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Thank you for your time 
and attention today. 
Please visit us at Perficient.com 
Healthcare Enterprise Data Model: 
The Buy vs. Build DebateNovember 18, 2014 
facebook.com/perficient 
twitter.com/Perficient_HC 
linkedin.com/company/perficient
Perficient is a leading information technology consulting firm serving clients throughoutNorth America. 
We help clients implement business-driven technology solutions that integrate business processes, improve worker productivity, increase customer loyalty and create a more agile enterprise to better respond to new business opportunities. 
About Perficient
3 
•Founded in 1997 
•Public, NASDAQ: PRFT 
•2013 revenue $373 million 
•Major market locations: 
•Allentown, Atlanta, Boston, Charlotte, Chicago, Cincinnati, Columbus, Dallas, Denver, Detroit, Fairfax, Houston, Indianapolis, Minneapolis, New York City, Northern California, Oxford (UK), Philadelphia, Southern California, St. Louis, Toronto, Washington, D.C. 
•Global delivery centers in China and India 
•>2,200 colleagues 
•Dedicated solution practices 
•~90% repeat business rate 
•Alliance partnerships with major technology vendors 
•Multiple vendor/industry technology and growth awards 
Perficient Profile
BUSINESSSOLUTIONS 
Business Intelligence 
Business Process Management 
Customer Experience and CRM 
Enterprise Performance Management 
Enterprise Resource Planning 
Experience Design (XD) 
Management Consulting 
TECHNOLOGYSOLUTIONS 
Business Integration/SOA 
Cloud Services 
Commerce 
Content Management 
Custom Application Development 
Education 
Information Management 
Mobile Platforms 
Platform Integration 
Portal & Social 
Our Solutions Expertise
Healthcare Practice 
Strategic Partners 
Experts in Consumer-Driven Healthcare Technology 
HEALTH PLAN 
PROVIDER 
Connected 
Health 
Business Intelligence 
and Analytics 
Interoperability & Integration 
Information 
Exchange 
Regulatory 
Compliance 
Solutions & Services 
CONSUMERS 
Select Clients 
Global Delivery Centers/Offshore Delivery 
Domestic Delivery Center
David MeintelDirector of Healthcare, Perficient 
David has 20 years of experience in data warehousing and analytics in a wide range of industries. Focusing this experience in the last 4 years exclusively on the healthcare industry, David has worked with a large number of provider and health plan organizations to assist them in better leveraging their data assets. 
Our Speaker
Agenda 
•Brief look at the challenge in healthcare causing the need for a data warehouse 
•Evolution of the solution to the challenge 
•Discuss key factors in the decision to buy or build your data model 
•Reality!
The Challenge 
Regulatory Compliance 
Population Health Management 
ReduceRe-Admissions 
Service-Line Management 
Claims Analysis 
Other…
Evolution of the Solution 
Organizations move from siloedsolutions to consolidated operational data stores to enterprise warehouse… 
Operational
Enterprise Data Model 
Data structures to hold all of the key decision making information for the enterprise integrated across subject areas such as: 
Clinical 
Claims 
Financial 
Operational
Enterprise Data Model 
•Architected to be extensible 
•Phased implementations 
•The “single version of the truth” for the organization 
•Have evolved greatly over the years
Enterprise Data Model (example) 
Core Provider Content 
Payer Content 
Supply Chain Content 
Core Master Data 
Provider Patient Data 
Payer Patient Data 
Supply Chain Data 
•Person 
•Patient 
•Organization 
•Facility 
•Distributors 
•Product Pricing Tier 
•Price Activation 
•General Ledger 
•Accounts Payable 
•Accounts Receivable 
•Contract (Supplier) 
•Member (Insured) 
•Subscriber 
•Member Enrollment 
•Member Enrolled PCP 
•ADT Event (Hospitalization) 
•Biospecimen 
•Encounter 
•Finding 
•Lab Result 
•Payer 
•Regulatory Agencies 
•Contact 
•Groupings/Hierarchies 
•Unified Standard Codes 
•Supplier 
•Wholesaler 
•Distributor 
•Unified Standard Codes 
•Practitioner 
•Unified Standard Codes 
•Groupings/Hierarchies 
•Reference Data 
•Allergy 
•Diagnosis 
•Discharge Summary 
and Instruction 
•Imaging 
•Procedure 
•Surgery 
•Survey 
•Appointment 
•Bill 
•Bill Encounter 
•Care Team & Role 
•Contract (Patient) 
•Contracts 
•Disease Management 
•Encounter 
•Episode 
•EOB 
•COB 
•Provider Network 
•Campaign 
•Premium Payments 
•Location 
•Order 
•Patient Life Event 
•Patient Medications; Includes Order, Dispense, Administration, Formulary 
•Problem (chief complaint, etc.) 
