2018 Future of Healthcare WA HIMSS Presentation Sri

2018 Future of Healthcare WA HIMSS Presentation Sri Rajamani, Director, Solution Consulting at Health Catalyst 3. 29. 2018

• Is Healthcare Industry already Digital? • Digital Experience and Patient Interaction: ‘Data First’ vs ‘Process First’ Agenda • Digital Experience Part 1 : Placing Orders • Digital Experience Part 2 : Scheduling Visits • Digital Experience Part 3 : Switching Provider Networks • What are the key drivers for Key drivers for ‘Data First’ Experience • Northwest Local Trend Spotting • Conclusions

Various Digital Systems in Healthcare EMRs 1. Affinity - ADT/Registration 2. Allscripts - Ambulatory EMR Clinicals 3. Allscripts Enterprise/Touchworks Ambulatory EMR 4. Allscripts Sunrise - Acute EMR Clinicals 5. Aprima ERM 6. Cerner - Acute EMR Clinicals 7. Cerner - Power. Works Ambulatory EMR 8. Cerner Home. Works - Other 9. CPSI - Acute EMR Clinicals 10. e. Clinical. Works - Ambulatory EMR Clinicals 11. Epic - Acute EMR Clinicals 12. Epic - Ambulatory EMR Clinicals 13. GE (IDX) Centricity Ambulatory EMR Clinicals 14. Mc. Kesson Horizon - Acute EMR Clinicals 15. Mc. Kesson Horizon Enterprise Visibility 16. Meditech 5. 66 EHR w/DR 17. Next. Gen - Ambulatory Practice Management 18. Quality Systems (Next Gen) Ambulatory EMR Clinicals 19. Siemens Sorian Clinicals Inpatient EMR Finance/Costing 1. 2. 3. 4. 5. 6. 7. Affinity - Costing Allscripts (EPSi) - Budget Allscripts (EPSi) - Costing Allscripts (TSI) - Costing BOXI - GL Cost Flex - Costing Digimax Materials Management - Inventory Management 8. IOS ENVI - Costing 9. Kaufman Hall Budget Advisor - Other 10. Lawson - Accounts Payable 11. Lawson - Accounts Receivable 12. Lawson - GL 13. Lawson - Supply Chain 14. Mc. Kesson - Accounts Payable 15. Mc. Kesson Enterprise Materials Management 16. Mc. Kesson HPM - Costing 17. Mc. Kesson HPM - GL 18. Mc. Kesson PFM - Accounts Payable 19. Mc. Kesson PFM - GL 20. Mc. Kesson Series - Accounts Receivable 21. Meditech - GL 22. Microsoft Great Plains - GL 23. Oracle (Hyperion) - Costing 24. Oracle (People. Soft) - GL 25. Oracle (People. Soft) - Supply Chain 26. PARExpress 27. PPM - Costing 28. Smartstream - GL 29. Strata. Jazz - Costing Billing 1. Affinity - Hospital Billing 2. CHMB 360+ RCM - Hospital Billing 3. CPSI - Hospital Billing 4. Epic - Hospital Billing 5. GE (IDX) Centricity - Hospital Billing 6. GE (IDX) Centricity Professional Billing 7. Health. Quest - Patient Accounting 8. Keane - Hospital Billing 9. Mc. Kesson Series - Patient Billing 10. Mc. Kesson STAR - Hospital Billing 11. MD Associates - Professional Billing 12. Siemens Sorian Financials Inpatient Registration and Billing Pat. Sat 1. Fazzi - Patient Satisfaction 2. Health. Stream - Patient 3. 4. 5. 6. Satisfaction NRC Picker - Patient Satisfaction PRC - Patient Satisfaction Press Ganey - Patient Satisfaction Sullivan Luallin - Patient Satisfaction HIE 1. Adirondack ACO Clinical Data from HIXNY (HIE) 2. ADT HIE Patient Programs 3. Vermont HIE HR/ERP 1. API Healthcare - Time and Attendance 2. i. CIMS 3. Kronos - HR 4. Kronos - Time and Attendance 5. Lawson - HR 6. Lawson - Payroll 7. Lawson - Time and Attendance 8. Maestro 9. MD People 10. Now Solutions Empath - HR 11. Oracle (People. Soft) - HR 12. People. Strategy/Genesys HR 13. People. Strategy/Genesys Payroll 14. Ultimate Software Ultipro - HR 15. Work. Day Terminology 1. AHRQ Clinical Classification Software (CCS) 2. Charlson Deyo and Elixhauser Comorbidity 3. Clinical Improvement Grouper (Care Process Hierarchy) 4. CMS Hierarchical Condition Category 5. CMS Place Of Service 6. LOINC 7. National Drug Codes (NDC) 8. NPI Registry 9. Provider Taxonomy 10. Rx Norm 11. CMS/NQF Value Set Authority Center Claims 1. 2. 3. 4. 5. 6. 7. 8. 835 – Denials Adirondack ACO Medicare Aetna - Claims Anthem - Claims Aon Hewitt - Claims BCBS Illinois BCBS Vermont Children's Community Health Plan (CCHP) - Payer 9. Cigna - Claims 10. CIT Custom - Claims 11. Cone Health Employee Plan (United Medicare) - Claims 12. Discharge Abstract Data (DAD) 13. Hawaii Medical Service Association (HMSA) - Claims 14. Health. Net - Claims 15. Healthscope 16. Humana (PPO) - Claims 17. Humana MA - Claims 18. Kentucky Hospital Association (KHA) Claims 19. Medicaid - Claims 20. Medicaid - Claims - CCO 21. Merit Cigna - Claims 22. Merit Select. Health - Claims 23. MSSP (CMS) - Claims 24. Next. Gen (CMS) - Claims 25. Ohio Hospital Association (OHA) Claims 26. Pro. Health - Claims 27. PWHP Custom - Claims 28. QXNT - Claims 29. UMR Claims Source 30. Wisconsin Health Information Organization (WHIO) - Claims Clinical Specialty 1. 2. 3. 4. 5. 6. Allscripts - Case Management Apollo - Lumed X Surgical System Aspire - Cardiovascular Registry Carestream - Other Cerner - Laboratory e. Clinical. Works - Mountain Kidney Data Extracts 7. GE (IDX) Centricity Muse - Cardiology 8. HST Pathways - Other 9. Image. Trend 10. Imm. Trac 11. Lancet Trauma Registry 12. Mac. Lab (Cath. Lab) 13. MIDAS - Infection Surveillance 14. MIDAS - Other 15. MIDAS - Risk Management 16. Navitus - Pharmacy 17. NHSN 18. NSQIPFlat. File 19. OBIX - Perinatal 20. On. Core CTMS 21. Orchard Software Harvest - Pathology 22. PACSHealth - Radiology 23. Pharmacy Benefits Manager 24. PICIS (OPTUM) Perioperative Suite 25. Provation 26. Quadramed Patient Acuity Classification System - Other 27. QXNT/Vital - Member 28. RLSolutions 29. Safe. Trace 30. Siemens RIS - Radiology 31. SIS Surgical Services 32. Status. Scope - Clinical Decisions 33. Sunquest - Laboratory 34. Sunrise Clinical Manager 35. Surgical Information System 36. Thera. Doc 37. Trans. Chart - Other 38. Varian Aria - Oncology 39. Vigilanz - Infection Control

