build vs. buy a healthcare enterprise data warehouse: which is best for you?

© 2013 Health Catalyst

Prop©rie2t0a1ry3

aHnedalCthonCfaidtaelnytsiat l

Proprwiewtawr.yheaanldthCcaotnafliydsetn.ctoiaml

Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalyticsFollow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics

Enterprise Data Warehousing in HealthcareBuild vs Buy considerations

www.healthcatalyst.com

http://www.healthcatalyst.com/















Context for this topic

Assess Design Implement Test

Deploy

“Do we have the tools to use data to transform care

delivery and streamline operations?”

“Assessment of our current state indicates we need a

different future state. What should that look like?”

“Key to our future state will be an Enterprise Data Warehouse (EDW) to integrate data from multiple sources and facilitate Triple Aim reporting. Make it so.”

“We will test our EDW to ensure it is meeting our expectations.”

“We will roll out our EDW and analytic applications to a broad group of users, including clinicians, leaders, and administrators.”

DecisionShould we build this EDW from scratch, or partner with a vendor to deliver this capability for the organization. Are those my only options?

1

© 2013 Health Catalyst Proprietary and Confidential

www.healthcatalyst.comFollow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics

2

















Agenda



3

● Examine the options– Building an EDW

– Buying an EDW

– Hybrid solution

● Other Considerations

● About Health Catalyst

● Questions

















Poll Question


Prop©rie2t0a1ry3


Proprwiewtawr.yheaanldthCc

aotnafliydsetn.ctoiaml www.healthcatalyst.com


4

















Building an EDW


Prop©rie2t0a1ry3





5

















What is an EDW?Metadata, Security, and Auditing

Common, Linkable Identifiers

Financial Source Marts

Administrative Source Marts

Departmental Source Marts

Patient Source Marts

EMRSource Marts

HRSource Mart

Hospital Operations

Primary Care

Asthma

FINANCIAL SOURCES(e.g. EPSi, Peoplesoft, Lawson)

ADMINISTRATIVE SOURCES(e.g. API Time Tracking)

EMR SOURCE(e.g. Epic, Cerner)

DEPARTMENTAL SOURCES(e.g. Apollo)

PATIENT SATISFACTION SOURCES

(e.g. NRC Picker, Press Ganey)

Human Resources (e.g. PeopleSoft)



6

















Why choose to build an EDW?

Benefits of a data warehouse:● Performance

● Integration

● Ease of use

Historically● Dearth of proven solutions for healthcare

● Pioneers had to demonstrate value prior to funding



7

















Considerations: building an EDW



8

Worst case scenario: project failure● 50% of data warehouse projects fail

Common among unsuccessful EDW builds:● A solid business imperative is missing● Executive sponsorship and engagement is missing● Frontline users are not involved from start to finish

Ongoing success is elusive● Most healthcare IT groups not prepared to function like a

software company● Limited opportunities to learn lessons before funding is

cut

















http://www.gartner.com/newsroom/id/492112



















Pros/Cons: Building an EDW



9

Pros● Building it yourself means infinite customization● Getting “something” built yourself may be “good enough”

(for now)● Pride of authorship

Cons● Staffing● Shortage of qualified resources● Re-learning lessons● “Skunkworks” projects can be culturally divisive● Project management challenges


















Prop©rie2t0a1ry3


Follow the discussion on Twitter - #HCDatawarehouse, #TimeforAnalytics

Buying an EDW




10

















Why might someone buy an EDW?



11

Developing well-engineered, custom software maynot be your core competency

Market offerings for healthcare data warehousing solutions are better than 10 years ago

Support and maintenance agreement help ensurelong term success

















Considerations: Buying an EDW



12

Many of the same risks with any vendor relationship

Evaluating an analytics vendor● Completeness of vision● Culture and values● Total cost● Ability to execute

– Where else have they had success?

– Will their approach work for my organization?

– Do they have expert resources?

More information:● How to evaluate a clinical analytics vendor

















http://www.healthcatalyst.com/How-to-Evaluate-a-Clinical-Analytics-Vendor

























Pros/Cons: Buying an EDW



13

Pros● Shortest time to value

● Real world experience: what works best in practice

● An infusion of help

● Lower total cost of ownership

Cons● Initial cost

● Knowledge transfer

● Tradeoff between “perfect” and “extremely good”

















Poll Question


Prop©rie2t0a1ry3





14

















Hybrid Build and Buy


Prop©rie2t0a1ry3





15

















Buying AND Building an EDW



16

In practice, more like “Buy and Extend”● Leverage a vendor partner for some components

● Develop, using internal resources, others

Examples:● Select a vendor to:

– Implement the data warehouse

– Integrate several high priority data sources

● Leverage internal resources to:– Integrate additional data sources

– Develop additional analytic applications

– Integrate data from the warehouse into operational processes

















Why choose to build AND buy?



