Targeted Analytics: Using Core Measures to Jump-Start Enterprise Analytics
•Télécharger en tant que PPTX, PDF•
1 j'aime•1,553 vues
How top healthcare organizations are realizing the benefits of data analytics in such core areas as core measures, clinical alerting, surgical analytics, service line profitability, diabetes management, revenue cycle management, claims management and utilization.
Recommandé
Recommandé
Contenu connexe
Tendances
Tendances (20)
Similaire à Targeted Analytics: Using Core Measures to Jump-Start Enterprise Analytics
Similaire à Targeted Analytics: Using Core Measures to Jump-Start Enterprise Analytics (20)
Plus de Perficient, Inc.
Plus de Perficient, Inc. (20)
Dernier
Dernier (20)
Targeted Analytics: Using Core Measures to Jump-Start Enterprise Analytics
- 1. Targeted Analytics:Using Core Measures to Jump-Start Enterprise Analytics
- 2. About Perficient Perficient is a leading information technology consulting firm serving clients throughout North America. We help clients implement business-driven technology solutions that integrate business processes, improve worker productivity, increase customer loyalty and create a more agile enterprise to better respond to new business opportunities.
- 5. 2010 Revenue of $215 million
- 6. 20 major market locations throughout North America
- 7. Atlanta, Austin, Charlotte, Chicago, Cincinnati, Cleveland, Columbus, Dallas, Denver, Detroit, Fairfax, Houston, Indianapolis, Minneapolis, New Orleans, Philadelphia, San Francisco, San Jose, St. Louis and Toronto
- 10. 500+ enterpriseclients (2010) and 85% repeat business rate
- 11. Alliance partnerships with major technology vendors
- 15. Business Process & Workflow Consulting
- 16. Usability and UI Consulting
- 19. Package Selection, Implementation and Integration
- 20. Architecture & Application Migrations
- 21. EducationPerficient brings deep solutions expertise and offers a complete set of flexible services to help clients implement business-driven IT solutions Our Solutions Expertise & Services
- 22. Our Speaker Michael Faloney Healthcare Director responsible for development and delivery of business intelligence and analytics solutions Responsible for engagement delivery and improving data solutions for Perficient's healthcare clients 20+ years progressive professional experience across technology, business, and process domains +18 years in the IT fields of data warehousing, business intelligence, project/technical management, and applications development Significant experience in developing enterprise data strategies, data architecture, data governance, data quality, data integration, master data management, metadata management, reporting and analytics Held technical and management positions focused on delivering data warehousing and business intelligence solutions to the healthcare, financial services, and telecommunications industries
- 23. Today’s Agenda The Case for Healthcare Business Intelligence Options for Healthcare Business Intelligence The Targeted Analytics Approach Core Measures Example of Building an Enterprise Analytics Platform with Targeted Analytics Next Steps
- 25. Meaningful Use
- 27. Skill shortages
- 30. Attracting the Insured dollarQuality of Care Increasing internal & external pressures makes the ability to accurately analyze the organization’s data in a timely manner to make critical financial, clinical or operational decisions a requirement, not a “Nice to Have” Innovative Research Financial Effectiveness Operational Efficiencies Regulatory Compliance Healthcare Business Intelligence
- 34. Outcome Tracking
- 35. Patient Safety
- 39. Clinical Trial Effectiveness Analysis
- 42. Material Usage Analysis vs. Outcomes
- 43. Cost Management
- 49. Meaningful Use
- 50. Expanded Granularity using ICD-10
- 51. State Reporting
- 53. More likely to have an enterprise view and support from the beginning
- 54. Potentially longer time-line to deliver capabilities
- 56. More likely to have departmental view at the beginning
- 57. Potentially shorter-time to deliver capabilities
- 58. Potentially requires significant rework to move to an enterprise platform
- 59. Can have either a departmental or enterprise view
- 60. Pre-built components offer potential for accelerated delivery
- 61. Often more of an accelerator based approach vs. shrink-wrap
- 62. Often provides only part of the solution and forces users to fit their problem into the package solution
