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Crystal Run Healthcare shares their story about using proven strategies to care for patients in an accountable care model by using data to drive those strategies. Gregory A. Spencer, MD, FACP, CMO, and CMIO at Crystal Run Healthcare discusses why they moved towards analytics and data warehousing as well as the 6 requirements their health system had as they searched for a partner: 1) The solution needed to hit the ground running. 2) The solution needed to provide quick, actionable data. 3) There needed to be a library of analytical applications. 4) The healthcare data model needed to be able to evolve. 5) They needed to be taught how to fish for the data. 6) A long-term relationship with the vendor was important
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© 2014 Health Catalystwww.healthcatalyst.comProprietary. Feel free to share but we would appreciate a Health Catalyst citation.
© 2014 Health Catalystwww.healthcatalyst.comProprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Data-Driven Healthcare That Works – A Physician Group PerspectiveBy Dr. Gregory Spencer, CMO & CMIO, Crystal Run Healthcare
© 2014 Health Catalystwww.healthcatalyst.comProprietary. Feel free to share but we would appreciate a Health Catalyst citation.
The Journey to Data-Driven Healthcare
For Crystal Run Healthcare, the journey to data-driven healthcare began in 2007.
We decided as a practice we needed both a mission statement and a vision.
The answer?
To improve the quality, availability of, and satisfaction with healthcare services in the communities we serve.
And we would do this with data.
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The Journey to Data-Driven Healthcare
This was not our first foray into data. Crystal Run was a relatively early adopter of the electronic health record (EHR).
Our vision quickly propelled us forward in the quest for data-driven care in our population health management efforts.
Compare the Triple Aim today with our 1997 mission statement, you’ll see they align nicely.
We had unknowingly began prepping for Triple Aim by embracing the need to improve care and make it part of our business.
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Population Management Is Critical for Future Viability and Population Health Improvement
Facing competitive pressure within our community, it was imperative for Crystal Run to quickly learn to navigate the value-based world.
We learned the importance of putting in place systems that enable population health management.
It’s easier to manage risk within larger patient populations so we knew we had to expand in size, scope and geography.
We also needed to evolve and continue to build the skill sets of the Crystal Run team, so we would become the practice of choice, for patients and physicians.
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Population Management Is Critical for Future Viability and Population Health Improvement
To accomplish our goals, here are a few examples of what we’re doing to implement data-driven, value-based care.
Crystal RunInitiatives
Waste Reduction
On-site Care Managers
Identification of High-Risk Patients
Bluetooth-Enabled Devices
Crystal Run Healthcare Quality Initiatives
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Population Management Is Critical for Future Viability and Population Health Improvement
1 – Waste Reduction
Crystal Run’s strategy for care management is to provide high-quality, value-based care that is data-driven and evidence-based.
For example, if procedures and tests have not been shown to benefit the patient, then we try to eliminate them.
As a result, clinicians review every test and procedure to ensure it will contribute to advancing the patient’s health.
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Population Management Is Critical for Future Viability and Population Health Improvement
2 – On-site care managers
Registered nurse care managers are located at each of our medical homes. Their role is to meet with patients and coordinate care as needed.
There’s also a care manager in the hospital — paid for on Crystal Run’s dime — who coordinates the transition of care.
In addition, a team visits with patients in their homes if they can’t make it to the office.
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Population Management Is Critical for Future Viability and Population Health Improvement
3 – Identify high-risk patients
Identifying high-risk patients and those who need complex care management is very important.
However, being able to identify these patients is only possible with systems in place to evaluate risk and then create lists of patient, also known as registries.
Then the patients in those lists needing management are evaluated by providers or sent to care managers.
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Population Management Is Critical for Future Viability and Population Health Improvement
4 – Bluetooth-enabled devices
If a patient has multiple admissions or identified as high-risk they receive a Bluetooth enabled monitoring device, such as a scale or blood pressure device for home use.
Should the device monitor and record problematic changes it will notify a nurse or care manager and the patient can be quickly contacted.
For example, if a patient with CHF has a sudden weight increase, a nurse can reach out and intervene.
