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HIMSS Clinical & Business Intelligence
Community of Practice
January 23, 2014
Welcome
Shelley Price, MS, FHIMSS
C&BI Community Organizer
Director, Payer & Life Sciences, HIMSS
Nancy Devlin
C&BI Community Organizer
Senior Associate, Payer & Life Sciences, HIMSS
Michael Brooks, BS, MBA, CPHIMS
C&BI Community Co-Chair
Specialist Leader, Healthcare Information Management
Deloitte Consulting LLP
J.D. Whitlock, MPH, MBA, CPHIMS
C&BI Community Co-Chair
Corporate Director, Clinical & Business Intelligence
Catholic Health Partners
Agenda • Welcome
• HIMSS C&BI Community Updates / Announcements HIMSS14, new tools & resources, Committee application call
• Presentation & Discussion:
“Reducing Readmissions and Improving VBP and Core Measures Scores with a Real-Time Predictive Analytics Solution” o Indranil Ganguly, VP and CIO JFK Health System
o Raj Lakhanpal, CEO, SpectraMedix, SpectraMedix
• Wrap-Up / Next Steps
C&BI Community Updates / Announcements
HIMSS14 Events Pre-conference Symposia
Sunday, February 23, 8:00am-4:00pm
Early-bird registration pricing ends January 27 Linking Clinical Analytics & Business Intelligence to Improve Clinical Care and Operational
Performance
This symposium provides contextual, practical, actionable information attendees can use to develop a
robust C&BI strategy. The C&BI Roadmap outlines the sequential steps to effectively implement, adjust and
sustain that strategy over time.
Transitioning to Fee-for-Value through ACOs, Care Coordination and Clinical Integration
This symposium explores how new models of fee-for-value are driving change, with Accountable Care
Organizations as the most recognizable. Learn how technology is helping providers move from siloed-care
to team-based coordinated care to deliver value.
Keeping the Delicate Quality Measurement Ecosystem in Balance
Improving national health through timely and accurate clinical quality measure reporting is a key goal of the
drive to automate the U.S. healthcare system. To succeed in this venture, a complex ecosystem of public
and private players and initiatives must be kept in delicate and collaborative balance. This session will
illustrate this ecosystem through the eyes of its players, and provide an understanding of need to keep all
components healthy and functional in cooperative symbiosis.
HIMSS14 Events C&BI Community Reception
Tuesday, February 25, 5:00-6:00pm
HIMSS C&BI Knowledge Center, Hall A, Booth 2383
Invitations with Registration coming soon
Thank you to our Community Supporters:
C&BI Educational Sessions Monday-Thursday
45+ sessions
New “Topics” tool on himssconference.org
HIMSS14 Events C&BI Knowledge Center
Monday-Wednesday | Hall A, Booth 2383
HIMSS FY15 Committees HIMSS Annual Call for Committee Volunteers Serving on a HIMSS Committee is an excellent opportunity for professional development, networking and active engagement around key health IT topics, settings, and constituencies.
The HIMSS Annual Call for Committee Volunteers for the 2015-2016
fiscal year January 2 – March 6, 2014 Visit the HIMSS Committees page for more information Or come to the C&BI table at the HIMSS14 Communities Open House
Monday, February 24 at 5:00pm
C&BI Community
Guest Speaker
10
Indranil Ganguly MBA, CHCIO, FHIMSS, FCHIME
Raj Lakhanpal MD, FRCS, FACEP
Reducing Readmissions and Improving
VBP and Core Measures Scores
with a
Real-Time Predictive Analytics Solution
11
The Current Clinical Intelligence & Analytics Environment
Disparate tools and systems that are not healthcare specific
Clinical Analytics Landscape
12
An Integrated Real-Time Predictive Analytics Solution
Hospital Healthcare
Organization Health System
13
A Clinical Analytics Solution Must Be Actionable • Integrates real-time data to effect current performance
• Provides predictive analytics to identify patients at risk
and impact care prior to discharge
• Drills down to detail level for specific stakeholders
• Integrates with workflow or provides “Work Lists”
• Alerts those responsible for taking action
• Enables messaging and collaboration
• Facilitates transitions in care across the continuum
14
Real-Time Predictive Clinical Analytics directly enable:
1. Performance Improvement for Regulatory Changes
• Readmissions penalties
• Value-Based Purchasing & Core Measures improvement
• Never events, patient safety
2. Financial Improvement with Reimbursement Changes
• Shared savings, bundled payments
• Accountable care, MU-2
3. Enterprise-Wide Data Integration for Business Efficiency
Why Adopt a Clinical Analytics Solution?
