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Management Engineering & Process Improvement

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June 6, 2014

Cecilia Backman, MBA Committee Chair

MEPI COMMUNITY MISSION

Support and promote the profession of management engineering and process improvement among the members of HIMSS by providing opportunities for networking, collaboration, publication, promotion and professional development of Management Engineers and Process Improvement professionals in healthcare organizations.

www.dataenabledhealth.com

Predictive Analytics Usage and Implications in Healthcare

J. Bryan Bennett, Adjunct Professor and Predictive Analytics SME, Northwestern University June 6, 2014

Presented by: HIMSS Management Engineering and Process Improvement (ME-PI) Community


Agenda Predictive Analytics (PA) Versus Other

Types of Analytics How a Well Defined Process Makes For a

Successful Predictive Analytics Program Areas Where Predictive Analytics Can be

Utilized Right Away Getting Started With a Healthcare

Predictive Analytics Program

June 6, 2014 4 @dataenabledhlth


Predictive Analytics Versus Other Types of Analytics


What is Predictive Analytics? Predictive analytics is the practice of

extracting information from existing data sets in order to determine patterns and predict future outcomes and trends.

It does not tell you what will happen in the future. It forecasts what might happen in the future

with an acceptable level of reliability, and includes what-if scenarios and risk assessment.



Gartner Even Goes Further In addition to predicting what might

happen, they add: Analysis measured in hours or days (real-time

or near real-time). The emphasis on the business relevance of

the resulting insights, like understanding the relationship between x and y.

An emphasis on ease of use, thus making the tools accessible to business users.

Source: www.gartner.com



Gartner Analytic Ascendancy Model



Gartner Analytic Model Examples Type of Analytics

Question Answered

General Business Example Healthcare Example

Descriptive Analytics

What Happened?

How many cars did we sell last year?

How many patients were diagnosed with HBP last year?




Question Answered



What Happened?



Diagnostic Analytics

Why Did It Happen?

Why did we only sell x cars last year?

Why did these patients develop HBP?




Question Answered



What Happened?




Why Did It Happen?



Predictive Analytics

What Will Happen?

If I run x advertising programs, how many cars can we sell?

What are the chances Mr. Jones’ HBP will result in a stroke?




Question Answered



What Happened?




Why Did It Happen?



Predictive Analytics

What Will Happen?

If I run x advertising programs, how many cars can we sell?

What are the chances Mr. Jones’ HBP will result in a stroke?

Prescriptive Analytics

How Can We Make it Happen?

What do we need to do to sell x number of cars?

Mr. Jones should be put on x medication to prevent his HBP from resulting in a stroke.



The Importance of Well Defined Process for a Successful PA Program


Where Does Process Fit In? In any technological transition, three

continuums must be addressed equally for the transformation to be successful Technology People Process



Healthcare Transformation Change Model

Paper-Based Healthcare

Organization

Data-Enabled Healthcare

Organization DATA / TECHNOLOGY

ORGANIZATIONAL / PEOPLE

PROCESS / WORKFLOWS



Data-Enabled vs Data-Driven Data-Driven: letting the data dictate how

we treat and manage customers with as much automated decisions as possible

Data-Enabled: providers are provided real-time or near real-time information to enable them to make better decisions and diagnoses based on hundreds or thousands of patients with similar symptoms and demographics



Data-Enabled Healthcare Organization

A DEHO will also be able to better manage their “patient portfolio” or community to provide more consistency and an improved overall quality of care.*

* “Big Data Needs the Big Three to Succeed”, August 8, 2013, www.himssfuturecare.com



Data-Enabled Healthcare Organization Change Model

Paper-Based Healthcare

Organization

Data-Enabled Healthcare

Organization

Resistance To Change

Isolated Acceptance Phase 3

Phase 4

DATA / TECHNOLOGY

ORGANIZATIONAL / PEOPLE

PROCESS / WORKFLOWS

Minimal Data

Capture Network-Wide And Outside Data Capture

Phase 3

Phase 4

Phase 4 EHR

Implementation Analysis & Modeling

Integration of Data Sources

Predictive

Prescriptive



Process is Least Addressed Continuum

A study of over 1,000 physicians during the implementation of a computerized provider order entry system we observed that: Comments and behaviors related to the

process represented 62% of the issues Positive and negative



Comments & Observations Negative Comments Included: I don’t have time for this; I will call from my phone

to place orders I did not know I went to med school to become a

secretary. This is ridiculous!! All it does is take time away

from my patients. I am with the patient now 5 minutes and with the computer 15 – 20 minutes.

