Michael Dulin, MD, PhD
Michael Dulin, MD, PhD, was recently named chief clinical officer for analytics and outcomes research within Carolinas HealthCare System's Dickson Advanced Analytics Group (DA2). In this new position, he will provide clinical leadership to DA2 in partnership with Allen Naidoo, PhD, who will help him jointly lead the department.
"Through the work underway within DA2, we have a tremendous opportunity to better manage the health of an entire population, overcome resource limitations, increase efficiency and value, and perhaps, most importantly, make the care we provide truly patient centered," said Dr. Dulin.
To learn how advanced analytics are helping providers across the System and the nation deliver safer, higher quality care through DA2, Dr. Dulin shared his insights about the new program and services.
1. What is the importance of advanced analytics for organizations like Carolinas HealthCare System?
In today's rapidly changing healthcare environment, organizations like Carolinas HealthCare System must be able to change their delivery systems to provide patient-centered, high value, efficient services. A crucial competency that is foundational to this transformation in our care delivery is our ability to understand and use data and advanced analytics.
The creation of the Dickson Advanced Analytics Group (DA2) in 2012 was a key step in this process. The DA2 team was created with the understanding that the future of healthcare delivery would be fundamentally changed by data and technology, and our sustainability would be dependent upon our ability to understand and use our data in a meaningful way.
Dr. Dulin has demonstrated success in multiple roles during the 15 years he has worked at Carolinas HealthCare System.
He initially trained within Carolinas Medical Center's family medicine residency program, and then served as a primary care physician within a Carolinas Physician Network practice for three years.
He then became the director of research and evidence-based medicine, where he led the way in making CMC's family medicine program one of the top in the country in terms of research funding and academic achievement.
During this time, he also developed a strong national reputation as an expert in comparative effectiveness and applied outcomes research.
The work underway within DA2 is reliant on our use of the most advanced technology to compile all of our data into one place that we are calling the Enterprise Data Warehouse (EDW). The EDW provides all of the data that DA2 needs to perform advanced analytics and deliver business intelligence for our System.
2. How does this type of work help move the needle in terms of outcomes?
Through our work System-wide, we are sharing our diverse clinical and patient experiences and intelligence to co-develop solutions that integrate data across the continuum and address unmet healthcare needs. The projects we are implementing require collaborative input from providers and experts in information technology and analytics. The transformation of the United States healthcare system will require collaboration across transdisciplinary teams and engagement of the healthcare delivery systems themselves.
Today, at broad level, many providers make decisions without full access to the right data at the right time and place. What will change as we build our data and analytics capabilities is that providers will begin making more informed decisions. In addition, providers will be able to start thinking about entire populations and take into context other data outside of the clinical domain when building their care plans. For example, a provider might need to better understand availability of healthy foods and the safety of the neighborhood parks when they advise patients on making lifestyle changes.
This type of data and analytics can be used across the care continuum. For example, in the hospital, we are already using analytics to transform the discharge process by providing a better understanding of each patient's risk for readmission. The hospital-based team can use this data to prioritize their work and take into account what specific factors place a patient at high risk and address these factors directly in the discharge plan.
3. Are we involved with data analytics on a national level?
Yes, the DA2 research team has been an early national leader in thinking about how to leverage data to better understand population health. Current examples include our work that has improved asthma outcomes and targeted high-risk neighborhoods across the community to improve access to care.
Subsequently, Carolinas HealthCare System has joined other healthcare systems and technology companies, such as IBM and Premier healthcare alliance, to launch the Data Alliance Collaborative (DAC). The DAC is a first-of-its-kind initiative aimed at improving population health through data analytics and business intelligence.
The DAC allows members to share their experiences and intelligence to co-develop solutions that integrate data across the continuum of care. The solutions allow health systems and providers nationwide to leverage the same data model and actionable information, adding value to patient care. The reach and diverse capabilities of this network is impressive, especially as it allows us to analyze care within different healthcare settings.
The DAC combines data and resources from four geographically distinct healthcare systems, operating nearly 100 hospitals and more than 1,600 non-acute sites caring for 28 million people. IBM brings unparalleled technology expertise, and Premier offers scale through its 2,800 hospital members and proven collaborative methodology.
4. What impact will the DAC and our System's various analytics capabilities have on patient care?
Data integration through the DAC and our other capabilities can help our providers ensure that they are developing and deploying best practices for population health, while accounting for unique care delivery processes and cultures. This offers them the ability to make more informed decisions for patient care.
With care connected across the continuum, we can better understand what care a patient needs - for example, what drugs the patient is taking or allergic to, what procedures the patient had recently, what disease state the patient has, and more. This helps reduce unnecessary care that can compromise safety and add to already expensive bills for both consumers and healthcare systems.
Our new all-cause predictive readmissions tool mentioned before is also an amazing innovation. It analyzes both electronic medical records and administrative data to determine a patient's risk of being readmitted prior to being discharged from the hospital. We have already implemented this in a number of our larger hospitals to allow providers to better predict, with nearly 80 percent accuracy, a patient's risk for 30-day readmissions. It also identifies the key individual factors about each patient that increase their readmissions risk, allowing the care team to use personalized, evidence-based interventions.
5. What differentiates DA2 from other healthcare systems using big data?
Two key differentiators are the sheer size of our integrated healthcare system and our access to integrated clinical and operational data. We have access to and are able to cull through a myriad of clinical and other information, which allows us to assemble data to concentrate our efforts on treating a patient beyond a real-time diagnosis. Our data and analytics model allows us to predict healthcare needs for patients. In addition, we're able to identify opportunities to improve care, identify challenges, define problems and target solutions.
6. What else do you think physicians should know about this new initiative?
The work of DA2 is about improving the health of the patient and of the population, and to better understand and address their needs because we have to be able to see the bigger picture. By combining our capabilities and resources, we will be able to achieve this goal and help patients more quickly and efficiently.
Healthcare organizations must quickly adapt in today's rapidly changing healthcare environment to meet the needs of a growing patient population. Collaboration is clearly the best approach.