Conclusions Paper

An Analytic Prescription
Developing a Robust Strategy and Culture

Featuring
Bill Guise, Senior Director of Application and Information Architecture,
Dignity Health
Mark Pitts, Vice President of Enterprise Informatics, Data and Analytics,
Highmark Health
Stephen Ruberg, Distinguished Research Fellow of Advanced Analytics,
Global Statistical Sciences, Eli Lilly and Company
Kimberly Nevala, Director of Business Strategies, SAS Best Practices (Moderator)

Contents
The Promise of Analytics................................................... 1
Promise Unfulfilled.................................................................1

Analytics in Action.............................................................. 2
Improve quality of care..........................................................2
Ensure completeness of care...............................................2
Accelerate scientific discovery.............................................3
Expand understanding in real-world context...................3

How to Develop a Robust Analytics Strategy

and Culture.......................................................................... 3
1. Think big, start small and move fast................................3
2. Dont baffle them with equations....................................4
3. Present a business case, not an analytics case.............4
4. Show them youre really going to help them...............4
5. Show tangible results in their terms.............................4
6. Embed analytics into operational processes................4
7. Get people to believe in models....................................5
8. Build it and they will come................................................5
9. Consider an analytics center of excellence...................5
10. Make it irresistibly sexy....................................................6

Closing Thoughts............................................................... 6
About the Presenters......................................................... 6
For More Information........................................................ 7
The health care and life sciences industry lags financial
services and retail in bringing analytic expertise to the front
of the business. The biggest barrier to broader analytics
adoption is cultural the need to adapt peoples mindsets
and business processes, and to create a culture where
people understand, value and demand fact-based decisions
and strategies.
At the May 2014 SAS Health Analytics Executive Conference,
industry leaders from Dignity Health, Highmark Health, Eli Lilly
and Company, and SAS shared what they have done to prove
the value of analytics to their business leaders and what
worked for them as they developed an analytic culture in
their organizations.

The Promise of Analytics

Consider the many ways big data analytics can advance the
practice of health care toward the triple aim: better health,
better care experience and lower costs. The potential is mindboggling. Masses of genomic data, clinical trial data, electronic
health records (EHRs), claims data, research study data and
more terabytes and petabytes of it can be brought together
to reveal important discoveries and support better operational
and medical decisions. For example:
Protocol-based medicine draws on research results to
identify best practices for specific conditions, medical
histories and patient populations.
Personalized medicine merges diverse data sources,
including genetic profiles, with historical clinical data to lead
to personalized diagnosis and treatment based on a patients
specific biomarkers.
From a public policy perspective, analytics has a powerful
role in designing more effective programs and policies,
assessing program effectiveness on fact-based measures,
and uncovering fraud and abuse.
Performance management and optimization techniques can
uncover waste, inefficiency and fraud in operations, while
leading to better ways to use limited resources skilled
providers, capital, facilities, etc.
The health care industry is only scratching the surface of the
value that lies within all the available data. If organizations could
apply the insights from the data they already have even before
bringing in any new information we could see germane,
significant improvements in health care delivery and outcomes.
As health care undergoes major transformations, the analytic
insights will be fundamental to economic survival. Our mission
is to help the people were serving, but whether you call your
organization a for-profit or a not-for-profit, if your bottom line
isnt black, youre not going to be around to help anyone, said
Mark Pitts, Vice President of Enterprise Informatics, Data and
Analytics at Highmark Health. Smart, lean operational decisions
become ever more critical as we bring more people onto the
health care rolls and transform the health care system from a
fee-for-service model to pay for performance.

Masses of genomic data, clinical

trial data, electronic health records
(EHRs), claims data, research study
data and more can be brought
together to reveal important
discoveries and support better
decisions and ideally, to bring
analytic insights right to the point
of care.

Promise Unfulfilled
Much of the potential for analytics is still untapped. Its a curious
dichotomy. The work of life sciences and health care is rooted in
scientific discovery and analysis, yet it has been a struggle to
bring that inherent analytic expertise to the front of the business
to transform operational and clinical practices, improve
outcomes and innovate.
Its not for want of technology and software. With cloud
computing, high-performance analytics and highly visual ways
of doing analytic explorations, technology is not the hurdle to
analytics adoption. And its not because the volume, velocity
and variety of data are overwhelming. Big data technologies
can conquer the drowning-in-data problem.
No, the biggest barrier to analytics adoption in health care
and other industries in general is cultural. Its a change
management issue. Its about adapting peoples mindsets
and business processes. Its about creating a culture where
people understand, value and demand fact-based decisions
and strategies.

