Copyright © 2015 Splunk Inc.

Data Informed Healthcare Delivery

Process Improvement

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Agenda

Problem Background and MotivationProcess Analytics Solution OverviewSolution Features and Benefits: ExecutiveSolution Features and Benefits: Operations UserSolution Features and Benefits: Informatics UserProduct Demonstration

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Information Flow in Care Delivery: Spaghetti

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002133/

Requires complex cross domain coordination

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And Flow is Care Condition Specific

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Current picture of My Visit

Source: HIMSS Presentation, capturing patient flow value stream

Algorithmsforinnovation.org

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National Average Wait Time for Specialist Visit

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Underlying Problem AreasExamples

Process variations that reduces efficiency without improving outcomeMismatch of supply and demand: Nurse Staffing, Patient Scheduling, Beds, Operating Room, Emergency DepartmentBest Practices/Checklist hard to implement

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Event Type Event ID Attributes (Timestamp, Department, Resource)

Registration 4798668 02/06/2015 14:00 A John

Lab 4798669 02/06/2015 14:00 B Pete

Consultation 4798670 04/06/2015 11:00 C Rose

Medication Order

4798671 04/06/2015 12:00 C Pete

Medication Dispense

4798672 04/06/2015 10:00 D John

Transport 4798673 04/06/2015 15:00 E Pete

Billing 5798670 03/06/2015 14:00 F Pete

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Good News: Increasing Healthcare Digitization-Flows are Captured in Events

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Virtual

Physical

Cloud

Healthcare Data is Time Oriented and Diverse

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EHR Systems

WebServices

Developers

App Support

Telecoms

Networking

Desktops

Servers

Security

Devices

StorageMessaging

Patient Surveys

clickstream

HIE

PatientNetworks

Healthcare Apps IT Systems and Med Devices Patient Generated Data

MedicalDevices

CDR Mobile

PHI Access Audit Logs

HL7 Messaging

Sensors

Departmental and

HomegrownApplications

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Goal With Splunk: From Spaghetti To LasagnaReduce Unwarranted Variations

Source: processmining.org

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Real Time Diverse Data Integration

End to End Process Discovery and KPI visibility

Detect and Monitor Process Anomaly and Bottlenecks

Predict, Recommend, and Forecast

Using Process Analytics: Improvement Method + Real Time Data Analytics

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Patient Flow Data Sources Examples

Health Event Data:

Application Event Logs

HL7 Messages and Logs

Web Logs

Device Data:

RTLS Asset Tracking

Patient Tracking (optional non-US)

Medical Device Logs

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Future State My Visit Enabled by Process Analytics

Source: HIMSS Presentation, capturing patient flow value stream

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Anticipated Improvements and MeasurementsAnticipated Improvement Opportunities

Prediction of Resource Requirements next hour/day/week

Identify Over provision of low or non value added activity

Find low utilization of expensive clinicians, operating room, devices, supplies, and clinic space.

Discover use of clinicians for less skilled activities

Identify routine care delivered in expensive settings

Detect long waiting time and delays because of lack of cross functional coordination

KPI to ImproveTime for patient waiting for an inpatient bed ER Wait Time

Cycle time of discharge order received to room clean and ready. Waiting time for scheduled surgery

Reduction in inventory and equipment capex/opex

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Traditional Process Analysis Vs. Splunk ApproachSplunk ApproachDiscover actual behavior of people, organization, and machines and relate to modeled behavior.

Correlate millions of ad-hoc events showing how reality is different from perceptions, opinions, and beliefs.

Provide clue for standardization, reduce unwarranted variations, and better prepare to handle ad-hoc events.

Traditional ApproachBased on the opinion of the expert.

Assemble an appropriate team and to organize process modeling sessions. The knowledge of the team members is used to build an adequate process model.

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Why Now? Shift in The Payment System and Care Delivery Models

New Care Delivery Models: Accountable Care

Organizations, Mergers, Acquisition, and Partnerships.

Shift of Payment Systems: fee for service to fee for quality.

Margins are thinner, infection penalty, readmission penalty.

