A High Level Review of Major Healthcare Vertical Utilization

for Students and Faculty

Presented September 26, 2015

California State University, Fullerton

Mihaylo College of Business and Economics

PERSPECTIVES ON ANALYTICS IN THE HEALTHCARE INDUSTRY

TODAY’S TOPICS• Who am I?

• What is a HealthCare Vertical, and what types are there?

• Common themes: BI and data integration

• Reporting vs Analysis vs Modeling

• Analytic approaches: dash boarding, scenarios, trending

• Modeling approaches: P4P and BF Skinner, Epidemiology, predictive risk modeling

• Practical implementations of Advanced Analytics in HealthCare

• Future tools: Mobile, Internet of Things™, pre-clinical intervention via modeling

• A thought about tools

• What about careers?

• Open discussion!

Don’t fall asleep

Who am I?

• Michael PhippsDirector Clinical & Operational AnalyticsNew Century Healthhttps://www.linkedin.com/in/michaelwphipps

• Administrator of Analytics & HCA Internship program

• Business owner of the “BI Stack”

• Former management of Advanced Analytics @ Fortune 200 company

• 20+ years on both Provider / Payor side in health care

• IT and Business experience

• 5+ SQL dialects, 4+ BI GUI solutions, several certifications, dozens of data warehouses

• I am an analyst first and a leader second. I love talking shop.

• Avid Dr. Who fan, desperately waiting for Fallout 4 and the Star Wars premier

Ground Rules• Geeking out is part of the job and a big

part of making it fun. Please relax • If you have a passion about anything,

you can apply your passion to analytics.

• Good analysts are invariably educators. This is part of my ethos.

• There is no greater compliment one analyst can pay another than to help them become better at their craft.

• Please ask questions, challenge assertions, and above all ENGAGE!

• I promise not to take any of this too seriously, and I encourage you to as well.

WHAT IS A HEALTHCARE VERTICAL? A vertical, or channel, is how we describe the major domains within the healthcare industry.

Each vertical will have specializations in analytics, but they will also have commonalities!

Pharma•Development / testing

•Marketing•Finance

Insurance•Government Programs

•Commercial•Exchange•Specialty

Delivery•Hospitals•Physician groups•Ancillary providers

•Social work

Research•Devices•Procedures•Drugs•Other Academia

Regulation•State•Federal•Oversight agencies

Others•Software developers

•Systems support•Revenue Cycle

The patient exists across each domain, but few recognize non-delivery aspects

Fun fact: my vertical is approximately 7”

• Regardless of the vertical, analytics plays a key component

• While specialization exists, core competencies cross domains especially in entry level roles

• Business Intelligence (BI) isn’t all about the fancy tools. Consider MS Excel- the most popular BI tool on the planet

• Major concepts to consider

• Situational awareness

• Process improvement

• Trend analysis

• Predictions

• Previously, many of these verticals were highly siloed

• Even within the vertical itself, sub-silos were common

• Early integration efforts focused on financial analysis and research support, a lot of data warehouses / marts / stores / etc.

• These days, ‘lateral analytics’ and similar nonrelational approaches are replacing DWs using metadata

• This results in massively complex capabilities with specialized needs

COMMON THEMES: BI AND DATA INTEGRATION

• “What next & control”

• Highly technical & heavy stats

• Focused on predictive data

• Most data pulls are model training

• Not typically client facing

• Context is mostly strategic

• “Who, what, & where”

• More technical

• Focused on established metrics

• A lot of data pulls

• Context is mostly operational

• Visualizations

REPORTING VS ANALYSIS VS MODELING

Reporting Analysis• “Why and how”

• Technical, creative, and math

• Development of metrics

• Data pulls, visualizations, and explanations

• Blend of operational and strategic

Modeling

Each of these roles are critical in Analytics, but very different applications

ANALYTIC APPROACHES: DASH BOARDING, SCENARIOS, TRENDING• Dash boarding is a favorite executive “buzz word”

• Good dashboards are RARE. Most are basically brochure-ware and not actionable

• Interactivity, trending, drilling, and directed observation are game-changers

• Focus on the “call to action”

• Scenarios and “walled garden” approaches are powerful tools to drive enterprise thought

• Never perfect, always evolving

• Excellent for mid-level leadership and external consumers

• Outstanding mobile opportunities

• Trending and benchmarking is fundamental to any analysis. Context is everything.