}}

The competitive, legal and

regulatory environment for health
care is such that youve got to get
your act together from an analytics
perspective, or youre going to be
in trouble.
Bill Guise, Senior Director of Application and
Information Architecture, Dignity Health

Imagine the opportunity to use

data and analytics to reduce
preventable medical errors.
Analysis of EHRs can be used to
automatically detect misdiagnoses,
monitor medication use and better
assess risks to provide the optimal
therapeutic interventions.

Analytics in Action
At the 11th annual SAS Health Analytics Executive Conference,
we heard from experts who are leading the charge to create an
analytic culture in pharmaceutical development and integrated
health care delivery. In a panel discussion, they described some
ways their organizations are applying analytics to improve
quality, close care gaps and accelerate scientific discovery
proving the value to earn rapid acceptance.

Improve quality of care.

Theres a pressing need and a moral imperative to use data
to ensure that patients receive the best possible care that leads
to the best possible outcomes. An obvious first prospect is to
reduce the high incidence of preventable medical errors.
The Centers for Disease Control and Prevention (CDC) in the
US does not track preventable medical errors as a cause of
death, but if it did, in 2006 it would have been No. 6 higher
than diabetes, said Pitts. Case in point: Just a few weeks earlier,
his wife, a nurse, caught three potentially life-threatening
medication errors from automated dispensing systems. It took
a human to be the last line of defense.
Imagine the opportunity to use data and analytics to reduce
such risks. Analysis of electronic medical records can be
used to detect misdiagnoses, monitor medication
compliance and better assess risks to provide the optimal
therapeutic interventions.

Ensure completeness of care.

The primary challenge and the holy grail is being able to get
into the exam room with the results of analytics while the
provider is with the patient, making care decisions, said Pitts.
Physicians could get alerts notifying them of gaps in the
patients care, such as a screening, medication or vaccination
that had been missed. Imagine the potential to prevent serious
and costly medical problems by addressing them much earlier,
when they were only minor symptoms or known risk factors.
For getting that 360-degree view of consumers/patients,
health care could take some lessons from retail, said Bill Guise,
Senior Director of Application and Information Architecture at
Dignity Health. In retail, the mantra is know your customer.
Know everything about your customer and build those longlasting relationships. You have data you know because of
shopping behavior and interactions through various channels.
You have data you can infer about them. And if you build the
right value proposition, as retail does with loyalty programs,
customers will give you information willingly because they
see the value to them.
The health care industry hasnt done much to explore these
approaches that work so well for retail. That gap is hard to
understand, when the stakes are so high and so personal. As
Pitts noted: If we can improve the quality of care, optimize the
delivery of that care, influence the behavior of folks who are at
risk for serious conditions, and prevent those conditions from
happening in the first place, then we will have made a real
difference not only in the cost curve in health care, but in
peoples lives.

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Expand understanding in real-world context.

The health care industry lags

financial services and retail in the
ability create a 360-degree view
of the customer/patient/member
and deliver the right insights at the
right moment.

Accelerate scientific discovery.

It takes 12 to 14 years and $1 billion or more to develop drugs
right now, said Stephen Ruberg of the Global Statistical
Sciences group at Eli Lilly and Company. His Advanced
Analytics team is working to change that. Theyre using analytics
to design better clinical development programs that identify
effective drugs more quickly, and also to identify subgroups of
patients for whom a therapy will work particularly well. Genetic
variation is proving to be far more complex than originally
imagined, but sophisticated analytic techniques are uncovering
secrets in the human code that bring us closer to the ideal of
personalized medicine.

Pharmaceutical companies such as Eli Lilly are working to

integrate clinical trial data with real-world evidence, said
Ruberg. Theres the scientific mandate we need to do the
correct science to create the correct drugs. But theres also
the practical question how is it changing peoples lives?
Pharmaceutical companies are creating collaboratives and
consortiums to share data, such as placebo data from clinical
trials, to get that essential, holistic perspective.
For another example, Pitts described an analytic initiative at
Highmark that helps identify which wellness programs or
outreach interventions are mostly likely to be adhered to,
and which patients/members/employees have the highest
propensity to benefit from them. That information enables an
employer to optimize investments in such programs.