"You can't manage what you can't measure."
- W. Edwards Deming
15
Readmissions Reduction Program
• Reduces Medicare payments up to 1%, 2% and 3% in 2013, 2014
and 2015 for high readmission rates
• In 2013 and 2014, hospitals must reduce readmissions for:
• Heart Failure (HF), Acute Myocardial Infarction (AMI),
Pneumonia (PN)
• For 2015, CMS is finalizing inclusion of new conditions:
• COPD, Elective Total Hip Arthroplasty (THA), Total Knee
Arthroplasty (TKA)
2013: ~2/3 of hospitals reviewed were penalized
and 307 received the maximum
2014: The total number increased and 18 received
the maximum 2% penalty
16
Value-Based Purchasing Program
• Medicare payments withheld up to 1% in 2013,
increasing incrementally to 2% in 2017. Hospitals earn
back payments by improving clinical quality.
• 12 Clinical Process of Care Measures
• Measures include: SCIP, Pneumonia (PN), Heart Failure
(HF), Acute Myocardial Infarction (AMI)
• Eight HCAHPS Measures
• Measures include: Nurse and Doctor Communication,
Staff Responsiveness, Discharge Info and Overall
Rating
17
Value-Based Purchasing
• Outcomes Domain (2014 & 2015)
• 2014: 30-Day Mortality Rate: HF, AMI, PN
• 2015: Central Line-Associated Blood Stream Infection,
Patient Safety (PSI-90)
• Efficiency Domain: Medicare Spending per Beneficiary
(2015)
Domain 2013 Weight 2014 Weight 2015 Weight
Clinical Process of Care 70% 45% 20%
HCAHPS 30% 30% 30%
Outcomes 25% 30%
Efficiency 20%
Domain Weights
18
Readmissions Reduction and VBP Case Study
CentraState Healthcare System
19
282 bed community medical center
• 14,384 Inpatient admissions (excludes newborns)
• 154,959 Outpatient visits (excludes SDS)
• 62,340 ED visits
• 511 board certified physicians
• Family Medicine residency program
Senior services
• 94 unit Assisted Living Facility
• 123 bed Skilled Nursing Facility
• 430 unit Continuous Care Retirement Community
Case Study: CentraState Healthcare System
20
Planning process
• Identified key drivers
− Silos of data, lack of integration
− No real-time data collection
− Limited end-user access / visibility to data
• Defined enterprise analytics and reporting strategy
− Multi-stakeholder review process
− Data dictionary / report catalog cleanup
− Evaluated existing tools & built future state view
Case Study: CentraState Healthcare System
21
Implementation Process
• Defined governance structure and long-term
deployment roadmap
• Defined data acquisition approach and timeline
• Identified and validated KPIs most relevant to
a community hospital of our size
• Performed data gap analysis: data required for
selected KPIs versus data available
Case Study: CentraState Healthcare System
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• Reduced HF
readmission rate
• Reduced
readmission
penalty
FOCUS implemented at CentraState in Dec 2012.
CHF readmission rate reduced 50.5% in six months.
0%
10%
20%
30%
Q1 2013 Q2 2013
28.1%
13.9%
Our readmissions committee struggled for a year to track results. FOCUS enabled
us to efficiently monitor and reduce readmissions and facilitate workflow changes.
