EEPAK MATHUR has over 19 years of experience in healthcare analytics and informatics. He currently serves as the Director of Healthcare Reporting and Analytics at Visiting Nurse Service of New York, where he oversees analytical teams and regulatory reporting. Prior to this role, he held several positions involving data analytics, reporting, and quality improvement at organizations like Oxford Health Plans and CIGNA Healthcare. EEPAK MATHUR has expertise in areas like SAS programming, dashboarding, data quality, and reporting to CMS and the New York Department of Health. He also has experience developing analytical strategies to increase revenue and optimize business objectives.
Information Management in Pharmaceutical IndustryFrank Wang
This document discusses the challenges and opportunities for information management in the biopharma industries. It covers topics like challenges in R&D, clinical trials, sales and marketing productivity. It also discusses the evolving biopharma value chain and how information management can help in areas like pharmaceutical R&D, clinical operations, sales, marketing, manufacturing and supply chain optimization. Finally, it discusses how the pharmaceutical industry is at a crossroads with challenges like declining R&D productivity and changing market landscapes in emerging markets and developed nations.
Scott Thomas Duce has over 20 years of experience in healthcare analytics and quality improvement. He currently works as a Senior Manager of Clinical Analytics at Healthfirst, where he has led initiatives to improve star ratings and health outcomes. These initiatives include creating programs for prenatal visits, osteoporosis testing, diabetes education, well-child visits, and access to care. He also manages a team of clinical analysts and has experience in finance analytics.
The document discusses how digitizing healthcare can transform the industry by moving from standalone systems to integrated systems that provide real-time access to data. It notes healthcare is moving from paper-based systems with data silos to integrated electronic systems that can improve quality of care through features like alerts and collaboration. The document also discusses how capturing unstructured data from sources like clinical notes using technologies like natural language processing can provide insights to help monitor metrics, identify conditions, and support research.
The Importance of a Quality Reporting Process in a Pay-for-Performance Enviro...Mallory Johnson
This document summarizes key factors for successful reporting in pay-for-performance healthcare programs. It discusses the growing push for pay-for-performance under the Affordable Care Act and in Medicaid programs. Successful reporting requires clearly defined processes, preparation and validation of reports, flexibility to adapt to changing requirements, using data to drive decision-making, and aligning organizational strategy with reporting needs. Reporting is important to demonstrate achievement of quality goals and access incentive payments.
This document discusses managing healthcare costs in an era of healthcare reform. It includes an agenda for a presentation on the topic with sections on the state of analytics in healthcare, strategic profit and loss statements, use cases, best practices, sample reporting, and a question and answer session. It emphasizes that healthcare transformation requires integrated clinical, financial, administrative, and research data from across healthcare providers as well as analytics. It also notes that a lack of understanding of healthcare costs is a barrier to effective reimbursement approaches and that financial decision support is a top priority for providers.
Transforming Clinical Practice InitiativeCitiusTech
The Transforming Clinical Practice Initiative (TCPI) is designed to help small practices and clinicians achieve large-scale health transformation. The initiative is designed to support more than 140,000 clinician practices over four years duration in sharing, adapting and further developing their comprehensive quality improvement strategies. The TCPI is one part of a unique strategy advanced by the Affordable Care Act to strengthen the quality of patient care and manage health care expenditures, ultimately saving the taxpayer from substantial costs. This document describes the initiative in detail with the type of participants, eligibility and reporting requirements of the participants. Understanding the implementation of this initiative not only helps clinicians, but opens up a huge market for Healthcare IT companies offering the products and services like EHR implementation, Integration, EHR/ Data Migration, Implementation of HIE etc.
The document summarizes a panel discussion on pricing systems and best practices for the wine industry. The panelists discussed how pricing is important from different perspectives within a company. They also addressed common challenges with pricing and outlined best practices, such as centralizing pricing data and modeling pricing throughout the supply chain. The panel recommended companies develop a pricing roadmap and solutions to improve their pricing models over time.
Information Management in Pharmaceutical IndustryFrank Wang
This document discusses the challenges and opportunities for information management in the biopharma industries. It covers topics like challenges in R&D, clinical trials, sales and marketing productivity. It also discusses the evolving biopharma value chain and how information management can help in areas like pharmaceutical R&D, clinical operations, sales, marketing, manufacturing and supply chain optimization. Finally, it discusses how the pharmaceutical industry is at a crossroads with challenges like declining R&D productivity and changing market landscapes in emerging markets and developed nations.
Scott Thomas Duce has over 20 years of experience in healthcare analytics and quality improvement. He currently works as a Senior Manager of Clinical Analytics at Healthfirst, where he has led initiatives to improve star ratings and health outcomes. These initiatives include creating programs for prenatal visits, osteoporosis testing, diabetes education, well-child visits, and access to care. He also manages a team of clinical analysts and has experience in finance analytics.
