Tag Archives: Healthcare

Improving CMS Star Ratings… The Secret Sauce

Many of our customers are Medicare health plans and one thing that keeps coming up in conversation is how they can transform business processes to improve star ratings. For plans covering health services, the overall score for quality of those services covers 36 different topics in 5 categories:

1. Staying healthy: screenings, tests, and vaccines

2. Managing chronic (long-term) conditions

3. Member experience with the health plan

4. Member complaints, problems getting services, and improvement in the health plan’s performance

5. Health plan customer service

Based on member feedback and activity in each of these areas, the health plans receive a rating (1-5 stars) which is published and made available to consumers. These ratings play a critical role in plan selection each Fall. The rating holds obvious value as consumers are increasingly “yelp minded,” meaning they look to online reviews from peer groups to make buying decisions. Even with this realization though, improving ratings is a challenge. There are the typical complexities of any survey: capturing a representative respondent pool, members may be negatively influenced by a single event and there are commonly emotional biases. There are also less obvious challenges associated with the data.

For example, a member with CHF may visit north of 8 providers in a month and they may or may not follow through on prescribed preventative care measures. How does CMS successfully capture the clinical and administrative data on each of these visits when patient information may be captured differently at each location? How does the health plan ensure that the CMS interpretation matches their interpretation of the visit data? In many cases, our customers have implemented an enterprise data warehouse and are doing some type of claims analysis but this analysis requires capturing new data and analyzing data in new ways.

We hear that those responsible for member ratings, retention and acquisition routinely wait >6 months to have a source or data added to a reporting database. The cycle time is too great to make a quick and meaningful impact on the ratings.

Let’s continue this discussion next week during your morning commute.

Join me as I talk with Frank Norman a Healthcare Partners at Knowledgent.

During this “drive time” webinar series, health plans will learn how to discover insights to improve CMS Star ratings.

Part 1 of the webinar series: Top 5 Reasons Why Improving CMS Star Ratings is a Challenge

Part 2 of the webinar series: Using Your Data to Improve CMS Star Ratings

Part 3 of the webinar series: Automating Insights into CMS Star Ratings

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Posted in Application Retirement, Big Data, CIO, Customers, Data Warehousing, Enterprise Data Management, Healthcare | Tagged , , | Leave a comment

ROI via Application Retirement

ROI = every executive’s favorite acronym and one that is often challenging to demonstrate.

In our interactions with provider clients and prospects we are hearing that they’ve migrated to new EMRs but aren’t receiving the ROI they had budgeted or anticipated. In many cases, they are using the new EMR for documentation but still paying to maintain the legacy EMR for access to historical data for billing and care delivery. If health systems can retire these applications and still maintain operational access to the data, they will be able to realize the expected ROI and serve patients proactively.

My colleague Julie, Lockner wrote a blog post about how Informatica Application Retirement for Healthcare is helping healthcare organizations to retire legacy applications and realize ROI.

Read her blog post here or listen to a quick overview here.

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Posted in Application ILM, Application Retirement, Healthcare | Tagged , , | Leave a comment

Are You Getting an EPIC ROI? Retire Legacy Healthcare Applications!

Healthcare organizations are currently engaged in major transformative initiatives. The American Recovery and Reinvestment Act of 2009 (ARRA) provided the healthcare industry incentives for the adoption and modernization of point-of-care computing solutions including electronic medical and health records (EMRs/EHRs).   Funds have been allocated, and these projects are well on their way.  In fact, the majority of hospitals in the US are engaged in implementing EPIC, a software platform that is essentially the ERP for healthcare.

These Cadillac systems are being deployed from scratch with very little data being ported from the old systems into the new.  The result is a dearth of legacy applications running in aging hospital data centers, consuming every last penny of HIS budgets.  Because the data still resides on those systems, hospital staff continues to use them making it difficult to shut down or retire.

Most of these legacy systems are not running on modern technology platforms – they run on systems such as HP Turbo Image, Intercache Mumps, and embedded proprietary databases.  Finding people who know how to manage and maintain these systems is costly and risky – risky in that if data residing in those applications is subject to data retention requirements (patient records, etc.) and the data becomes inaccessible.

A different challenge for CFOs of these hospitals is the ROI on these EPIC implementations.  Because these projects are multi-phased, multi-year, boards of directors are asking about the value realized from these investments.  Many are coming up short because they are maintaining both applications in parallel.  Relief will come when systems can be retired – but getting hospital staff and regulators to approve a retirement project requires evidence that they can still access data while adhering to compliance needs.

