1. © 2014 Health Catalyst
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© 2014 Health Catalyst
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Proprietary. If you would like to share, we simply ask that you cite Health Catalyst
5 Critical Information Systems Needed
to Drive Accountable Care Organizations
By Dale Sanders

2. © 2014 Health Catalyst
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Information Systems for Accountable
Care Organizations (ACO)
2
Electronic Medical
Record (EMR)
Used in a consistent and
meaningful way across the
accountable care enterprise
to document patients’
healthcare status and
treatment and support
safe, evidence based care.
1 Health Information
Exchange (HIE)
Enable the sharing of
patients’ clinical data across
disparate EMRs in the
accountable care enterprise.
2 Activity Based
Costing (ABC)
Enables detailed, patient-
specific collection of cost
data. The ACO can then
precisely understand cost of
production and revenue
margins in capitated payment
models.
3
Patient Reported
Outcomes (PRO)
A clinical outcomes
assessment system that
enables the complete
understanding of clinical
outcomes and quality, from
the patient’s perspective.
4 Enterprise Data
Warehouse (EDW)
Central to enabling the
analysis of data collected in
the information systems. the
exposure and integration of
the data drives ROI rates as
high as 450% in two years.
5

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Significant focus in last 7years on
EMR and HIE adoption.
The inability to integrate and analyze
data in an EDW is “the single most
frustrating issue” those organizations
face.
Without integrated activity based and
patient reporting data precise
predictive analytics and patient risk
stratification is unachievable.
3
Information Systems for Accountable
Care Organizations (ACO)
The EDW is the center of
data collection systems,the
platform that enables the
analysis of
clinical, financial, and patient
reported data in a single
database repository.

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Accountable Care Organization –
(ACO) Background
4
ACO is simply a shift in reimbursement
from procedure-based, fee-for-service
towards fee-for-quality, disease, or
condition-based reimbursement with
capitated payments to healthcare
delivery organizations on a per-case
and per-capita basis.

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Accountable Care Organization –
(ACO) Plans and Services
5
A quick assessment of the most
successful U.S. healthcare
systems, such as Intermountain
Healthcare, reveals one very
simple common trait: They offer
health insurance plans and
health delivery services under a
single CEO who balances the
economics of care with access
to care and quality of care.

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Healthcare Industry IT Snapshot
6
• IT Investment over six years in excess of $100 billion.
• Physician satisfaction with EMR products stimulated by
federal incentives is only 39% and declining
• 78% of public HIEs fail due to financial insolvency after
federal and state grant monies removed
• One-third of the organizations in the CMS Pioneer ACO
Program drop out because they can not adequately
quantify the quality of care and financial risk for
managing patients in the ACO

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EDW Return on Investment
7
• Average ROI from an EDW is 431% over five years
• Intermountain Healthcare enjoyed a 1,468% ROI in less
than two years when implementing their EDW

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Healthcare Analytic Adoption Model
Less than 10% of healthcare organizations with any type of EDW operate
at a level 5 of the Healthcare Analytic Adoption Model
8
Level 8
Level 7
Level 6
Level 5
Level 4
Level 3
Level 2
Level 1
Level 0
Personalized Medicine
& Prescriptive Analytics
Clinical Risk Intervention
& Predictive Analytics
Population Health Management
& Suggestive Analytics
Waste & Care Variability Reduction
Automated External Reporting
Automated Internal Reporting
Standardized Vocabulary
& Patient Registries
Enterprise Data Warehouse
Fragmented Point Solutions
Tailoring patient care based on population outcomes and
generic data. Fee-for-quality rewards health maintenance.
Organizational processes for intervention are supported
with predictive risk models. Fee-for-quality includes fixed
per capita payment.
Tailoring patient care based on population metrics. Fee-
for-quality includes bundled per case payment.
Reducing variability in care processes. Focusing on
internal optimization and waste reduction.
Efficient, consistent production of reports & adaptability
to changing requirements.
Efficient, consistent production of reports & widespread
availability in the organization.
Relating and organizing the core data content.
Collecting and integrating the core data content.
Inefficient, inconsistent versions of the truth.
Cumbersome internal and external reporting.

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Principles of Information Technology
9
As healthcare becomes a more tech-savvy, computerized
industry, healthcare executives MUST understand three
core principles and their impact on business.

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Business Moves at the Speed of
Software
10
IT software is now the dominant
variable in business agility and
adaptability.
The best software and
information technology can drive
unprecedented business insight
and business models.
The worst software can drive a
business into the ground.
Principles of
INFORMATION
TECHNOLOGY
1

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Big Value Comes From Big Data
11
The software and underlying
technology enabling analysis of
patterns in large data sets is
driving extraordinary new ability
for businesses to identify
opportunities for greater
efficiency, higher quality, lower
overhead, higher margins, and
new products.
That is the power of the EDW.
Principles of
INFORMATION
TECHNOLOGY
2

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Big Value Comes From Big Data
12
Data management maturity
passes through three phases.
1. Data Collection
2. Data Sharing
3. Data Analysis
Phase 3 is characterized by the
implementation of the EDW.
Principles of
INFORMATION
TECHNOLOGY
3

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Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
A Landmark, 12-Point Review of Population Health Management
Companies (Also by Dale Sanders)
Prior to his healthcare experience, Dale Sanders worked for
fourteen years in the military, national-intelligence, and
manufacturing sectors, specializing in analytics and decision
support. In addition to his role at Health Catalyst, he continues to
serve as the senior technology advisor and CIO for the National
Health System in the Cayman Islands. Previously, he was CIO with
the Northwestern University Medical Center, and regional director of Medical
Informatics at Intermountain Healthcare where he served in a number of
capacities, including chief architect of Intermountain’s enterprise data
warehouse. Dale is a founder of the Healthcare Data Warehousing Association.
He holds Bachelor of Science degrees in Chemistry and in Biology from Ft.
Lewis College, Durango Colorado, and is a graduate of the U.S. Air Force
Information Systems Engineering program.