2015 Healthcare Analytics Summit™: Thursday Recap
The final day of the 2015 Healthcare Analytics Summit started on September 10. Attendees had access to 20 presentations, including a keynote from Ed Catmull, co-founder of Pixar. There was an homage to the Price is Right game show, a book signing from Dr. Catmull, and someone even won an Apple Watch by participating with the HAS’15 app.
Keynote: Value-based Healthcare Documentary Follow Up
Caleb Stowell, MD, Vice President Research and Development, International Consortium for Health Outcomes Measurement (ICHOM)
The theme of outcomes improvement continued with the first session of the day as Dr. Stowell followed up yesterday afternoon’s documentary on value-based healthcare with a presentation and Q&A. He opened by asking an important question: “How do we get to value-based healthcare without a meaningful definition of value?” Dr. Stowell advised we start by figuring out what’s most important to the patient. He said that healthcare must move away from a system of what we do, to a system of what we achieve.
Our achievements can begin by reducing the amount of money we spend on healthcare and increasing our efforts to improve outcomes (sound familiar?). But the challenge comes when these spending reductions—the transition to value-based purchasing—are viewed as negatively impacting providers financially. Providers are now in transition and are still investing in the care models that will help them move into the value-based world.
One of the popular questions from the audience asked how competition prevents us from achieving value-based healthcare. Dr. Stowell didn’t necessarily view competition in healthcare as bad, but said that organizations need to find their competitive advantage, their differentiation, and grow from that.
ICHOM acknowledges transition to value-based healthcare will be a challenging journey. Defining what to measure, getting used to measuring it, and developing the right models to make meaningful comparisons will take time and require patience. And defining value is a tricky, but critical, step to measure and compare healthcare systems. Dr. Stowell stressed the need for the participation and transparency of healthcare institutions in this endeavor. He said the journey from defining what to measure, getting healthcare systems to regularly measure these outcomes, and ensuring an apples to apples comparison is getting better, but there is a long way to go.
The good news: healthcare is heading in the right direction.
Keynote: How Partners HealthCare Uses Analytics to Improve Population Health Outcomes
Timothy Ferris, MD, MPH, Senior Vice President for Population Heath Management, Partners HealthCare
Dr. Timothy Ferris, Partners Senior Vice President of Population Health, began by asking the audience if their organizations have coherent, comprehensive analytics strategy; 64% said “No.” Similarly, 64% of the audience believed getting answers to analytics questions was somewhat difficult. Armed with an understanding of the audience’s analytics challenges, Dr. Ferris continued to tell the Partners story: how it overcame challenges to improve population health outcomes. From implementing an enterprise data warehouse to communicating not only with internal stakeholders but also the public, Partners is “now delivering care in a way it was only dreaming about in the 90s.” It has the real-time, clinically accurate data to significantly improve outcomes. And it’s not stopping at outcome improvement. “What often gets left out,” says Dr. Ferris, “is performance assurance.” Partners improved population health outcomes by making sure its team is actively implementing improvements.
Dr. Ferris shared a few of the challenges facing healthcare in this new era. Among them:
- How to make external incentives meaningful to physicians?
- Ensuring finances do not enter in to the decision-making or creation of patient care plans.
- How to encourage best practice behavior, without incentives?
- How much change can the organization tolerate?
To be successful, Dr. Ferris said the organization’s strategy an organization must be linked. He also recommended healthcare organizations constantly take the temperature of their teams, adjust as needed, but always be moving forward.
Keynote: How Allina Uses Analytics to Improve Outcomes (including Documentary)
Timothy Sielaff, MD, PhD, FACS, Chief Medical Officer, Allina Health
What happens when a health system and its leaders invite patients and their families to strategic meetings? Dr. Timothy Sielaff, Allina Health’s Chief Medical Officer, believes it adds the necessary dose of reality to drastically improve outcomes. Allina Health is in the middle of an analytics journey that sometimes feels like a grieving process. Dr. Sielaff believes an organization’s analytics journey involves the five stages of grief commonly associated with death: denial, anger, bargaining, depression, and, ultimately, acceptance. But he assured the audience it’s healthy and normal to go through these emotions as they get started with analytics.
In healthcare, we often focus on the what and how of providing care, when we really need to focus on the why. This is the philosophy espoused by the leadership at Allina Health. Part of the “why” is understanding that 60% of healthcare provides value, but 40% is wasteful. Unfortunately, eliminated waste is usually represented as lost value, so Allina had to figure out a way to effectively make this conversion.
Allina positions quality as an organizational strategy, and value as a tactic. Quality is just as important as finance and is represented by a board committee. But where Allina is realizing genuine value additions are via patient advocates and care coordinators.
Patient advocates sit in on leadership meetings, a process that has terrified many executives and physicians who feel the exposure (it’s difficult to talk about facilities improvements and other major cost expenditures in front of patients). But Allina sees it as an absolute game changer that’s catalyzing their ability to work with the variety of individuals they treat.
