© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics © 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics John L. Haughom, MD July 2014 The Deployment System: An Organizational Structure to Support Sustainable Change

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Implementing an Effective System of Production in Healthcare Analytic system Content system Deployment system Scalable and sustainable outcomes

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Content system 3 Deployment system components Organize teams for scalable improvement Analytic system Combine Lean and analytics Apply Agile

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics A Demonstration… 4 Discovery ApplicationsDiscovery Applications Foundational ApplicationsFoundational Applications Advanced Applications`Advanced Applications` Population Suites e.g., Ischemic Heart Disease Workflow / Operational Suites e.g., Acute Medical Patient Injury Prevention Suites e.g., Infection Prevention Patient Injury Prevention Modules e.g., CAUTI, CLABSI, SSI Workflow/Operational Modules e.g., ICU, MedSurg, Emergency Population Modules e.g., CABG, Stent, AMI Labor Management Explorer Rev Cycle Explorer Patient Satisfaction Explorer General Ledger Explorer Readmission Explorer Population Explorer Patient Flow Explorer Practice Management Explorer Suite Financial Management Explorer CAFE—Comparative Analytics Framework and Exchange—across Healthcare Systems and National Benchmarks EDIT—Executive Dashboard Integration Tool (Key Performance Indicator editable collage from all app categories) Key Process Analysis (KPA) Cohort Builder Comorbidity Analyzer Payment Model Analyzer Readmission Predictor Patient Flight Plan Predictor ACO Explorer Suite Metric Correlation Analyzer Regulatory Explorer Attribution Modeler

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Improvement Methodology A goal is a desired result the workgroup envisions, plans and commits to achieve an organizational desired end-point by a specified deadline. AIM statements are written, measurable, and time-sensitive objectives that move the team toward achieving the goal.

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics 6 CV Heart Failure Goal: Decrease 30 day readmission rates of heart failure patients Establish a baseline of all cause 30 day readmission rates for HF patients, create and validate 30 day and 90 day readmission rates for all HF patients. AIM #1 AIM #2 AIM #3

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics 7 CV Heart Failure Goal: Decrease 30 day readmission rates of heart failure patients Identify high risk heart failure patients and extend the identification of these patients to a Risk Stratification Model to predict the likelihood of all cause 30-day readmission rates. AIM #1 AIM #2 AIM #3

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics 8 CV Heart Failure Goal: Decrease 30 day readmission rates of heart failure patients Schedule a follow-up appointment for all HF patients within 24 hours of discharge with a focus on high risk patients being seen within hours after discharge. AIM #1 AIM #2 AIM #3

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics 9 CV Heart Failure Goal: Decrease 30 day readmission rates of heart failure patients AIM #1 AIM #2 AIM #4 AIM #3 Establish a medication reconciliation baseline and track compliance in order to achieve 75% compliance by X date.

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics 10 CV Heart Failure Goal: Decrease 30 day readmission rates of heart failure patients AIM #2 AIM #3 AIM #5 AIM #4 A follow-up phone call from a nurse post-discharge to assess whether the patient has obtained his/her medication and has no barriers to making their follow-up appointment.

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Two Important Questions… Why is a deployment system necessary? What is the most important ingredient to make a deployment system successful? 11

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Why is a deployment system necessary? To spread best practice… …to sustain improvements.. …and to support continuous learning and continuous improvement.

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics For different results, something has to change… “Insanity is doing the same thing over and over and expecting different results.” Albert Einstein "Every system is perfectly designed to get the results it gets." Paul Batalden, MD

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Outcome of a Traditional Deployment System Baseline performance Improvement with focused project Inability to sustain gains over time Characteristics of a typical team Temporarily assigned No technical team members Approach work like a project (one-time event) No analytic system

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Deployment System Team Structure Team interactions Guidance team Direction, prioritization of resources & remove barriers Clinical implementation team Fundamental knowledge of process Work group drafts: Workflows Measurements Knowledge assets Content SME* Technical SME Analytic SME Nurse lead Physician lead Broad representation of stakeholders across the continuum of care *SME = Subject matter expert

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Two Important Questions… Why is a deployment system necessary? What is the most important ingredient to make a deployment system successful? 16

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Healthcare: The Way It Should Be Why? 17 Available for FREE download at: A handbook… …for transformation. engagement.

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Levels of Engagement Engaged 18 Hungry for best practice Committed to continuous learning Disengaged ∧ Relatively Traditional Craft of Medicine Accepting the need for change; more team oriented, data-driven profession style of practice Less hungry “Do it my way” Traditional Craft of Medicine Need to be convinced a new way is necessary; want to be shown it is necessary and that it works

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Engaging the “Smart Cogs” Focus on the opinion leaders 2º2º Many studies have looked at how these groups differ: Innovators are highly cosmopolitan and open to new things. Early adopters tend to be opinion leaders. Early majority provide “legitimization” of the innovation. Late majority are skeptical. Laggards put trust in the status quo. Innovations do not spread equally over different society segments (social groups),but through 5 stages with a particular profile of reaction. Tipping point at % adoption Rogers’ diffusion of innovation model

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Linking the three systems Clinical Integration hierarchy GUIDANCE TEAM CLINICAL IMPLEMENTATION TEAM WORK GROUP

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Two additional points… We are never too old or too young We achieve the most when we get together and figure out best practice.

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Poll Questions 2. Does your organization have the necessary organizational structure that not only supports the spread of innovation and improvement, but also allows improvements to be sustained over time? 79 Respondents a. 5 – Definitely – 15% b. 4 – 17% c. 3 – 31% d. 2 – 27% e. 1 – Not at all – 11% 22

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics Thank You Upcoming Educational Opportunities Six Reasons Why Healthcare Data Warehouses Fail Date: August 13, 1-2pm, EST Presenter: Steve Barlow, Co-founder and former CEO, Health Catalyst Healthcare Analytics Summit Join top healthcare professionals for a high-powered analytics summit using analytics to drive an engaging experience with renowned leaders who are on the cutting edge of healthcare using data-driven methods to improve care and reduce costs. Date: September 24th-25th Location: Salt Lake City, Utah Save the Date: For Information Contact: Dr. John Haughom:

© 2014 Health Catalyst Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics 24 Transforming Healthcare Through Analytics