Consumer-Centric Healthcare
with Integrated Informatics
SAS M2007 Conference, Las Vegas, October 2007
Dave Kil, Chief Scientist, Health Informatics
Accenture Technology Labs
Copyright © 2007 Accenture All Rights Reserved
Contents
• Introductions
• Motivations
• Healthcare Informatics Trends
• Overview – Integrated Healthcare Informatics &
Consumer Experience Optimization (CEO)
• Technology Components with Results
• Future Directions
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Motivations
The Opportunity
• Reducing medical costs without sacrificing care
and with active participation from healthcare
consumers – how to make healthcare and
wellness fun & rewarding
Our Solution
• The Insight Engine for Member Health
Management is an informatics suite that
improves consumer health and cuts medical
costs Health-care premiums
• Our estimates show medical cost savings of 2- still outpacing wages
5% at the population level can be realized and inflation
beyond benefits from existing care management
- Wall Street Journal
or disease management systems Sept 26, 2006
– Focus on Provable ROI & consumer experience
optimization
– Incorporate all available data to predict &
maximize impact
– Multi-channel, personalized optimization
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Healthcare Informatics Trends
Current situation Road blocks Target Future
Silo’ed data/analytics EHR/Integrated analytics
Niche predictive models Integrated Impact & ROI prediction
• Repeatable ROI Behavioral triggers
Cost + RTTM clinical triggers
proof
Consumerism = Higher OOP cost with • Economic incentive Consumerism = Consumer Exp.
HSA mismatch Optimization
• Health behavior
Short-term focus (1 year) Long-term focus (3–5 year)
change
measurement Optimized to each consumer with
Cookie cutter benefit plans • Traditionalism and incentives
Contentious outcomes (providers, DM,
inertia
• Financial well-being Scientific outcomes with drilldown
etc.)
Once-a-year touch with claims lag Continuous real-time engagement
Tech-centric, scalable, continuous
Nurse-centric CM/DM
wellness
4
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The Consumer Health Insight Engine uses analytics
to reduce medical costs and improve care
Insight Engine: Member Health Management
Integrates data sources into "Scores" consumers across
single, unified view multiple dimensions (health,
lifestyle, impactability, etc.)
Member- Health
centric Data
Model Trajectory
Predictors
Acquires or infers health risk
assessment (HRA), claims, Predicts and
behavioral marketing, and Data Acq. Intervention personalizes ROI for
biometric-sensor/, and Manager each intervention
ecological momentary Harvest Analyze Opportunity opportunity
assessment data Data & Predict Finder
Optimizes interventions
Rules Act and Optimize over predicted future
Resource
Validates, calibrates and Manager Adapt Processes health, costs,
Allocation
creates intervention/EBM, Manager enagagability and
consumer-engagement rules impactability
Business
ROI Engine Process
Integrator
Measures actual outcomes
using predictive models and Optimized intervention decisions
propensity score shaping are integrated with enterprise
systems (CM, benefits, medical
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policies, etc.) via SOA 5
The platform addresses the shortcomings of
current approaches
Limitations with Current Approaches Insight Engine for Member Health Management
Medical cost savings are difficult to • ROI Engine scientifically dissects contribution of
measure, understand and prove inter-dependent programs to pin-point value
• Hierarchical Rules Manager facilitates rules creation,
validation, and deployment
Missed opportunities as members are • Health Trajectory Predictors forecast disease
qualified for programs based on progression using lifestyle and HRA data
historical clinical triggers instead of • Intervention Opportunity Finder intelligently searches
future health needs for intervention candidates
Suboptimal ROI because member • Resource Allocation Manager personalizes
engagability and impactability are not intervention programs using engagement parameters
considered and continuous consumer derived from HRA and lifestyle data (inferred where
touch is too expensive with a nurse- necessary)
centric touch platform • ROI optimized across the population and over time
• High-tech touch channel with consumer-centric IHM
Hybrid out-sourced and in-sourced • Modular SOA design integrates with commercial off-
approaches require complex IT, process the-shelf (COTS) solutions including DM/CM tools
and governance resulting in limited • Future-proofed to support future interventions (esp.
