1. Mike Deegan Technical Consultant Hyland Software Inc. Global Healthcare Services

2. Agenda Phase 1 Current landscape of unstructured data in Healthcare Phase 2 Challenges facing Healthcare Systems Phase 3 IE approach to solutions Phase 4 Leveraging technology to improve decision making

3. Ohio State – BS ISE May 2013 About me… Hyland Global Healthcare Services Internship & Work Experience Reducing lead time Reducing WIP Improving material handling Healthcare Metrics Quality of Care Patient Satisfaction Physician Utilization

4. Welcome to the world of managing unstructured data!

5. We’re not reinventing the wheel just learning how to use it! http://p-hamilton.blogspot.com/2011/08/common-but-strange-product- design-terms.html

6. Evolution of Unstructured Data in Retail Unstructured line items on a spreadsheet or ledger Scanning & barcodes Paper receipts Completely digital transactions Spending trends & notifications Efficiency!

7. But what about Healthcare? Current Fee-for-Service Payment System The Problem Care is fragmented instead of coordinated. Each provider is paid for doing work in isolation, and no one is responsible for coordinating care. Quality can suffer, costs rise and there is little accountability for either. HospitalSpecialist Primary Care Home Health $$$$ Patient-Centered Global Payment System The Solution Global payments made to a group of providers for all care. Providers are not rewarded for delivering more care, but for delivering the right care to meet the patient’s needs. $ Primary Care Hospital Specialist Home Health Source – Recommendations of the Special Commission on the Health Care Payment System, July 2009 How?

8. 3 Important Elements Accountable Care Organizations Financial Incentive to Improve Quality & Reduce Cost HIMSS Level 7 Increased Competition HITECH Act – Meaningful Use Financial incentive to increase available data, improve clinical processes & ultimately improve the quality of care delivery

9. Accountable Care Organization - “Payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in total cost of care for an assigned population of patients”

11.  Electronic Medical Record (EMR) aka Electronic Health Record (EHR) Healthcare Information and Management Systems Society (HIMSS)  Electronic Medical Record Adoption Model (EMRAM)

13. HIMSS Stage 7 *U.S. Hospitals at Stage 7 – 2.9% *U.S. Clinics at Stage 7 – 4.33% *Hospitals & clinics evaluated by HIMSS Analytics as of end of Q4 2013

14. Theory of Diffusion of Innovations

15. We are here Stages of Meaningful Use

17. Convert paper documents to electronic forms Instantaneously capture discreet data that was previously unusable Online & tablet forms at registration & POC Automated business processes / clinical workflows Automatically validate & post payments & submit claims Reduce readmission rates Washington State - $31 Million in savings by reducing by 23% Design Processes to gather more discreet data

18. Create discreet data from unstructured data Natural Language Processing Convert physician diagnosis notes & recording into usable data Advanced Optical Character Recognition Lift discreet data from paper forms and documents

19. Sustainable Improvement AdministratorsPhysiciansNursesHealthcare IT Do what IE’s do best - Serve as Change Agents Leverage the IE skills & problem solving mindset Approach clinical & business aspects from a holistic & systems point of view

21. “ “ There is no passion to be found playing small – in settling for a life that is less than the one you are capable of living. - Nelson Mandela