The document discusses how digitizing healthcare can transform the industry by moving from standalone systems to integrated systems that provide real-time access to data. It notes healthcare is moving from paper-based systems with data silos to integrated electronic systems that can improve quality of care through features like alerts and collaboration. The document also discusses how capturing unstructured data from sources like clinical notes using technologies like natural language processing can provide insights to help monitor metrics, identify conditions, and support research.
The Importance of a Quality Reporting Process in a Pay-for-Performance Enviro...Mallory Johnson
This document summarizes key factors for successful reporting in pay-for-performance healthcare programs. It discusses the growing push for pay-for-performance under the Affordable Care Act and in Medicaid programs. Successful reporting requires clearly defined processes, preparation and validation of reports, flexibility to adapt to changing requirements, using data to drive decision-making, and aligning organizational strategy with reporting needs. Reporting is important to demonstrate achievement of quality goals and access incentive payments.
This document discusses managing healthcare costs in an era of healthcare reform. It includes an agenda for a presentation on the topic with sections on the state of analytics in healthcare, strategic profit and loss statements, use cases, best practices, sample reporting, and a question and answer session. It emphasizes that healthcare transformation requires integrated clinical, financial, administrative, and research data from across healthcare providers as well as analytics. It also notes that a lack of understanding of healthcare costs is a barrier to effective reimbursement approaches and that financial decision support is a top priority for providers.
Transforming Clinical Practice InitiativeCitiusTech
The Transforming Clinical Practice Initiative (TCPI) is designed to help small practices and clinicians achieve large-scale health transformation. The initiative is designed to support more than 140,000 clinician practices over four years duration in sharing, adapting and further developing their comprehensive quality improvement strategies. The TCPI is one part of a unique strategy advanced by the Affordable Care Act to strengthen the quality of patient care and manage health care expenditures, ultimately saving the taxpayer from substantial costs. This document describes the initiative in detail with the type of participants, eligibility and reporting requirements of the participants. Understanding the implementation of this initiative not only helps clinicians, but opens up a huge market for Healthcare IT companies offering the products and services like EHR implementation, Integration, EHR/ Data Migration, Implementation of HIE etc.
The document summarizes a panel discussion on pricing systems and best practices for the wine industry. The panelists discussed how pricing is important from different perspectives within a company. They also addressed common challenges with pricing and outlined best practices, such as centralizing pricing data and modeling pricing throughout the supply chain. The panel recommended companies develop a pricing roadmap and solutions to improve their pricing models over time.
How to Assess and Continuously Improve Maturity of Health Information Systems...MEASURE Evaluation
This document describes a new toolkit for assessing and continuously improving health information systems (HIS) to achieve better health outcomes. The toolkit includes:
1) A five-stage scale to measure the maturity of six HIS components, from emerging to optimized.
2) An assessment tool that maps the current and desired future stages to guide improvement planning. It is administered through key informant interviews and a stakeholder workshop.
3) The goal is to help countries strengthen their HIS through a collaborative, participatory process focused on setting priorities and tracking progress over time.
This document discusses trends in digitizing healthcare, including adopting electronic medical records and mobile health technologies. It describes investment in healthcare IT in various countries and regions, focusing on China. The opportunities of transforming healthcare through more integrated systems with better quality of care and outcomes are outlined. The document promotes using multifunction printers and analytics platforms to capture paper documents, simplify workflows, and unlock insights from structured and unstructured clinical data through searching, automated outputs, and personalized patient engagement.
Driving Home Health Efficiency through Data AnalyticsCitiusTech
This whitepaper highlights how data analytics can help track key performance indicators to drive clinical, financial and operational efficiency to improve quality of home health in an efficient manner.
Member Engagement Using Sentiment Analysis for Health PlansCitiusTech
Sentiment analysis (or opinion mining) is a natural language processing technique used to determine whether data is positive, negative or neutral. Sentiment analysis for health plans deals with member opinions to improve healthcare services and patient experience.
Information Management In Pharmaceutical IndustryFrank Wang
Pharmaceutical Industry Information Management Opportunities and Challenges in Research, Development, Clinical, Sales, Marketing, Managed Markets, Manufacturing, Supply Chain and Distribution
The way healthcare services are now planned, monitored and evaluated has considerably changed in the last decade. Many healthcare organizations have now moved from Activity-Based M&E(ie, what are we really doing?) to Performance-Based M&E which focuses on the overall results (ie what have we achieved?).
Therefore the focus now is on the Results and consequences of actions and implementations, rather than on the inputs (treatment, time, human resources) provided.
In Secondary Healthcare Management for instance, this is called Results-Based Management (RBM) and Performance-Based M&E play a vital role in Results-Based Management.
This document provides an overview of various tools and concepts related to data quality management models. It discusses key aspects of data quality including accuracy, accessibility, comprehensiveness, consistency, currency, definition, granularity, precision, relevancy, and timeliness. Specific quality management tools are also outlined, such as check sheets, control charts, Pareto charts, and scatter plots. Examples are given for how these data quality principles and tools apply across different domains like healthcare records and data warehousing.
