Big Data Analytics in Healthcare In pursuit of the Triple Aim with Analytics. David Wiggin, Director, Industry Marketing, Teradata 20 November, 2014
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1 Big Data Analytics in Healthcare In pursuit of the Triple Aim with Analytics David Wiggin, Director, Industry Marketing, Teradata 20 November, 2014
2 Agenda The Triple Aim Population Health in Russia The Potential Value of Analytics Customer Case Studies 2
3 We Agree on The Triple Aim * Better care for individuals Safety & Effectiveness Patient-centeredness Timeliness Efficiency Equity Better health for populations Improve Poor Nutrition Fight Physical Inactivity Deal with Substance abuse Reducing percapita costs Administrative efficiencies Quality improvement Coordination of care Care management Fraud detection 3 3 * Institute for Healthcare Improvement -
4 Life Expectancy in the Russian Federation is Going Up However, according to the OECD report (p.24), the United States and the Russian Federation have lower life expectancies than would be predicted by their GDP per capita alone the United States and the Russian Federation relatively low life expectancies, given their levels of health spending Many other factors, beyond national income and total health spending, affect life expectancy and explain variations across countries. People are living longer, but life expectancy not as long as in comparison countries OECD (2013), Health at a Glance 2013: OECD Indicators, OECD Publishing. 4
5 Global comparison rates of death / 1000 population This reflects the combination of the age of the population & life expectancy 5
6 Life Expectancy is a function of Four Health Factors Source: University of Wisconsin Population Health Institute (UWPHI) 10% 40% 20% 30% Health Behaviors Clinical Care Social & Economic Factors Physical Environment Healthcare (clinical care) is important, but not the whole story. Different Perspectives for Assigning Weights to Determinants of Health, University of Wisconsin Population Health Institute (UWPHI) 6 Source: Placeholder
7 The Top 10 Risk Factors for Death - Which are related to Health Behaviors? WHO, Global health risks: mortality and burden of disease attributable to selected major risks 7
8 The Link Between Risk Factors & Disease / Death WHO, Global health risks: mortality and burden of disease attributable to selected major risks 8
9 The Russian Federation compared to other countries: Alcohol Consumption & Daily Smoking, 2011 Alcohol Consumption Daily Smoking OECD (2013), Health at a Glance 2013: OECD Indicators, OECD Publishing. 9
10 A Macro-Economic Thought Experiment: Life Expectancy & GDP Given a - GDP = $2.1trillion b - Population = 143,000,000 (a/b) - GDP per capita = $14,600 c - GDP per capita per month = $1,200 d - Deaths per year = 2,000,000 (c*d) GDP value of extending life expectancy by a month = $2.4 billion Would you consider investing $100 million to increase average life expectancy by one month, with a resulting GDP increase of $2.4 billion? (Yield = 24:1 return on investment) Note - Of course, your public health leadership are well equipped to build this model with the precision of DALY (Disability Adjusted Life Years), the GDP contribution of adults by cohort, etc. 10
11 Our journey so far There may be an opportunity to improve the health of the citizens of the Russian Federation The economic impact could be significant Each 9 month improvement in average life expectancy yields approx. 1% GDP increase Improved health is also a multiplier for productivity We have arrived at a fork in the road Population health reforms built on a foundation of summary statistics without a way to measure results or discover more detail or Population health changes derived from analytics on detailed historical data & up-todate feedback on what is working, how well and what next 11
12 Healthcare Data - Detail, Reference & Business Process Administrative Claim, claim detail - Inpatient - Outpatient - Prescription drug - Others (DME, SNF, etc) Encounter Eligibility / enrollment Provider Clinical (EMR / EHR) ADT (Admission, Discharge, Transfer) Clinical measures (bp, BMI) Lab results Procedures Discharge notes Genomics Reference Evidence based medicine Quality measures Rx side effects, drug-drug interactions Outcomes research Groupers - Episodes of care - Predictive analytics Personalized medicine Business Processes Care / disease management Quality management Actuarial / underwriting Fraud detection 12
13 Analytics for Population Health and Health Care What have others done? Health Behaviors Patient Engagement & influencing health behaviors Clinical Care - four key dimensions of measuring health care Utilization - Should these drugs be used together? always / never - What can we learn from regional differences in care? Cost effectiveness usually varies Cost - Is 50% of health care spent on 5% of the population? Should this change? - Fraud, waste and abuse is estimated to be at least 3% of total health care cost - Are inventory levels managed well, avoiding stock-outs and high, unnecessary carrying costs Quality - Is treatment protocol appropriate for diagnosis, age, gender of patient? - Are evidence based guidelines as benchmark for quality Access - Travel distance from patient home to site place of health care service - Adequate Physicians per 1,000, especially in rural areas? Telemedicine investment? 13
