A Health Catalyst Overview: Learn How a Data First Strategy Can Drive Increased Outcomes Improvement

1. How a Data First Strategy Drives Outcome Improvement March 27, 2018

7. © 2018 Health Catalyst Harald zur Hausen 7 1976 Published hypothesis that human papillomavirus (HPV) caused cervical cancer 1983 Identified HPV16 and HPV18 in cervical cancers 2006 Vaccine available 2017 60% of adolescent children have been vaccinated 42 years

8. © 2018 Health Catalyst Poll a. Less than 1 year b. 2-3 years c. 4-5 years d. 6-8 years e. 9 or more years How long does it take your institution to turn high quality medical evidence into common practice? 8

9. © 2018 Health Catalyst Alzheimer's 9 5.7 million AmericansDeaths up 123% since 2000 $277 billion in 2018 No known way to prevent, cure, or slow progression Source: Alzheimer’s Association, 2018 Alzheimer’s Disease Facts and Figures, March 20, 2018

11. A Data First Strategy Build Institutional Analytic Skills Use Data to Improve Clinical Practice Key Takeaways

15. © 2018 Health Catalyst 6 Rights of a Data First Strategy • EHR data is necessary but not sufficient • Utilize all available data, i.e. socio- economic, environmental, genetic • Generate better data, i.e. activity based costing, patient reported outcomes 16 Data

16. © 2018 Health Catalyst 6 Rights of a Data First Strategy • Consistent, sharable definitions for: – Metrics – Populations – Identity – Vocabulary • Decentralized stewardship • Culture of data driven decision making and prioritization 17 Data Governance

17. © 2018 Health Catalyst 6 Rights of a Data First Strategy • From event to insight quickly • Framework to evaluate the cost of slow • Examine the entire process: – Generation or Entry – Movement – Processing – Analysis 18 Data Time Governance

18. © 2018 Health Catalyst 6 Rights of a Data First Strategy 7 Core Skills Domain Knowledge, Query, Movement, Modeling, Analysis, Visualization, Process Improvement 3 Orders of Complexity • Descriptive: What happened, what’s happening • Predictive: What’s likely to happen • Prescriptive: What interventions will have the biggest impact on the desired outcome 19 Data Time Governance Skills

20. © 2018 Health Catalyst 6 Rights of a Data First Strategy • Decouple the data from the apps and algorithms • Innovate with new tools and workflows • Apps both consume existing data and produce new data or insights • Enable data-first apps, not just process-first apps 21 Data Time Place Governance Skills Applications

21. © 2018 Health Catalyst The Data Operating System Data Ingest Real-time Streaming Source Connectors Catalyst Analytics Platform Fabric Data Services Real-time Processing Health Catalyst Applications Data Quality Data Governance Pattern Recognition Hadoop/ Spark Data Export Population & Registry Builder Leading Wisely Care Management Atlas Client-built Applications NLP Touchstone Benchmarks CORUS Cost Accounting Patient Safety Measures Manager ACO Financials Patient Engagement HL7 Data Pipelines Metadata Data Lake Reusable Content AI Models Third-party Apps Artificial Intelligence Pipelines Marketplace SAMD & SMD Fabric Application Services Terminology & Groupers EMR Integration Security, Identity & Compliance Patient & Provider Matching Value Sets & Measures Standard, Extensible Data Models RegistriesFHIR HL7 Analytic Accelerators

23. © 2018 Health Catalyst 2018 Chevrolet Silverado: “When nothing less than the most dependable will do” Common Structures Reduce Variation 24 What creates dependability? Customize on common platform for specific needs

24. © 2018 Health Catalyst Common Data Structures Reduce Variation 25 Claims Data: “When nothing less than the most dependable will do” What creates dependability? Customize on common platform for specific needs

27. © 2018 Health Catalyst Creating Customization in Common Data Structure 28 Measures Builder • Standardize and maintain analytic capabilities around measures within a central repository for all measure. Help inform governance and increase efficiency. Two Health Catalyst Examples Population Builder • Standardize and maintain custom populations for analytic use cases. Quickly define precise population, save, replicate on demand, and publish to downstream applications and tools.

34. © 2018 Health Catalyst Poll a. Large report queue supplemented with occasional ad-hoc analysis b. Broad access to modern, self-service visualizations c. IT thinks they are doing a good job, but clinicians and the finance team don’t feel their needs are being met d. Analysts collaborate with clinicians and provide real-time insights; data scientists regularly create and update machine learning models e. Data scientists and analytic engineers spend lots of time on Snapchat because there isn’t enough work for them to do How would you describe your institution’s analytic situation? 35

39. © 2018 Health Catalyst 0 1 2 3 4 5 Reactive Descriptive Prescriptive Analytic Work-Stream Skill Continuum Health Care Data* Data Query Data Movement Data Modeling Data Analysis Data Vizualization Process Improvement Technical Assessment: Analysts (n=41) Skill Capacity Skill Gap Descriptive Predictive Prescriptive

44. © 2018 Health Catalyst Total Hip (THA) and Total Knee (TKA) Arthroplasty are the most prevalent surgeries for Medicare patients, numbering over 400,000 cases in 2014, costing more than seven billion dollars annually for the hospitalization alone. Today, more than seven million Americans have hip or knee implants, and the number is rising. Furthermore, substantial variation in the cost per case has raised questions about the quality of care. At Thibodaux Regional Medical Center, total joint replacement for hips and knees emerged as one of the top two cost-driving clinical areas with variation in care processes. To address this, Thibodaux Regional maintained its focus on the IHI Triple Aim while developing organizational and clinical strategies to transform the care of patients undergoing THA and TKA. Thibodaux Regional successfully transformed the care processes and outcomes for patients undergoing hip and/or knee joint replacement. Results include: 76.5% relative reduction in complication rate for total hip and total knee replacement. 38.5% relative reduction in LOS for patients with total hip replacements. 23.3% relative reduction in LOS for patients with total knee replacement. $815,103 cost savings, achieved in less than two years. Using Data to Spotlight Variation and Transform Total Joint Care $

46. 6 Rights of a Data First Strategy Data Time Place Governance Skills Applications

47. Consolidate analytic expertise Mentorship and education Outsourcing Build Institutional Analytic Skills

48. Use Data To Improve Clinical Practice 76.5% relative reduction in complication rate for total hip and total knee replacement. 38.5% relative reduction in LOS for patients with total hip replacements. 23.3% relative reduction in LOS for patients with total knee replacement. $815,103 cost savings, achieved in less than two years.$

49. Questions Jared Crapo <jared.crapo@healthcatalyst.com> Sam Turman <sam.turman@healthcatalyst.com>

50. Thank You