Enhancing Competitive Advantage through Improved HEDIS Reporting and NCQA Rat...CitiusTech
The objective of this document is to provide a high level understanding of the Healthcare Effectiveness Data and Information Set (HEDIS), which is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service. This document helps in understanding different components of the HEDIS in terms of the measure sets (what it is meant for health plans, changes to the previous year), different methods of collecting data for HEDIS and key requirements for reporting HEDIS
Transforming Post-Acute Care with IMPACTCitiusTech
On October 6, 2014, a bipartisan bill on Improving Medicare Post-Acute Care Transformation (IMPACT) was signed. The IMPACT Act seeks to standardize assessments for vital care issues across the gamut of post-acute care (PAC) providers and builds a framework to ensure that the delivered care is mindful of the patient needs; thereby eliminating the current silo-focused approach to quality measurement and resource utilization.
The document defines management information systems and nursing management information systems. A management information system is designed to transform data into useful knowledge for management objectives like decision making and resource allocation. Similarly, a nursing management information system manages clinical data to aid nurses in improving patient care. The document then discusses applications of nursing MIS like fiscal management, workload tracking, staff scheduling, and office automation. It also covers implementation procedures and potential benefits like better care planning and drug administration.
Maryann Tompkins has over 15 years of experience in grants management, business planning, and administration. She currently serves as the Grants Manager at Novartis Pharmaceuticals, where she reviews funding requests, manages relationships with patient advocacy groups, and ensures regulatory compliance. Previously, she held roles in business planning, operations support, and administration at Novartis and its research institute. She has an MBA and BS in business administration and technical skills including SAP, Ariba, Microsoft Office, and clinical research databases.
The document discusses how accurate, consistent data is essential for healthcare organizations to succeed in the transition to value-based care. It explains that population health management, care coordination, predictive analytics, performance improvement, and clinical quality reporting all require reliable data captured across settings. Ensuring data quality requires establishing governance and processes to standardize, monitor, and protect this valuable asset. When structured properly, healthcare data can be leveraged for strategic decision making, care management, and financial success under new payment models.
Health Informatics Journal - Balanced ScorecardJulius Veracion
The document summarizes the design and evaluation of a balanced scorecard for the health information management department at a large urban hospital in Canada. The creation of the balanced scorecard involved 6 months of planning, development, implementation, and evaluation. Key steps included aligning the scorecard with the hospital's strategy, identifying relevant metrics, gathering staff input, and conducting an evaluation survey. The majority of health information management staff agreed that the balanced scorecard is a useful reporting and management tool, supporting the success of developing it for the department. The process used to identify metrics can help other health information management departments create their own balanced scorecards.
The convergence of health plans and healthcare providers has led to the growing importance for provider-led health plans (Payviders). This eBook highlights the data and technology capabilities necessary for Payvider organizations to optimize performance and drive operational efficiencies.
Introduction to Population Health Analytics, Predictive Analytics, Big Data a...Frank Wang
UNH HCAD 6635 Healthcare Analytics Session 12, the last session of Health Information Analytics. Details of the topics of this session will be covered in HCAD 6637 "Advanced Analytics and Health Data Mining"
Opioid Epidemic - Causes, Impact and FutureCitiusTech
In 2017, everyday, more than 130 people died in the US after overdosing on opioids. This document talks about America's worst drug crisis ever and shares how technology can play a role to cope up with this epidemic.
Strategic Medical Affairs in pharma and medical devicesAnjan Banerjee
Strategic medical affairs in pharma and medical devices outlines key drivers influencing the growing role of medical affairs functions. Regulatory requirements, demand for local excellence, and the need for transparency are pushing medical activities to expand in areas like medical strategy, clinical operations, and regulatory submissions. Medical affairs contributes throughout the product lifecycle by collecting and disseminating knowledge to internal and external audiences, and can help integrate products into healthcare systems from drug development to reimbursement.
Louis Schwartz has over 23 years of experience leading IT organizations in healthcare settings. He currently works as a Solutions Consultant for Philips Healthcare, where he helps define project scopes and ensures smooth transitions between project phases. Prior to this role, he held several leadership positions within the US Army, including Health Information Systems Officer and Chief Information Officer, where he implemented electronic health records and oversaw IT departments. He has a track record of delivering projects on time and within budget while coaching teams to success.
Dr. Brian Thomas has over 15 years of experience leading teams and managing operations in healthcare technology and clinical applications. He is currently an Area Service Manager at Kaiser Permanente where he oversees a team of 30 employees and manages an annual budget of $3.5 million. Previously, he held director roles at United Health Group, Catholic Healthcare West, and Thincoll Health Care Solutions where he implemented electronic medical records systems, oversaw projects, and delivered cost reductions. Dr. Thomas has a Doctorate in Education from Pepperdine University and is a Project Management Professional.
This document summarizes a presentation on developing a framework for monitoring the impact of health reform. It discusses why states should develop such a framework and have Medicaid involved. Key points include using the framework to track progress on goals, define each program's contributions, and avoid duplicative data collection. The presentation provides examples from California and Maryland and outlines steps to develop a framework, including defining scope, choosing measures, identifying data sources, and engaging stakeholders. It emphasizes establishing the framework early to monitor baseline trends and impacts over time.