Aging Populations, new population with insurance:

more demand on constrained resources

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Why Now? Increased Patient Participation

More Choices- new entrants in the market- Wal-Mart,

Walgreens, CVS

Patient’s skin in the game: Highly deductible plans,

sharing of costs

Availability of Patient Portals, Online

Communities, and Consumer tools- Mobile, Sensors, Home Health

Increased Transparency on cost and quality data

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Business Value of Process Analytics

Increase Staff Productivity, reduce error, optimize time

1Reduce cost

without outcome tradeoff

2 3Improve patient

outcome, experience, and

engagement

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Executive

Solution Features and Benefits

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Process KPI Dashboards• Waiting Times/Delays at Highly Utilized Flow Steps• Current Bed Capacity• Current Imaging Frequency• Current discharge to bed readiness time

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Visualize Patient Flow

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Visualize Asset Flow

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Business Benefits

Process Flows and real time Capacity and Time Metrics

1Comparison

Data- by min, hour, days, months etc.

2 3Make data

informed time critical

operational decisions

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Clinical Operations

Solution Features and Benefits

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Finding and Troubleshooting Bottlenecks

Utilization Management KPI temporal view

Visualize flow and frequency

Visualize Entity RelationsEx: relations among conditions and procedures

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Automatic Notifications: Actionable Alerting

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Business Benefits

Monitoring for Joint

Commission and other best

practices

1Detect trends, anomalies, and inconsistencies

and troubleshoot

2 3Make data

informed time critical

operational decisions

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Informatics

Solution Features and Benefits

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Real World Business Questions, Improvement Opportunities, feedbacks

Data Collection Data Preparation

Exploratory Visualization, Statistics and Machine Learning

Communication, VisualizationReports, Findings

Evaluation

Knowledge Discovery, developing and evaluating Knowledge, Rules, and KPI

Decision Support Product

Think of the Process/Walk in the Patients’ shoes

Process Mining Platform

Pre Mortem Data :Real Time Monitoring, Anomaly Detection , and Predictions

CaseManagement

Anomaly Detection,

Linkage, Correlations/

Patterns

AlertsPredictive

Modeling/Model

Maintenance

Data Warehouse

New Events

Standard Reports/Que

ries

Data Archival

Rules System

Process Data Mining Core Engine

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Analytics PlatformIntegrate Untapped Data: Any Source, Type, Volume, Velocity

Healthcare Apps Data/HL7 Events

Healthcare Apps Audit Logs

Medical Device (PACS)/RFID Metadata (logs)

Patient Generated Data

Hadoop Clusters Relational Database No SQL Data StoreSplunk Clusters

Explore Visualize Dashboard ShareAnalyze Monitor and alert

External Applications Integration

(SDK, REST API)

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Application Development Platform

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Business Benefits

Diverse Data Integration

and Enrichments

1Tools for process

discovery and visualizations

2 3Make real time

knowledge available to

operations and executives

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Splunk ResourcesSearch Tutorial: http://docs.splunk.com/Documentation/Splunk/latest/SearchTutorial/WelcometotheSearchTutorialTraining Videos: http://www.splunk.com/view/educa3on-videos/SP-CAAAGB6Splunk Docs: http://docs.splunk.com/Documentation/Splunkbase Apps & Answers: http://apps.splunk.com/

http://answers.splunk.com/Splunk Wiki: http://wiki.splunk.com/ Developers: http://dev.splunk.com/

Exploring Splunk Book: http://www.splunk.com/goto/book

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Interactive, cut/paste examples from popular source repositories: D3, GitHub, jQuery

Splunk 6.x Dashboard Examples Apphttps://splunkbase.splunk.com/app/1603

Custom SimpleXML Extensions Apphttps://splunkbase.splunk.com/app/1772

Splunk Web Framework Toolkit Apphttps://splunkbase.splunk.com/app/1613

Machine Learning Toolkit:

https://splunkbase.splunk.com/app/2890/

Example Advanced Visualizations and Machine Learning Toolkit

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http://dev.splunk.com/view/python-sdk/SP-CAAAEU2

http://dev.splunk.com/sdks

http://dev.splunk.com/restapi

REST API, SDKs, and Custom Search Command

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Thank YouAdrish SannyasiHealthcare Solution ArchitectSplunk, asannyasi@splunk.com