Predictive Analytics for Healthcare Organizations

1. Predictive Analytics for Healthcare Organizations Tony Jurek Balaji Apparsamy Yasim Kolathayil Morgann Carlon 30-Sept-2014

2. Introduction

3. Introduction and Kick Off 3 Importance of Analytics for Healthcare Organizations 6 Case Study: The Impacts of Analytics at BayCare 14 Enabling Analytics for ACOs 20 Summary – What Next 26 Q&A 29 Contents

4. Team resumes Role – Engagement Director Role - Director Tony Jurek Director Deloitte Consulting Minneapolis Tony is Director in the Information Management practice of Deloitte Consulting. Tony advises healthcare clients in the Business Analytics space Balaji Apparsamy Director, Data Management & Enterprise Web Applications BayCare Health SystemClearwater, FL Balaji provides strategic leadership and governance over long term data strategy to increase the competitive advantage for Baycare. Leadership over patient centric CRM solution to improve on patient engagement, care coordination to reduce care gaps and financial risks Role – Program Manager Role – Consultant • Yasim Kolathayil • Manager • Deloitte Consulting • Dallas • Yasim is a Manager in the Information Management practice of Deloitte Consulting. Yasim is currently focused on providing value to health care clients in the business intelligence (BI) and business analytics space. • Morgann Carlon • Consultant • Deloitte Consulting • Minneapolis • Morgann is a Consultant in the Information Management practice of Deloitte Consulting. Morgann is currently focused on healthcare analytics strategies for her clients.

5. Importance of Analytics for Healthcare Organizations

6. What does “Analytics” Mean to You?

7. Six Trends Shaping Healthcare Healthcare organizations are experiencing the “perfect storm” at the intersection of changing demographics, technological innovation and governmental regulation. Expanding Definitions of Health Demanding Demographics • Consumer health technologies • Medical expense management • Direct-to-consumer tools and decision support • Genotypic diagnostics and targeted therapeutic interventions • Personalized health information • Individualized risk assessment • Personal health records • Genetic screening Rising Pressure in Policy, Politics, and Economics • Online platforms for collective action • Focus on cost reduction and improved health outcomes • Communities of interest become communities of action Healthcare Organizations Expanding Connectivity: Anytime, Anywhere • Mobile health • Delivery of information and services • Peer-to-peer health management • Adherence support and self care • Sensing technologies • Collection of biometric data Increasing Transparency Converging Relationships • Technology shapes health behavior • New technologies integrate layers of data • OTC diagnostics provide real-time feedback • Advancement of data analysis • Simulations anticipate risk • Patient self-care • Public health preparedness • Open platforms for innovation • Connects outsiders to specific projects inside companies • Encourages cross-disciplinary and external collaboration • Streamlines expert sourcing The Result – More data from more sources creates new challenges and opportunities

8. Analytics Can be a Game Charger for Healthcare Organizations Take an Enterprise View Start with the End in Mind Use the Right Solutions for the Job • Not Everything Looks Like a Nail • Focus on Value • Deloitte Products & IP • Vendor Technologies • Deloitte Advice and IC • Partner Network • Solutions, not tools bring the pieces together and drive new insights • Align projects and partners with shared risk and shared reward • One-Size Does Not Fill All • Focus on the Future • 1-2 Yr. Target Maturities • 2-3 Yr. Target Maturities • 3-5 Yr. Target Maturities • Don’t “rip and replace” but “leverage and lift” the value of the systems you already have • Alignment across functions makes everyone successful • Leaders Need 360O Insight • Focus on Excellence • Market Excellence • Clinical Excellence • Operational Excellence • Financial Excellence • You can’t manage what you don’t measure – metrics that matter • Understand what separates areas to better bring them together

9. Key is understanding the two sides of Analytics Descriptive Analytics • Reporting • After the fact performance measuring • Static • Should be insightful Predictive Analytics • Future facing • Trending • Pattern Analysis • Scoring to determine “Next Best Action” • Cohort Determination • Should also be insightful Hindsight Insight foresight