Denise Weston has over 20 years of experience in healthcare management, finance, and operations. She has a proven track record of reducing costs while improving revenue, including saving $763 million in one year through identifying fraud, waste, and abuse. She has expertise in organizational management, finance, operations, and data analytics. Her experience includes senior roles at Amerigroup Corporation, where she led teams and departments focused on program integrity, premium integrity, and cost containment.
Management information and evaluation systemGagan Preet
An MIES (Management Information and Evaluation System) helps managers collect and use data to make timely decisions. An effective MIES provides accurate, complete and timely information through various modules like registration, billing, diagnostics, and medical records. It also evaluates programs through process, output, effects and short-term impact evaluations to assess objectives and make improvements. MIES formats should include feedback mechanisms so decisions are made at all levels of the organization.
How to Assess and Continuously Improve Maturity of Health Information Systems...MEASURE Evaluation
This document describes a new toolkit for assessing and continuously improving health information systems (HIS) to achieve better health outcomes. The toolkit includes:
1) A five-stage scale to measure the maturity of six HIS components, from emerging to optimized.
2) An assessment tool that maps the current and desired future stages to guide improvement planning. It is administered through key informant interviews and a stakeholder workshop.
3) The goal is to help countries strengthen their HIS through a collaborative, participatory process focused on setting priorities and tracking progress over time.
This document discusses trends in digitizing healthcare, including adopting electronic medical records and mobile health technologies. It describes investment in healthcare IT in various countries and regions, focusing on China. The opportunities of transforming healthcare through more integrated systems with better quality of care and outcomes are outlined. The document promotes using multifunction printers and analytics platforms to capture paper documents, simplify workflows, and unlock insights from structured and unstructured clinical data through searching, automated outputs, and personalized patient engagement.
Driving Home Health Efficiency through Data AnalyticsCitiusTech
This whitepaper highlights how data analytics can help track key performance indicators to drive clinical, financial and operational efficiency to improve quality of home health in an efficient manner.
Member Engagement Using Sentiment Analysis for Health PlansCitiusTech
Sentiment analysis (or opinion mining) is a natural language processing technique used to determine whether data is positive, negative or neutral. Sentiment analysis for health plans deals with member opinions to improve healthcare services and patient experience.
Information Management In Pharmaceutical IndustryFrank Wang
Pharmaceutical Industry Information Management Opportunities and Challenges in Research, Development, Clinical, Sales, Marketing, Managed Markets, Manufacturing, Supply Chain and Distribution
The way healthcare services are now planned, monitored and evaluated has considerably changed in the last decade. Many healthcare organizations have now moved from Activity-Based M&E(ie, what are we really doing?) to Performance-Based M&E which focuses on the overall results (ie what have we achieved?).
Therefore the focus now is on the Results and consequences of actions and implementations, rather than on the inputs (treatment, time, human resources) provided.
In Secondary Healthcare Management for instance, this is called Results-Based Management (RBM) and Performance-Based M&E play a vital role in Results-Based Management.
This document provides an overview of various tools and concepts related to data quality management models. It discusses key aspects of data quality including accuracy, accessibility, comprehensiveness, consistency, currency, definition, granularity, precision, relevancy, and timeliness. Specific quality management tools are also outlined, such as check sheets, control charts, Pareto charts, and scatter plots. Examples are given for how these data quality principles and tools apply across different domains like healthcare records and data warehousing.
Enhancing Competitive Advantage through Improved HEDIS Reporting and NCQA Rat...CitiusTech
The objective of this document is to provide a high level understanding of the Healthcare Effectiveness Data and Information Set (HEDIS), which is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service. This document helps in understanding different components of the HEDIS in terms of the measure sets (what it is meant for health plans, changes to the previous year), different methods of collecting data for HEDIS and key requirements for reporting HEDIS
Transforming Post-Acute Care with IMPACTCitiusTech
On October 6, 2014, a bipartisan bill on Improving Medicare Post-Acute Care Transformation (IMPACT) was signed. The IMPACT Act seeks to standardize assessments for vital care issues across the gamut of post-acute care (PAC) providers and builds a framework to ensure that the delivered care is mindful of the patient needs; thereby eliminating the current silo-focused approach to quality measurement and resource utilization.
The document defines management information systems and nursing management information systems. A management information system is designed to transform data into useful knowledge for management objectives like decision making and resource allocation. Similarly, a nursing management information system manages clinical data to aid nurses in improving patient care. The document then discusses applications of nursing MIS like fiscal management, workload tracking, staff scheduling, and office automation. It also covers implementation procedures and potential benefits like better care planning and drug administration.
Maryann Tompkins has over 15 years of experience in grants management, business planning, and administration. She currently serves as the Grants Manager at Novartis Pharmaceuticals, where she reviews funding requests, manages relationships with patient advocacy groups, and ensures regulatory compliance. Previously, she held roles in business planning, operations support, and administration at Novartis and its research institute. She has an MBA and BS in business administration and technical skills including SAP, Ariba, Microsoft Office, and clinical research databases.
