Data + APIs: A Perfect Marriage
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This document discusses how data and APIs can enable better integration of healthcare services. It notes that the healthcare industry has undergone three paradigm shifts: from paper to digital records, from sick care to preventative health care, and from passive to engaged patients. The document outlines Kaiser Permanente's complex existing systems and data flows. It envisions how open APIs could enable new applications and services by integrating Kaiser's data with other sources, like location data to suggest farmers markets or transit options. This would support a vision of digital health that makes services accessible and affordable beyond hospital walls by leveraging analytics, mobile access, and cloud-based delivery of care.
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Data + APIs: A Perfect Marriage
- 1. Data + API = a perfect marriage Aashima Gupta Executive Director, Incubation & Innovation Kaiser Permanente
- 3. The Healthcare Landscape An Evolution: • • • Paper Electronic Digital (One paradigm shift) Sick Care Health Care (Second Paradigm Shift) Patient as a passive recipient of care Patient as a participant in the conversation about care (Third paradigm shift)
- 4. First Paradigm Shift: Paper Digital
- 5. Second Paradigm Shift: Sick Healthcare
- 6. Third Paradigm Shift: Passive Patient Engaged
- 7. API - Access to information, Access to Applications, Access to knowledge QCare Provider Accumulators External Claims (Paper) General Ledger (G/L) Common Membership Membership Referrals Individual Demographics Risk Adjustment Tracking System (RATS) Claims Detailed Benefits Benefit Interface Group / Contract KPIC Detailed Benefits Extract Disease Prevention PCP Selection KP Clearing House (External Claims) Preventive Alerts PCHS EOC Print Vendor (Moore) Personal Advantage Member External Claims (Electronic) HealthTRAC Perot Broker Commissions Member Employer Group Extract ID Card Vendor (Personix) Internal Encounters (Electronic) Immunization Tracking IVR AMR Apria Disease State Management CNA Health International Panel Management KP HealthConnect EpicCare Dictation / Transcription Provider (SER) Referrals EKG Prelude Bridges Claims and Encounters Cadence Patient (EPT) Tapestry ExaBytes DSS (Business Intelligance) Formulary (XXX) Pharmacy Pharmacy RX Resolute 150 Charges Payor (XXX) Lab Benefit Accumulator s (Data) Employer Group (PPG) Special Features Flag (Category List) Coverage (CVG) PIMS ARC Reporting Benefits Engine Benefit Accumulator s (Definitions) Benefit Package Display (CMD) Medical Record Radiology Optical (SDS) Patient Recall MOOPS / Deductible (CMM) Network Component (CMP) OctoPOS Modalities Picture Archive Capture System (PACS) Cache Clarity Finanical Data Marts Benefit Package (CMK) IDX / RIS OctoPLUS Clinical Data Marts Benefit Plan (EPP) Component Group (CMG) Adjudication Table (CML) Authorization Received Benefit Tier (CMT) Referral Class Adjudication Formula (CMA) Benefit Variable (CMW) Limit Variable (CMW) Benefit Bucket (CMB) Data Warehouse Operation al Data 2011 Global size of healthcare data 5 Exabytes = All words ever spoken by humans
- 8. Mashup: KP Location Farmers Markets Transit Options
- 11. Health Happens Outside Our Hospital Walls Health is everywhere ! How do we make it accessible ? How do we make it affordable ?
- 13. Ask yourselves, what will you do with data?
- 14. Thank you
Editor's Notes
- * SMAC - is a key tactic as a foundation for the above three paradigm shifts * Online/Mobile : we need to think "Beyond the browser" - API * API - Access to information, Access to Applications, Access to knowledge * Mashup : KP Location -> Farmers Markets ->Transit Options * Mashup : Wellness -> Analytics -> Goals * Think Different - Crowdsource : Location of ERs across the country ? Location of AED across the country ? * Health is everywhere - How do we make it accessible, How do we make it affordable ?
- Health Care –Massive Data – locked inside corporate –Interconnected quagmire
- As the Internet becomes “pure plumbing”, Kaiser Permanente is developing and delivering capabilities beyond the browser. These capabilities will be driven by the ability to expose digital assets through an open interface, where appropriate, to trigger application innovation through KP and our partners (developer community, other vendors, and start ups).
- I’ve gone from the “Road Less Travelled” to the new (much worn) road to Digital HealthThank you