10. An 360o Enterprise-View of a Healthcare Organizations Challenges Re-Admissions Analytics Value Based Care Population Management Care Coordination Disease Management • Market Demographics • Sizing & Segmentation • Brand & Identity • Access & Pricing • Research and Development • Project & Trials Management • Applied Research • Translational Research • Value-Based • Care • CEO • CMO • Quality & Safety • Clinical Effectiveness • Perioperative Care • EHSS & HITS • Alliances & Partnerships • Joint Ventures • Physician Integration • Strategic Affiliations • Market • Demographics • Research & • Development • Innovator • Advanced • Alliances & • Partnerships • Quality & • Safety • Developed • Market • Clinical • Mergers & Acquisitions • Strategy & Growth • Valuation & Pricing • Post-Merger Integration • Foundation • Patient Satisfaction • Environment & Setting • Clinical Integration • Mobile Health • Mergers & • Acquisitions • Patient • Satisfaction • Financial • Operational • Accounting • & Finance • Human • Resources • Accounting & Finance • Close, Plan & Report • Cost Accounting & DSS • Revenue Cycle Performance • Human Resources • HR Transformation • Bus. Model Transformation • Compensation Alignment • Governance & • Compliance • Supply • Chain • CFO • COO • Technology • & Facilities • Governance & Compliance • Governance & Controls • Security & Privacy • ICD-10 • Tax Optimization • Supply Chain • Sourcing & Procurement • Logistics & Distribution • Demand Management • Technology & Facilities • Infrastructure & Architecture • HIT and ERP Shared Services • Real Estate & Facilities

11. Deloitte Health Analytics Product Portfolio Our balanced product portfolio is designed to impact key issues in healthcare, while maximizing value, aligning with the core business, maintaining a competitive position, and enabling innovation. Health System Intellect Total Cost Intellect • Clinical Intellect • Clinical Care Optimizer • Readmission Optimizer • Quality Optimizer Sustainable Margin and Quality Dashboard Procedure Cost Analysis Revenue Intellect • Performance Intellect • PI Workbench • Operations Optimizer Revenue Financial Analysis Insight Provider Performance Management Patient Engagement Care Management Contracting and Reporting Outcomes Miner Population Miner Precision Miner Cohort Identification Signal Exploration Gene Based Matching Descriptive Analytics Statistically Nuanced Analytics Research Knowledge Management Drug Exposure / Response Analysis • Comparative Analytics Biomarker Hypothesis Generation & Validation

12. Oracle Enterprise Healthcare Analytics + Deloitte Analytic Applications A powerful combination of capabilities to help meet the demands of the information driven healthcare environment Security Metadata Delivery Exception Management System Oracle EHA Apps Business Rules Conformed Data Mart (HCD) OBI-EE/Java Source Data Extract Reporting OHADI: Application Toolkit Interface Tables EHA Healthcare Data Model ConvergeHealth By Deloitte Apps All Sources OHADI: WIL Exec Ad Hoc Query Validation, Standardization, and Transformation Clinical Financial Administrative Research OLAP Clinician Custom Applications Data Mining Master Data Interface (MDI) MDM: Term. Unit ofMeasure … NLP De – identification MPI Master Data “Real” Time Master Data Management & Other Services MDM Loaders Researcher MDM ETL OHADI: HDWF > Applications MDM, Conformance, Metric Definition, Benchmarks, etc. OHADI: Interface tables > HDWF, business rules, MDM, and metadata management Source Independent HDWF 3NF EDW Source Dependent Applications: Reports, Dashboards, Scorecards, etc.