- Carl Ausfahl, AVP Quality/Performance, CentraState Healthcare System
Results on Readmissions
23
Clinical Intelligence Framework
24
• Collect - Flexible multi system dynamic
interface
• Predict - Proprietary models to identify patients
• Present - Real-time work flow systems and alerts
• Improve - Sophisticated feed back system for QI
Real-Time Predictive Analytics Solution
Transitions in Care
Health System Solution
ACO Analytics
eMeasures/MU-2
Population Health
Reducing Readmissions
VBP/Core Measures
eMeasures/MU-2
Hospitals Ambulatory Providers
25
Case Study 1: Heart Failure Readmissions
Judy Finn
26
Case Study HF Readmissions Objectives
• Identify admitted cases likely to be discharged with HF,
PN, AMI, or COPD
• Predict risk of 30-day readmission for these conditions to
enable targeting of resources
• Facilitate care coordination and discharge planning to
reduce readmissions
• Support transitions in care in home care, sub acute care
and long-term care
• Alert Emergency Department of recent discharges to
avoid readmission
27
Case Study: HF Inpatient List
1
Case Study: HF Inpatient List
28
Case Study: HF Inpatient Work List
Judy
Finn
Case Study: HF Inpatient Work List
29
Transitions in Care
30
Case Study: CMO/CQO View
31
Case Study: CMO/CQO View
Case Study: CMO/CQO View
32
Case Study 2: Value-Based Purchasing
An actionable analytics solution should:
• Capture and aggregate data in as close to real-time
as possible
• Provide the ability to “drill down” to various
stakeholders to make the information actionable
• Assist with improvement of patient experience of
care scores
• Continually measures financial impact (overall)
33
Value-Based Purchasing
34
Value-Based Purchasing
Physician 3 Physician 1
Physician 2
Physician 5 Physician 7 Physician 9 Physician 11 Physician 1
Physician 4 Physician 6 Physician 8 Physician 10 Physician 12
Brown W
Brown W
Brown W
Brown W
Brown W
Brown W
Brown W
Brown W
Brown W
Brown W
Physician 4
Physician 3
Physician 8
Physician 12
Physician 1
Physician 16
Physician 2
Physician 14
Physician 7
Physician 9
List of Visits - Brown
35
Return on Investment for a Complete Clinical Analytics Platform
Non-Tangible ROI
• Improved care coordination across the continuum of care
• Improved HCAHPS scores through enhanced patient experience
• Improved business efficiency with enterprise-wide data integration
• Identification of high utilization/cost patients upon admission
ROI 2013 2014
Readmissions Penalty 0.95% 0.02%
Penalty Financial Impact $850,000 $13,000
Projected increase VBP scores X
Based on 2011 Total Medicare Reimbursements
36
Total Cost of Ownership
Feature Build
Buy
In-House SaaS
Hardware X X
OS, ETL Tools X X
Data Warehouse Tools X X
Dashboards X X
System Engineers X X
Data Architect/DBA X
ETL Manager X
Data Analyst X X X
Project Manager X X X
37
What’s Next: Health 2.0 Clinical Analytics Platform
Inpatient Predictive Analytics to impact care prior to
discharge
• Concurrent Core Measures reporting
• Key conditions such as sepsis
MU-2 Compliance and electronic reporting of CQMs
Ambulatory Predictive Analytics/Real-time Alerts for:
• Population health management
• Risk Stratification
38
Core Measures
Inpatient CORE Measure Work List
ED CORE Measure Work List
Concurrent Core Measures: CORE Measure Work List
39
Alerts
Use Case: It is the second day since a patient on the Med/Surg floor has
had cardiac surgery. Post operative glucose levels for day 1 are missing
and day 2 are still pending
Cardiac Surgical procedure completed: Post operative glucose level readings missing
Surgery Date and Time: 6/22/2013 10:00 am
Current Date and Time: 6/24/2013 8:00 am
CORE MEASURE ALERT
Missing Lab Result Glucose levels missing for a surgery patient, click here to view details.
40
ACO Quality Performance Drill Down
41
• Collect data reliably at the front end
• Make your analytics actionable with real-time
data and predictive analytics
• Integrate with workflow as a key feature
• Ability to annotate and forward key
performance indicators (KPIs) to direct reports
Best Practices
42
• Integrate financial implications with quality
improvement efforts
• Make managers accountable for financial
implications
• Analytics across the continuum of care
(Don’t forget ambulatory and post acute care)
Best Practices
43
Questions?
44
Thank You!
Raj Lakhanpal, MD
CEO, SpectraMD
609-336-7733, x301 (office)
609-865-3244 (cell)
Indranil Ganguly, MBA, CHCIO,
FHIMSS, FCHIME
Vice President, CIO
JFK Health System
732-321-7702
• Want to get involved?
Speaker or topic ideas
Key note presenter
Blogger, twitter
Contact Nancy Devlin
• Community Website
www.himss.org/ClinBusIntelCommunity
Wrap-Up
We would like to extend our appreciation to the supporters of the
C&BI Community
Wrap-Up
JOIN US!
• Next meeting: Thursday, March 27, 2014
TBA
Next Steps
FY13 Leadership and Contact Information Co-Chairs: Michael Brooks, BS, MBA, CPHIMS Specialist Leader Deloitte Consulting LLP [email protected] HIMSS Community Organizers: Shelley Price, MS, FHIMSS Nancy Devlin Director, Payer and Life Sciences Sr Assoc., Payer and Life Sciences HIMSS HIMSS [email protected] [email protected]
48
J.D. Whitlock, MPH, MBA, CPHIMS Corporate Director, Clinical & Business Intelligence Catholic Health Partners [email protected]
Thank You
…see you at HIMSS14!!