The document discusses how accurate, consistent data is essential for healthcare organizations to succeed in the transition to value-based care. It explains that population health management, care coordination, predictive analytics, performance improvement, and clinical quality reporting all require reliable data captured across settings. Ensuring data quality requires establishing governance and processes to standardize, monitor, and protect this valuable asset. When structured properly, healthcare data can be leveraged for strategic decision making, care management, and financial success under new payment models.
Health Informatics Journal - Balanced ScorecardJulius Veracion
The document summarizes the design and evaluation of a balanced scorecard for the health information management department at a large urban hospital in Canada. The creation of the balanced scorecard involved 6 months of planning, development, implementation, and evaluation. Key steps included aligning the scorecard with the hospital's strategy, identifying relevant metrics, gathering staff input, and conducting an evaluation survey. The majority of health information management staff agreed that the balanced scorecard is a useful reporting and management tool, supporting the success of developing it for the department. The process used to identify metrics can help other health information management departments create their own balanced scorecards.
The convergence of health plans and healthcare providers has led to the growing importance for provider-led health plans (Payviders). This eBook highlights the data and technology capabilities necessary for Payvider organizations to optimize performance and drive operational efficiencies.
Introduction to Population Health Analytics, Predictive Analytics, Big Data a...Frank Wang
UNH HCAD 6635 Healthcare Analytics Session 12, the last session of Health Information Analytics. Details of the topics of this session will be covered in HCAD 6637 "Advanced Analytics and Health Data Mining"
Opioid Epidemic - Causes, Impact and FutureCitiusTech
In 2017, everyday, more than 130 people died in the US after overdosing on opioids. This document talks about America's worst drug crisis ever and shares how technology can play a role to cope up with this epidemic.
Strategic Medical Affairs in pharma and medical devicesAnjan Banerjee
Strategic medical affairs in pharma and medical devices outlines key drivers influencing the growing role of medical affairs functions. Regulatory requirements, demand for local excellence, and the need for transparency are pushing medical activities to expand in areas like medical strategy, clinical operations, and regulatory submissions. Medical affairs contributes throughout the product lifecycle by collecting and disseminating knowledge to internal and external audiences, and can help integrate products into healthcare systems from drug development to reimbursement.
Louis Schwartz has over 23 years of experience leading IT organizations in healthcare settings. He currently works as a Solutions Consultant for Philips Healthcare, where he helps define project scopes and ensures smooth transitions between project phases. Prior to this role, he held several leadership positions within the US Army, including Health Information Systems Officer and Chief Information Officer, where he implemented electronic health records and oversaw IT departments. He has a track record of delivering projects on time and within budget while coaching teams to success.
Dr. Brian Thomas has over 15 years of experience leading teams and managing operations in healthcare technology and clinical applications. He is currently an Area Service Manager at Kaiser Permanente where he oversees a team of 30 employees and manages an annual budget of $3.5 million. Previously, he held director roles at United Health Group, Catholic Healthcare West, and Thincoll Health Care Solutions where he implemented electronic medical records systems, oversaw projects, and delivered cost reductions. Dr. Thomas has a Doctorate in Education from Pepperdine University and is a Project Management Professional.
This document summarizes a presentation on developing a framework for monitoring the impact of health reform. It discusses why states should develop such a framework and have Medicaid involved. Key points include using the framework to track progress on goals, define each program's contributions, and avoid duplicative data collection. The presentation provides examples from California and Maryland and outlines steps to develop a framework, including defining scope, choosing measures, identifying data sources, and engaging stakeholders. It emphasizes establishing the framework early to monitor baseline trends and impacts over time.
Denise Weston has over 20 years of experience in healthcare management, finance, and operations. She has a proven track record of reducing costs while improving revenue, including saving $763 million in one year through identifying fraud, waste, and abuse. She has expertise in organizational management, finance, operations, and data analytics. Her experience includes senior roles at Amerigroup Corporation, where she led teams and departments focused on program integrity, premium integrity, and cost containment.
Management information and evaluation systemGagan Preet
An MIES (Management Information and Evaluation System) helps managers collect and use data to make timely decisions. An effective MIES provides accurate, complete and timely information through various modules like registration, billing, diagnostics, and medical records. It also evaluates programs through process, output, effects and short-term impact evaluations to assess objectives and make improvements. MIES formats should include feedback mechanisms so decisions are made at all levels of the organization.
This document provides a summary of Carolyn Isaacson's background and experience. She has over 23 years of experience in healthcare, including leadership roles as Director of Nursing and Manager of Clinical Services. Currently, she is the Director of Quality and Compliance Management at Altus ACE, where she is building the infrastructure for quality and compliance. Previously she held national roles at UnitedHealthcare managing clinical adherence programs. She has extensive experience in quality monitoring, ensuring regulatory compliance, and training and developing staff.