How to Develop a Robust

Analytics Strategy and Culture
Its easy to get people to agree in concept about the value of
analytics, but its not always easy to move from vision to action,
from high-level road map to implementation. Our panelists
shared what has worked for them as they developed an
analytics culture in their organizations how they gained executive endorsement and the trust and partnership of the business
side. Here are their top 10 success tips.

1. Think big, start small and move fast.

Genetic variation is proving to be

far more complex than originally
imagined, but sophisticated
analytic techniques are uncovering
secrets in the human code that
bring us closer to the ideal of
personalized medicine.

Thats the phrase I like to use, said Ruberg. Its great to have
a vision, a strategy and a dream of where you want to get to,
but lets start small and move fast with getting those things
done. Visionaries often take too broad a view, and the
problem becomes so big and complicated that it never gets
off the ground.
Even tiny improvements, percentage-wise, can yield big
numbers. Consider staggering statistics such as $1 trillion of
waste in the health care system, nearly 80,000 preventable
deaths a year and another 1.5 million people injured by
medications. An analytics project that delivers even a 1 percent
improvement can make a huge difference in costs, care and
peoples lives.

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2. Dont baffle them with equations.
Most people who have been through high school and college
still have a lingering math phobia from those days, said Ruberg.
They see a statistician coming and they fear, are there going to
be equations in this presentation; are you going to try to
smother me with a lot of math? If we can tell stories and give
analogies, people dont have to be afraid of this stuff.

3. Present a business case, not an

analytics case.
Data scientists think the business should just accept the beauty
of analytics at face value, but if you go into a meeting talking
about data warehousing, logistic regressions, machine learning
and analytic algorithms, youre sunk. You have to present your
case in business terms, said Guise. Once you have your use
cases, then your dialogue is about your plan to deliver the use
case, the cost to deliver and the benefit over time. When you
take that to a CFO, they get it.
This is fundamentally an economic problem, said Pitts. We
have a limited number of resources a limited number of skilled
providers, a limited amount of capital available to invest as we
transform our health care system as we bring more people onto
the health care rolls. The question is, how do we allocate those
resources in a way that will optimize the result, so we can
achieve the goals we have set for ourselves?

Or show them the movie Moneyball. The 2011 film about how
empirical analysis transformed the Oakland Athletics from a
losing franchise into a record-setting winner won over an
executive for Rubergs call to analytics.
The financial services industry has this down, said Guise.
In financial services, re-engineering for improvement is in
everyones DNA. You save a lot of money to invest in the
business to grow your revenue. The right analytics initiatives
can pay for themselves.

}}

Show how you saved money,

changed a decision, improved
something or made a better drug
development determination earlier
in the process. When you can do
that, you gain credibility, and push
turns to pull.
Stephen Ruberg, Distinguished Research
Fellow of Advanced Analytics, Global Statistical
Sciences, Eli Lilly and Company

4. Show them youre really going to help them.

6. Embed analytics into operational processes.

Ive been successful at applying the concept of analytics and

turning those into business cases that finance and business
people can understand and buy into, but also in helping the
operations folks understand how this is going to help them,
said Pitts. I have to show them that this isnt going to be one
more report that you have to try to dig up; were going to try to
integrate this into your process to help you do what you want to
do, which is take better care of the patient at lower cost with
better outcomes.

When a new iPhone comes out, people flock to the stores to

get it, said Guise. When I come out with a new technology, I
want people running to it, rather than running away from it. If
what youre doing makes their process more difficult in any way,
folks will just not use it.

5. Show tangible results in their terms.

Show the business tangible results in terms that are meaningful
to the people who want to use your technology, said Ruberg.
Show how you saved money, changed a decision, improved
something or made a better drug development determination
earlier in the process. Until you do that, it doesnt really hit
home. When you can do that, you gain credibility, and push
turns to pull. Were busier now than we could ever imagine.