17

Best of both worlds● Rapid implementation

● As customizable as a purely “build” solution

● Higher potential for return on investment

Mitigates risk● Benefit from the lessons your vendor has learned

● Infusion of resources to help deploy and train

















Other considerations



18

Potential pitfalls for any data warehouse project● “Boil-the-ocean syndrome”

● Seeking governance “perfection”

● Rigid architecture

Insights● Original article

● Comparing data warehouse architectures for Healthcare

Other Resources● Healthcare Data Warehousing Association (HDWA)

● The Data Warehousing Institute (TDWI)● Health Catalyst Knowledge Center

















http://www.healthcatalyst.com/best-build-buy-healthcare-enterprise-data-warehouse



http://www.healthcatalyst.com/star-schema-vs-late-binding-healthcare-data-warehouse



















http://www.hdwa.org/




http://www.tdwi.org/



http://www.healthcatalyst.com/knowledge-center/



Health Catalyst ProfileIntegrated Delivery Systems

Community Hospitals

Academic Medical Centers

Children’s Hospitals

Patients Impacted



20

Hospitals& Clinics

25M 1400

Founded 2008

Employees 140

HQ Salt Lake City, UT

















What does Health Catalyst offer?

Late-Binding™Data Warehouse Platform

Data Warehouse, Architecture, Metadata Management, Security, and

Auditing

Analytic ApplicationsKey Process Analysis, Dashboards, Advanced

Analytics

ServicesInstallation Services,

Clinical Improvement Services

Integrates Disparate Data

Apply Evidence and Standardize

Change Processand Behavior



21

















Application Families



22

















Reduce Healthcare Labor Costs byusing an EDW and Analytics“The work our organization is doing with the Health Catalyst team pushes the envelope of what it means to have near real-time data at our fingertips to make operational decisions. Their technology and processes put us on track to understand the potential upstream and downstream financial impact of even the smallest decision.”

~ Director Clinical Planning and Financial Management

Objective

• Manage labor costs by allocating resources appropriately to the demand for services

• Eliminate the need to manually pull and consolidate reports on a monthly basis for a 3rd party point solution

• Enable business and unit managers to better track and manage performance by providing more timely information

Health Catalyst Solution

• Late-Binding™ DataWarehouse

• Labor Productivity Advanced Application Module

• Installation Services

• Improvement Services

Results to date

• Estimated 2% reduction in total salaries and benefits to date

• 66% percent increase in the speed of data availability

• Estimated NPV of $425K over a 4-year period from automated data integration

• 500% increase in the number of managers using data to drive decisions © 2013 Health Catalyst

Proprietary and Confidential www.healthcatalyst.com


23

















How to Reduce Heart FailureReadmissions

• Late-BindingTM data warehouse that enables faster time-to-value

• Integration of clinical, patient satisfaction and financial data to establish baseline, ongoing and balance measures

• Discovery, Foundational and Advanced HF applications including cohort finder, registry and evidence- based clinical content

• Healthcare analytic visualization including gauges and trend lines for at-a-glance view

• Seasonally adjusted rate reduction of 21% in 30- day and 14% in 90-day readmissions

• 2X increase in the number of phone calls made to patients within 48 hours of discharge

• Average of 63 % increase in physician medication reconciliation within 48 hours of discharge

• Follow-up appointment intervention baseline and balance measures established

“Our data is now accessible to stakeholders throughout the organization, including clinical teams who can use it to drive improvements in care processes, care quality and patient outcomes”

~ Director of Clinical & Business Analytics

Objective Health Catalyst Solution Results to date



24

• Define Heart Failure (HF) baseline measures for 30 and 90-day readmissions rates

• Implement evidence- based practice interventions to drive HF readmission rate reductions

• Establish balance metrics including ED visits, observation days and patient satisfaction

• Develop sustaining processes for evaluating readmission rates to ensure continuous process improvement

















Questions and AnswersAdditional Information

• See us at HIMSS 2014 booth #6076

• Call 801.708.6800 to request a meeting

• Listen to two clients speak:– “Improving Outcomes with

an Innovative Approach to Population Health Analytics”

» Stanford Hospital & Clinics

» Yohan Vetteth, Pravene Nath, MD

» Date/Time: Thursday, 2/27, 12 PM

» Location: Room 304A, Session #229

– “Blending Clinical and Financial Data to Drive the Value Equation”

» Texas Children’s Hospital

» Charles Macias, MD» Date/Time:

Wednesday, 2/26, 1 PM» Location: Room 304A,

Session #191

• Follow us on Twitter– @healthcatalyst

Explore our site: www.healthcatalyst.com



25

https://twitter.com/healthcatalyst
























build vs. buy a healthcare enterprise data warehouse: which is best for you?

Health & Medicine