•Event (General) 
•Exposure & Lifestyle 
•General Ledger 
•Location 
•Patient Satisfaction 
•Payroll 
•Immunization 
•Product Master 
•Policy 
•Coverage 
•Benefit 
•Claims (all types) 
•Claims (Adjustments) 
•Purchase Order 
•Invoice 
•Product Item Master 
•Purchase History 
•Contracts 
•Suppliers 
•Wholesalers 
•Unified Standard Codes 
•Groupings/ 
Hierarchies 
•Ambulatory Encounter (date, time, type) 
•Ambulatory procedure 
•Ambulatory Test order 
•Ambulatory Result 
•Ambulatory Diagnoses 
•Ambulatory Billing 
•Wellness Targets 
•HEDIS Measures 
•PQRS Measures 
•ACO Measures 
•Quest Measures 
•Agreement 
•Money Item 
•Financial Transaction 
•Claim Recovery
Buy vs. Build 
Key areas to consider: 
–How experienceplays into the equation 
–How is time to value impacted 
–How is riskfactored in with the decision 
–How easy is it to integrateother solutions 
–How the decision to build vs. buy can impact your internal team 
–How will costbe impacted
Experience 
Key points to consider 
–Buy 
•Experience comes bundled in 
•Top sellers of EDM have years of experience both technical and healthcare 
•Clinicians, technologists and business analysts to bridge the two 
–Build 
•Does your current staff have the requisite experience? 
•If not, you will likely need to hire or contract someone who does 
•In addition to IT resources with technical skills, this will require plenty of support from your line of business resources (clinicians, etc.) 
Many of our customers have existing data warehouses that we end up replacing and most were built internally.
Time to Value 
Key points to consider 
–Buy 
•Large portion of design is already done for you 
•Customizations willneed to be done regardless of what your vendor tells you 
•Often times you can implement in a phased approach to reduce time to value even more 
–Build 
•The more experience your team has the faster this will go 
•Often time subject area driven to reduce time to value 
•Only build what you need, can reduce time as well 
Implementing something that is already designed, will be faster than designing and building it yourself.
Risk 
Key points to consider 
–Buy 
•Lower typically due to 
–Level of experience and resources that went into it 
–Refined over time (customer experiences incorporated) 
–Repeatable so potential issues are known 
•Sometimes monolithic in nature can cause scope to grow larger than needed 
–Build 
•Higher typically due to 
–Organizations typically don’t do this lots of times, so no experience 
–Common mistakes are likely to be encountered due to lack of experience 
Manage scope and leverage experience to mitigate risk.
Integration / Accelerators 
Key points to consider 
–Buy 
•Standardized models encourage accelerators 
•Integration points need to be standard and often times take a lowest common denominator approach, which sometimes causes slight increase in effort 
–Build 
•If you build it yourself, you have the ultimate in flexibility to design interface the way you want them 
•Integrating with outside solutions will likely take more effort due to no standard approach for vendors to build to 
When standards exist, so does common integration points and pre-built accelerators…don’t reinvent the wheel.
18 
Integration / Accelerators
Staff Impact 
Key points to consider 
–Buy 
•Many key decisions on design are made for you 
•Staff doesn’t have to be experts in designing model which lessens the pressure in early phases 
•Learning curve for potential new technologies 
–Modeling tool, ETL tool, Metadata management etc 
•Consulting assistance for peeks in need often more effective than hiring a large team 
–Build 
•Every decision is yours to make, increases pressure 
•Analysis paralysis is a common issue, trying to make perfect 
•Leverage strengths of team in choosing technologies 
Make sure staff is setup for success, not failure.
Cost 
Key points to consider 
–Buy 
•Initial purchase price may seem high 
•Total cost of ownership generally lower 
•Other accelerators also help to reduce total cost of ownership 
–Build 
•Pay as you go 
•Paying to reinvent the wheel 
Buying might cost more up front, but will save money over time.
Summary 
Experience–Leverage experience of people who have done what you are trying to do 
Time to Value–Implementing a model that is already designed will be faster 
Risk-Managing scope and leveraging experience will mitigate risk 
Integration / Accelerators–Don’t reinvent the wheel 
Staff Impact–Know your staff and make sure they are set up for success 
Cost–Buying a model might have higher initial costs, but building will cost more over time
Reality, Buy and Build 
Buy 
–Data model 
•Leverage the experience of many 
•Don’t reinvent the wheel 
–High value initial use case 
•Physicalize required portions of the data model 
•Connectivity to your source systems to populate model 
•Gain quick value for investment made in model 
Build 
–Custom analytics for your use case 
•Leverage existing investments in tools 
•This is what your end user with interact with the most 
–Additional use cases 
•Follow patterns from initial use case 
•Leverage experience and iterate
Questions?
