Post on 18-Jul-2020
The Revolution in Healthcare – Achieving Value Driven
Outcomes with Healthcare AnalyticsCharlton Park, MBA/MHSM
1Achieving Value Driven Outcomes with Healthcare Analytics
4 hospitals
35,000discharges
1,700,000+ambulatory visits
Source: American Hospital Association
$1,680,000,000expense
12neighborhood
clinics
2Achieving Value Driven Outcomes with Healthcare Analytics
EDUCATION
1,250 Health Care Provider Trained Annually:
School of Medicine
College of Nursing
College of Pharmacy
College of Health
School of Dentistry
Eccles Health Sciences Library
50%
GROWTH
IN 5 YEARS
1.7 MILLION
Patient Visits
>1,400
Providers
ACCESS
4 Hospitals
12 Community
Clinics
19
Regional Partners
>10% of the
Continental U.S.
$291 Million+ Grants in FY2017
35+ Disease-Causing
Genes Identified
10 All-Time Members of
National Academy of
Science or Medicine
1NCI Comprehensive
Cancer Center
DISCOVERY
1 Nobel Laureate
>160,000 member
Health Plan3
Achieving Value Driven Outcomes
• Why are Analytics Critical?
• Making Analytics a Priority
• Driving Engagement with Analytics
• Joint Replacement
• Sepsis Care
• Supply Variation
• Revenue Capture
• Predictive Analytics
• Increasing Value
4Achieving Value Driven Outcomes with Healthcare Analytics
Why are Analytics Critical?
• U.S. healthcare spending is growing at an
unsustainable pace (>17% of GDP)
• Shift from volume to value based
reimbursement models
• Healthcare data has incredible potential to
impact quality and outcomes (EMRs)
5Achieving Value Driven Outcomes with Healthcare Analytics
Measurement
“...The future success of the U.S. healthcare system and the U.S. economy as a whole are completely dependent on our ability to measure and improve healthcare value. Although this concept seems quite simple, understanding and measuring both quality and cost are quite complicated.”
D.Scheurer,MD, E.Crabtree,MPH,PhD(c), P.J.Cawley,MD, MBA, T.H.LeeMD,MSc, The Value Equation: Enhancing Patient Outcomes While Constraining Costs
Achieving Value Driven Outcomes with Healthcare Analytics 6
Analytics and Value
• We need to be able to measure in order to make
improvements
• Analytics enable us to understand relationships
between Quality / Patient Satisfaction / Cost
• Transparency to accurate data helps facilitate the
engagement of providers and stakeholders in
process improvement
7Achieving Value Driven Outcomes with Healthcare Analytics
Example: Transparency
8
Provider Scorecard:
• N>30
• 2 x year
• Rolling 12 months
• Provider Section
• Wait and Delay
• Ease of Scheduling
• Comments
Individual Scorecards
0
25
50
75
100
Dr. A Dr. B Dr. C Dr. D Dr. E Dr. F Dr. G Dr. H Dr. I Dr. J
Nat
ion
al P
erc
en
tile
Ran
k
Peer Scorecards
System Scorecards Public Scorecards
Achieving Value Driven Outcomes with Healthcare Analytics
Results
9Achieving Value Driven Outcomes with Healthcare Analytics
Making Analytics a Priority
• The collection, creation, and organization of data and
analytics isn’t easy
• Strong cross-functional teams are needed in order to
deliver accurate, actionable analytics
• Sponsorship and Vision from Senior leadership is critical
10Achieving Value Driven Outcomes with Healthcare Analytics
Value Measurement
“… A fundamental and largely unrecognized problem: We don’t know what it costs to deliver health care to individual patients, much less how those costs compare to the outcomes achieved.”
“Understanding costs could be the single most powerful lever to transform the value of health care.”
- Robert S. Kaplan & Michael E. Porter
11Achieving Value Driven Outcomes with Healthcare Analytics
Example: Emergency Appendectomy
12
Emergency
Department
10:54am
IMCU
6:59pm
SICU
Surgical ICU
2:16am
SSTU Surgical Specialty & Trans. Unit
3:25pm
10:54am - Day 1 Day 2 Day 3 Day 4 – 1:45pm
IMCU Intermediate Care Unit
1:30pm
OR9:46 to
10:48
Emergency
Department
• Labor
• Supplies
• Imaging
• Pharmacy
• Lab
• Other Services
Operating
Room
• Labor
• Supplies
• Other Services
Surgical ICU
• Labor
• Supplies
• Pharmacy
• Lab
Step down and
Floor Units
• Labor
• Supplies
• Other Services
Total Cost of
Providing Patient
Care=
Achieving Value Driven Outcomes with Healthcare Analytics
Data Flow
Clinical Data Sources Financial Data Sources
Clinical and Financial Data Marts
Encounter-Level Costs
Encounter and Patient-
Level Quality and
OutcomesCost Allocation
Methods
Quality & Outcome
Rules
Reports and Dashboards
Data Warehouse
Source Systems
BI Analytics Tools
13Achieving Value Driven Outcomes with Healthcare Analytics
Cost Allocations
14
91066 - UUH OPC 29A
EMERGENCY RM
91275 - UUH ANC 13A
CLINICAL LABS
91259 - UUH ANC 12C CT
IMAGING
91238 - UUH ANC 22A
ANESTHESIOLOGY
91237 - UUH ANC 22A POST
ANESTHESIA
91031 - UUH IPC 24A SURG ICU
91271 - UUH IPC 11C
PHARMACY IP
91607 - UUH ANC 14A NONINV
CARD MON
91665 - UUH IPC 24A
INTERMEDIATE CARE
91239 - UUH ANC 13A
RESPIRATORY THRPY
91054 - UUH ANC 37A DISTRO
INVENTORY
91642 - UUH IPC 21A SURG
SPEC TRANSPL
91040 - UUH IPC 33A GEN
ACUTE REHAB
91236 - UUH ANC 22A
OPERATING RM
91243 - UUH ANC 13A
PULMONARY LAB
91277 - UUH ANC 13A BLOOD
PRODUCTS
Facility Cost $X,XXX.XX
Emergency Appendectomy (47.01
Laparoscopic Appendectomy),
3.12 Clinical LOS
Achieving Value Driven Outcomes with Healthcare Analytics
Cost Analytics
15
Analyze Variation
• Labor
• Imaging
• Labs
• Pharmacy
• Supplies
• Implants
Achieving Value Driven Outcomes with Healthcare Analytics
Engaging Providers with Analytics
• Accurate and actionable data, including
metrics that are meaningful to providers
• Involve providers in the development of
analytics
• Get specific (provider scorecards, O.R.
