Health Care Analytics Forum

"The Life Cycle of a Health Care Claim" and "Data Mining and Predictive Modeling in Health Care". 

THE FIRST VIDEOS ARE HERE - EXCLUSIVE FOR MEMBERS -- They will appear right below if you are logged in.

Slide decks are also available for download

 In addition we will have "SAS JMP", "IBM Analytics", and "Teradata Analytics" presentations.  Although this is health care centric all of these sessions will include information that should be useful to anyone that does analytics in any industry. 

This is an all day event but you will be able to come and go as you please during the day. We will have multiple tracks running simultaneously:

Location: CPC in Edina, MN at Highway 100 & W. 70th St. (6901 Normandale Road, Edina MN 55435)

FREE, but you must Login and then Sign Up.  SPACE IS LIMITED.
Lunch, snacks, & beverages provided by our sponsors

The Life Cycle of a Health Care Claim Track (all day, main hall)

Many of us may see claims after they end up in a data warehouse.  Few of us completely understand everything that happens to that claim before we see it.  We hope to change that.

We will start with a claims inception when a Provider, Facility, or Pharmacy, provides a service to it's birth as it enters the payment system.  Continuing on into childhood as the claim enters the clearing house and on to the payer. Exploring the difficult adolescence as it is examined for Fraud & Abuse, faces rejection, and deals with adjustments.  Reaching adulthood with reimbursement completed the claim takes on another life as it enters many data warehouses where it may get repeatedly poked.  It pushes on as it is analyzed along with others to determine possible patient engagement where it may result in a return to services for the patient and the whole process starts over again.  What should we know about what happens in this process, and what is it we don't know that we should know.

• "Healthcare Transformation: Leveraging analytics to drive new competencies" As the adoption of electronic medical records digitizes more and more data, how will health systems and health insurers leverage this data into actionable information to improve their operations and clinical outcomes? This session will examine the key issues facing healthcare organizations today and how analytics and performance management capabilities can assist their efforts to drive operational efficiencies and support care process collaboration to become the low-cost, high quality service providers that today's turbulent times demand.
  -- Susan D. Noack, Worldwide Industry Executive, Healthcare Business Analytics, IBM Corporation
• "Future Tense" How everything is going to be different and why you should care.
  --David Stumpf, MD, PhD, Senior Vice President for Innovation and Transformation at UnitedHealth Group
• "Coding and Reimbursement" an expert on the medical and facility side that will speak to inception.  Coding schemes - CPT, rev code, ICD-9 and 10, Proc modifiers, etc... UB92 and HCFA 1500.
  --Richard Henriksen, Owner, Henriksen Healthcare Consulting, 612.242.3426
• "Turning patients into data: How prescription claims are created, processed, and resolved."
  --Brandon Young is a PharmD candiatate at the University of Minnesota.  In his nine years working in community pharmacy he has seen it all when it comes to prescription claim creation and processing.  He shares with us some complexities commonly encountered and how they affect the patient..
• "The Clearing House - Enabling the Business of Healthcare Through Secure Connectivity and Data Exchange"
  --Kris Olberg, Chief Architect, Director, Office of the CTO, Emdeon, a provider of revenue & payment cycle management.
• "The Payer Perspective: Fraud, Abuse and the Different States of a Claim and Why You Should Care" An Authority on Medical Fraud and Abuse and Payer Systems will speak to the how claims are received, examined, accepted or rejected, and ETL'd. 
  --James Brady, Director of Fraud Analytics, Ingenix.
• "Visual Analytics in Healthcare" Measurements, transactions, tests and all sorts of data abound in healthcare.  Making sense of it all to inform better decisions is greatly facilitated with visual analytics.  Using examples looking at hospital drug costs and patient data, we will show the importance of interactive visualization in all phases of analysis—from data exploration to decisions for better decisions and better health outcomes.
  --Anne Milley, Senior Director Analytics Strategy, JMP Product Marketing at SAS.
• "Seeing the Big Picture in Health Claims Analysis by Standardizing the Analytic Puzzle Pieces" - The potential analytic value of standardizing the claims submission process can be significantly diminished by the variety of transformations that occur during each claims system's intake, validation, grouping, pricing, adjudication and payment processes.  The next frontier is establishing standards in the analytic data warehouse environment to create uniform dimensions, views and metrics from all of health claim puzzle pieces.  Dr. Rissman will share his work in this space, and the expected benefits it will deliver.
  --A. Kent Rissman, PhD, Director Actuarial Consulting, Ingenix Consulting