Questions? 
Connect with Perficient 
-Upcoming events & webinars 
-On-demand webinars 
-White papers & perspectives-Thought leadership 
David Meintel 
David.Meintel@Perficient.com | Phone: 646.457.4865

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Healthcare Enterprise Data Model: The Buy vs. Build Debate

  • 1. Thank you for your time and attention today. Please visit us at Perficient.com Healthcare Enterprise Data Model: The Buy vs. Build DebateNovember 18, 2014 facebook.com/perficient twitter.com/Perficient_HC linkedin.com/company/perficient
  • 2. Perficient is a leading information technology consulting firm serving clients throughoutNorth America. We help clients implement business-driven technology solutions that integrate business processes, improve worker productivity, increase customer loyalty and create a more agile enterprise to better respond to new business opportunities. About Perficient
  • 3. 3 •Founded in 1997 •Public, NASDAQ: PRFT •2013 revenue $373 million •Major market locations: •Allentown, Atlanta, Boston, Charlotte, Chicago, Cincinnati, Columbus, Dallas, Denver, Detroit, Fairfax, Houston, Indianapolis, Minneapolis, New York City, Northern California, Oxford (UK), Philadelphia, Southern California, St. Louis, Toronto, Washington, D.C. •Global delivery centers in China and India •>2,200 colleagues •Dedicated solution practices •~90% repeat business rate •Alliance partnerships with major technology vendors •Multiple vendor/industry technology and growth awards Perficient Profile
  • 4. BUSINESSSOLUTIONS Business Intelligence Business Process Management Customer Experience and CRM Enterprise Performance Management Enterprise Resource Planning Experience Design (XD) Management Consulting TECHNOLOGYSOLUTIONS Business Integration/SOA Cloud Services Commerce Content Management Custom Application Development Education Information Management Mobile Platforms Platform Integration Portal & Social Our Solutions Expertise
  • 5. Healthcare Practice Strategic Partners Experts in Consumer-Driven Healthcare Technology HEALTH PLAN PROVIDER Connected Health Business Intelligence and Analytics Interoperability & Integration Information Exchange Regulatory Compliance Solutions & Services CONSUMERS Select Clients Global Delivery Centers/Offshore Delivery Domestic Delivery Center
  • 6. David MeintelDirector of Healthcare, Perficient David has 20 years of experience in data warehousing and analytics in a wide range of industries. Focusing this experience in the last 4 years exclusively on the healthcare industry, David has worked with a large number of provider and health plan organizations to assist them in better leveraging their data assets. Our Speaker
  • 7. Agenda •Brief look at the challenge in healthcare causing the need for a data warehouse •Evolution of the solution to the challenge •Discuss key factors in the decision to buy or build your data model •Reality!
  • 8. The Challenge Regulatory Compliance Population Health Management ReduceRe-Admissions Service-Line Management Claims Analysis Other…
  • 9. Evolution of the Solution Organizations move from siloedsolutions to consolidated operational data stores to enterprise warehouse… Operational
  • 10. Enterprise Data Model Data structures to hold all of the key decision making information for the enterprise integrated across subject areas such as: Clinical Claims Financial Operational
  • 11. Enterprise Data Model •Architected to be extensible •Phased implementations •The “single version of the truth” for the organization •Have evolved greatly over the years
  • 12. Enterprise Data Model (example) Core Provider Content Payer Content Supply Chain Content Core Master Data Provider Patient Data Payer Patient Data Supply Chain Data •Person •Patient •Organization •Facility •Distributors •Product Pricing Tier •Price Activation •General Ledger •Accounts Payable •Accounts Receivable •Contract (Supplier) •Member (Insured) •Subscriber •Member Enrollment •Member Enrolled PCP •ADT Event (Hospitalization) •Biospecimen •Encounter •Finding •Lab Result •Payer •Regulatory Agencies •Contact •Groupings/Hierarchies •Unified Standard Codes •Supplier •Wholesaler •Distributor •Unified Standard Codes •Practitioner •Unified Standard Codes •Groupings/Hierarchies •Reference Data •Allergy •Diagnosis •Discharge Summary and Instruction •Imaging •Procedure •Surgery •Survey •Appointment •Bill •Bill Encounter •Care Team & Role •Contract (Patient) •Contracts •Disease Management •Encounter •Episode •EOB •COB •Provider Network •Campaign •Premium Payments •Location •Order •Patient Life Event •Patient Medications; Includes Order, Dispense, Administration, Formulary •Problem (chief complaint, etc.) •Event (General) •Exposure & Lifestyle •General Ledger •Location •Patient Satisfaction •Payroll •Immunization •Product Master •Policy •Coverage •Benefit •Claims (all types) •Claims (Adjustments) •Purchase Order •Invoice •Product Item Master •Purchase History •Contracts •Suppliers •Wholesalers •Unified Standard Codes •Groupings/ Hierarchies •Ambulatory Encounter (date, time, type) •Ambulatory procedure •Ambulatory Test order •Ambulatory Result •Ambulatory Diagnoses •Ambulatory Billing •Wellness Targets •HEDIS Measures •PQRS Measures •ACO Measures •Quest Measures •Agreement •Money Item •Financial Transaction •Claim Recovery