14 1. BCBS TN (Health Insurance) Invests in Patient Engagement Objectives Invest in customer-centric clinical data warehouse, predictive analytics and member segmentation / outreach Approach Analyze (health risks, behaviors, gaps) Identify opportunities (segmentation of members) Align programs (to individuals) Reach members (right channel, right time) Results Measure ROI on all programs (e.g. disease management, wellness, etc) & adjust Member engagement drives health behaviors, improving health, reducing cost Membership growth 2014 CIO 100 Award 14
15 2. Discovery Analytics for Healthcare Insurer Objectives Create a blue zone among members where it did not naturally occur Discover new ways to improve population health and reduce the cost of health care Approach Invest in discovery analytics for data scientist, using map-reduce, advanced statistics & data visualization capabilities Results Identified off-label / inappropriate prescription drug use & contacted clinicians identified Analyzed member interactions to improve satisfaction / engagement 15
16 3. Large Commercial Health System Objectives (operational, cost, quality): Avoid stock-outs, reduce inventory costs across hundreds of facilities Consolidate financial data from disparate systems Assess quality of care & treatment effectiveness Approach Enterprise Data Integration from > 200 hospitals & physician groups Provide access to 1,000 SCM users & 3,000 financial users Report on gaps-in-care and key quality measures Results Reduced pharmaceutical costs by $15 million/year and medical supply costs by $3 million/year Reduced inventory by nearly $3 million Monthly reporting cycles: 4 days to 1 day Quality of care improves 16
17 4. U.S. CMS (Centers for Medicare & Medicaid Services) Objectives Streamline data management for program integrity and program management Approach Integrate 10 years detail data into high performance data warehouse representing healthcare experience of almost 50 million Medicare beneficiaries Results Increased pace and value of fraud prosecutions Integrated, reliable data warehouse for program management - Statistics, BI tools, analytics applications leverage in-database capabilities of the integrated data warehouse - Analytics include trend analysis & top conditions (utilization), top expenditures (cost), provider relations (quality) 17
18 5. Michigan Department of Community Health Objectives Deliver improved, coordinated services to citizens of Michigan by making best use of available data Approach Integrate healthcare and human services data from 9 agencies into a single data warehouse (claims, eligibility, providers, birth/death records, LTC, WIC, immunizations, lead screening, newborn screening, and notifiable diseases) Provide analytics to > 8,000 users Results Advanced healthcare analytics saves > $300 million annually Medicaid administrative costs reduced by 25% Recoveries for Medicaid fraud have doubled Data warehouse helped Michigan go from last to first in child immunization rates Track and substantiate savings in Medicaid pharmacy costs 18
19 6. Large (top 5) U.S. Health Insurance Company Objective (operational, cost): Speed up clinical audit of handwritten physician notes / medical records by automating the process Approach Digitize handwriting on paper forms using OCR Use NLP to fuzzy match on clinical keywords by procedure code to reduce number of claims that required manual review Develop web app for use by nurses Results Annual case review load (capacity) with same staff 5X Able to review more suspect procedures for fraud, waste and abuse with same staff 19
20 Closing Thoughts Our experience: healthcare industry customers deliver 10:1 Return on Analytics Investment (ROI). Our advocated approach to capture & integrate detail data once, and push analytics to the data base, has delivered transformational business / analytics value. The wide variety of goals for our healthcare customers include competition, cost reduction, fraud detection, supply chain management, program management and more. This approach is robust enough for all these analytics. There are cascading benefits to investing in healthcare beyond cost savings, including improved population health and broader macroeconomic benefits that result from a healthier population. 20
21 On a related note: Life Sciences Analytics Framework LIFE SCIENCES ECOSYSTEM TERADATA CAPABILITIES DELIVERED VALUE Discover, Develop/ Manufacture Drugs, Biologics, Devices Sales/ Marketing Analytics Finance/ Performance Management Bring Safe, Effective Treatments to Market Quickly Sales/Marketing for Clinicians/ Consumers, Safety/Surveillance Managed Markets Analytics When You Know More, You Can Do More Supply Chain Management Maximize Product Success Manage Operations, Supply Chain, Profitability Research/ Development Regulatory/ Compliance Reporting Optimize Financial Performance 21 Teradata Confidential
22 22 A Few Good Books on Big Data Analytics
23 Resources Healthcare Insurance Case Study with 2 videos Work-in-the-Era-of-Healthcare-Reform-Blue-Cross-Blue-Shield-of-North-Carolina/ Follow-up contact: Alexander.Chulapov@Teradata.com 23
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