Empowering Population Health Using Real-time Analytics at Critical Moments of Care amitechsolutions.com

Agenda SETTING THE STAGE FOR POPULATION HEALTH CASE STUDY – PROVING THE POTENTIAL OF POPULATION HEALTH TECHNOLOGIES TO ACCENTUATE THE IMPACT OF POPULATION HEALTH CASE STUDY - HOW TECHNOLOGY CAN IMPROVE PERFORMANCE NEXT STEPS TAKEAWAYS | 2

The Challenges in Population Health | 3

Aging Population & Generally Declining Health Triple Aim Pressure CONSUMER EXPERIENCE COSTS POPULATION HEALTH Louder Voice of Consumer Rising Healthcare Costs Aging Population & Generally Declining Health | 4

The “Big Picture” Problem CARE MANAGEMENT Clinical Analytics Clinical Decision Support Advanced Care Planning Patient Population of the Primary Care Office Care of a Patient Primary Care Office OTHERS WHO SUPPLY/REQUIRE INFORMATION & COORDINATION PATIENT ENGAGEMENT Mobile Automated Outreach Patient Portals CLAIMS AND COST Risk Stratification PAYER DISTANCE MONITORING Telehealth/Telemedicine Remote Patient Monitoring Specialty Care / Hospitals / Device / Radiology, Lab, Rx / Referral / Tracking/HIEs | 5

The Changing Landscape Source: “The View from Healthcare’s Front Lines: An Oliver Wyman CEO Survey” | 6

Manage Chronic Conditions to Lower Cost of Care Fully Automated Blended Automated with Health Coaches Blended Automated with Care Managers Case Management CARE DELIVERY PATIENT STRATIFICATION 40-60% 20-25% 5-15% 2-3% | 7

The Parts of the “Whole” Harnessing Structured, Unstructured Data Sources to Surface New & Deeper Insights EXOGENOUS DATA (Behavioral, Socioeconomic, Environmental) 60% OF DETERMINANTS OF HEALTH GENOMICS DATA 30% OF DETERMINANTS OF HEALTH CLINICAL DATA 10% OF DETERMINANTS OF HEALTH 1100 TB GENERATED PER LIFETIME 6 TB 0.4 TB | 8

Carondelet Medical Group Case Study | 9

CMG Scorecard Program – 1 Year Study 1. PROGRAM OBJECTIVE 2. PROGRAM APPROACH 3. BUSINESS OUTCOME Improve health of diabetic population & lower cost of care in southern Arizona – Tuscon A team-based approach with navigator, PCP, nurses, dieticians all working together for coordination of care Data analytics for risk stratification & tying specific clinical path- ways for intervention based on risk score 48% reduction in hospital inpatient costs 13% reduction in ED costs | 10

Scorecard Program 1 2 3 4 5 IDENTIFY ASSESS STRATIFY ENGAGE MANAGE Inpatient Diabetic Population Identification 2 ASSESS Health Assessment 3 STRATIFY Scorecard Risk Stratification 4 ENGAGE Enrollment / Team-based Clinical Staff 5 MANAGE Management / Interventions Through Web- based Tool RISK + - CLINICAL PATHWAYS A B C D CARE COORDINATION — DISEASE/CASE MANAGEMENT HEALTH RISK FOOD HEALTH PROMOTION/ WELLNESS TAILORED INTERVENTIONS NAVIGATOR CLINICAL TEAM – PCP/ NUTRITIONIST/ NURSES | 11

CMG Scorecard Program Results REDUCTION IN INPATIENT HOSPITAL COST CARONDELET DIABETES SCORECARD YEAR 1 PROGRAM RESULTS 48% 13% REDUCTION IN ED COST | 12

New Technology Landscape | 13

The Technology Timeline RECOGNIZE THE ECONOMIC IMPACT OF POPULATION HEALTH HEALTH MAINTENANCE ORGANIZATIONS DISEASE MANAGEMENT POPULATION HEALTH AS A STRATEGY ALTERNATIVE PAYMENT MODELS 1972 1980s 1997 2003 2018 | 14

Tech Support CLINICAL IoT CONSUMER-GRADE WEARABLES STREAMING DATA / ANALYTICS BIG DATA ECOSYSTEM DATA SCIENCE MACHINE LEARNING ARTIFICIAL INTELLIGENCE | 15

Technology Vendors Potentially Confusing Range of Technical Approaches for Supporting Population Health Strategies CUSTOM DATA INTEGRATION & REPORTING EHR VENDOR MODULES SPECIALIZED POP HEALTH PLATFORMS | 16

Modern Data Architecture Case Study | 17

Streaming Analytics in Action FEATURES SCALABLE: Cloud Native, Distributed REAL-TIME: IoT, Stream Data Processing ADAPTABLE: Service-oriented SMART: Multiple Data Sources, Integrated Health/ Clinical Content Library PREDICTIVE: Dynamic Set of Thousands of Personalized Business Rules | 18

Predicting Hospitalization Findings included patterns that suggest ways to predict hospitalization, falls, blood clots. HOSPITALIZATION EXAMPLE: 1. Significant CHANGE IN SLEEP compared to prior experience. 2. Major change in ACTIVITY LEVEL. 3. SPIKE IN SLEEP INDEX 4 days before hospitalization. | 19

Sustaining Behavior with Personalization COMPLEX BUSINESS RULES PERSONAL IDENTIFICATION INTUITIVE NOTIFICATION STYLES ONE SIZE DOESN’T FIT ALL | 20

Know Your Audience CHALLENGE Only one third of employees who have access to a wellness program are willing to participate. Wellness programs typically fail to engage users beyond the first few weeks or months. SOLUTION In addition to activity tracking and traditional reward programs, leverage behavioral science, modern data architecture and advanced analytics. Personalized goals Customized communication Real-time monitoring Right-time intervention RESULTS Increased initial engagement rate and longer sustained engagement Savings of $15M per year in claims reimbursement for one client | 21

Next Steps | 22

Capabilities then Technical Ecosystem Business Strategy Technology Strategy Population Health Operations Technology Capabilities Use strategically aligned technical capabilities to help inform business strategy and deliver technology capabilities in tandem with the the evolution of business operations rather than in reaction to business needs. Execute specific technical capabilities to produce the most business value and increase technical flexibility to support emerging Population Health needs. | 23

Takeaways | 24

Key Takeaways 1. Technology allows us to achieve broader and more effective population health than ever before 2. Remain focused on the business capabilities you need to enable rather than getting distracted by specific technologies 3. Leverage the appropriate combination of technologies to meet your needs rather than relying exclusive on a population health vendors, EHR capability, or custom solutions 4. Use technology to make interventions more timely and person in order to have the most impact on patients   | 25