NCH Healthcare System

HIMSS 2015

Michele Thoman, RN - CNOSarah Richardson - CIO

Jeff Dindak – Sr. IT Director

2 hospitals (715 beds)

An alliance of 650 physicians and medical facilities

throughout Collier County and Southwest Florida

Extensive inpatient and outpatient services

In 2014, the system had 28,938 admissions,

93,673 ED visits, 3,418 births, 453 open heart

surgeries, nearly 11,000 surgical procedures and

over 3,000 on staff

Member of the Mayo Clinic Care Network

Non-for-profit, multi-facility healthcare system in Naples, Florida

NCH Healthcare System

1991 2000 2010

NCH becomes a

Cerner Lab/Rad

Client

1998:

NCH

implements

Cerner’s CDR

2001:

HIM

CPDI

MRP

Clinical Doc

& Orders

2003:

ED Doc

Tracking

2005:

Pharmacy

eMAR

Surgery

2007: :

CPOE

Physician Doc

2009:

Scheduling

(replacing

SMS)

RHO ITWorks

2011-12:

Rev Cycle, Registration

MU Stage 1

Care Management

HIE, Patient Portal

Women’s Health

Smart Rooms

Infection Control & Rehab

Most Wired

2010:

Infrastructure

System Migration

Domain Upgrades

Workflow Opt.

Device Int.

Mobility

NHIQM/Quality

Ev. Based Care

Lab Upgrades

HIMSS Stage 6

Cerner IT Works

NCH’s HCIT Journey 2013-14

CPOE Mandate

Smart Room Exp.,

CareAware Connect,

Med Rec, CareAware

5.2, BMM, Blood Admin

Physician Playbooks

Ambulatory EMR

HIMSS Stage 7

2015 IT Project Roadmap

Anesthesia

Acuity

PC Endoscopy

ProVation

Infection Prevention Uplift

NHIQM Upgrade

Physician Playbooks

Depart Process Optimization

Lab Cardiac Panels

Patient Portal Phases 2 & 3

Millennium 2015 Upgrade

Concurrent Coding

Smart ED

Infusion Management

Alarm Management

Stryker Bed Integration

HIE Expansion

Telemedicine

ICD-10

eSignature

Care Compass

PowerChart ECG

Dynamic Documentation

Full Smart Room Technology Suite

Phase I – March 2012

Vitals Link – Integrated Vitals Collection

Staff Link – Staff Assignment

Alert Link – Secondary Alerting to Caregiver’s Phone

Phase II – August 2012

Room Link – Integrated Digital Signage

My Station – Enhanced Patient Engagement

Capacity Management – Provider/Resource Presence Detection

Phase III – October 2012

iAware – Aggregated, personalized view (dashboard) of all information relevant to patient care

Phase IV – October 2013

Smart Room Expansion to an additional 71 patient rooms (163 total)

CareAware Connect – Development Partner

2.4

2.45

2.5

2.55

2.6

2.65

2.7

2.75

2010 2011 2012 2013

NNH

DNH

NDNQI RN Staffing & Resource Adequacy

0

5

10

15

20

25

30

35

40Jan…

Fe…

Ma

…

Apr…

Ma…

Jun…

Jul-…

Au

…

Se…

Oct…

No…

De…

Ja

n…

Fe…

Ma…

Apr…

Ma…

Ju

n…

Jul-…

Au…

Se…

Oct…

No

…

De…

Jan…

Fe…

Ma…

Ap

r…

Ma…

Jun…

Impact of Sepsis ImprovementsActual # Mortalities Projected # Mortalities

$5.8 million cost avoided

275 lives saved since 2012

0%

10%

20%

30%

40%

50%

Jan…

Feb…

Mar…

Apr…

Ma…

Jun…

Jul-1

2

Aug…

Sep…

Oct…

No

v…

Dec…

Jan…

Feb…

Mar…

Apr…

Ma…

Jun…

Jul-1

3

Aug…

Sep…

Oct…

Nov…

Dec…

Jan…

Feb…

Mar…

Apr…

Ma…

Jun…

Sepsis Mortality (Actual vs Baseline)Actual Sepsis Rate Baseline / Proj Rate Linear (Actual Sepsis Rate)

