65,000voices

OptimizingDataTools&TechnologyforPopulation

HealthManagementCenterofCareInnovations:PopulationHealthLearningNetwork

MikeHirst,DirectorofDataServices

§ ApplyBaldrigelearningtodataandpopulationhealth§ Definethe4layersofdatainteroperability§ Examinekeyfactorsthatcontributetoasuccessfulpopulationhealthdataplatform

§ Evaluateandassessyourorganization’scurrentcapabilitiesanddiscussyourchallenges

Objectives

§ HealtheIntentRegistriesandEDW•  Tableau•  BusinessObjects

§ HealthCatalyst•  Qlik

§  i2iTracks•  ApplicationReports

§ AzaraDRVS•  ApplicationReports

PopularPopulationHealthTools

Nosolutionwillbesuccessfulwithoutasoundapproachtodatastrategy,planningand

datagovernance.

Water,WaterEverywhere,notadroptodrink!“TheRimeoftheAncientMariner”SamuelTaylor

Coleridge(1772-1834)EnglishPoet

Data,DataEverywhere,notathoughttothink!

WheredoIbegin?

BaldrigeA-D-L-I

Approach(A)

Deployment(D)

Learn(L)

Integrate(I)

§  Approach•  Whatisyourorganization’sapproachtodatacollectionandreporting?

§  Deployment•  Howdoyoudeploythatapproachtoensureithappens?

§  Learning•  Howisyourinformationstructuredanddisplayedtofacilitatelearning?

§  Integration•  Howisinformationyouarecollectingintegratedintothehealthcaresystem?

DataManagement(ADLI)

PopulationHealthApproach:TransformingResearchintoAction

Research&PublicationHypothesis? Professional

OrganizationRecommendations&Guidelines

NCQA,AHRQ,GPRA,NQF CMS

OrganizationalObjectives&Initiatives OrganizationalScore ClinicScore TeamScore IndividualScore

ActionListsEmpanelment Evaluations CompensationWorkPlans

DataServicesApproach

DataLayer

UserLayer

OrganizationLayer

DeployingInteroperability

TechnologyLayer

§  ExchangingData&MaintainingInterfaces•  APIs,HL7,DataOn-boarding

§  NoSQLDatabases•  KeyValuePair(Hadoop),Document(MongoDb),Graphing(Neo4J),

Columnar(HPVertica)

§  ChangestoEHR•  ChangeManagement,VersionControl

§  ExternalTechnology,Equipment,Telehealth•  Security,CommonWellHealthAllianceHIE,transmissionstandards

§  MasterDataManagement•  MultiplePersonIDs

TechnologyLayer(Goal:Send/Receive/StoreData)

§  StandardNomenclature•  ICD-10,SNOMED,CPT,LOINC•  Selection,curation,maintenance,updates

§  DataStandardization•  Mappingnon-standarddatatostandarddata•  ETLprocesses

§  Tags•  Usedforquickreference,approvedstandardizedlist

§  NamingConventions•  Approvednamingformatsfordatawarehousingschema

DataLayer(Goal:DataStandardization)

§  DataWarehousing,DataModeling,DataMarts,Applications•  Clinical,Operational,Financial,Customer-Focus

§  Templates•  AllpossibleDiabetescodesacrossallnomenclatures(ICD-10,CPT,RxNorm)

§  Concepts•  Type1Diabetes,Type2Diabetes

§  Context•  HEDIS,UDS,Local

§  MachineLearning&Discovery§  ReportingTools/DataModeling

•  Tableau,BusinessObjects,R,SAS,SPSS

UserLayer(Goal:DataModels/Visualizations)

§  Workflows•  SupportDataEntry•  ModelImplementationbackintosourcesystem

§  DataGovernance(Policies&Procedures)§  Security(HIPAA)§  Regulations(Medicare,Medicaid)§  StaffEducation&Training§  LeadershipSupportandFunding

OrganizationLayer(Goal:Integration/Sustainability)

KeyFactorsforSuccess

§ Understandwhoyourkeystakeholdersareandbuildworkingrelationshipswiththem•  Valuethedifferencesandstrengthseachofyourvoicesbring

§ Whoarethe“DataStewards”inyourorganization?•  Howdoyoucommunicatewiththemandbuildrelationships?

§  IntegratedInformationTeams•  Informationsupportisalignedwithandanextensionoftheproductlineo Medicalservices,BehavioralHealth,Finance,HumanResources

BuildRelationships

UnderstandStakeholderNeeds

§  Executivestaff•  Howwellarewedoingwithcorporateobjectives?

•  Arewemeetingourtargets?

§  Managers•  Aretherevariationsoccurringinourprocessesandhow

canIidentifythem?

§  Frontlinestaff•  DoIhavetheinformation

toolsIneedtoproactivelydomywork?

•  Dotheinformationtoolssavemetime?