}}

When I come out with a new

technology, I want people running to
it, rather than running away from it. If
what youre doing makes their
process more difficult in any way,
folks will just not use it.
Bill Guise, Dignity Health

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7. Get people to believe in models.
You would think scientists would gravitate to analytics, but the
reality is that people with medical degrees or PhDs in biology or
chemistry trust their own instincts and knowledge more than an
analytical model, said Ruberg. Sometimes you have to
convince them to believe in models, that models can represent
complex systems.

You would think scientists and

medical professionals would
naturally gravitate to analytics, but
sometimes you have to convince
them that models really can
represent complex systems.

You may have to convince people to believe in the model even

if you dont know why it works. Correlation is not causation,
but its a start. Pitts described a study at the University of
Ontario, where machine-learning algorithms monitored
telemetry output from devices attached to premature babies
in neonatal intensive care. What the researchers found was
remarkable. The systems were able to predict, with a high
degree of accuracy, when one of those premature infants was
developing an infection and would present with clinical
symptoms 48 hours later.
Researchers and clinicians have no idea how the machine is
predicting that, but the important thing is that it can predict it,
said Pitts. We can still go back and try to determine causality,
but the idea here is that we need to be comfortable working
and acting on correlation, without having established that
causal relationship.

8. Build it and they will come.

Build a capability, and not necessarily to the requirements to
solve a specific problem, said Pitts. When you give people
the tools, the data and the right support to work with it when
you build the best performance envelope you can people
will surprise you with the innovations that they will bring to
the table.

You may have to help show the possibilities. Business users

dont know what the math can do, so theyre not going to ask
you for it, said Pitts. No business user is going to come to me
and say, Hey Mark, can you take all these customer call notes
and run the text through a vector space model and run machine
learning against it to detect when these events are going
to occur?
You have to get out there and help them understand whats
possible. The conversation goes more like this: Here are the
50,000 calls that came in yesterday, and here are the 50 that
you need to be concerned about. We did that with no human
involved in the process besides building the model, and we can
do this for every single customer interaction. We can score it,
we can put it in front of you the next day, and then you can do
something about it. Then their eyes start to light up.

Business users dont know what the

math can do, so theyre not going
to ask you for it. Data scientists
might have to be the ones saying,
Heres something really valuable
we can do for you. Then their eyes
start to light up.

9. Consider an analytics center of excellence.

Most organizations have pockets of analytics expertise, but you
gain great synergies and economies of scale by bringing your
brightest stars together to focus on the most important
analytical approaches. A center of excellence is a very effective
way to accelerate an organizations analytic maturity, according
to Ruberg. Eli Lillys Advanced Analytics Hub brings together
about 20 experts with postgraduate degrees to focus on five
analytical approaches that were deemed to fundamentally
change the business.

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The group spends about 50 to 60 percent of its time consulting
with statisticians, clinical design teams and business groups;
about 20 percent of its time doing methodology or research
on tool development; and about 20 percent on deep technical
training for other statisticians or general training for product
management audiences as well as attending conferences
and getting its methodologies in front of the Food and Drug
Administration and other regulatory bodies.
A center of excellence mobilizes analytics resources for the
good of the organization not just for specific business units or
one-off projects. As such, it helps change the culture to one of
appreciation for the value of analytics-driven decisions.
However, dont stifle pockets of innovation, said Guise. Centers
of excellence provide economies of scale from standardization
and from bringing like-minded people together. But I never
want to stop progress. If individual pockets [of data talent] want
to do their own thing if they spend a buck and get more than
that in return, Im OK with that autonomy.

A center of excellence mobilizes

analytic resources for the good
of the enterprise not just for
specific business units or one-off
projects. As such, it ultimately
changes the culture to one of
appreciation for the value of
analytics-driven decisions.

10. Make it irresistibly sexy.

If youve laid the groundwork such as building an advanced
analytics laboratory show it off. Share the technology of
networked computers and visual analytics on big screens,
where bright research minds can work interactively with the
data, in a very visual way. People will see that when they ask
what-if questions, they can get answers instantly. Thats exciting,
and inspires everyone to keep asking more questions.

Rubergs group opened an advanced analytics laboratory inside

Eli Lillys research lab that will reinvent how analytics gets done.
Picture eight networked computers, visual analytics and big
screens where researchers can delve into the data to ask
questions that lead to more questions and possibly down
unexpected paths.
People will be able to ask what-if questions, and in less than
five minutes they can either shut off a path or say, Wow, thats
interesting, so whats the next question? said Ruberg. Thats
the next big thing.