Data Mining and Predictive Modeling Track (afternoon)

•  "Reengagement" Care Solutions Modeler will speak to how claims are assembled into an analytic dataset to identify consumers for engagement. 
  --Felix Friedman, Director, Predictive Analytics and Evaluation, Optum Health
• "Title Forthcoming"
  --Luc Mongeon, PhD, MBA,  Program Manager, Clinical Analytics, Medtronic, Inc.
• "Advanced methodologies for predictive modeling
  --Vladimir Cherkassky Ph.D. ,MS,  University of Minnesota Department of Electrical & Computer Engineering
• "Monte Carlo Simulation". 
  --Maneesh Shrivastav PhD,  Principal Business Development Associate, Medtronic.
• "Building a 360 view of business based on billions of consolidated data points" Today’s session will focus on the attributes of the D&B database that are most relevant to the Healthcare professional and how those attributes can be leveraged to improve insight into your market and customers to drive better results.
  --Chris Lucas Vice President, Customer Data Integration Solutions D&B Sales & Marketing Solutions

IBM Track (10am - noon, room #10)

• "Breaking Away in the next 100 Years in Healthcare" Imagine if you had all the answers you need to win. IBM will showcase their roadmap for analytics and the technology that will get us there.
  --Rob Risany, Program Director Enterprise Solutions, IBM

• Workshop

 JMP Track (morning, room #20)

• Predictive Analytics with JMP Pro:  JMP Pro is newest member of the SAS Predictive Analytics Suite.  An overview of JMP Pro and it’s advanced capabilities (including bootstrap (random) forests, boosting methods for decision trees and neural networks, and improved stepwise regression) will be shown.
  --Sam Gardner, JMP Systems Engineer. 
• Workshop 

Teradata Track (afternoon, room #20)

• Health Informatics Graduate Program at the University Of Minnesota
  --Terrence Adam, B.S., Ph.D., MD, University of Minnesota Department of Pharmaceutical Care & Health Systems Social, Administrative and Clinical Pharmacy Graduate Program.
• "Data Mining at 3M"
  --Jean-Marie Bertoncelli Manager 3M Corporate IT
• "In-Database Analytics with Teradata" With the explosion of data in the healthcare industry, the need to leverage compute power and opportunity to manage resources is becoming a hot topic. Teradata, the leader in data warehousing solutions, has partnered with analytics providers such as SAS to help tackle these data challenges and offer a powerful platform for fast analytics.
  --Jerry Heying, Teradata Solution Architect
• "Claims to Measure Quality" A well respected MD will speak about using and how various parties use that information to support their business operations.
  -- Dr Kay Schwebke, Medical Director, EBM Connect and Infecttious Diiseases and International Medicine, UMN.

This agenda is subject to change.  Questions? Contact Dan Atkins.

David A Stumpf, MD, PhD is Senior Vice President for Innovation and Transformation within Ingenix, a UnitedHealth Group company. UnitedHealth Group (UHG) is a Fortune 25 health and well being company. He works with UHG subsidiary companies, Ingenix, OptumHealth, and health plans to maximize the value and usefulness of data and analytics in the clinical arena. This includes external activities with the National Quality Forum (NQF; and their HITAC), Health Information Technology Standards Panel (HITSP), Physicians Consortium for Practice Improvement (PCPI), and professional medical societies. Previously positions within UGH were SVP for Clinical Data Strategies; National Medical Director for Physician Engagement and Improvement; and the Illinois Medical Director. Dr Stumpf is also Professor Emeritus of Neurology at Northwestern University Feinberg School of Medicine where he served as Chair of Neurology for nine years, raising $50M in philanthropic support which continues to fund key programs. He has been active in professional societies, including a decade on the Practice Committee, Treasurer and Member of the Board of Directors of the American Academy of Neurology. Previously he served on the Boards of Northwestern Memorial Hospital, Northwestern Medical Faculty Foundation, the Pediatric Faculty Foundation and the Children's Memorial Foundation. His clinical training was at Strong Memorial Hospital in Rochester NY (Pediatrics) and at Harvard's Longwood Program (Neurology) at the Brigham, Beth Israel and Children's Hospitals. He is the author of over 100 medical publications. He is Board certified by the American Board of Pediatrics and the American Board of Psychiatry and Neurology and completed his Maintenance of Certification in the latter in 2008. He is also adept in medical informatics. He lives in Evanston and Woodstock and works in Chicago, IL and Minnetonka, MN.