13. Case Study: Impacts of Analytics at BayCare

14. Introduction BayCare Health System is a leading community-based health system in the Tampa Bay area. Composed of a network of 11 not-for-profit hospitals, outpatient facilities and services such as imaging, lab, behavioral health and home health care, BayCare provides expert medical care throughout a patient's lifetime. With more than 280 access points conveniently located throughout Tampa Bay, BayCare connects patients to a complete range of preventive, diagnostic and treatment services for any health care need. In 2013, BayCare provided $243.5 million in community benefit, which includes $110.8 million in traditional charity care

15. Readmissions Identification of consistent process (or lack of it) to capture data that causes potential readmission, and make it available at the right time, right place for right people Common Causes • Lack of coordination of care between settings • Estimated high volume related to social issues • Lack of compliance with prescribed therapy Prevention • Readmission flag on EMR • Standard discharge procedure and patient education • Discharge phone calls and follow up • Improved patient experience People Process Technology

16. Readmissions - Impact Reduction of readmission is a spectrum of process, that leads to the transformation of providing care to the patients Patients • One fifth of the Medicare patients are readmitted within 30 days • Huge cost impact on unplanned readmissions within 30 days Hospitals • Reductions in reimbursements • Penalties and risks due readmission trends • Three fourth of the readmissions are preventable Fee for Service Value based (PHM)

17. DataRetirement DataCreation DM&ACapabilities DataUsage DataStorage DataMovement BayCare Strategy Population Management Predictive Outcomes Scorecards Dashboard Analytics KPI Digitization Integration Data Collection Analytics & Predictive Modeling Act on Data EDW DG HIE EMR Registration Clinical Labs Financial Sustainability Financial Pharmacy

18. 2014 Accomplishments Beginning of the journey, in the right direction • Standard method to identify patients at High Risk for Readmission • Implemented Interdisciplinary Plan of care • EMR ‘task’ to Case Manager and Social Worker when patient identified as High Risk for Readmission • Monitor Home Care admits and Pilot rollouts Next stage • Transition of Care Management Process model • Ongoing monitor and improvements

19. Enabling Analytics for ACOs

20. Analytics can address the critical needs of ACOs Critical ACO needs How analytics can help ACOs address these critical needs 5. Technology adoption 1. Integrated Patient Care management 2. Accountability and Organizational Effectiveness 3. Population Health Management 4. Safety and Quality Reporting Compliance • Access to a holistic 360 degree view of patient data and analyze data overtime to identify trends and spot gaps in care coordination and delivery • Use predictive modeling techniques and solutions to prevent adverse events and readmissions Integrated Patient Care management Accountability and Organizational Effectiveness • Defines shared accountability among the ACO leadership to provide collaborative care • Measures organizational effectives and key capabilities across excellence areas enables organizational savings and growth opportunities. Population Health Management • Enables risk stratification and can identify the subpopulations that are most at risk • Summarize and explain population level outcomes data to budget for the healthcare expenses of a defined population Safety and Quality Reporting Compliance • Enables ACOs to measure the quality and compliance metrics for CMS shared savings • Reporting capabilities and detailed metrics are required to operate, manage and measure an ACO 5. Technology adoption • Creation of sophisticated technology platform allowing for longitudinal view of patients and more practice of evidence based medicine • Analytics system focus on acquiring clinical data and facilitating a care management workflow

21. Analytics enables a 360 degree view of patient and spot gaps in care coordination and delivery Sample metrics to measure patient engagement, satisfaction, plan of care and membership analysis Integrated care coordination by ACO • Medication Reconciliation • 30 Day Post Discharge Physician Visit • Measure of Processes of Care (MPOC-28) • Plans Of Care Compliance • Communication with Nurses • Communication with Doctors • Call Center - Hold Time • Responsiveness of Hospital Staff Proactive Plan of Care and Follow-up Patient/ Care Giver Experience • Member Insurance Affiliation • Dual Eligibility • Employer Affiliation • YTD Total Medicare Membership Growth • Termed Group Count • Success of Member Education • Patient Education/Outreach Participation • Patient Channel Responsiveness • Young Adult Health Care Survey (YAHCS) Patient/ Membership Analysis Patient Engagement Improved patient engagement and care coordination