Appendix
Diane M. Carr, FHIMSS Chair
Deputy Executive Director North Bronx Healthcare Network
J.D. Whitlock, MPH, MBA, CPHIMS Vice-Chair Director, Clinical & Business Intelligence Catholic Health Partners
Thompson Boyd, MD, CPHIMS Physician Liaison Hahnemann University Hospital
Michael Brooks, BS, MBA, CPHIMS Specialist Leader Deloitte Consulting LLP
Julie Burgoon, MBA, CPHIMS, PMP Manager, Health IT BlueCross BlueShield of Tennessee
Linda Campbell, FHIMSS, CPHIMS, PMP, MT, ASCP & SH Principal Consultant Sonoran Consulting Solutions
Terri Gocsik, CRNA, MS, CPHIMS Senior Manager Aspen Advisors
Ray Hess, MS, FHIMSS VP, Information Management The Chester County Hospital
Michael Kurliand, MS, RN IS Strategy Consultant Children’s Hospital of Philadelphia
Arthur Panov, MPH, CPHIMS HIT Architect, Biostatistics IBM
Maxine Rand, DNP(c), MPA, RN-BC, CPHIMS Director, Clinical Ed, Practice & Informatics Kaiser Permanente
Wolf Stapelfeldt, MD Chairman, Department of General Anesthesiology Cleveland Clinic
BOARD LIAISON: Brian Jacobs, MD, FHIMSS VP & CMIO, Executive Director, Center for Pediatric Informatics Children’s National Medical Center Kathleen C. Kimmel, MHA, RN, CHE, CPHIMS, FHIMSS Chief Clinical Officer Health Care DataWorks
2013-2014 C&BI Committee COMMITTEE MEMBERS
C&BI Community of Practice The goal of the C&BI Community is to bring together thought leadership and share knowledge that will support the future success of our members by improving their ability to understand and form partnerships to manage C&BI as a part of doing business and providing accountable and quality care to their members. The Community will support activities that promote peer-to-peer networking, problem solving, solution sharing, and education.
Topics of focus may include:
• Storage and Management of Data and Supporting Technologies
• Knowledge Management to Support Accountable and Quality Care
• Case, Risk & Cost Management
• Best Practices Clinical & Business Analytics
• Clinical Decision Support
• Research Data Warehousing/EDW
• Data Lifecycle Management
C&BI Community of Practice
• Open to all HIMSS members (current membership: approx 5050 people)
• Will meet virtually 6-9 times/year
• Agenda for the meetings may include:
• Commencing with a short series of 2-Minute Drills presented various Community members
• Topical discussion with key note presenter
The ‘2-Minute Drill’ is based loosely on the sports analogy, and in this case
is a fast-paced (short in length) presentation on a hot, emerging, or timely topic, news event (e.g. research paper, game-changing market or technology news), or recent and relevant event (e.g., federal public meeting, legislative/federal/judicial news, critical conference or educational event).
2-Minute Drills foster greater peer-to-peer networking, member engagement, problem solving,
solution sharing, and education. If you are interested in presenting any drills, please contact Nancy or Shelley.
FY14 C&BI Task Forces
NEW! Population Health Task Force
CHAIR: William Beach, PhD. | Program Chair, Health Services Administration | Hodges University
This group creates resources and tools to help healthcare organizations use C&BI to execute population health management initiatives to include creating tactical C&BI strategies around data and analytics as well as strategies for organizational planning and patient engagement. Meeting times: 3rd Tuesday of the month, 2:00-3:00pm ET
Data and Analytics Task Force
CO-CHAIR: David Dobbs, PMP | Health Analytics National Service Line Director | Leidos Health
CO-CHAIR: Carol Muirhead, MBA | Sr. Informatics Project Specialist | PinnacleHealth
This group create resources and tools to help providers and provider organizations manage, integrate and aggregate the necessary information to support robust data and analysis, facilitate effective reporting by translating data into meaningful knowledge, resulting in improved quality, clinical and financial outcomes.
Meeting times: 3rd Tuesday of the month, 1:00-2:00pm ET
Value of Operationalizing the Data Task Force
CHAIR: Amy Rosa, RN | Director, Clinical Informatics | Baptist Health
This group creates resources and tools focused on industry use cases. The use cases highlight best practices and lessons learned by providers and provider organizations using information to drive improved business and clinical decision-making.
Meeting times: 1st Thursday of the month, 1:00-2:00pm ET
