Transcript Dr. Arthur Kapoor Founder and CEO of HealthEC LLC at the

Big Data – How it relates to Population Health
Management (PHM) Overview
By Arthur Kapoor
Presented by:
Dr. Arthur Kapoor
Founder and CEO of HealthEC LLC
at the Healthcare-IT
Summit,
05th-Oct-16 at NJIT,
Newark , NJ.
2 | Private and Confidential | © 2016 HealthEC®, LLC
Big Data in Healthcare
Actionable Insights
Quality Patient Care at the right time
Lower Spend/Operating Costs
Agile & Scalable/Adaptable Solution
→ Care Coordination with Patient Assessments
→ Pop Health Analytics on Utilization & Costs
3 | Private and Confidential | © 2016 HealthEC®, LLC
Delivering Actionable Insights
Advanced Analytics solution that are designed to:
Deliver real-time reporting
Point-of-care insights and
Empower clients to take smart patient-centered
decisions quickly and with confidence
4 | Private and Confidential | © 2016 HealthEC®, LLC
Healthcare EcoSystem
HIE
SNF/Home Health
Clinical Gateway & E Connectors
Hospitals
Gateway
Local Health Departments
VPN
PCP & Specialist EHRs
CDR
Data
Marts
EMPI/RLS
Registry
Consent
Audit
VPN
Surgery Centers
Clinical Messaging
Imaging Centers
Outside Labs
5 | Private and Confidential | © 2016 HealthEC®, LLC
Surescripts
All Payers Claims
Immunization
Registry
Big Data – Sources to Applications
Data Sources
Data Transformation
Internal
Sources
Externa
Sources
Multiple
Formats
Multiple
Locations
Multiple
Applications
Middleware
R
A
W
D
A
T
A
Extract
Transform Load
Data
Warehouse
Traditional CSV,
Tables
6 | Private and Confidential | © 2016 HealthEC®, LLC
Platforms & Tools
T
R
A
N
S
F
O
R
M
E
D
BI Analytics
Queries
Reports
OLAP
Data
Mining
Hadoop Ecosystem
7 | Private and Confidential | © 2016 HealthEC®, LLC
Big Data Across the Continuum
FUNCTIONAL REPORTING AREAS
Organizational
Practice
Provider
Hospital
Financial
Analytical Reports
8 | Private and Confidential | © 2016 HealthEC®, LLC
Pharmacy
Clinical
Care Mgmt
Quality
Measures
How Big Data Influences Behavior
Actionable Insights
Monitor & Evaluate Organizational performance (Cost, Utilization, Quality, AtRisk Patients, etc.)
Monitor & Evaluate Physician & Practice Performances
Ensure Regulatory Compliance - Effectively measure the Key Quality Indicators
based on (MSSP,HEDIS,PQRS, etc.)
Plan and evaluate Care Managers’ Productivity
Monitor Annual Wellness Visits
Enhance your Risk Analytics - High Risk patients, Predictable (Admissions, Readmissions, Cost, etc.)
Actionable Big Insights
Generate real-time alerts for Care Management, Patients’ self monitoring and
Provider/PCP intervention
Get unprecedented Analytical insights on financial impact, based on population
health data (Current Vs Future)
Recommended Action and Plan-of-care
9 | Private and Confidential | © 2016 HealthEC®, LLC
Big Data Architecture
Hadoop Framework
10 | Private and Confidential | © 2016 HealthEC®, LLC
Big Data In Cost Reduction
Provide Hot-spotting capability to optimize resources
High Risk/Cost
Lab Result
Proprietary
Algorithms
Hospital
Pharmacy
eMPI
(Enterprise Master
Patient Index)
Rising Risk/Cost
Stratify patients by risk
and cost
Claims Data
Data Mapping &
Integration
Big Data provides actionable
decision-making, enabling
identification of high-risk
patients
Hot-spotting
Healthy/ Low Cost
Inclusion of other data sources
allows “Fine Tuning” of
information being presented
Assessments
EMR/EHRs
Telehealth
1
11 | Private and Confidential | © 2016 HealthEC®, LLC
2
Outputs achieved:
 Reduced ED visits by
8.3%
 Hospital admissions
by 14.7%
 Skilled Nursing
Facility bed-days by
29.3%
 2 Medicare Shared
Savings Programs –
Costs reduced by over
$500 per-memberper-year
 4 ACO clients with
38,000 combined
patients lives; saved
over $14 million in
2015
Patient-centric Data
Automation tools to assist in the management of interventions to close Care-gaps
Track the High-risk Population and Monitor Performance and Outcomes
Automated Interventions
High Risk / Cost
Referrals
Rising Risk
Evidence based
Care Programs
Provider Alerts
Personalized Health
Review
Patient Care Reminders
Healthy
3
Assign Care Team & Care
Programs
12 | Private and Confidential | © 2016 HealthEC®, LLC
4
Prioritize Care
Workflow
5
Interventions
Big Data Analytics For Everyone
Hospital
Pharmacy
Data Mapping &
Integration
Claims Data
eMPI
(Enterprise Master
Patient Index)
Patient
Assessments
EMR/EHRs
Telehealth
13 | Private and Confidential | © 2016 HealthEC®, LLC
Data Mapping &
Integration
Proprietary
Algorithms
HIE
Includes standardized
benchmarks for managed
care
Lab
Hospitals
Predicts future
expenditure from current
chronic illness burden
Provider, Patient,
Commercial, Medicare
and ACO Dashboards
Provides an analysis on
Medical Loss Ratio.
Bench-marked
Used By
Lab Result
Enables PQRS and ACO
Quality Measures
Physician
Groups
CHCs Other
PCP’s
Other
Agencies
Thank You
14 | Private and Confidential | © 2016 HealthEC®, LLC