22. Analytics enables shared accountability among the ACO leadership to provide collaborative care Key Capabilities Key Capabilities CMO COO CMIO CEO CFO Note: The capabilities that are in bold are shared across the excellence areas Note: The capabilities that are in bold are shared across the excellence areas

23. Population Health Management Objectives Analytics Impact Key Questions Analytics enables ACOs to budget for the healthcare expenses of a defined population • Does clinician have the capability to evaluate health risks based on year over year comparing assessments? • Is clinician auto notified of new or conflicting info requiring resolution? • Can analytics deconstruct the patient groups to examine and manage population sub groups? • Comprehensive understanding of patient health/risk • Consumer health segmentation • Patient cohort identification & Stratification • Epidemic monitoring Health Assessment • What are the cost drivers, at risk individuals in the population? • Can analytics make predictions for given patient groups to offer most effective intervention? • Can the at-risk patients be prioritized and offer tailored interventions? • Track population trends • Clinical campaign management & targeted outreach • Chronic disease management • Risk-pool stratification • Shared decision making Risk Stratification • Are the at risk patients receiving timely care? • Is physician receiving real time patient and population data at point of care? • Does the clinician have access to decision making tools to provide best possible care? • Improved patient health status • Improved patient satisfaction • Personalized patient care • Evidence based intervention • Enables use of social media Patient-Centered Intervention • Does ACOs have tools to measure outcomes and patient satisfaction to compare against national and local benchmarks? • Does the conclusions make sense? • Does ACOs have access to scorecard to understand and improve performance? • Improved patient outcomes • Financial reporting • Risk and regulation compliance • Quality & compliance reporting • Clinical performance management • Reimbursement reporting Impact Evaluation and Outcomes Measurement

24. Reporting capabilities and detailed metrics are required to operate, manage and measure an ACO Reports will provide valuable information allowing ACOs to track performance and identify areas for improvement.  • Regulatory Metrics • Outcomes Metrics • Guidelines Metrics • Efficiency Metrics • Clinical Process Metrics • Payer Metrics • Payer Mandated Metrics • Outcomes Metrics • Physician Metrics • Process Metrics • Claims for Reimbursement Metrics ACO • ACO Reports • Accountable Care Metrics Reporting capabilities are required to collect and submit quality and safety data to CMS and private payers.

25. Sophisticated analytics platform enables longitudinal view of patients and practice of evidence based medicine 1 2 3 Data Integration & Management Data Analytics & Content 4 5 Core Applications & Workflow /Automation Physician / Patient Engagement

26. What Next

27. Unprecedented Market Changes Are Creating New Challenges for Healthcare Providers The evolution occurring in the industry is driven primarily by four macro-drivers: • Heightened consumer expectations on value, simplicity, and transparency • Ubiquitous technology adoption (e.g. Web, Mobile, Social) combined with always-on consumers • Transparency in cost & quality • Shift from volume to value (e.g., P4P, risk sharing) HC Delivery • Realignment of relationships and scope of services across healthcare industry • Risk shifts from Health Plans to Providers • Players are seeking new ways to create and deliver value (e.g., disintermediation of traditional players) • Rise in government programs (e.g., Medicare, Medicaid, Duals, and HIX) • Heightened regulatory oversight These macro trends make it imperative for industry leading provider organizations to adapt to change enabled by their best in class people and processes

28. The Unified Data Platform – Oracle and Deloitte Where do investments in technologies like Oracle EHA, and Deloitte’s Analytical Applications fit in this future view? Level 2 View – Data Source/Producers Data Consumers Data Brokering Data Ingestion/Enrichment Data Collection ConvergeHealth by Deloitte Oracle • HDM • DBMS Oracle - OBIEE Oracle - OBIEE ConvergeHealth by Deloitte Oracle • MDM • ODI • Data Quality

29. Healthcare organizations should enable advanced analytics to provide integrated patient care

30. Q&A