Many providers have overcome these hurdles by successfully implementing an application retirement strategy based on the Informatica Data Archive platform.  Several of the largest pediatrics’ children’s hospitals in the US are either already saving or expecting to save $2 Million or more annually from retiring legacy applications.  The savings come from:

  • Eliminating software maintenance and license costs
  • Eliminate hardware dependencies and costs
  • Reduced storage requirements by 95% (data archived is stored in a highly compressed, accessible format)
  • Improved efficiencies in IT by eliminating specialized processes or skills associated with legacy systems
  • Freed IT resources – teams can spend more of their time working on innovations and new projects

Informatica Application Retirement Solutions for Healthcare provide hospitals with the ability to completely retire legacy applications, retire and maintain access to archive data for hospital staff.  And with built in security and retention management, records managers and legal teams are satisfying compliance requirements.   Contact your Informatica Healthcare team for more information on how you can get that EPIC ROI the board of directors is asking for.

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Posted in Application Retirement, Data Archiving, Healthcare | Tagged , , , , , , , , | Leave a comment

Why an EMR is Not Enough Part II

A lesson learned from other industries, like retail and financial services, is that while analytics and data warehouses are critical components to delivering big results from data — neither is easy. Gartner reported that 80% of data warehousing initiatives fail to meet expectations, often running over budget and failing to deliver a ROI.

  • Executives are often frustrated because responses to their requests for new reports and edited reports take too long
  • Misunderstood requirements and costly rework are the result of a lack of collaboration between stakeholders and IT
  • BI consumers lose confidence in data; they don’t trust it because they lack transparency into its lineage and don’t understand why it appears differently after being aggregated with data from other applications

 

Expecting value from data without making a commiserate investment in data results in unmet expectations. Accessing data is hard, each request requires new effort, establishing enterprise standards for data quality are an enormous effort and transforming data to fit into a heterogeneous intelligence environment is complicated and time consuming.

 

Introducing multiple sources of data across organizational boundaries creates a need for an environment that supports effective collaboration between stakeholders and the information technology team implementing solutions to manage data. To be genuinely useful, data must be verifiable and trustworthy since only then will stakeholders have the confidence to make data-driven decisions.  To realize the value of data, from Epic and beyond, IT leaders must implement business intelligence and data warehousing best practices that:

  • bring data together across applications including clinical and financial data
  • foster collaboration between clinicians, IT and business stakeholders
  • establish trust and confidence in business intelligence and decision making.
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Posted in Healthcare | Tagged , , , | Leave a comment

An EMR isn’t enough, Part I

EMR vendors have long encouraged that their EMR and business intelligence capabilities negate the need to have a plan to integrate data or implement a separate data warehousing and business intelligence. This philosophy begs the question – how can one transactional clinical application support the intelligence needs of an enterprise? Consider customer relationship management data for feeding customer driven marketing initiatives, time tracking data full of valuable employee utilization stats, payer claims data and newly acquired practices running an EMR independent of Epic… just to name a few. 

With the recognition that an EMR accounts for only a fraction of the data needed for reliable and comprehensive business intelligence comes requirements to reconcile terminology and data quality standards across an increasingly large set of trading partners and stakeholders, to access data from other sources (like payroll, CRM and claims) and to migrate clinical data from legacy applications.

In fact, business intelligence and analytics are dependent on data from across the enterprise. Most clinical and financial decisions are dependent on data; great potential lies within data – making it a valuable asset. This is not a new idea. What is a newer concept is what it means to really elevate data to the status of an asset. Unlocking the potential of data as an asset requires that healthcare organizations begin to think about and invest in data in new ways; making investments beyond traditional infrastructure like databases and data storage. Healthcare organizations must make investments in the ongoing management and improvement of the data itself as they do with any other asset, like talent, buildings or their EMR – for example understanding its quality and allocating people and systems to managing it. Moving faster in this competitive climate and delivering differentiated results requires it.

Check back next week for Part II which explores treating data as an asset further.

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Posted in Healthcare, Uncategorized | Tagged , , , | Leave a comment

Ochsner Health System Realizes the Potential of Data

Last week, we hosted a webinar Realizing the Potential of Your Data with Ochsner Health System. Jonathan Stevenson, Director of Analytics, joined me for a dialogue on what they’ve learned in their early steps toward becoming an Accountable Care Organization.

We had a an interactive audience asking questions. A few of which, with their answers, are included below: (more…)

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Posted in Data Governance, Data Integration, Data Quality, Healthcare | Tagged , , , , , | Leave a comment

The Rising Need for Data Integration Around Predictive Analytics

There was an interesting story that surfaced recently. Indiana University researchers found that a pair of predictive modeling techniques can make significantly better decisions about patients’ treatments than can doctors acting alone. Indeed, they claim a better than 50 percent reduction in costs and more than 40 percent better patient outcomes. (See a story by Derrick Harris over at GigaOM for additional analysis, and I will also cover this subject in greater detail in a forthcoming column in TDWI’s “BI This Week.”) (more…)

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Posted in Big Data, Data Integration, Healthcare | Tagged , , , , | Leave a comment

Great Interview with Ochsner Health System

 HISTalk published a recent interview with Ochsner Health System CIO, Chris Belmont. Chris and his team are great Informatica clients and I really like how he conveyed the benefits of making Informatica the data backbone of their Epic implementation.  I can’t say it any better than Chris already has so I’ve extracted a few take-always below and you can read the entire interview here

On the importance of migrating legacy data into the new EMR: “Informatica was critical in getting us there. We learned on the first site. We thought it was a good idea to go in there with an empty slate and say, let’s just build it all from scratch and start with a clean slate. Let’s make sure the record’s in good shape. We quickly realized that was a bad idea. Not just in the clinical areas, but in the registration area.”