Sabrina Russell has over 20 years of experience in healthcare leadership roles focused on patient safety, quality improvement, and operations management. She has a proven track record of successfully restructuring departments, implementing process improvements, and achieving quality and compliance goals. Her areas of expertise include quality improvement, strategic planning, clinical risk management, and regulatory compliance. She holds a Master's degree in Management and multiple safety and process improvement certifications.
MIES-MANAGEMENT INFORMATION AND EVALUATION SYSTEM - Define, Objectives, Impl...sonal patel
An MIES is a system to collect, analyze, and use data to help managers make timely decisions. It transforms data into useful knowledge for directing resources and achieving objectives. An effective MIES provides accurate, complete, and timely information to managers so they can analyze, plan, make decisions, take action, and evaluate performance. It also includes feedback mechanisms so decisions can be made at all levels of an organization. Evaluation of an MIES involves assessing its processes, outputs, effects, and both short and long-term impacts.
Karen Kracht has over 15 years of experience in advanced research, analysis, and project management in both medical insurance and sales fields. She currently works as a Benefit Plan Systems Analyst for Covenant Management Systems, where her responsibilities include maintaining health plan benefits, monitoring regulatory changes, analyzing medical network use, and negotiating provider contracts. Previously, she held various administrative and analyst roles with other organizations, developing reports, analyzing trends, and assisting with management projects. Kracht has extensive skills in claims processing, coding, contracting, data analysis, and customer service.
Avoid PRM failures by avoiding ensuring it's not simply a repository for documenting simple tasks. PRM failures occur when the IT solutions only serves to document activities instead of serving to streamline the physician experience.
The document discusses key concepts in healthcare operations management. It defines operations management as coordinating processes to deliver quality healthcare services in a cost-effective manner. Core functions include planning, scheduling, purchasing, quality control, and inventory control. Decision areas encompass designing services, managing quality, planning processes and capacity, setting locations and layouts, managing human resources, and scheduling maintenance. Metrics measure performance from financial, customer, and operational perspectives to continuously improve the healthcare system.
- A healthcare data analyst applies specialized knowledge of data acquisition, management, analysis, and interpretation to provide actionable insights from healthcare data to physicians, researchers, and decision-makers.
- They gather data from sources like electronic health records, billing claims, and patient surveys to help organizations improve quality of care, lower costs, and enhance patient experience.
- Healthcare data analysts provide data insights that drive clinical process improvements and help various organizations with population health management, cost containment, and quality improvement.
Cynthia Cadwell has over 30 years of experience in nursing and healthcare quality improvement. She currently works as a nurse practitioner providing clinical care and case management to injured workers. Her background includes roles in healthcare consulting, clinical research, quality improvement, and executive leadership positions at hospitals and healthcare companies. She has extensive experience designing and implementing programs to improve clinical outcomes and reduce costs.
Pamela Wilhelm seeks a position utilizing her skills in process analysis, project management, system documentation, and as a subject matter expert. She has over 15 years of experience in the pharmaceutical industry, most recently as Manager and SME for Aggregate Spend at Boehringer Ingelheim Pharmaceuticals, where she led transparency reporting efforts and ensured accurate and timely data. Prior to that, she managed clinical operations systems and processes at Boehringer Ingelheim and various IT roles at other companies.
IBM Healthcare Business Analytics solutions including Cognos, TM1 and SPSS. How healthcare challenges are met and costs are optimized through the use of Data Visualizations, Performance Management, and Predictive Analytics.
Danika Tynes has over 17 years of experience in program management, analytics, and management consulting. She specializes in driving large projects, introducing change initiatives, and collaborating with stakeholders. Her background includes strategy development, program delivery, process improvement, change management, and technology integration. Currently she is a Research Professor at Georgia Tech Research Institute, where she provides program support as the Systems Integrator for Georgia's Medicaid Management Information System transformation initiative.
Wendelyn Bradley is a clinical informatics leader with over 30 years of experience in healthcare IT, operations, and consulting. She currently serves as an Epic Organizational Readiness Lead at Scripps Health, helping to implement a $0.5 billion integrated IT system. She has a background in nursing, medical informatics, and holds credentials including BSN, MA, MS in Medical Informatics.
Lane Hickey has over 25 years of experience in healthcare administration, finance, and operations. He holds a Master of Public Health degree and has held leadership roles at Kaiser Permanente, Dermpath Specialists, and Portland State University. Currently, he owns and operates Dermpath Specialists, a medical billing and pathology lab services company serving dermatologists and other providers.
This document summarizes the professional experience and qualifications of an individual with over 25 years of experience in healthcare consulting, strategic planning, program evaluation, policy analysis, and management. Some of the key experiences include:
- Providing consulting services to evaluate and improve healthcare programs and facilities.
- Conducting strategic planning and developing strategic plans.
- Analyzing policies and ensuring regulatory compliance.
- Managing multi-million dollar budgets and programs.
- Developing and implementing training programs.
