The Revolution in Healthcare Achieving Value Driven ... · 4 hospitals 35,000 discharges 1,700,000+...

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


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


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)


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


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


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


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


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=


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


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


Cost Analytics

15

Analyze Variation

• Labor

• Imaging

• Labs

• Pharmacy

• Supplies

• Implants


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


Engaging in Analytics

• Physician Engagement (CVO)

• Subject Matter Experts

• Support Teams


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


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)


Supply Costs & Utilization

• Operating Room analytics

focused specifically on

supplies

• Creates transparency to

existing variation

• Provides actionable

infomation


Longitudinal Patient Care

• Focus on populations

• Analyze interactions with

patients over time

• Drill into individual patients

costs and clinical details


Provider Scorecards

• Provide unique provider specific data

to individual physicians

• Deliver scorecards directly to each

providers inbox

• Follow up with support and feedback

loop


Predictive Analytics

• Predicting Readmissions

• Includes more than 20 variables

• Helps nursing staff prioritize

which patients to focus on for

follow-up, etc.


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


Engaging Providers with Data


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


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


Delivering Value


Appendix


Ambulatory Value Explorer


Labor Efficiency

• Benchmarks (ODB) are collected

for each operating unit

• Budgets are set based on

benchmarked efficiency targets

• Reports track to budgeted

efficiency targets


Daily Revenue to Budget Tracking


Hospital-to-Hospital Transfers


Clinic Volumes


Primary Care


Patient Reported Outcomes


NBC News Video


The Revolution in Healthcare Achieving Value Driven ... · 4 hospitals 35,000 discharges 1,700,000+...

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