Introduction and Overview
Value Based Healthcare
A key component of value-based care is performance management. Payers need to measure the quality and effectiveness of the care healthcare professionals provide to 1) determine the amount they should be reimbursed for their service, 2) identify patients who are at risk and 3) proactively manage the health of their members. HEDIS quality measures are managed by the NCQA (National Committee for Quality Assurance) and they are "used by more than 90% of America's health plans to measure performance on important dimensions of care and service." There are similar quality measures in other regions in the world. Details on how to address this use-case and an educationional 15 min video as well as videos with specific examples using TIBCO Spotfire and TIBCO Data Science - Statistica are available on this Community Wiki page.
Quality and Outcomes
The Institute of Medicine (IoM) defines health care quality as "the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." TIBCO supports six quality domains provided by the IoM.
Supporting Healthcare Insurers, Plans, Pharmacy Benefit Management Systems
Healthcare payers and benefit managers often need patient medical data to support operations and aid in decisions support / analytics. TIBCO is uniquely positioned to source EHR data via HL7’s FHIR connector via Business Works in an intuitive workflow. Spotfire can be used for analytics and dashboards and Business Process Management can provide medical staff and care management workflows. See examples of these assets in action.
Customer (Patient) Analytics
Quality and Re-calls
IoT and Smart Hospitals
eviCore - 500% process improvement - by managing and modeling data associated with benefits management. From medical procedures, to insurance claims, to patient data. Read more details in this case study.
University of Iowa Hospital & Clinics - 74% reduction in surgical site infections and improved patient care - transforming O.R. strategy by using predictive analytics to identify patients risk. Read more details in this case study featuring Associate Chief Medical Officer Dr. John Cromwell
University of Chicago Medicine - Applying data science in real-time by alerting rapid response team to go to the bedside of a patient who is likely to go into cardiac arrest. Successfully reducing number of cardiac arrests in the hospital by an estimated 15 to 20%. Read more details in this case study
Change Healthcare - press article about how Change Healthcare brings Blockchain-Powered Smart Contracts to Healthcare
Cerner - achieves goal of Health Insurance Portability and Accountability Act (HIPAA) compliance as well as increased agility, time and cost savings, without complexity. Read more details in this case study
GE Healthcare - GE Healthcare’s data artisan and project manager Greg Gegner ran an interactive session at TIBCO NOW about pitfalls, challenges, and solutions they encountered to mature from a classic IT BI organization to a flexible function-driven organization that brings big data discovery and analytics wins to the business. Presentation slides here
eClinicalWorks - delivers insights at the point of care and saves customers millions by improving quality,
TIBCO Provides Healthcare Solutions for All - read this blog with further customer success stories for the Healthcare industry
Questions and Feedback
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