Terrence Adam, M.D., Ph.D. received a Bachelor of Science in Pharmacy from South Dakota State University in 1996. He obtained a Doctor of Medicine and PhD in Health Informatics at the University of Minnesota in 2003. He continued his medical training at the Mayo Clinic in Scottsdale Arizona where he completed a residency in Internal Medicine in 2006, and was the Chief Medical Resident in 2007. Dr. Adam joined the faculty at the University of Minnesota, College of Pharmacy as an Assistant Professor in the Department of Pharmaceutical Care and Health Systems. In addition to his work in the College of Pharmacy, Terrence is the Director of Graduate Studies for the University of Minnesota’s Health Informatics graduate program; he also serves patients as a Clinician Educator/Preoperative Care Physician at the Minneapolis Veteran’s Administration.  Dr. Adam’s research work includes the development of clinical information systems and their cost-effectiveness, electronic prescribing implementation evaluation and the use of clinical databases to assess the clinical significance of drug-drug interactions and assess peri-operative risk assessment and patient outcomes.

JeanMarie Bertoncelli (JM) has been working at 3M for the past 21 years.  At first he was a mainframe system engineer for 3M France then in 2002 he got a position within the 3M Information and technology architecture team in the US.   In 2008  Jm had the opportunity to work for the 3M BI team and more specifically on the Predictive Analytics platforms.  Jm did learn how to use the platform and started on model building and  data mining. Since Jm has been involved in different project like sales predictions, customer attritions, customer segmentation, new business opportunities and more...

Susan D. Noack is the Worldwide Industry Executive for Healthcare, for IBM Business Analytics. She's spent her entire career in the healthcare industry, including the last 30 within healthcare IT and enabling strategies. Her experience includes working within the hospital provider market, evolving health information exchange (HIE) initiatives, and with large physician organizations and health insurers. Responsible for the Healthcare Industry with IBM Business Analytics, she continues to be an advocate for IT and analytics as enablers to improving our quality of care, and to change our care delivery systems.

Rob Risany is the Program Director of Enterprise Solutions in the Business Analytics group of IBM. Rob works with clients to define breakaway applications of predictive analytics focused on optimising outcomes at the point of interaction. Rob brings more than 15 years of enterprise software and industry experience to IBM including enterprise application integration, business process management, business intelligence, and predictive analytics

Vladimir Cherkassky is Professor of Electrical and Computer Engineering at the University of Minnesota, Twin Cities campus. Dr. Cherkassky is co-author of Learning from Data, now in its second edition, and he has also authored the forthcoming Introduction to Predictive Learning.
He has been recently selected as Fellow of IEEE, for ‘contributions and leadership in statistical learning and neural networks’. He has served on editorial boards of IEEE Transactions on Neural Networks (TNN), Neural Networks (the official journal of INNS), Natural Computing: An International Journal and Neural Processing Letters. He was a Guest Editor of the IEEE TNN Special Issue on VC Learning Theory and Its Applications published in September 1999. Dr. Cherkassky was organizer and Director of NATO Advanced Study Institute (ASI) From Statistics to Neural Networks: Theory and Pattern Recognition Applications held in France in 1993.
He received the IBM Faculty Partnership Award in 1996 and 1997 for his work on learning methods for data mining. In 2008, he received the A. Richard Newton Breakthrough Research Award from Microsoft Research for development of new learning methodologies for predictive learning.