On the value of Application Retirement: “That’s going to be a big win for us. In fact, we’re targeting about $13 million in operational benefit when we turn off those legacy platforms. Informatica is going to allow us to get there.”

On not ever being 100% Epic:  “We’re watching it, but frankly it will be a while – and I would argue never – that we’ll be 100 percent Epic. A lot of the data that we have that Informatica allows us to get our hands on and load into our warehouse is non-Epic data.”

On the nuggets Informatica is helping them to uncover: “We’re correlating a lot of data, not just from Epic, but I think right now we have like 25 different systems that we’re running through Informatica and into our warehouse. The gold nuggets that are coming out of that data are just tremendous.”

On challenges and opportunities: “It’s going to be, how do we do more with the data we have…having that data in a format that’s easily, quickly, and very accessible is going to be key. Gone are the days where you can throw an army of analysts in a room and say, “Give me this report” and you wait three weeks and they give you something that’s less than optimal. I think the days of, “Tell me what I need to know before I even know that I need to know it” — I think those are the days that we’re looking forward to. With the tools we have with partners like Informatica with their tools, I think we can achieve it.”

Meet Chris and his team in Informatica Booth 5005 during HIMSS 2013.

HIMSS 2013 — right time, right place, it’s on!

 

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Posted in Application Retirement, Data Integration Platform, Data Migration, Healthcare, Master Data Management | Tagged , , , , , | Leave a comment

Learn How Ochsner Health System is Unlocking the Potential of Data in Booth 5005

Nothing tells a more compelling story than a happy customer. This is why we are excited to have Ochsner Health System join us during HIMSS. Jonathan Stevenson, Director of Analytics and Data Management, will be in Informatica booth 5005 sharing the Ochsner Health System accountable care plans, the analytics vision, success to date and lessons learned.

Ochsner Health System is Southeast Louisiana’s largest healthcare delivery network with eight hospitals, thirty eight health centers, over twelve-thousand employees and hundreds of applications. This data resides in disparate clinical and operational data silos. This is a challenge for an organization that has been chosen to be one of the early shared savings program participants. The requirements for success include knowing what’s happening with patients outside of the four doors of Ochsner, forming community best practices and knowing where patients are seeking care. (more…)

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Posted in Data Integration, Data Integration Platform, Data Migration, Healthcare | Tagged , , , , , | Leave a comment

No More Excuses – Healthcare Organizations Need to Mask Their Patient Data

Data breaches in healthcare have increased 32 percent in the past year and have cost the industry an estimated $6.5 billion annually according to the Ponemon Institute. Responsible for these breaches were largely employee handling of data and the increasing use of mobile devices. Forty-one percent of healthcare executive surveyed attributed data breaches related to protected health information (PHI) to employee mistakes. Half of the respondents said their organization does nothing to protect the information contained on mobile devices. “Healthcare data breaches are an epidemic,” said Dr. Larry Ponemon, chairman and founder, Ponemon Institute, in an announcement of the study results.

Why are healthcare data breaches becoming more common?
PHI data is in all production and test systems, as well as numerous copies that are created of production systems for test, training and application development purposes. In addition to these production systems, PHI data lives in servers inside and outside of the organization. As more mobile devices are used to access critical patient data, and doctors are using their mobile devices to address medical issues from all over the country (if not the world), more sensitive patient data is exposed. In addition to PHI data such as social security number, a lot of sensitive data that healthcare organizations have is contained in textual notes. So the textual data also needs to be protected. But patient data needs to be protected not only within the hospital or healthcare organization. As patient data is used for clinical trial and research purposes, it is important to protect the data that leaves the organization.
To address these concerns, Informatica has seen organizations move towards an end-to-end, enterprise wide data privacy solution that enables them to:
- Consistently define sensitive data and set data privacy policies
- Identify where sensitive data lives throughout the organization
- Create subsets of production data for testing purposes, greatly reducing costs of managing test data (reducing hardware and software)
- Mask data according to all required PHI rules
- Report / provide audit trail that data has been masked and data is secure
Maintaining many, individual privacy solutions can be both costly and risky. An enterprise wide solution centralizes data privacy management, streamlining development and ongoing maintenance.

For more information on healthcare privacy challenges and how to address them, please join us in our upcoming webinar.

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