$5.8 million cost avoided

275 lives saved since 2012

Join the Movement

SOUTHWEST FLORIDA

Blue Zones Project™

BLUE ZONES

Move Naturally

Right Outlook

Eat Wisely

• Wine @ 5

• Plant Slant

• 80% Rule

Connect

The Power 9Lessons for Living Life Longer, Better

• Loved Ones First

• Belong

• Right Tribe

• Downshift

• Sense of Purpose

16

Blue Zones Awareness

RESULTS – WHAT TO EXPECT

•Measurable increase in Well-Being of the population

•Lower Healthcare Costs

• Improved Productivity

•Community seen as innovator in Preventative Health

•Alignment for Grants, Gifts, and Funding

•Less Tobacco Usage

•More Active Population – Walking, Biking, and Moving

• Increased consumption of fruits and vegetables

•Local, regional, and national media

The 5 Elements of Well-Being

Liking what you do each day and being motivated to achieve your goals

Having supportive relationships and love in your life

Managing your economic life to reduce stress and increase security

Liking where you live, feeling safe and having pride in your community

Having good health and enough energy to get things done daily

Purpose Social Financial Community Physical

Purpose >

Social >

Financial >

Community >

Physical >

Well-Being: The North Star for Accountability

• 25-year commitment initiated January 2, 2008

• 500 telephonic “community” surveys completed per day, 7 days/week

• 2,000,000+ completed surveys• For results based on this sample of respondents, the maximum 95% margin of

sampling error is ±0.2 percentage points

• Design support and oversight from leading behavioral economists, psychologists, and experts in psychometric survey design and statistical analysis

• Largest and most comprehensive health survey and database

Purpose

Social

Financial

Community

Physical

Cost Goes Down When Well-Being Goes Up

Source: “Evaluation of the Relationship Between Individual Well-Being and Future Health Care Utilization and Cost” Population Health Management, Volume 15, Number 00 2012. Patricia L. Harrison, MPH, James E. Pope, MD, Carter R. Coberley, PhD, and Elizabeth Y. Rula, PhD

1 Point =

2.2% likelihood of hospital admission

1.7% likelihood of ER visit

1.0% likelihood of incurring healthcare costs

Population Well-Being

Performance Goes Up When Well-Being Goes Up

10 %Workforce Well-Being

5% fewer unscheduled absences

24%lower presenteeism

5%higher reported job performance

6%more days of ‘best work’ in 28-day period

Source: “Evaluation of the Relationship Between Individual Well-Being and Future Health Care Utilization and Cost” Population Health Management, Volume 15, Number 00 2012. Patricia L. Harrison, MPH, James E. Pope, MD, Carter R. Coberley, PhD, and Elizabeth Y. Rula, PhD

Beach Cities Well-Being Climb!

0

0.5

1

1.5

2

2.5

3

3.5

2010 2011 2012

Beach Cities Well-Being Climb

Finklestein, E.A., Trogdon, J.G., Cohen, J.W., and Dietz, W. (July 2009). “Annual Medical Spending Attributable to Obesity: Payer- and Service-Specific Estimates.” Health Affairs 28(5) w822-w831.

Solberg LI, Maciosek MV, Edwards NM, Khanchandani HS, Goodman MJ. Repeated tobacco‐use screening and intervention in clinical practice: health impact and cost effectiveness. American Journal of Preventive Medicine, 2006;31(1):62‐71.

Beach Cities Well-Being Jump by the Numbers!

What it means?• $2.35M h.care savings₁• $8.03M savings in work loss

productivity

What it means?• $6.97M h.care savings₂

₁Finklestein, E.A., Trogdon, J.G., Cohen, J.W., and Dietz, W. (July 2009). “Annual Medical Spending Attributable to Obesity: Payer- and Service-Specific Estimates.” Health Affairs 28(5) w822-w831.

₂Solberg LI, Maciosek MV, Edwards NM, Khanchandani HS, Goodman MJ. Repeated tobacco‐use screening and intervention in clinical practice: health impact and cost effectiveness. American Journal of Preventive Medicine, 2006;31(1):62‐71.

Well-being Analysis of Florida Counties

Top Quintile

2nd Quintile

3rd Quintile

4th Quintile

5th Quintile

Building Momentum in Naples to Set the Stage for Southwest Florida

32

• Positive engagement of city leadership,

business, media, and other community

sectors

• Opportunities to leverage current

community efforts and partnerships

• Great variation in well-being within

Naples

Questions?

33

Join the Movement

SOUTHWEST FLORIDA

Blue Zones Project™