Hospital Corporation of America: Improving Health Care with Data

Early LessonsEarly LessonsRyan RichardsonDirector, Strategic AnalyticsOperations and Service Lines Group

Company OverviewCompany Overview

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Salt Lake City DenverKansas City

Miami/Fort Lauderdale/WPB

Dallas /Fort Worth

San Antonio

New Hampshire

Western Idaho

San Jose

Southern California

Las Vegas

Idaho Falls

Myrtle Beach

Trident / Charleston

JacksonvilleNorth Central Florida

OrlandoTreasure Coast

N-VA

Richmond

S-VA

Augusta

Tallahassee

Wichita

Oklahoma City

Central Louisiana

Lafayette

New OrleansPanhandle

El Paso

Corpus ChristiMcAllen

Brownsville

TerreHaute

Frankfort

ChattanoogaNWGAAtlanta

Middle GA

Anchorage

Nashville

HoustonTampa

Austin

Central London

Gold labels indicate top 10 domestic markets by 1Q 2015 Adjusted EBITDA.

• HCA, founded in 1968, operates 165 hospitals across the US and in London• Provide ~ 4% - 5% of all U.S. hospital services

Company StructureCompany Structure

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• HCA hospitals report through a Division Group structure• HCA’s service line infrastructure:

– Identify opportunities– Standardize operations– Ensure compliance– Identify and disseminate best practices– Centralize vendor management

HospitalHospital

HospitalHospital

HospitalHospital

Division

HospitalHospital

HospitalHospital

HospitalHospital

Division

Group Operations and Service Lines Group•Cardiovascular Services•Pediatrics•Inpatient Rehab•Behavioral Health•Oncology•Ambulatory Surgery Centers•Surgical Services•Robotics•Telemedicine•Non-service line operational support

• Physician Relations• CRM

Strategic Analytics TeamStrategic Analytics Team

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• Established February 2015• Goals:

1. To provide efficient support to growing group of service lines• Assume existing standard reports, leveraging technology to streamline processes (Excel)• Responsive ad-hoc request support• Proactive trend identification and strategic support*

2. Navigate service line leads through byzantine process of accessing data within HCA3. Prevent duplication of efforts within Operations and Service Lines Group

• Without a clear support structure, service line leads get data from any available source

HCA Data StructureHCA Data Structure

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• Many one-off database platforms• HCA largely agnostic on business intelligence• Data-driven organizational culture • Perfect environment for Alteryx

Storage BI/Data Consumption

• Long running Ambulatory Surgery Center report received by large constituency• Prior process involved running multiple queries in Business Objects, populating Access database, then reporting in

Excel using VBA to pull in data needed for specific report– Very buggy process– Results in huge files to be distributed– Takes a full day excluding troubleshooting

Use Case #1 – Data blendingUse Case #1 – Data blending

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(>1m rows)

Prior Process:

• Focus on rapid improvement of current process– No attempt at process redesign– Use of existing, vetted SQL (via Business Objects)

• Alteryx enables rapid conversion of existing reports without the need for a common platform (Access)• Runs in under 30 minutes

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or

Use Case #1 – Data blendingUse Case #1 – Data blendingCurrent Process (beta):

• Standard monthly volume reporting– HCA management wants not only reports, but trends and analysis showing reasons behind large variances– Time-consuming process consisting of:

• Running standard reports• Looking for variances• Drilling into variances for specific areas with large favorable/unfavorable variances

– Somewhat subjective threshold• Providing narrative to accompany results

• Multiple hours per service line per month - big opportunity for improvement

Use Case #2 – Drill Analysis: Inpatient AdmissionsUse Case #2 – Drill Analysis: Inpatient Admissions

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• Starting at HCA summary level and quickly drilling into detail, Alteryx dramatically streamlines process of identifying variances and causes behind them

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Use Case #2 – Drill Analysis: Inpatient AdmissionsUse Case #2 – Drill Analysis: Inpatient Admissions

Incoming data for current and

prior periods

Incoming data summarized several ways 1. Overall

summary written to .tde

Data filtered to identify +/- outliers

Outliers joined to more detailed summary of

incoming data

2. Outlier summary written

to .tde

Outliers joined to even more detailed

summary of incoming data

3. Outlier detail summary written

to .tde

4. Outlier deeper detail summary written to .tde

Outliers joined to most detailed summary of

incoming data

5. Most detailed summary written

to .tde

GroupHCA Division Hospital Service Line Diagnosis

• Starting at HCA summary level and quickly drilling into detail, Alteryx dramatically streamlines process of identifying variances and causes behind them• Pre-built, refreshable Tableau report references most current .tde files generated by Alteryx

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Use Case #2 Simplified – Drill Analysis: Inpatient AdmissionsUse Case #2 Simplified – Drill Analysis: Inpatient Admissions

GroupHCA Division

Hospital

Diagnosis

Service Line

.tde #1

Top variances Identified

.tde #2 .tde #3 .tde #4

Division

.tde #5

Join

Join

Join

• Golden age of data-driven decision making– Affordable storage

• More data being collected

– Tools needed to exploit data relatively inexpensive

• Alteryx streamlines process of reaching meaningful conclusions– Regardless data platform– Regardless BI solution

– More time spent on value-added analysis

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ConclusionConclusion