Closing Thoughts
In a lot of ways, developing a robust and sustainable analytics
strategy and culture is like treating an illness or developing a
cure for a new disease, said Kim Nevala of SAS. It requires us
to start with a very clear view of the diagnosis or the problems
we face, and take a very deliberate and often iterative approach
to finding the right solutions and treatment.
Going a step beyond that, its not just about finding the
treatment or the drug or in this case the analytics solution
and technology. We also have to understand the right dosage,
the right frequency and the proper modalities by which that
treatment will be delivered or in this case, how the analytic
output and insight will be delivered. That means we have to
understand what the various audiences and consumers of
analytics and data really think about the information and
what they are ready, willing and able to consume.
Ready, willing and able. Thats the human and cultural side of
the equation. Our biggest stumbling blocks are adapting
business processes and peoples mindsets, said Nevala. That
means the solution to this problem bringing analytics to the
forefront and further embedding it into our organizations is
extremely complicated. But this is a problem we can solve.

About the Presenters

Bill Guise
Senior Director of Application and Information Architecture,
Dignity Health
Guise has brought to health care IT 25 years of financial services
and retail experience defining business and technology
strategy, building world-class organizations, and engineering
and operating global technology platforms. Business analytics
and data warehousing have been core offerings during most
of his IT career, supporting both internal and external customers
to facilitate a wide array of corporate functions.

7
Before joining Dignity Health, Guise was Vice President of
Integrated Retail at Sears Holdings Corp., where he used
analytics to drive pricing in the stores, marketing campaigns
and internal cost re-engineering programs.
Mark Pitts
MS, MAcc, Vice President of Enterprise Informatics, Data and
Analytics, Highmark Health
Pitts works at Highmark Health, the third-largest integrated
health care delivery and financing network in the nation. He
has more than 25 years of experience solving business
problems with technology and analytics. He has applied his
multidisciplinary skills in leading real-world implementations
of enterprise resource planning, financial and business
intelligence systems, and multimillion-dollar greenfield
development projects to solve enterprise-scale
business challenges.
Pitts progressed from the IT shop to business, driving the
financial performance of health care organizations in areas such
as managed care contracting, provider compensation, payment
integrity, forecasting, clinical quality, medical billing, receivables
management and analytics. His innovative work has been
recognized with a variety of awards, and his creations support
benefits measured in billions of dollars.
Stephen J. Ruberg, PhD
Distinguished Research Fellow of Advanced Analytics, Global
Statistical Sciences, Eli Lilly and Company
Ruberg has more than 33 years of experience in the
pharmaceutical industry, including 14 years at Eli Lilly. During
his career he has served as a statistician and scientific leader in
all phases of drug development from discovery through postmarketing. He has worked on numerous drug development
programs across a variety of therapeutic areas.
In 1994, Ruberg was elected a Fellow of the American Statistical
Association. He has been published extensively in statistical and
biological/medical journals. During the Bush administration,
Ruberg was appointed to the Board of Directors of the National
eHealth Collaborative by the Secretary of Health and Human
Services, which had the remit of creating the National Health
Information Network. In 2009, Ruberg was named the Scientific
Leader for the newly formed Eli Lilly Advanced Analytics Hub,
which he currently leads.

Kimberly Nevala
Director of Business Strategies, SAS Best Practices
A frequent writer and speaker, Kimberly Nevala is responsible
for industry education, key client strategies and market
analysis in the areas of business intelligence and analytics,
data governance and master data management for the
SAS Best Practices team. She has more than 15 years of
experience advising clients worldwide on the development
of sustainable business strategies and the importance of
culture and change management.

For More Information

If you missed the 11th annual SAS Health Analytics Executive
Conference or the live streaming virtual conference, you can
watch the session An Analytic Prescription: Developing a
Robust Strategy and Culture and all other conference sessions
on demand at sas.com/virtual14.
Download the white paper Anatomy of an Analytic Enterprise:
sas.com/anatomy.
Read the SAS health care and life sciences blog A Shot in the
Arm: sas.com/hlsblog.
Find out more about SAS solutions for health care providers,
health insurers and life sciences at sas.com/healthanalytics.

To contact your local SAS office, please visit: sas.com/offices

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