Question 1: Why has CHS invested in DA2?

Let's first of all begin the case discussion by understanding why CHS has invested in DA2. You
might want to drive your discussion in a way to cover the opportunities presented to hospitals by
the Affordable Care Act. Think through what big data analytics in healthcare systems could
potentially offer. Exhibit 3 & 4 in the case would help answer this question.
Why did CHS invest in DA2 and what opportunities could it bring? It would be changes in ACA
that opened opportunities in the data analytics of CHS
Biggest reason is ACA which brought on the following changes.
Reasons
- Compensation change into outcome quality instead of service fees
o To increase the care quality
o Opportunities in analytics
 Create systems that track changes in quality
 Focus in strategic priority and performance measure is in Quality &
Patient Experience
- HIPAA
o Suppporting the use of patient data to improve healthcare systems
 Data is shared with organizations subject to HIPAA
- Rapid increases in computing power and decreases in data storage costs
o Build predictive models incorporating complex data
Statement
- Part of why CHS invested in DA2 as a response to the passing of the Affordable Care Act
(ACA). One of the changes in ACA is outcome quality from a service-based
compensation to improve quality in care. The change in compensation provided CHS the
opportunity creates systems that track changes in quality. As a result, one of their
strategic priorities and measuring performance is to focus quality and patient experience.

Question 2: How successful has DA2 been so far? Why?

As DA2 worked successfully on the four pilot programs, which collectively address the range of
CHS strategic priorities and secure internal supporters across the organization, you might want to
address these as documented in the case. It appears to me that there are other factors that explain
the success in addition to the quality and usefulness of DA2’s work though. I will give you an
opportunity to address that here.
Speaking of these four pilot programs, I might want to drive the discussion to learn about which
of the four you think presents the toughest challenge? 
- What are the pilot programs
o Mapping underserved communities
 Key was geotagging
 o Reducing readmissions
 Uses an algortithm that calculates a readmission score
o Advanced Illness management
 For managing patients with high risk of readmission
o Patient segmentation model
 Identifies hogh risk patients
 Cost estimation
 Influenced on contract bidding against healthcare payers
- Success Evidence
o Received investments
o High demands from internal customers
 Quickly outstripped capacity to meet demand
 Potential as another revenue stream
- Reasons for success
o Increasing need for data driven decisions
o Undertaking strategic objectives
 Prioritizing projects of strategic importance
o Building strong relationships with care providers
Statement
- DA2 was successful considering that the internal demand for their services increased
twofold to the point that it quickly outstripped DA2’s capacity to meet customer demand.
A key part of that success is that they maintained alignment with strategic objectives in
that they DA2 reported to Lovin and CHS’s strategy function. Close proximity with the
people in charge of maintaining CHS’s strategy enable DA2 to prioritize projects that that
contribute to strategy and ROI. According to CHS, a key part of the success was building
strong relationships with care providers, with in-network physicians providing DA2’s
data and providing the implementation of DA2’s tools.

Question 3: What are Dulin's most important challenges going forward?

Looking ahead, the case listed the challenges facing Dulin including (a) managing demand with
the aid of the DA advisory board; (b) convincing clinicians to enter complete patient data and to
use the analytics results; (c) insuring data privacy in a closed loop system while pushing the
limits of what data can be used to boost the predictive power of DA's models; and (d)
determining whether to graduate from a cost to a profit center. Can you elaborate more on each?
What are issues or concerns with each challenge?
- Managing demand with the aid of the DA advisory board;
o High demands from internal customers
 Quickly outstripped capacity to meet demand
o Priority setting process was made
 Interviews with clinical teams and internal focus group
 Determined proposals with alignment to strategy
 Resource balancing on proposal vs upkeep
 Matrix assessment
 - Convincing clinicians to enter complete patient data and to use the analytics results;
o
- Ensuring data privacy in a closed loop system while pushing the limits of what data can
be used to boost the predictive power of DA's models; and
o HIPAA
- Determining whether to graduate from a cost to a profit center
o Issue is because of
 High demands from internal customers
 Quickly outstripped capacity to meet demand
- Constrained abilities to look for external opportunities to turn into profit center
Statements
- Managing demand with the aid of the DA2 advisory board & determining whether to
graduate from a cost to a profit center comes from the success of DA2. Part of the result
of that success is the high demand from internal customers that quickly outstripped
capacity to meet demand. Ensuring data privacy in a closed loop system while pushing
the limits of what data can be used to boost the predictive power of DA's models provides
an obstacle due to HIPAA regulations. Although HIPAA supported the use of patient
data, employee information is kept closer guard and violation will lead to heavy
consequences. Convincing clinicians to enter complete patient data and to use the
analytics results is an issue because patient data is generally sensitive and can breach
privacy when bad actors obtain them.

