chief analytics officer fall usa 2017 - eric poon

Democratizing Analytics In Healthcare: Duke’s Journey

Eric Poon, MD MPH

Chief Health Information Officer

Duke Health

Professor of Medicine

Duke University School of Medicine

Durham, NC

Corinium Chief Analytics Officer Conference

Oct 2017, Boston, MA

Building Blocks of Democracy

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Duke Health is…

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Duke Regional Hospital

- 369 Beds (23 Psych, 30 Rehab)

Duke University Hospital

- 957 Beds (19 Psych)

Duke Raleigh Hospital

-186 Beds

Duke School of Medicine

Duke Clinical Research

Institute

-75+ Clinics, 1.5M patient visits

Duke Health Clinical Enterprise: • 65,000 IP and 1.5M OP visits/year • FY16 revenue: $4.0B

Duke Health Research Enterprise: • FY16 Open IRB Studies: 2,039 • 2015 NIH Funding: $285M

• Duke has historically been highly data-driven, but patient data were walled into separate “gardens” specific to clinical specialty

• Epic replaced over 135 clinical systems at go-live …along with each systems’ analytics platform

• Opportunity to re-think how to provide analytics services at the enterprise level for both the ’haves’ and ‘have-nots’ groups

Analytics at ‘Old’ Duke

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What are the Building Blocks for An ‘Analytics Democracy’?

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Trust

Collaboration & Partnership

Accountability & Governance

Reusability & Scalability

Communication & Celebration

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Trust





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Analytics Customers & Collaborators

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Duke Executive

Leadership & Enterprise

QI

Individualized Analytics (for

Patient & Caregivers)

Population Health

Academic Faculty & Research

Communities

Innovation

Data Quality & Access

Iterative Implementation & Learning

Advanced Analytics Methods

Business Analysis 101

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Common Analytics Misconceptions Our Business Analysts Work Through with Clinicians

• There is so much data in the system, the data must be able to answer my question.

• Just give me all the data that I need, and I will figure out what question I want to ask of it.

• My clinical workflow is everyone else’s workflow

• The clinical conclusion is so obvious to me that the data must be able to re-create my train of thought Was the patient intubated 3 days post-op?

Do all patients with dysuria and pyuria have a UTI?

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Analytics Foundations Architects, Data Developers, BI Admins, Data Modelers, ETL Developers

Information Delivery Report and Dashboard Developers

Customer Solutions Lead, BA, Quality, PM, etc.

Customer

Our analytics team wraps functional layers of skillsets around the customer at the center

Analyst

BI Dev

DW Dev

Architect

Build Dev

Modeler

Collaboration Type B -Agile Sprints

Collaboration Type A - Operational Reporting

Analyst BI Dev

Agile Analytics Development

13 Credit: www.mm1.com

No Show/Late Cancellation Predictive Model

No Show/Cancel w/in 72 Hrs

• Phone Reminder

• Appt Rescheduled

• Number Times Changed

• Appt Month

• Appt Length

No Show

• Appt Rescheduled

• Phone Reminder

• Appt Length

• Number Times Changed

• Employment Status

Top Predictors Predictive Model Performance

From Data Science

… to Implementation Science

• Beta test with GI

• Pilot in select GI & Ortho Clinics

• Roll out to additional clinics/specialties with

Leadership Guidance

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Dr. Ziad Gellad (GI) Dr. Chad Mathers (Ortho) Dr. Ben Goldstein (B&B)

Trust





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Accountability Lessons Learned

• Measure of Success for Improvement Projects

• Close Alignment between Analytics and Improvement Projects

• Respect Power of Leadership in Change Management

• Leverage Governance Bodies

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Duke’s Clinical Systems Governance

Enterprise Operations Committee (EOC)

ITIOC - Executive Steering

Committee

SOM Informatics Governance Committee

(SIGC)

Privacy & Security Steering Committee (PSSC)

Clinical IT Optimization Committee (CITOC)

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Cardiology Emergency

Department Endo/Bronch Eye Center Transplant HIM

Imaging Laboratory MedLink MyChart Nursing - Ancillary

Oncology

Pediatrics Peri-Operative Pharmacy &

Med Mgt Provider

Optimization Research Revenue Cycle

Women’s Services

Infection Control Referral

Stakeholder Groups

Analytics Governance – Aligned with Clinical Systems

Enterprise Operations Committee (EOC)

ITIOC - Executive Steering

Committee

SOM Informatics Governance Committee

(SIGC)

Privacy & Security Steering Committee (PSSC)

Reporting Requests: Clinical IT Optimization Committee

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Cardiology Emergency

Department Endo/Bronch Eye Center Transplant HIM

Imaging Laboratory MedLink MyChart Nursing - Ancillary

Oncology

Pediatrics Peri-Operative Pharmacy &

Med Mgt Provider

Optimization Research Revenue Cycle

Women’s Services

Infection Control Referral

Stakeholder Groups

Population Health IT Oversight (Healthy

Planet, ACO)

Enterprise Data Quality

Program

Projects Over 250 hrs

of Effort

Trust




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Analytics Architecture to Support Reusability

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Source Data

(Clarity, Caboodle,

EPSi, ServiceNow)

Data Integration

Layer

User Access Layer

Enterprise Data Dictionary

Data Extracts

Static Reports

Pre-built Dashboards

Self Service Tools

(Tableau, Slicer Dicer)

Statistical Packages (R, SAS)

ASAP

Stork

Beaker

HB

PB

Transplant

Universes

HB

PB

BPA Cubes

Database Views

RMDM Funding

Aortic Stenosis

Dehisence

NoShow

Finance Claims

Xsplant Mmgt

Xsplant Finance

PORT No-shows

PORT ICU ServiceNow:

Outages

Finance -Denials

ServiceNow: ServiceCost

TVAR Registry

AS Cohort

Enterprise Data Dictionary Metadata

Data Curation

Data elements defined by source, transformations,

characteristics, etc.

Data Project Inventory

Metadata

Data Curation

Analytics Center of Excellence, Duke Health Data Quality Program 23

Data Curation

Data Expert Directory

Data Experts

• Over 70 data domain experts identified and inventoried

• Searchable Data Expert Directory

• Roles and Responsibilities

Stewardship

Trust





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Marketing Your Efforts

Reflections… • Discussions about democratizing analytics stokes

fear about loss of control • Be clear about what problem you will solve by yourself

and which ones you want to partner to solve • Don’t underestimate resistance to change • Find every opportunity to communicate

• Beware of self-proclaimed silver bullets!

• One size doesn’t fit all • But a limited number of standard approaches can prevent

your being stretched too thin

• Be prepared for customers to take an active part • Their enthusiastic involvement is indicative of your

success!

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Thank you!

• Eric Poon, MD MPH

• [email protected]

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mailto:[email protected]