- 63. Either a pre-packaged or accelerator –based approach
- 64. Typically tied to vendor’s transaction system(s)
- 65. Potentially limited ability to work outside their platform
- 68. Based on Perficient’s BI Enable Approach
- 69. Balances process, technology and organizational constructs
- 70. Heavily leverages the accelerator library
- 71. Provides project, functional and technical oversight
- 73. How Does Targeted Analytics Work? GOVERNANCE Enterprise View Enterprise View Strategic Direction Strategic Direction Data Stewardship Data Ownership Data Guardianship ENTERPRISE ARCHITECTURE Architectural Vision Technical Oversight Standards Technical Direction Cardiovascular Diabetes Implementation Efficiency Architecture Vision Business Capabilities 1 2 Develop Initial Application (SCIP Core Measures) Populate Accelerator Library Pneumonia Core Measures Meaningful Use Clinical Alerting 3 Develop Additional Applications ACCELERATOR LIBRARY Visualization Components Integration Components Metadata Components Data Model Components Other Components
- 74. Core Measures Example Starting with SCIP Core Measures, you set the initial foundation of your analytics platform through the creation of enterprise level, re-usable components PROCEDURE DIAGNOSIS SCIP VALUE CORE MEASURE TYPE CORE MEASURE DESC PHYSICIAN PATIENT TIME Data Integration Data Source 1 Data Source 2
- 76. Report Templates
- 79. Time
- 80. Patient
- 81. Diagnosis
- 82. Procedure
- 83. Physician
- 86. Metrics:
- 87. SCIP Value
- 88. Hierarchies
- 90. Transformations
- 93. Automation ConstructsData Source 1 Data Source 2
- 95. Report Templates
- 98. Time
- 99. Patient
- 100. Diagnosis
- 101. Procedure
- 102. Physician
- 103. Core Measure Type
- 105. Metrics:
- 106. SCIP Value
- 107. Hierarchies
- 109. Transformations
- 110. Data Quality Rules
- 114. Report Templates
- 115. Dashboard Framework
- 117. Time
- 118. Patient
- 119. Diagnosis
- 120. Procedure
- 121. Physician
- 122. Core Measure Type
- 124. Metrics:
- 125. SCIP Value
- 126. Hierarchies
- 128. Transformations
- 129. Data Quality Rules
- 131. Automation ConstructsData Source 1 Data Source 3
- 133. Report Templates
- 134. Data Visualization
- 135. Report Templates
- 136. Dashboard Framework
- 137. Dashboard Widgets
- 138. Dashboard Framework
- 140. Time
- 141. Patient
- 142. Diagnosis
- 143. Procedure
- 144. Physician
- 145. Core Measure Type
- 147. Metrics:
- 148. SCIP Value
- 149. Hierarchies
- 151. Time
- 152. Patient
- 153. Diagnosis
- 154. Procedure
- 155. Physician
- 156. Core Measure Type
- 158. Facility
- 159. Metrics:
- 160. SCIP Value
- 161. Pneumonia Metrics
- 162. Hierarchies
- 164. Transformations
- 165. Data Quality Rules
- 167. Transformations
- 168. Data Quality Rules
- 171. Automation ConstructsData Source 1 Data Source 3
- 173. Report Templates
- 174. Data Visualization
- 175. Report Templates
- 176. Dashboard Framework
- 177. Dashboard Widgets
- 178. Dashboard Framework
- 180. Time
- 181. Patient
- 182. Diagnosis
- 183. Procedure
- 184. Physician
- 185. Core Measure Type
- 187. Metrics:
- 188. SCIP Value
- 189. Hierarchies
- 191. Time
- 192. Patient
- 193. Diagnosis
- 194. Procedure
- 195. Physician
- 196. Core Measure Type
- 198. Facility
- 199. Metrics:
- 200. SCIP Value
- 201. Pneumonia Metrics
- 202. Hierarchies
- 204. Transformations
- 205. Data Quality Rules
- 207. Transformations
- 208. Data Quality Rules
- 211. Automation ConstructsData Source 1 Data Source 3
- 213. Report Templates
- 214. Data Visualization
- 215. Report Templates
- 216. Dashboard Framework
- 217. Dashboard Widgets
- 218. Dashboard Framework
- 220. Time
- 221. Patient
- 222. Diagnosis
- 223. Procedure
- 224. Physician
- 225. Core Measure Type
- 227. Metrics:
- 228. SCIP Value
- 229. Hierarchies
- 231. Time
- 232. Patient
- 233. Diagnosis
- 234. Procedure
- 235. Physician
- 236. Core Measure Type
- 238. Facility
- 239. Metrics:
- 240. SCIP Value
- 241. Pneumonia Metrics
- 242. Hierarchies
- 244. Transformations
- 245. Data Quality Rules
- 247. Transformations
- 248. Data Quality Rules
- 251. Automation ConstructsData Source 1 Data Source 5 Data Source 3 Data Source 4
- 253. Report Templates
- 254. Data Visualization
- 255. Report Templates
- 256. Dashboard Framework
- 257. Dashboard Widgets
- 258. Dashboard Framework
- 260. Time
- 261. Patient
- 262. Diagnosis
- 263. Procedure
- 264. Physician
- 265. Core Measure Type
- 267. Metrics:
- 268. SCIP Value
- 269. Hierarchies
- 271. Metrics:
- 272. SCIP Value
- 273. Pneumonia Metrics
- 275. Hierarchies
- 277. Transformations
- 278. Data Quality Rules
- 280. Transformations
- 281. Data Quality Rules
- 284. Automation ConstructsData Source 1 Data Source 5 Data Source 3 Data Source 4
- 285. In Summary
- 286. Q & A
- 287. Follow Perficient Online Perficient.com/SocialMedia Daily unique content about content management, user experience, portals and other enterprise information technology solutions across a variety of industries. Twitter.com/Perficient Facebook.com/Perficient
- 288. Thank You!
Notes de l'éditeur
- Thank you, Jeremy.Today I want to begin by reviewing some of the challenges facing organizations in addition to their 4010 to 5010 Migration.Next I want to examine the choices for a migration solution.I want to zero in on what Perficient believes is a rapid implementation solution called “Step Up/Step Down” from our partner Edifecs.We will demonstrate how this solution addresses the challenges.Finally, I plan to review the Pros and Cons of this solution based on Perficient’s practical experience and then discuss Next Steps.
- Let’s examine our options:Step Up / Step Down: This strategy implies making changes to the intake system of transactions (Gateway component) such that the inbound transactions are mapped or transformed from the 5010 transaction set to the 4010A1 transaction set and then passed downstream leaving the complete existing processing engine intact. In addition, outbound transactions are converted back to 5010 before being sent to trading partners. This strategy would limit the scope and the remediation effort as the transactions currently being processed would continue unchanged.Remediation: This strategy implies making enhancements to core processing (or back-end) systems to meet HIPAA 5010 and ICD-10 compliance while at the same time upgrading the front-end systems (such as Gateway) in order to process 5010 transactions and ICD-10 code sets.Complete replacement of systems: This strategy originates from the belief that the 5010 and ICD-10 changes are significant enough to require complete replacement of the entire claims processing system for the health plan or provider organization. This would include the adjudication (claims processing) systems, transaction processing systems (EDI Gateway), user interfaces, reporting systems and potentially other business systems.If your organization is facing any of the challenges that we reviewed, especially competing large IT projects or you are getting a late start, we believe that the Step Up/Step Down solution can save time and money and mitigate risk.
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- ChallengesWe just looked at the timeline for an understanding of the regulatory deadline pressures. Here are a few other challenges facing organizations with a 4010 to 5010 migration:Competing large IT projects – most of our large provider organizations, especially hospitals, are working to implement electronic medical records systems which are enterprise level efforts. In healthcare payers, we are seeing claims processing systems being modernized and streamlined to reduce paperwork and costs.Here is a big issue: The lack of experienced professionals with EDI X12 experience. Not only is there a shortage of people, but the rules and standards are being updated faster than tax software! Here is the issue that our video highlighted: Making sure that your 4010A1 and new 5010 transactions match for billing and accounts receivable. Your CFO isn’t going to want to hear that after the migration that the billing has suddenly increased or, worse yet, decreased. It will be critical to choose a solution that allows the management of this important issue. Otherwise there is a serious audit risk from government agencies and external organizations.We hear this one a lot. We are waiting on our healthcare application software vendor for ICD-10 upgrades, but we think their timeline will make us miss our regulatory deadlines! In addition, an upgrade to a major application (think EPIC or Cerner) will kick off extensive integration and regression testing in our organization. We need some options . . .
- Let Perficient’s Healthcare team be your rapid response to jumpstarting your 4010 to 5010 migration! We appreciate your time today and now we will take questions. While you are creating your questions in the chat window, I want to get you thinking about these questions as well.