Health IT Summit Houston 2014 - Case Study "EHR Optimization for Organizational Value in a Changing Healthcare Environment"
Luis Saldana, MD, MBA, FACEP
CMIO
Texas Health Resources
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
Melody Anderson has over 20 years of experience in management, operations, and emergency preparedness. She has a track record of streamlining operations, improving productivity, and maximizing staff performance across various sectors. Most recently, she worked as the Manager of Enrollment Accounting at Molina Healthcare, where she improved efficiency, boosted cost prevention, and ensured compliance. Prior to that, she spent over 20 years at Fred Hutchinson Cancer Research Center in progressively challenging roles, managing budgets over $1 million, developing strategic plans, and leading disaster preparedness trainings.
Strategic Application of IT for Performance Improvement in hospital industry_...DrDevTaneja1
Hospital industry has been laggard in using IT tools to improve Performance Management.
The hospital industry must move beyond Transaction Reporting HMIS to Performance Improvement Tools like Visual Analysis Business Intelligence
Hospital industry must use IT spending as a Strategic Resource to optimize business outcomes & productivity
Dignity Health is one of the largest health systems in the US, founded in 1986. It operates 39 hospitals and has over 56,000 employees. The presentation discusses Dignity Health's population health management strategy and supporting data and technologies. It outlines their clinical integrated networks and the key pillars of their population health approach. It also describes the challenges of accessing and integrating data from multiple sources to support population health management goals.
1. EEPAK MATHUR, MPH, MBA, MHA BIOSTATISTICIAN & INFORMATICS
EXECUTIVED
Accomplished, goal-producing, and results-oriented Informatics Executive with 19+ years of progressive
experience and expert proficiency in bridging the gap between business and technical areas to maximize growth
potential and business profitability; oversee all aspects of increasing reporting efficiencies, data quality, and analytical
awareness resulting in increased revenue and decreased cost.
Charismatic spokesperson and articulate presenter with a passion for superlative communications, outstanding
interpersonal skills, and a reputation as an effective leader and team builder.
Regarded for the ability to create and implement enterprise wide processes and procedures to ensure the
consumption of data and information is optimized in order to meet business and IT objectives.
Diversely experienced in business and Information Technology with expertise and experience in SAS Programming,
creation of Dashboards and Key Performance Indicators, Business Project Management, IT Service Management,
Data Analytics and Informatics, Business Process Modeling and Management, Establishing Catalogs of Service and
Service Level Agreements, and Regulatory Reporting to CMS and New York State Department of Health.
AREAS OF EXPERTISE
Big Data Descriptive & Statistical Analytics Team Building & Leadership
IT Service Management SAS Programming
Strategic Planning & Tactical Execution Vendor Management
Dashboarding and KPI creation Encounter Data Reporting to CMS and NYSDOH
Information Architecture Data Quality and Auditing
Experience managing multi-disciplinary teams Utilization, Cost, and Trend Reporting
EXPERIENCE & ACHIEVEMENTS
Visiting Nurse Service of New York: CHOICE Health Plan, New York, NY 6/2004-Present
Director, Healthcare Reporting and Analytics
Department head of a Reporting and Analytical team supporting the CHOICE Health Plan for all retrospective and
prospective reporting and analytical needs. Responsibilities include oversight of trending, utilization and cost, drill
down, and quality analytics using authorization, claims, and EMR data sources. Regulatory reporting includes
collaboration with CMS Regional Offices as well as the New York State Department of Health.
• Responsible for conducting analyses for VNSNY CHOICE’s programmatic approaches for its targeted
populations, including clinical interventions and outcomes, medical costs, operational efficiency and
effectiveness, pharmacy and medication analysis, and opportunities for improvement.
• Responsible for formulating study design, methodology, and analyses with appropriate parties; applying
statistical methods and analyses where relevant, and investigating and utilizing industry metrics where
available.
•
CAREER HIGHLIGHTS
Dynamic Achiever with exceptional big data analytics and data governance experience.
Thought Leader with clear focus on building and deploying state-of-the-art dashboards for Senior Leaders to make
informed decisions.
Change Agent who managed mission-critical business solutions in dynamic, complex and challenging environments
Published in numerous medical journals such as American Journal of Medicine, Journal of Quality Improvement, and
Archives of Internal Medicine.
Successfully led CHOICE Health Plan through 6 years of CMS sponsored Medicare Data Validation Audits achieving
97% overall rate or higher every year.
Key driver of strategic transformation from a Reporting/Analytics culture of reactivity to proactivity. Establish catalog of
services, SLAs and other KPIs as relates to reporting. Ensure that the creation and consumption of data and information
across the enterprise is optimized in order to fulfill business objectives
Proactively implemented new reporting strategies as New York State Department of Health moved to a risk based
premium for their Medicaid Managed Long Term Care (MLTC) product. Strategies included improvement in submission
of accurate SAAM/UAS data, MEDS III / EDPS Encounter data, Financial Cost Reporting, etc. leading to increase
premiums for MLTC members.
