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© 2014 Caradigm. All rights reserved. Caradigm and the Caradigm Logo are trademarks or registered trademarks of Caradigm USA LLC.
All other product names and logos are trademarks or registered trademarks of their respective companies.
Victoria Tiase, MS, RN, Director Informatics Strategy, NewYork-Presbyterian Hospital Kathleen McGrow, MS, RN, PMP, Director Customer Marketing, Caradigm April 23, 2014
Healthcare Analytics & Managing Population Health
Cost, Quality and Access to Appropriate Care
2
The US spent
$2.6 trillion on health in 20101
$432 billion on heart disease and stroke
$212 billion on diabetes2
1. Kaiser EDU.org. “U.S. Health Care Costs.” 2. 2011 National Diabetes Fact Sheet 3. GE Healthcare. “Clinical Decision Support Decision: Defining our Problem Statement.” 2011.. 4. NEMJ “Care in US Hospitals” July 2005 5. 2009 National Vital Statistics, CDC. Estimating HAIs and Deaths in US Hospitals, 2002, Klevens 2002
30% of the total annual US
expenditure on healthcare spent on
ineffective or redundant care.3
30% of care delivered is not evidence-based and is not in accordance with the best clinical knowledge.3
Healthcare-associated infections kill more people every year than breast cancer and prostate cancer combined. 5
Reimbursement to Improve Quality
The impact on Healthcare organizations
• Non-payment for never events and hospital-acquired conditions
• Meaningful Use incentives
• Value-based Purchasing
Management of at-risk patients enables organizations to realize 50% or more of shared savings Single payment for inpatient, outpatient,
and post-acute care services
$280 M in payment penalties based on readmission rates for AMI, HF and pneumonia—added conditions in 2015
Hospital Readmissions Reduction Program
Shifting Risk to Providers
The Impact on Healthcare Organizations
Challenges of Cost and
Quality
Government Regulations
and Initiatives
New Payment Methods
Provider Risk
Models
Need for Population
Health
The new demands of population health require solutions that
facilitate collaboration, deliver insights and enable care teams to achieve integrated, accountable
care.
The Advisory Board. “Survey results: Percentage of providers taking on risk doubled since 2011.” June 2013.
Population Health
Balancing risk and clinical programs
RIS
K/R
EWA
RD
LEV
EL
CARE MODEL
Low
Independent Integrated
Hig
h
Coordinated
FFS
U&C
DRG
VBP
Bundled payment
Shared savings
Capitation
Full risk
Readmission penalties
Population Health Framework
Four Capabilities for Success
Population Health
Data Control
Healthcare Analytics
Care Coordination and Management
Wellness and Patient Engagement
Promote healthier lifestyles for your patients.
Make information accessible where and when you need it.
Generate insights and drive better decisions.
Drive improved outcomes for patient populations.
Freeing your data from information silos
Caradigm Intelligence Platform
Data formats HL7 CCD CSV XML
Patient Encounter Lab Results Claims
HOSPITAL
OUTPATIENT PRACTICE
GOVERNMENT
LAB PHARMACY
PAYER
HOME
Amazing Things are Happening Here …
About NewYork-Presbyterian Hospital (NYP) • NYP is composed of six main facilities located in and around New York City
– Columbia University Medical Center
– Weill Cornell Medical Center
– 2,600 patient beds
– 2 million inpatient and outpatient visits
• US News & World Report Honor Roll - #1 in NYC
Use of EHR at NYP • Main EHR for clinical care: Allscripts Sunrise Clinical Manager
– Computerized provider order entry: 81,000 orders per day
– Nurse charting, ancillary clinical documentation: 98,000 notes per week
– Provider documentation: 49,600 notes per week
• Active user accounts: 26,300
– 1,300 resident physicians, 1,300 medical students
• NYP successfully attested to Stage 1 and well-poised for MU Stage 2
– Patient Engagement (myNYP.org)
– Clinical Analytics and Public Health reporting
1
0
Aggregating Data from Multiple IT Systems
Lab Report
Discharge Medications
Stress Report
EKG Report & PDF of Tracing
Surgery Report
Echo Report
Nursing Discharge Instructions
Cath Report
Discharge Summary
Near real-time data repository
NYP Regional Health Collaborative
Population Health
Infrastructure /
Capabilities Patient Centered Medical Homes
Targeted Care Initiative (TCI)
Integration & Coordination of
Community-based Programs and Services
Health Information Exchange
Medical Village
Care Coordination Tools
Use of Patient Registry
• Disease Coordination
• Prevention of Readmissions
• Monitoring of DVT risk
Use of Quality Reporting Dashboards
• Prevent CAUTI
• Monitor Pain Assessment
• Assess care management of patients on care pathways
Clinic Visits with a Diabetes Diagnosis
Last H1AC was >9 and have not had a visit in 3 months or longer
CHF Readmission Prevention
DVT Risk Monitoring
CAUTI Reduction
ACTIVE FOLEY
NO = No active foley catheter order present in SCM
YES = Active foley catheter order present
APPROVED INDICATION
NO = Indication for foley catheter is a non-approved indication (i.e. “other:…”)
YES = Indication for foley catheter is approved indication
DAILY REVIEW
NO = Daily review for necessity not completed at some point in patient hospital stay
YES = Daily review completed or those patients w/o a foley catheter order
2
0
Pain Assessment Pilot
Care Pathway Status Draft
Lessons Learned as the Journey Continues
• New demands for data analytics - regulatory and quality initiatives
• Data quality management process is key
• Incremental process – care is complex and multi-faceted
• Priority, Patience, & the Patient
©2014 Caradigm. All rights reserved.
Thank You
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