Data + API = a perfect marriageAashima Gupta

Executive Director, Incubation & Innovation

Kaiser Permanente

The Healthcare Landscape

An Evolution:

• Paper Electronic Digital (One paradigm shift)• Sick Care Health Care (Second Paradigm Shift)• Patient as a passive recipient of care Patient as a participant in the

conversation about care (Third paradigm shift)

First Paradigm Shift: Paper Digital

Second Paradigm Shift: Sick Healthcare

Third Paradigm Shift: Passive Patient Engaged

KP HealthConnect

Benefits Engine

Prelude

Benefit Plan (EPP)

Patient(EPT)

Coverage (CVG)

Benefit Package (CMK)

Adjudication Table(CML)

Component Group (CMG)

Component (CMP)

MOOPS / Deductible

(CMM)

Benefit Package Display (CMD)

Adjudication Formula (CMA)

Benefit Bucket (CMB)

Benefit Variable (CMW)

Benefit Tier(CMT)

Limit Variable (CMW)

NetworkAuthorization

ReceivedReferral Class

Common Membership

Benefit Accumulator

s (Definitions)

QCare

Special Features

Flag (Category

List)

Employer Group Extract

Individual Demographics

Membership

MemberDetailed Benefits

Claims

Accumulators

KP Clearing House

(External Claims)

Risk Adjustment Tracking System

(RATS)

Provider

Cadence

Lab

Pharmacy

Optical (SDS)

EKG

Dictation / Transcription

External Claims(Electronic)

General Ledger(G/L)

Referrals

Broker Commissions

IVR

Patient Recall OctoPLUS

OctoPOS

Tapestry

Employer Group (PPG)

Detailed Benefits Extract

Resolute

Payor (XXX)

Charges

Claims and Encounters

External Claims(Paper)

Internal Encounters (Electronic)

Benefit Accumulator

s (Data)

Benefit Interface

EpicCare

Formulary (XXX)

ReferralsProvider(SER)

Medical Record

Member

Clarity

Data Warehouse

AMR

Bridges

Apria

ID Card Vendor

(Personix)

EOC Print Vendor(Moore)

Group / Contract

Radiology

IDX / RIS

Picture Archive Capture System

(PACS)Modalities

PCHSKPIC Perot

Health International

Personal Advantage

CNA

PIMSPharmacy

RX

ARC

Clinical Data Marts

Finanical Data Marts

Reporting

Operational

Data

DSS(Business Intelligance)

Cache

HealthTRAC

Immunization Tracking

Panel Management

Disease State Management

Disease Prevention

Preventive Alerts

PCP Selection 1 5 0ExaBytes

2011 Global size of healthcare

data

5 Exabytes = All words ever spoken by humans

API - Access to information, Access to Applications, Access to knowledge

Mashup: KP Location Farmers Markets Transit Options

Mashup: Wellness Analytics Goals

Cloud

Social Mobile

Analytics

Behavior

Context

Access

Delivery

Digital Health

Convergence

Health Happens Outside Our Hospital Walls

Health is everywhere ! How do we make it accessible ?

How do we make it affordable ?

Ask yourselves,

what will you do with data?

Thank you