2. DEEPAK MATHUR, MPH, MBA, MHA Page 2 of 2
• Provide leadership for oversight of regulatory reporting requirements and ensures financial, utilization, and
clinical quality data is collected and reported to the appropriate regulatory agencies within prescribed time
frames.
• Member of the Visiting Nurse Service of New York Institutional Review Board (VNSNY IRB)
• Responsible for creation of new reporting strategies to help manage the oversight of delegated vendors used
for all CHOICE Health Plan products.
• Provider leadership to staff in creating new processes for reporting of RAPs data and analyses for HCC scoring,
analysis of Prescription Drug Event data, etc. leading to better reporting and increased premiums from CMS.
• Proactively implemented new reporting strategies as New York State Department of Health moved to a risk
based premium for their Medicaid Managed Long Term Care (MLTC) product. Strategies included improvement
in submission of accurate SAAM data, MEDS III Encounter data, cost reporting, etc. leading to increase
premiums for all Medicaid products.
• Technical lead for VNSNY CHOICE in Business Intelligence initiative geared toward aggregation of all data
sources under one environment. Additional responsibilities include RFP processes for picking a BI vendor and BI
tool, liaison between business owners and technical team, etc.
• Provide oversight for streamlining the ETL processes for all reporting datamarts from different sources such as
DB2, Access, Oracle, SQL Server, Excel, and text files.
Oxford Health Plans, Trumbull, CT 6/2003-6/2004
Senior Healthcare Analyst, Healthcare Economics
• Developed, created, maintained, and enhanced Health Care Economics metric reporting tools using COGNOS
Powerplay for Oxford’s Intranet.
• Conducted trend analysis on utilization and financial metrics such as PMPM, Unit Cost, Average Cost, etc.
• Worked closely with matrix partners (Financial, Pricing, Medical Management, Special Investigation Unit) to
develop data and analytical capabilities to perform analyses on quality improvement and medical cost savings
strategies.
• Established position as an expert to support health plan measurement and effectiveness and health services
improvement initiatives.
CIGNA Healthcare, Bloomfield, CT 5/2000-6/2003
Senior Biostatistician, Medical Cost Analyses
• Developed, created, maintained and enhanced Medical Management metric reporting tools using COGNOS
Powerplay.
• Promoted collaboration with matrix partners (Systems, Market Research, Financial, Pricing, Regional
Medical Economics) to develop data and analytical capabilities to perform analyses on quality improvement
and medical cost savings strategies.
• Directed program assessments in support of Medical Management including managing and performing
statistical and methodological analysis.
o Statistical analyses mainly conducting using PC SAS BASE and SAS STAT version 8.2.
• Lead the development of metrics, study methodologies, benchmark initiatives, and data collection
methodologies.
• Serve as a focal point for communications and coordination of regional medical economics staff.
• Performed mentoring role for three analysts within department.
145 Milton Avenue │ Levittown, NY 11756 │ 516.510.2082 │ Dmathur145@yahoo.com
3. DEEPAK MATHUR, MPH, MBA, MHA Page 2 of 2
Qualidigm (Connecticut Peer Review Organization), Wethersfield, CT 1/1997-5/2000
Project Coordinator/Health Information Analyst • (6/1997 – 5/2000)
• Project team leader for Health Care Quality Improvement Projects. Responsibilities include: creating and
maintaining timelines, initiating and maintaining communications with external collaborators, oversee all team
members to ensure members are performing tasks in an efficient and timely manner, maintaining team
dynamics between members, identify and implement methods for improving HCQIP project process, etc.
• Provide oversight to abstraction process e.g. tool development, abstractor training and deployment, and
Internal Quality Control/Inter-Rater Reliability.
• Co-Chair of Connecticut Influenza and Pneumococcal Coalition.
Health Information Analyst • (1/1997 - 6/1997)
• Conducted Health Care Quality Improvement Project analytics on data provided by the Centers for Medicare
and Medicaid Services and the Kerr L. White Institute.
• Created reports in SAS and Excel for all 34 acute care hospitals in Connecticut as well as other health care
settings: Long Term Care, Skilled Nursing Facilities, private physician offices.
• Analyzed data in SAS version 6.12 by using various statistical methods and statistical models: frequency counts,
chi-square test, t-test, Wilcoxon Rank Sum test, Fisher’s Exact test, kappa statistics, linear regression modeling,
logistic regression modeling, ROC curves, partial residual plots, Goodness of Fit models.
EDUCATION, TRAINING & AFFILIATION
Certified in SAS 9.0 Base Programming and SAS Advanced Programming
Certified in ITIL® Foundation in IT Service Management
Inducted into Strathmore’s Who’s Who for Leadership and Achievement in the Healthcare Industry
Masters Business Administration, Healthcare, Quinnipiac University, 2003
Masters Healthcare Administration, Quinnipiac University, 2003
Masters Public Health, Boston University School of Public Health, 1996
145 Milton Avenue │ Levittown, NY 11756 │ 516.510.2082 │ Dmathur145@yahoo.com