I have not put orders in the computer for over 20 years and I am not starting now. I will retire before I start with this crap.



Comments & Observations Negative Observations included: Many would not ask questions because it

seemed they would feel diminished. Some doctors kept complaining about how

this is a “waste of my time” A few doctors left the floor and then

proceeded to call in the orders because they refused to place the orders themselves.



Process Rules!


Process, Solution & Hardware

Solution & Hardware


Implementation Problems Summary

Automating or adding technology to a bad process or not giving the process enough attention just results in a bad automated process. Personnel Buy-In Delayed training

Category Observations & Comments

Process Only 47% Process & Solution 13% Process, Solution & Technology 2%

Total 62%



Areas Where PA Can Be Utilized Right Away


Areas Showing Benefits Now Improved Patient Flow Reduced Readmissions Disease Outbreak Prediction Emergency Room Risks



Improved Patient Flow Can help an organization predict which

resources will be needed at any given time Predicting patient flow versus patient

tracking Reduces bottlenecks and wait times Especially in the emergency room Increases patient satisfaction



Improving Patient Flow Admissions and discharges Efficient patient placement at admission Find bottlenecks and drive for earlier or later

discharge times Capacity management Identify underused beds and labs to better target

patient usage Improves patient care and increased revenues

Transport and housekeeping Track job times and responsiveness to improve

turnover



Reduced Readmissions Risk of readmission in 30 days can be

predicted in order to assist with the decision to release a patient

Reduces cost of readmission and the opportunity cost of a patient occupying a bed that could be used by someone else

Requires a proactive versus reactive approach



Reducing Readmissions The hospital must understand the factors effecting

readmissions (discovery) Create an algorithm built on data from past patients

who were and were not readmitted, i.e. what was different?

Create automated processes to identify patients who are at risk for readmission based on clinical, demographics, etc. Counter with a strategic response Gaining information immediately from failures

Make sure personnel adher to the identified strategy Evaluate effectiveness of their approach.



Disease Outbreak Prediction Google Flu Trends has been shown to

foresee an increase in influenza cases 7 to 10 days earlier than the CDC Based on online search trends

People with symptoms seek further information Can pinpoint disease increase down to the hospital

level Resources can be allocated to prepare for

influx of patients with the flu



Predicting Disease Outbreak Google Flu Trends found a close relationship

between how many people search for flu-related topics and how many people actually have flu symptoms A pattern emerges when all the flu-related search

queries are added together They compared query counts with traditional flu

surveillance systems Discovered that many search queries tend to be

popular exactly when flu season is happening By counting the frequency of the search queries

they can estimate how much flu is circulating in different countries and regions around the world



Emergency Room Uses Used to predict whether a patient is likely

to: Go into cardiac arrest Suffer a stroke Potentially suffer from sepsis shock

While in the emergency room Collecting real time data along with

patient’s clinical history Compare to prior patient data



Getting Started With a Healthcare Predictive Analytics Program


Predictive Analytics Implementation Needs executive support Needs a well-defined business challenge or query

Want to know something more about your organization Is there a relationship between x and y?

Needs lots of data Past and current

Need the right team Quantitative (numbers) and qualitative (strategic) Transform data from information to intelligence and insight

for organization Needs to be an integral part of the organization’s

operations Need to track results and update models



Implementation Challenges in Healthcare Program Needs Healthcare Challenge Executive Support Executives have to manage organization’s staff to get

their cooperation and buy-in.





Well-Defined Business Challenge

Business challenges are everywhere. The real problem is prioritizing which one to address first.







Lots of Data There’s lots of data but a lot of it is locked in departmental silos which ultimately makes all the data useless.








Right Team The challenge will be finding qualified people in an already scarce resource pool and getting them to accept the lower wage healthcare may pay. Outsourcing might need to be an option. Bottom Line: GET HELP!









Integral Part of Organization Everyone must buy-in to the results of the analytics program including clinical, finance and operational staff.









Integral Part of Organization Everyone must buy-in to the results of the analytics program including clinical, finance and operational staff.

Track Results and Update Models With the right team in place this should not be an issue.



HIMSS Value Steps Impact


Questions and Answers Contact Information: J. Bryan Bennett

Healthcare Information Manager, Data Scientist and Professor

E-mail [email protected]

Website / Blogs www.dataenabledhealth.com www.himssfuturecare/blog/1266

Twitter @dataenabledhlth (health without the ‘ea’)


http://www.himssfuturecare.com/

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