chief analytics officer fall usa 2017 - eric poon
TRANSCRIPT
Democratizing Analytics In Healthcare: Duke’s Journey
Eric Poon, MD MPH
Chief Health Information Officer
Duke Health
Professor of Medicine
Duke University School of Medicine
Durham, NC
Corinium Chief Analytics Officer Conference
Oct 2017, Boston, MA
Duke Health is…
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Duke Regional Hospital
- 369 Beds (23 Psych, 30 Rehab)
Duke University Hospital
- 957 Beds (19 Psych)
Duke Raleigh Hospital
-186 Beds
Duke School of Medicine
Duke Clinical Research
Institute
-75+ Clinics, 1.5M patient visits
Duke Health Clinical Enterprise: • 65,000 IP and 1.5M OP visits/year • FY16 revenue: $4.0B
Duke Health Research Enterprise: • FY16 Open IRB Studies: 2,039 • 2015 NIH Funding: $285M
• Duke has historically been highly data-driven, but patient data were walled into separate “gardens” specific to clinical specialty
• Epic replaced over 135 clinical systems at go-live …along with each systems’ analytics platform
• Opportunity to re-think how to provide analytics services at the enterprise level for both the ’haves’ and ‘have-nots’ groups
Analytics at ‘Old’ Duke
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Trust
Collaboration & Partnership
Accountability & Governance
Reusability & Scalability
Communication & Celebration
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Trust
Collaboration & Partnership
Accountability & Governance
Reusability & Scalability
Communication & Celebration
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Analytics Customers & Collaborators
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Duke Executive
Leadership & Enterprise
QI
Individualized Analytics (for
Patient & Caregivers)
Population Health
Academic Faculty & Research
Communities
Innovation
Data Quality & Access
Iterative Implementation & Learning
Advanced Analytics Methods
Common Analytics Misconceptions Our Business Analysts Work Through with Clinicians
• There is so much data in the system, the data must be able to answer my question.
• Just give me all the data that I need, and I will figure out what question I want to ask of it.
• My clinical workflow is everyone else’s workflow
• The clinical conclusion is so obvious to me that the data must be able to re-create my train of thought Was the patient intubated 3 days post-op?
Do all patients with dysuria and pyuria have a UTI?
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Analytics Foundations Architects, Data Developers, BI Admins, Data Modelers, ETL Developers
Information Delivery Report and Dashboard Developers
Customer Solutions Lead, BA, Quality, PM, etc.
Customer
Our analytics team wraps functional layers of skillsets around the customer at the center
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Analyst
BI Dev
DW Dev
Architect
Build Dev
Modeler
Collaboration Type B -Agile Sprints
Collaboration Type A - Operational Reporting
Analyst BI Dev
No Show/Late Cancellation Predictive Model
No Show/Cancel w/in 72 Hrs
• Phone Reminder
• Appt Rescheduled
• Number Times Changed
• Appt Month
• Appt Length
No Show
• Appt Rescheduled
• Phone Reminder
• Appt Length
• Number Times Changed
• Employment Status
Top Predictors Predictive Model Performance
From Data Science
… to Implementation Science
• Beta test with GI
• Pilot in select GI & Ortho Clinics
• Roll out to additional clinics/specialties with
Leadership Guidance
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Dr. Ziad Gellad (GI) Dr. Chad Mathers (Ortho) Dr. Ben Goldstein (B&B)
Trust
Collaboration & Partnership
Accountability & Governance
Reusability & Scalability
Communication & Celebration
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Accountability Lessons Learned
• Measure of Success for Improvement Projects
• Close Alignment between Analytics and Improvement Projects
• Respect Power of Leadership in Change Management
• Leverage Governance Bodies
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Duke’s Clinical Systems Governance
Enterprise Operations Committee (EOC)
ITIOC - Executive Steering
Committee
SOM Informatics Governance Committee
(SIGC)
Privacy & Security Steering Committee (PSSC)
Clinical IT Optimization Committee (CITOC)
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Cardiology Emergency
Department Endo/Bronch Eye Center Transplant HIM
Imaging Laboratory MedLink MyChart Nursing - Ancillary
Oncology
Pediatrics Peri-Operative Pharmacy &
Med Mgt Provider
Optimization Research Revenue Cycle
Women’s Services
Infection Control Referral
Stakeholder Groups
Analytics Governance – Aligned with Clinical Systems
Enterprise Operations Committee (EOC)
ITIOC - Executive Steering
Committee
SOM Informatics Governance Committee
(SIGC)
Privacy & Security Steering Committee (PSSC)
Reporting Requests: Clinical IT Optimization Committee
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Cardiology Emergency
Department Endo/Bronch Eye Center Transplant HIM
Imaging Laboratory MedLink MyChart Nursing - Ancillary
Oncology
Pediatrics Peri-Operative Pharmacy &
Med Mgt Provider
Optimization Research Revenue Cycle
Women’s Services
Infection Control Referral
Stakeholder Groups
Population Health IT Oversight (Healthy
Planet, ACO)
Enterprise Data Quality
Program
Projects Over 250 hrs
of Effort
Trust
Collaboration & Partnership
Reusability & Scalability
Communication & Celebration
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Accountability & Governance
Analytics Architecture to Support Reusability
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Source Data
(Clarity, Caboodle,
EPSi, ServiceNow)
Data Integration
Layer
User Access Layer
Enterprise Data Dictionary
Data Extracts
Static Reports
Pre-built Dashboards
Self Service Tools
(Tableau, Slicer Dicer)
Statistical Packages (R, SAS)
ASAP
Stork
Beaker
HB
PB
Transplant
Universes
HB
PB
BPA Cubes
Database Views
RMDM Funding
Aortic Stenosis
Dehisence
NoShow
Finance Claims
Xsplant Mmgt
Xsplant Finance
PORT No-shows
PORT ICU ServiceNow:
Outages
Finance -Denials
ServiceNow: ServiceCost
TVAR Registry
AS Cohort
Enterprise Data Dictionary Metadata
Data Curation
Data elements defined by source, transformations,
characteristics, etc.
Analytics Center of Excellence, Duke Health Data Quality Program 23
Data Curation
Data Expert Directory
Data Experts
• Over 70 data domain experts identified and inventoried
• Searchable Data Expert Directory
• Roles and Responsibilities
Stewardship
Trust
Collaboration & Partnership
Accountability & Governance
Reusability & Scalability
Communication & Celebration
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Reflections… • Discussions about democratizing analytics stokes
fear about loss of control • Be clear about what problem you will solve by yourself
and which ones you want to partner to solve • Don’t underestimate resistance to change • Find every opportunity to communicate
• Beware of self-proclaimed silver bullets!
• One size doesn’t fit all • But a limited number of standard approaches can prevent
your being stretched too thin
• Be prepared for customers to take an active part • Their enthusiastic involvement is indicative of your
success!
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