§  Customers•  Iwanttotakeamoreactive

roleinmyhealthandwellness

•  I’mincontrolofmyhealthcareo  Shareddecisionmakingis

betweenmeandmyhealthcareteam

•  Iwanttoolsthatgivemeaccesstomyinformation

§ Haveanapproachandbeabletocommunicatethattoleadership

§ Demonstrateandcommunicateefficiencyandvalue•  Automateandstandardizeprocessesthatrequiredindividualeffort

•  ProjectManagement101(Scope,Resources,Time)•  Keepscopelimitedtowhatyouhaveresourcesandtimefor

§ Alignwithyourcorporategoalsandobjectives

GetLeadershipBuy-In

§  EstablishaDataGovernanceCommittee•  Organizationwiderepresentation

§  VersionControl§  ChangeManagement§  EnterpriseNamingMethods

•  StandardTags§  ToolandReportPlatformSelection§  Metadata

•  Business–userfriendlymethods•  Technical–datadictionariesandmodels•  Process–volumemetrics,logs,processtimes

§  DataLifecycle

§  HistoricalDataDecisions§  Standardization(concepts/context)§  AccessandSecurity(activedirectory)§  LargeProjectPlanningandTimelines§  PrioritySetting/RequestTool&Process§  ResourceAllocation(toolsvspeople)§  AlignmentwithCorporateGoalsand

Objectives§  Benchmarking

•  HEDIS,MGMA,Local,SimilarFacilities

§  PoliciesandProcedures

DataGovernance

§  “Where”doesthedatareside?§  “Who”isgoingtocollectit?§  “How”aretheygoingtocollectit?§  “Howfrequently”shoulditbecollected?§  “Howmuch”isneededtoanswerquestions?§  “Howshoulditbestored”?Sensitivity(PHI)?§  “Whohasaccess”andhow?§  Whatisthe“lifecycle”ofthedata?§  “Cost”ofCollection(human/otherresources)?

DeterminingDataCollectionCost

§  GeneralSkills§  MetadataKnowledge§  QueryingTools§  DataSourcesand

Databases§  ReportingTools§  CodingVocabulariesand

Nomenclatures§  RegulatoryMeasurement

Requirements

§  InformationSecurity§  QueryingSkills§  Chart/GraphingSkills

RelatedtoImprovement§  StatisticalSkills§  PopulationHealthand

PatientCenteredMedicalHome

§  ETLTools

WorkforceDevelopmentChecklistCategories

Listskillsineachcategorythenscoreskillsaccordingly:1=LittletoNoExperience2=TheoreticalKnowledge3=PerformwithAssistance4=PerformIndependently5=Expert,CanTeach

WorkforceProgression

VisualLearning

Southcentral Foundation IT Kronos Sign-On Related Helpdesk Calls

52.0

79.7

13.9

UCL

24.5

38.8

7.8

CL

1.60.0

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WEEK

Cou

nt

PDSA-Change Tested -Kronos user name and system sign on name made the same

Lower Control Limit (LCL) defaults to 0

BETTER

80% Reduction

Segmentation

AssessmentOverTime

ComparisonChart(Variation)

CustomerFocus

Access

Registries(ActionLists)FictitiousCustomer-OwnerInformation

§  MachineLearning§  DataModeling§  WorkflowModeling/Testing/Integration§  Proactive/IntegratedPopulationHealth

BeyondReporting

WhyIsAllThisImportant?

SelfAssessmentExercise

Characteristics

Level1 2 3 4 5

Capability, Workforce, Governance, Infastructure

Surviving Understanding Applying Analyzing IntegratingCapability:Canned Reports/Extracts/ ExcelSpreadsheets

Capability:Metrics/ Reports(Not Standardized/Not Centralized).

Capability:Dashboards/Regis-tries (Standardized);Align with CorporateGoals and Objectives.

Capability:Statistical DataModels/ MachineLearning.

Capability:Models integratedinto Workflows.

Workforce:Department StaffRun Reports.

Workforce:IT support throughticket system.

Workforce:Centralized DataServices Department(report writers anddata analysts)

Workforce:Data Scientists,DataArchitectsjoin Data Services

Workforce:Data Scientists,Application Developersand Data Servicesaligned

Governance:No clear dataownership, noproactive dataplanning

Governance:Limited to specificprojects, informal,siloed.

Governance:Data GovernanceCommittee mostly ITand EHR focused(security, changemanagement)

Governance:Data Stewardship &Information Focused(standardization,mapping, prioritysetting, data lifecycles)

Governance:OrganizationalPlanning and Fundingalign with DataSteward and DataGovernance objectives

Infrastructure:Data primarily intransactionalsystems. Queryoptions are limited.

Infrastructure:Query tools forspecialized stafffrom transactionalsystem.

Infrastructure:Data Warehousingwith multiple datasources. Dataavailable for query-ing, but data notstandadized

Infrastructure:Data warehouse datawith cleansed,standardized, andmodeled data. Refer-ence tables, report toolsintegrated.

Infrastructure:Certified metrics in thewarehouse,APIs,multiple database andapplications integrated

Discussion

Háw'aaHaida

Mahsi'Gwich’inAthabascan

IgamsiqanaghalekSiberianYupik

T’oyaxsmTsimshian

Gunalchéesh Tlingit

QuyanaYup’ik

Tsin'aenAhtnaAthabascan

Chin’anDena’inaAthabascan

QaĝaasakungAleut

QuyanaqInupiaq

Awa'ahdahEyak

QuyanaaAlutiiq

ThankYou!

907-729-6852|www.scfnuka.com|SCFEvent@scf.cc|@SCFNuka

UpcomingNukaEvents

EventName Date

CoreConceptsTraining May23-25,2018

NukaSystemofCareConference June18-22,2018

MotivationalInterviewing June25-26,2018

CoachingandMentoringProgram June25-29,2018

QualityManagementTraining June25-29,2018

IntegratedPrimaryCareTeamTraining June27-29,2018

BehavioralHealthIntegrationTraining June27-29,2018

Questions?