  • 13. Buy vs. Build Key areas to consider: –How experienceplays into the equation –How is time to value impacted –How is riskfactored in with the decision –How easy is it to integrateother solutions –How the decision to build vs. buy can impact your internal team –How will costbe impacted
  • 14. Experience Key points to consider –Buy •Experience comes bundled in •Top sellers of EDM have years of experience both technical and healthcare •Clinicians, technologists and business analysts to bridge the two –Build •Does your current staff have the requisite experience? •If not, you will likely need to hire or contract someone who does •In addition to IT resources with technical skills, this will require plenty of support from your line of business resources (clinicians, etc.) Many of our customers have existing data warehouses that we end up replacing and most were built internally.
  • 15. Time to Value Key points to consider –Buy •Large portion of design is already done for you •Customizations willneed to be done regardless of what your vendor tells you •Often times you can implement in a phased approach to reduce time to value even more –Build •The more experience your team has the faster this will go •Often time subject area driven to reduce time to value •Only build what you need, can reduce time as well Implementing something that is already designed, will be faster than designing and building it yourself.
  • 16. Risk Key points to consider –Buy •Lower typically due to –Level of experience and resources that went into it –Refined over time (customer experiences incorporated) –Repeatable so potential issues are known •Sometimes monolithic in nature can cause scope to grow larger than needed –Build •Higher typically due to –Organizations typically don’t do this lots of times, so no experience –Common mistakes are likely to be encountered due to lack of experience Manage scope and leverage experience to mitigate risk.
  • 17. Integration / Accelerators Key points to consider –Buy •Standardized models encourage accelerators •Integration points need to be standard and often times take a lowest common denominator approach, which sometimes causes slight increase in effort –Build •If you build it yourself, you have the ultimate in flexibility to design interface the way you want them •Integrating with outside solutions will likely take more effort due to no standard approach for vendors to build to When standards exist, so does common integration points and pre-built accelerators…don’t reinvent the wheel.
  • 18. 18 Integration / Accelerators
  • 19. Staff Impact Key points to consider –Buy •Many key decisions on design are made for you •Staff doesn’t have to be experts in designing model which lessens the pressure in early phases •Learning curve for potential new technologies –Modeling tool, ETL tool, Metadata management etc •Consulting assistance for peeks in need often more effective than hiring a large team –Build •Every decision is yours to make, increases pressure •Analysis paralysis is a common issue, trying to make perfect •Leverage strengths of team in choosing technologies Make sure staff is setup for success, not failure.
  • 20. Cost Key points to consider –Buy •Initial purchase price may seem high •Total cost of ownership generally lower •Other accelerators also help to reduce total cost of ownership –Build •Pay as you go •Paying to reinvent the wheel Buying might cost more up front, but will save money over time.
  • 21. Summary Experience–Leverage experience of people who have done what you are trying to do Time to Value–Implementing a model that is already designed will be faster Risk-Managing scope and leveraging experience will mitigate risk Integration / Accelerators–Don’t reinvent the wheel Staff Impact–Know your staff and make sure they are set up for success Cost–Buying a model might have higher initial costs, but building will cost more over time
  • 22. Reality, Buy and Build Buy –Data model •Leverage the experience of many •Don’t reinvent the wheel –High value initial use case •Physicalize required portions of the data model •Connectivity to your source systems to populate model •Gain quick value for investment made in model Build –Custom analytics for your use case •Leverage existing investments in tools •This is what your end user with interact with the most –Additional use cases •Follow patterns from initial use case •Leverage experience and iterate
  • 24. Questions? Connect with Perficient -Upcoming events & webinars -On-demand webinars -White papers & perspectives-Thought leadership David Meintel David.Meintel@Perficient.com | Phone: 646.457.4865
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