supplies, specific condition outcomes, etc.)
• Provide support
16
Financial
Data
Quality
Data
Operational
Data
Achieving Value Driven Outcomes with Healthcare Analytics
Engaging in Analytics
• Physician Engagement (CVO)
• Subject Matter Experts
• Support Teams
17Achieving Value Driven Outcomes with Healthcare Analytics
Joint Scorecard
• Metrics
• Patient was admitted to OTSS
• No Patient Safety Indicators (PSIs)
• Patient discharged to home health
• Patient did not return to ED within 90 day
• No Hospital Acquired Conditions (HACs)
• Readmission Rate
• Anesthesia Technique
18Achieving Value Driven Outcomes with Healthcare Analytics
Sepsis Scorecard
• Metrics
• Antibiotic delivered within 180 min
• Blood culture taken within 180 min
• IV fluid delivered within 180 min
• Lactate taken within 180 min
• Readmission rate
• Clinical length of stay
• Mortality rate
• mEWS score (modified early warning score)
19Achieving Value Driven Outcomes with Healthcare Analytics
Supply Costs & Utilization
• Operating Room analytics
focused specifically on
supplies
• Creates transparency to
existing variation
• Provides actionable
infomation
Achieving Value Driven Outcomes with Healthcare Analytics 20
Longitudinal Patient Care
• Focus on populations
• Analyze interactions with
patients over time
• Drill into individual patients
costs and clinical details
21Achieving Value Driven Outcomes with Healthcare Analytics
Provider Scorecards
• Provide unique provider specific data
to individual physicians
• Deliver scorecards directly to each
providers inbox
• Follow up with support and feedback
loop
22Achieving Value Driven Outcomes with Healthcare Analytics
Predictive Analytics
• Predicting Readmissions
• Includes more than 20 variables
• Helps nursing staff prioritize
which patients to focus on for
follow-up, etc.
23Achieving Value Driven Outcomes with Healthcare Analytics
Predictive Analytics
• Predicting No-shows
• Physician time is the most
valuable resource in the clinics
• Identifies where and who to
intervene with to increase
productive time in the clinic
24Achieving Value Driven Outcomes with Healthcare Analytics
Engaging Providers with Data
Achieving Value Driven Outcomes with Healthcare Analytics 25
1 - Engage Providers with Value-Driven Data 2 – Provide Transparency to Timely Information 3 – Support Value Improvement and Innovation
Results
• More that 50 provider driven quality improvement
& cost reduction projects
• Measureable improvements in Quality, Patient
Satisfaction, and Financial results
• Engaged Providers creating a culture of value
improvement
Achieving Value Driven Outcomes with Healthcare Analytics 26
Data and Analytics are Essential...
• To facilitate data-driven decision making
• To bending the cost curve and increasing
healthcare value
• To engaging physician partners
• To preparing for future challenges
• To building a culture of value improvement
Achieving Value Driven Outcomes with Healthcare Analytics 27
Delivering Value
Achieving Value Driven Outcomes with Healthcare Analytics 28
29Achieving Value Driven Outcomes with Healthcare Analytics
Appendix
Achieving Value Driven Outcomes with Healthcare Analytics 30
Ambulatory Value Explorer
Achieving Value Driven Outcomes with Healthcare Analytics 31
Labor Efficiency
• Benchmarks (ODB) are collected
for each operating unit
• Budgets are set based on
benchmarked efficiency targets
• Reports track to budgeted
efficiency targets
Achieving Value Driven Outcomes with Healthcare Analytics 32
Daily Revenue to Budget Tracking
Achieving Value Driven Outcomes with Healthcare Analytics 33
Hospital-to-Hospital Transfers
Achieving Value Driven Outcomes with Healthcare Analytics 34
Clinic Volumes
Achieving Value Driven Outcomes with Healthcare Analytics 35
Primary Care
Achieving Value Driven Outcomes with Healthcare Analytics 36
Patient Reported Outcomes
Achieving Value Driven Outcomes with Healthcare Analytics 37
Achieving Value Driven Outcomes with Healthcare Analytics 38
NBC News Video
Achieving Value Driven Outcomes with Healthcare Analytics 39