Question 4: Which organizations are best-placed to provide integrated data management

for individual patients?
Let’s discuss who is best place to take the lead in the U.S. in integrating individual patient data
from multiple sources (including clinical data, monitoring data and claims data). In the US health
care ecosystem, there are may players such as healthcare providers, electronic medical record
(EMR) companies, pharmacists, device manufacturers, payers, Google or Apple as the company
dedicated to organizing the world's information, IBM's Watson, etc. Who you do think might
have an opportunity to lead or has it already been leading ? The twin criteria of capacity
(resources, talent) and credibility (with both consumers and doctors) could be leveraged here for
justification.
Statement
- Companies with the dedication to organizing the world’s information, like Watson,
provides the best chances of taking the lead in integrating patient data. Part of that reason
is that some companies have existing AI used to assist medical professionals in providing
insights and discovering new forms of treatment. In data integration management, it can
undertake a large capacity of patient data and understanding the relationship between
dimensions to find insights such as likelihood high risk. In terms of IBM and Watson,
Medical professionals already use it to provide insights in medical research and people
already have an idea of Watson’s capabilities.
 1. 1. Carolinas Healthcare System Assignment Submitted by: Group A Members: Vinod
Maliyekal Sanmeet Dhokay Mandar Risbud
2. 2. Q1: Why has CHS invested in DA2? CHS invested in DA for following reasons: • US
Healthcare landscape was undergoing key changes like fee-for-value instead of just fee-for-
service. Rather than increase just the revenue (size), focus of CHS was to improve
outcomes. CHS firmly believed that deploying analytics could help improve outcomes. Thus,
instead of relying on various analytics skills scattered across the organization, it decided to
create a centralized group to manage Analytics needs. • Secondly, other important reason
for investing into DA2 was to use it to communicate strategy to outside world. • Thirdly, CHS
Information Services leadership rightly anticipated that cost of data storage would plummet
and hence generous DW can be built to support new analytics
3. 3. Q2: How successful has DA2 been so far? Why? DA2 was enormously successful. Soon
after it’s launch, DA2 received twice as many requests as its capacity. DA2 served not only
external customers (like CHS-affiliated hospitals, Payers, Patients and Government), but
also internal customers whose demand for analytics quickly outstripped the team’s capacity.
This shows the success rate of DA2. So much so, that many saw the potential for DA2 to
become an additional revenue stream by outsourcing its analytics services to third parties in
future. The reasons for success of DA2 are as follows: • Till now, 1/3rd of clinical work was
non-standard (that is, decisions were taken in ad-hoc manner, not backed by data). But
since the healthcare industry was moving to fee-for- value approach, more and more data-
driven decisions were required • Though DA2 operated as a cost-centre, it undertook all the
strategic initiatives. Thus, this group was part of corporate strategy • The key to success of
DA2 was continuing commitment to build strong relationships with the physicians and
nurses.
4. 4. Q3: What are Dulin’s most important challenges going forward? Dulin faced following
important challenges: • Working of DA2 had been attracting huge investments which had to
be recovered. However, the work pipeline for DA2 had more demand from internal
requirements (that is, non-revenue earning work). This constrained Dulin to test DA2’s ability
in external marketplace • DA2 generated lot of insights through interactive reports. But the
challenge was to translate these insights into actionable items
5. 5. Q4: Which organizations are best-placed to provide integrated data management for
individual patients? Organizations that have following capabilities are best-placed to provide
integrated data management:  A distributed data system, integrated through right
touchpoints  A corporate data warehouse  A scalable data model  Having high quality
data  Right data governance policies  Having patient segmentation data (based on risk,
spend potential etc)

CHS invested in DA because the US Healthcare landscape was undergoing fundamental changes
like fee-for-value instead of fee-for-service. Rather than increase just the revenue (size), the
focus of CHS was to improve outcomes. CHS firmly believed that deploying analytics could
help improve outcomes. Thus, instead of relying on various analytics skills scattered across the
organization, it created a centralized group to manage analytics needs. Second, another important
reason for investing in DA2 was to communicate strategy to the outside world. Third, CHS
Information Services leadership rightly expected that cost of data storage would plummet, and
they could build hence generous DW to support new analytics.
DA2 was enormously successful. Soon after its launch, DA2 received twice as many requests as
its capacity. DA2 served not only external customers (like CHS-affiliated hospitals, Payers,
Patients, and Government) but also internal customers whose demand for analytics quickly
outstripped the team’s capacity. Many saw the potential for DA2 to become an additional
revenue stream by outsourcing analytics services to third parties in the future. The reasons for the
success of DA2 are: Till now, 1/3rd of clinical work was nonstandard (that is, decisions taken in
an ad hoc manner, not backed by data). However, since the healthcare industry was moving to a
fee-for-value approach, the industry required more data-driven decisions. Though DA2 operated
as a cost center, it undertook all the strategic initiatives. Thus, this group was part of corporate
strategy. The key to the success of DA2 was continuing commitment to building solid
relationships with the physicians and nurses.