• Delivering data is easy(ish). Insight is hard. Action requires vigilance and maintenance.

• Outliers vs artifacts and data cleansing is critical to quality outcomes

MODELING APPROACHES: P4P AND BF SKINNER, EPIDEMIOLOGY, PREDICTIVE RISK MODELING• Modeling is one of the hottest segments of analytics these days (even hotter than “Big Data”)

• Free or open source tools, benchmarks, and datasets are available that are actually usable by the average analyst

• The “Democratization of data” is accelerating, spurred by EMR adoption, increasing standardization, mobile platform adoption, and integration of BI concepts into “tribal knowledge”

• Pay for Performance and Evidence Based Medicine are becoming the standard, and in some case legally required. The analytic burden of evidence in these cases is significant!

• Reinforcement via funding drives prescribing behavior and is saving lives (and money)- see HAC/POA, Outcome based Physician compensation agreements

• Member level risk modeling is now used in 100% of Medicare Part C & D populations, most Medicaid populations, and in several commercial implementations. This is a major analytic advance integrating clinical outcomes, financial trending, and predictive modeling

PRACTICAL IMPLEMENTATIONS OF ADVANCED ANALYTICS IN HEALTHCARE

Non-Margin driven revenue (AKA Float or Treasury income)

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PRACTICAL IMPLEMENTATIONS OF ADVANCED ANALYTICS IN HEALTHCARE

FUTURE TOOLS: MOBILE, INTERNET OF THINGS™, PRE-CLINICAL INTERVENTION VIA MODELING

• Mobile BI is revolutionizing healthcare. Consider “Safewatch”, Visible Body, and more

• Mobile no longer means one-way communication. Telemedicine is becoming more common and is leaving the hospital

• Even the FDA has released formal guidelines for mobile apps and analytic use.

• Devices are now talking to your doctor for you. From scales to blood testing to heart monitoring, all of these devices result in massive biomarker datasets

• Pre-clinical interventions have really become a bleeding edge tool! Depression screening is one example (Facebook)

• Epidemiologic surveillance now integrates social media, mobile platforms, and telemedicine. This surveillance is increasing efficacy of treatments and reducing time to care.

From this:

To this:

• SAS, R, MATLAB

• Business Objects, EXCEL, Tableau

• MSSQL, Oracle, Teradata

• PMP, CAPM, MS Project

• Outlook, Lync, SalesForce, ConstantContact

• LinkedIn, Facebook, Branchout

• Informatica, Infosphere, Embarcadero

• DVO, TALEND, Solix

• Kimball approach, Inman paradigm

• Statistical modeling techniques

• GUI driven BI tools

• ANSI SQL

• Project Management techniques

• Communication Skills (Staff, Leadership, and Executive levels)

• Building relationships

• Data Architecting methodologies

• Validation approaches

• Data Pump concepts

A THOUGHT ABOUT TOOLS

Focus on this: Not this:

A poor mechanic blames their tools. A wise mechanic improves their hands.

HOW TO GAIN SKILLS

Analytics is EVERYWHERE!

WHAT ABOUT CAREERS?

http://www.bloomberg.com/news/articles/2015-09-22/these-are-the-careers-where-workers-are-seeing-the-highest-pay-growth

Analytics professionals have many hats, and many names:• Business Analyst• Data Analyst• Business System Analyst• Programmer• Operator

Best advice for your career search:• Get in the door any way you can• Find your passion by jumping in• Create your own roles

Health care is an enormous industry and a small community

OPEN FORUM- ANY QUESTIONS?