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Data-Driven OutcomesWe had been relying initially on a data warehouse that we developed ourselves. Applying the strategies mentioned above, we achieved some relatively positive results, including the following:
Reduction of admission rates overall by nearly 20 percent
Improvement of mammogram screening rates from 60-65 percent to greater than 75 percent
Achievement of hemoglobin A1c rates of less than 9 percent
Improvement of pressure control by more than 75 percent for hypertensive patients
Reduction of avoidable admissions down to now less than 17 percent
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Data-Driven Outcomes
Crystal Run’s avoidable admissions are down to less than 17 percent at this point.
© 2014 Health Catalystwww.healthcatalyst.comProprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Data-Driven Outcomes
Crystal Run improved mammogram screening rates for its patients from 60-65 percent to greater than 75 percent. They achieved these improvements by implementing a data-driven approach during the second quarter of 2012.
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Inability to Keep Up with Accelerating Data Demands
While our results were solid, we wanted more. Our organization had depended on data for years, but, recently, we were noticing how it was becoming even more important in our quest to provide the best care for patients, advance our mission, and maintain our quality reporting requirements to outside entities.
But to be able to provide these services and achieve the types of outcomes that are required, we wanted to be able to store and track ever-increasing amounts of data in a more automated fashion.
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Inability to Keep Up with Accelerating Data Demands
In the past our analysts spent a lot of time with manual entry and extraction of the data.
We quickly learned the importance of automated processes for data presentation.
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Inability to Keep Up with Accelerating Data Demands
There’s also a need to marry claims data with clinical data from the EHR, so we can improve our knowledge of patient care provided outside our system.
We knew we needed to have an enterprise warehouse for data storage and be able to simplify, automate, and scale the reporting.
We also needed dedicated analytic applications to enable analysts with actuarial science and statistical expertise to help sort through the data.
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Crystal Run EDW Requirements
Crystal Run decided to find a partner to develop a more modern enterprise data warehouse (EDW).
Our requirements?
1. Quick integration and results
2. Short ramp up to actionable data
3. Included several analytical applications
4. Built with a healthcare data framework
5. Independence from vendor for self sufficient data mining
6. Solid long term relationship with vendor
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It’s All About the Data
The nature and sheer volume of healthcare data is much more complex in the healthcare industry.
These days there’s a sense of urgency for physician groups like Crystal Run, payers, and providers to get access to their data to provide data-driven care.
As a result, we need to take over ownership of managing, adding, and expanding our data sources.
Yet, dependence on a vendor to make changes hampers our ability to mine data in-house.
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It’s All About the Data
To date, Crystal Run has seen positive results by implementing a late-binding data warehouse and analytics system.
The flexibility of the architecture and the adaptable approach to mapping data to business rules and definitions when it’s most appropriate has given us a solution that can keep up with the complexity and rapid changes in healthcare data.
From our perspective, data-driven healthcare provides the much-needed insight needed to achieve our mission as well as the goals of the Triple Aim.
© 2014 Health Catalystwww.healthcatalyst.comProprietary. Feel free to share but we would appreciate a Health Catalyst citation.
More about this topic
Data-Driven Care: The Key to Accountable Care Delivery from a Physician Group Perspective (on demand webinar, slides, transcript)Gregory A. Spencer, MD, FACP, CMO/CMIO at Crystal Run Healthcare
Late-Binding Data Warehouse: The Best Solution to Aggregate Healthcare DataEric Just, Vice President of Technology
How to Use an EDW and Analytics to Reduce 30-day Heart Failure ReadmissionsA case study of how a health system used an EDW and analytics to achieve incredible results
Population Health Management: Implementing a Strategy for Success (a white paper)David Burton, MD, Senior Vice President and Former Executive Chairman
A Landmark, 12-Point Review of Population Health Management Companies (executive report)
Dale Sanders, Senior Vice President, Strategy
© 2014 Health Catalystwww.healthcatalyst.comProprietary. Feel free to share but we would appreciate a Health Catalyst citation.
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Dr. Gregory A. Spencer is the Chief Medical and Chief Medical Information Officer at Crystal Run Healthcare and the President of Medical Staff at Orange Regional Medical Center (ORMC) . Dr. Spencer graduated from the Medical College of Wisconsin (Marquette University) Medical School and completed his residency in Internal Medicine while in the US Air Force at Wilford Hall USAF Medical Center in San Antonio, TX. Dr. Spencer joined Crystal Run as an internist in 1996 and was appointed to Chief Medical Officer and Chief Clinical Information Officer in 2008. Dr. Spencer is board certified in Internal Medicine and is a Fellow of the American College of Physicians.