Working with DA2 attracted huge investments needing recovery. However, the work pipeline for
DA2 had more demand from internal requirements (that is, non-revenue earning work), which
constrained Dulin to test DA2’s ability in the external marketplace. DA2 generated many
insights through interactive reports. However, the challenge was to translate these insights into
workable items.

Organizations with the following can provide integrated data management: A distributed data
system integrated through the right touchpoints, a corporate data warehouse, a scalable data
model, having high-quality data, Right data governance policies, and having patient
segmentation data.
Presentation on theme: "Carolinas HealthCare System: Consumer Analytics"— Presentation
transcript:
1 Carolinas HealthCare System: Consumer Analytics
2 Why has CHS invested in DA?
There was an entry of consumer tech companies into the healthcare space and therefore CHS
needed analytics capabilities from an industry player that the consumer would trust to integrate
their healthcare data in the future. Therefore, they went for DA. DA had ongoing strategic
priorities to predict health needs, continually enhance patient outcomes and drive transformative
solutions to address community health issues. Da had successfully launched several pilots
covering a variety of medical conditions, geographies, and functional capabilities. In order to
renew the strategic road map to CHS’s growth, CHS partnered with DA to improve outcomes
rather than increasing its size. Most of DA’s capacity was used to provide tools in order to
support CHS-affiliated hospitals in delivering best-in-class healthcare to patients. DA developed
analytical tools for evidence based population health management, personalized patient care and
predictive modelling.

3 How successful has DA been so far? Why?

It collected and handled vast amounts of data efficiently; it created a data governance structure;
and it helped shift the organisation away from the anecdotal culture to evidence based one. After
the DA was launched, the team received more than twice as many requests as it had capacity to
accept. And therefore it created a priority setting process with predictive analytics. DA’s criteria
for success was to improve outcomes rather than increasing size of CHS. DA was committed to
building strong relationships with the nurses and physicians. The data collected through CHS
network, collected at many points of care, was used and any further recommendations and tools
were implemented by physicians. The communication strategy deployed by DA focussed on
improving the quality of outcomes by engaging the patient to change his or her behaviour.

4 What are Dulin’s most important challenges going forward?

Dulin was recruited to help execute on CHS’s vision of creating a unified, data-driven system.
Along with his team he had to decide out of the existing pilots which of them could be extended
for related issues without minimal redesigning. Having received large investments for DA
infrastructure, the CHS leadership wanted to explore external business opportunities for DA
where it could generate profits. Since internal DA services demand was quite high, external
market capabilities could not be tested for DA. Ensuring the data from the predictive models
improved the workflow, by engaging with the clinicians, was a major focus.
5 Which organizations are best-placed to provide integrated data management for individual
patients?
Companies like IBM Watson Health is meant to help physician, researchers, insurers and
patients use big data, analytics and mobile technology to achieve better health outcomes, calling
the business unit IBM’s “Moonshot” in healthcare. The University of California San Francisco
and Intel are working together to create a deep learning analytics platform that will deliver
clinical decision support and predictive analytics capabilities to its users. Microsoft has come up
with a new initiative Healthcare NExT which will combine work from existing industry players
and Microsoft’s research and AI units to help doctors to reduce data entry tasks, triage sick
patients more efficiently and ease outpatient care. Royal Philips has developed ItelliSpace the
latest edition of its comprehensive advanced visual analysis and quantification platform. The
product helps radiologists, detect/diagnose and follow up on treatment of diseases while using
new machine learning capabilities to support the physicians. Sentrein’s end to end remote patient
intelligence solution leverages the revolution in wearable multimodal bio-sensors and machine
learning to detect health deterioration in high risk patients earlier and with higher accuracy so
lower cost interventions can be utilized before the patient becomes acute and requires
hospitalization.
There was an entry of consumer tech companies into the healthcare space, and therefore CHS
needed analytics capabilities from an industry player that the consumer would trust to integrate
their healthcare data in the future. Therefore, they went for DA. DA had ongoing strategic
priorities to predict health needs, continually enhance patient outcomes, and drive transformative
solutions to address community health issues. Da had successfully launched several pilots
covering a variety of medical conditions, geographies, and functional capabilities. In order to
renew the strategic road map to CHS’s growth, CHS partnered with DA to improve outcomes
rather than increasing its size. DA used most of its capacity to provide tools to support CHS-
affiliated hospitals in delivering best-in-class healthcare to patients. DA developed analytical
tools for evidence-based population health management, personalized patient care, and predictive
modeling.