flexibility scalable high-tech channels)
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Looking for Inspirations from Consumer-Focused R&D
Projects and Consumer-Centric Companies Æ Fun Always
Sells
Persuasive
mirror
Nike+
Communications: Virtual Dining Online health Business
2.0 Top 10
ideas, July
2007
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Multiple-Player, Role-Playing, Lifestyle-Rewarded Wellness
Game to Bring Fun and Excitement to Take Care of One’s
Health
Watch with
speech
Speech/ Speaker Owner Speech Social context
Sensor
sensing processing
non-speech co-channel voice feature & emotion
and/or
separation separation filter extraction classification engine
calorie
tracking
Shoe with Time series
movement DSP & Activity
feature
sensor transformation classification
extraction
Wireless
pedometer
Immersive
Consumer
user data
profile
collection
Initialization Consumer
Avatar
engine profile understanding
engine
Simple effective user
Social
interface for interactive
network
and immersive user data
profile
collection
MPRPLR
Preprocessing game
Learning
Profiling
MPRPLR
analytics Rewards &
Outcomes
engine Database
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Population Navigator: Stakeholder-specific
views using RIA (Rich Internet Apps)
Intervention opportunities for
various population clusters
prioritized in terms of total cost
and ROI with drilldown
Overall population view to
population cluster-centric view to
understand ROI opportunities
and projected savings to be
tracked real time using ROI
engine
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Intervention Opportunity Finder: Analyze health
trajectories to identify intervention opportunities
Flexible population
navigation and drill- Map 1: All (119997 members) Map 2: ENMI (54933 members)
down across clinical
and lifestyle data Future Future
Analyze and compare past,
present and future health of
membership to identify
opportunity for intervention
Health Trajectory Predictors
using advanced analytics
Drill-down to individual members
for personalized analysis
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Resource Allocation Manager: Personalized
intervention programs that optimize ROI
Interventions are
assessed for each Personalized
member by interventions are
understanding the optimized to maximize
links between health, impact and ROI
lifestyle and
impactability
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50% cost savings? Regression to the Mean
Overall population
PMPM 4876 Æ 2126 Inpatient
population
Year-2 cost
Prevalence rate
$2000 PMPM
Year-1 cost
Members with year-1 cost at least $25K
Before and after
cost distributions
Members with
at least one inpatient
episode during year 1
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How to move from wait-and-see outcomes analysis to near-
real-time outcomes measurement and tracking
Predictive Ratio vs. Group Size
1.7
1.6
1.5
R2 = 0.3870
R2 = 0.7597
SOA paper by Cumming et al., 1.4
“A Comparative Analysis of PR μ and σ
Claims-based Methods of
Health Risk Assessment for 1.3
Commercial Population,” May
2002.
1.2
1.1
0.9
1 2 3 4
10 10 10 10
Group size
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Dynamic Impact Analysis PSS + PM for Operational
Performance Tracking in Tactical and Strategic Settings
Divergence from 0.83 to 0.09 after PDF shaping
0.83
0.49
Find control members similar
to test members on the fly
using ideas from machine learning
0.09
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ROI Engine: Rules driven by scientifically
measured outcomes Æ Facilitation of new
program design
Social
Social Networks
Networks Impact
Impact vs.
vs. Psychosocial
Psychosocial behavioral
behavioral
parameters
parameters
Email
Email Impact vs. Social Group Clusters
Impact vs. Social Group Clusters
• Decodes contributions
Disease
Disease Management
Management Impact
Impact vs.
vs. Disease
Disease Clusters
Clusters
from multiple programs
and intervention channels Health Coaching Impact vs. Disease Clusters
• On-the-fly control Heart
Cancer Diabetes
population selection disease
Understand program impact vs. disease
conditions
• Individual vs. group ESRD
Musculo- Liver HIV
impact analysis GUS
skeletal Infection
• Foundation for clinical
program optimization and Respiratory Digestive Inpatient
new program design COPD
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Causal pathway analysis to measure outcomes in multiple
dimensions (time & stakeholders)
OGTT: Oral Glucose
Tolerance Test
FPG: Fasting Plasma
Glucose
DCCT: Diabetes Control and
Complications Trial
UKPDS: UK Prospective
Diabetes Study
Kaiser Archimedes
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Future Directions
• Consumer experience optimization
– Sufficient statistics questionnaire design to minimize consumer burden
and maximize predictive accuracy while providing fun (immersive
gaming environment)
– Health MPRP online games with lifestyle rewards
– Integrated outcomes analysis with predictive analytics Æ Integrated
micromarketing
• R&D efforts focused on Consumer Health Insight Engine & CEO
– Non-traditional data gathering
– Preprocessing
– Mobile healthcare informatics
• SOA applied to both devices (SODA), enterprise Web services
architecture, and delivery channels
– Mobility
– Intelligent device integration
– Synergy among data, algorithms, and business services
– Tool vendor neutral solution accelerators
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