution
Ensure physicians have a leadership role and a
stake in the process
Establish strong data governance and
communication
PULLING IT ALL TOGETHER
Preparation
• Hardware
•Computing power
•Disaster Recovery
•Business Continuity
• Connectivity
•HIE’s
•EMR Sharing
•Internet
•mHealth
• Applications
•HIS
•Financial
•Facility planning
•Rev. Cycle
•Receiving, etc…
• Data
•Health care
•Business
•Data warehouse(s)
• Meaningful Use
Stage 1 focus
Collection &
Presentation
• Workflow
•Business processes
•Clinical processes
• Content
•Report cards
•Key Performance
Indicators
•Dashboards
•Reports
• Accessibility
•Appropriate medium
(mobile, web, app)
•Pervasive access
• Presentation
•Consumable Format
•User appropriate (CEO,
receptionist, Clinic
Admin., etc…)
• Meaningful Use
Stage 2 focus
Analysis &
Performance
• BI
•Measure
• Quality
• Outcomes
•Predictive modeling
• Facility efficiency
• Performance
•Benchmark
• Was BI/CI referenced?
• Was BI/CI relevant?
•Excellence
• Engaged with the user?
• Resulted in refinement or
additional search/query
• CI
•Sub categories…
• Meaningful Use
Stage 3 focus
Create the foundation, data and environment for
Clinical Intelligence & Healthcare Business Intelligence
FOUNDATIONS FOR CLINICAL AND
HEALTHCARE BUSINESS INTELLIGENCE
Information Management Symposium 2012
Nashville, Tennessee
James E. Gaston, FHIMSS
Sr. Dir. of Clinical & Business Intelligence
HIMSS and HIMSS Analytics
James.Gaston@HIMSSAnalytics.org
Twitter @JamesEGaston
Healthcare BI Summit
Minneapolis, Minnesota