It collected and handled vast amounts of data efficiently; it created a data governance structure,
and it helped shift the organization away from the anecdotal culture to an evidence-based one.
After the team launched DA, it received more than twice as many requests as it could accept.
Therefore, it created a priority-setting process with predictive analytics. DA’s criteria for success
were to improve outcomes rather than increasing the size of CHS. They committed DA to build
solid relationships with the nurses and physicians. They used the data collected through the CHS
network, collected at many points of care, and physicians implemented any further
recommendations and tools. The communication strategy deployed by DA focussed on
improving the quality of outcomes by engaging the patient to change his or her behavior.

CHS recruited Dulin to help execute CHS’s vision of creating a unified, data-driven system.
Along with his team, he had to decide which to extend for related issues without minimal
redesigning from the existing pilots. Having received significant investments for DA
infrastructure, the CHS leadership wanted to explore external business opportunities for DA to
generate profits. Since internal DA services demand was relatively high, Dulin could not test
external market capabilities for DA. Ensuring the data from the predictive models improved the
workflow by engaging with the clinicians was a significant focus.

Companies like IBM Watson Health intend to assist physicians, researchers, insurers, and
patients use big data, analytics, and mobile technology to achieve better health outcomes, calling
the business unit IBM’s “Moonshot” in healthcare. The University of California San Francisco
and Intel are working together to create a deep learning analytics platform to deliver clinical
decision support and predictive analytics capabilities to its users. Microsoft has come up with a
new initiative, Healthcare NExT, which will combine work from existing industry players and
Microsoft’s research and AI units to help doctors reduce data entry tasks, triage sick patients
more efficiently, and ease outpatient care. Royal Philips has developed ItelliSpace, its latest
comprehensive, advanced visual analysis, and quantification platform. The product helps
radiologists detect/diagnose and follow up on diseases while using new machine learning
capabilities to support the physicians. Sentrein’s end-to-end remote patient intelligence solution
leverages the revolution in wearable multimodal bio-sensors and machine learning to detect
health deterioration in high-risk patients earlier and with higher accuracy so providers can use
CHS has invested in DA for different reasons as below: There were many consumer tech
companies entered in the healthcare industry. CHS needed analytics capabilities that the
consumer would trust to integrate their healthcare data in the future. DA had already
implemented and had priorities to predict consumers’ health needs, improve patient outcomes
and implement solutions to resolve community health issues. DA had successfully launched
several pilots covering a variety of medical conditions, geographies, and functional capabilities.
CHS started working with DA to improve the quality rather than quantity to improve CHS’s
growth. DA had a capacity to provide tools to support CHS-affiliated hospitals to deliver high
quality service to its patients. DA developed analytical tools for evidence based population
health management, personalized patient care and predictive modelling.
DA has achieved main three key results, which are: It collected and handled vast amounts of data
efficiently. It created a data governance structure. It helped shift the organization away from an
anecdotal culture to an evidencebased on. Apart from all these, after the DA was launched, the
team received more than twice as many requests as it had capacity to accept. So it created a
priority setting process with predictive analytics. One of the reasons for these achievements was
DA’s standard for success was to improve outcomes rather than increasing size of CHS. The
communication strategy used by DA focussed on improving the quality of outcomes by engaging
the patients to change their behaviour. Another reason was DA was devoted to building strong
relationships with the nurses and physicians.
What are Dulin’s most important challenges going forward?
Dulin was hired to help execute on CHS’s vision of creating a unified, data-driven system. There
were some key challenges for Dulin while going ahead as mentioned below. Dulin and his team
had to consider which of the existing pilots could be expanded without or nominal redesigning
and implementation. In spite of receiving large technological investments for DA infrastructure,
the CHS leadership desired to explore external business opportunities for more profits, with the
help of DA. Dulin’s capacity to test DA’s potentiality in the external marketplace restrained, as
DA’s internal demand was high. DA’s major focus was to ensure the data from the predictive
models improved the workflow by involving clinicians.