80% of Factors Affecting Health Outcomes Fall Outside Traditional Healthcare Delivery © 2018 Health Catalyst 4

Where is Healthcare Digital Index? “Healthcare CEO, what is your Digitization Index? ” Data Assets x Data Usage x Data Skilled Labor Healthcare is one of the least digital sectors, and it shows in profit-margin growth. © 2018 Health Catalyst 5 Source: Mc. Kinsey Corporate Performance Analysis Tool; BEA; Mc. Kinsey Global Institute analysis

Digital Experience

Digital Experience Part 1 Placing Orders

Ordering a Speaker in Amazon. com Estimated Delivery Cheaper Options Feedback loop Peer Reviews Cost © 2018 Health Catalyst 8

Ordering Asthma Action Plan in EMR © 2018 Health Catalyst 9

What is the difference? VS © 2018 Health Catalyst 10 ‘Data First’ Experience ‘Process First’ Experience

Ordering Asthma Action Plan in EMR Predicted Risk Score How likely are clinicians to follow care recommendations if they are in an EHR vs reports. © 2018 Health Catalyst 11 15 x ‘Choosing Wisely’ Recent Orders

Digital Experience Part 2 Scheduling Visits

Scheduling ‘Hair Cut’ Visit © 2018 Health Catalyst 13

Scheduling ‘Urgent Care’ Visit © 2018 Health Catalyst 14

What is the difference? VS © 2018 Health Catalyst 15 ‘Data First’ Experience ‘Process First’ Experience

Digital Experience Part 3 Switching Providers

Switching Networks 206 – XXX - XXXX © 2018 Health Catalyst 17

Switching Networks 206 – XXX - XXXX MNP – Mobile Number Portability © 2018 Health Catalyst 18

Switching Providers Hospital A © 2018 Health Catalyst 19 What’s your experience? Hospital B

What is the difference? VS © 2018 Health Catalyst 20 ‘Data First’ Experience ‘Process First’ Experience

Key drivers for ‘Data First’ Expereince

Driver : Mergers & Acquisitions • The new company is not integrated until the data is integrated • HIE’s are not sufficient for data integration… not even close • Rip and replacing EHRs with a single, common vendor is not an affordable strategy • © 2018 Health Catalyst Source : Thanks to Dale Sanders Besides, hybrid vigor is a good thing… you should not put all of your digital eggs in one basket

Driver : Enable a Personal Health Record Updated, integrated, shareable, downloadable, transportable Healthcare data is currently locked in the cage of the health system and the technology of the EHR DOS © 2018 Health Catalyst Source : Thanks to Dale Sanders

Source : Thanks to Dale Sanders Driver : Providers becoming payers • The insurance industry is the tail wagging the healthcare dog • © 2018 Health Catalyst Does anyone, other than those in the insurance industry, seriously believe that the current payer/insurance economic model is working? • Critical to the improvement of this situation is the ability for providers to model and assume financial risk, and compete with, or completely disintermediate, insurance companies. • With a Data Operating System, providers have more and better data to model and manage risk than the insurers.

Source : Thanks to Dale Sanders Driver : Extend the life and value of current EHR investments © 2018 Health Catalyst

Northwest Trend Spotting

Disruptors of Healthcare © 2018 Health Catalyst 27 • 98 point 7 • Cross. Over Health • ‘Data First’ Platform - Data Operating System @ Health Catalyst

Conclusion

Courtesy : Dale Sanders @ Health Catalyst We’re not satisfied with the current trajectory of digital health But, at Health Catalyst, we’re not satisfied with ourselves, either. We are far from perfect. © 2018 Health Catalyst 29

Digital Disruption is Already Happening • The world’s largest taxi company… owns no taxis • The world’s largest voice/video communications companies… own no telco • The most popular media company… owns no content • The largest lodging company… owns no property • The world’s most valuable retailer… owns no inventory © 2018 Health Catalyst 30 • The world’s largest software vendors… don’t write the apps Thanks for the inspiration, Ron Kalifa of Worldpay

In the Digital Future of Healthcare… The world’s largest and most successful healthcare and health management companies, will own no hospitals © 2018 Health Catalyst