Care coordinators are a vital principle in the Allina organization. Although Allina is ahead of payers’ willingness to reimburse for the work that care coordinators are doing, they saved the organization $1.5 million and 100 fewer people died in the hospital last year, all attributable to the presence of care coordinators.
The data analytics infrastructure is the key to the car that drives the quality improvement efforts at Allina. They are trying to turn big data into information, then turn that information into knowledge. The beauty is being able to take all these bewildering and sophisticated techniques and use them to change people’s lives.
Allina’s perseverance through the stages of analytic grief has enabled it to deliver reliable, evidence-based, high-value care to its patients. Patients are only patients for a small percentage of their lives; the rest of the time they’re just members of society. And viewing them this way has helped Allina improve outcomes by focusing on the care continuum, from prevention and early detection to end-of-life care. By braving the new world of analytics, Allina is discovering how powerful data can be. Dr. Sielaff concluded by saying, “We’re trying to turn big data into information, information into knowledge, and knowledge into something that improves people’s lives.”
Keynote: Building Creative and Innovative Organizations
Ed Catmull, Co-founder of Pixar, President of Pixar and Walt Disney Animation Studios
What if we embraced failure as a natural consequence of creativity? Ed Catmull, Co-founder of Pixar and President of Pixar and Walt Disney Animation Studios, artfully drew the Summit to a close with a thought-provoking speech about creativity and failure, and how success isn’t possible without them. “All movies suck at first,” Ed Catmull admitted to a star struck audience; sponges eager to soak up Ed’s wisdom. “Protect your team while they work on things that don’t work. New ideas are fragile; protect them as they evolve. Nurture creativity.”
It’s easy to be creative, take chances, and embrace the trial and error philosophy in the movie industry. But even though healthcare is a less forgiving industry, we can learn from the masterminds behind Toy Story. We can make it safe to fail. We can learn to operate in a messy space, knowing it’s a chaotic but temporary breeding ground for creativity. We can work to replace the aura of danger around failure with one of trust and transparency. When polled about their creativity, 81% of attendees answered, “Yes. I am creative.” And if, as Ed confidently stated, creativity is a process by which we solve problems, healthcare needs more creatives willing to try new things more than ever before.
Closing Keynote: Dan Burton
Dan Burton closed HAS 2015 but sharing a few general thoughts in his quick and to-the-point final keynote presentation:
- Highest-rated presentations of the summit
- Keynotes: Jim Collins, Daryl Morey, and Ed Catmull (Ed’s was the highest rated).
- Breakout sessions (35 this year): Intermountain, Stanford (5 months to improvement), and The Price is Right
- Most-visited analytics walkabout stations (45 this year): evidence-based decision making (Allina Health), Patient Engagement (Crystal Run Healthcare), Poulation Registries (Texas Children’s Hospital), and Sepsis (Thibodaux Regional Medical Center)
- Reflections on our shared experience
- Analytics-based outcomes improvement is beginning to scale.
- The age of analytics is here. It’s not just happening in 2-3 places; it’s happening in 80+.
- The tools and infrastructure necessary to enable change is here.
- Continuing our shared march forward/motivation to continue important work
- Takeaways: twenty miles today and every day (from Jim Colins). There is a path forward, even if there isn’t a silver bullet. Change management is hard. Sustained, disciplined effort is key.
- This is “a special way to spend a lifetime.” Long-term commitment to a cause that matters is important.
- Thank you for devoting yourselves to this cause. We all want to be here. We chose to be here.
Thursday Breakouts at the 2015 Healthcare Analytics Summit
Breakouts on the final day of HAS kept up the theme of success stories and case studies in healthcare analytics.
The Price Is Right: How to Thrive in the New Value-based Care Delivery World
Thomas Burton, Co-founder and Senior Vice President of Product Development, Health Catalyst
Tom Burton took a unique approach to showing how important analytics is to value-based care. He used concepts and game from the show “The Price Is Right” to demonstrate how having the right tools and right information can help you “win the game” of value-based care.
MultiCare—Organizing for Accountable Care and Population Health
Christopher Kodama, MD, MBA, FAAP, President, MultiCare Connected Care
Christi McCarren, RN, MBA, CPHQ, Vice President, Retail Health & Service Lines, MultiCare Health Systems
Dr. Kodama and Christi McCarren described MultiCare’s effort to organize for population health management by leveraging data warehousing, analytics and knowledge management – with a specific focus on reducing septicemia mortality rates at the health system’s hospitals. They also addressed how to leverage the technology to scale quality improvement across the health system – a process that required MultiCare to nurture a new culture of continuous improvement. Accomplishing both aims requires a health system to engage physicians early in the design of an analytics program as well as its implementation. When physicians get their hands dirty and feel they “own” the data, they are less likely to doubt its validity and will start to focus on improving data integrity. As you move forward, don’t let perfection be the enemy of the good. A desire for perfection can paralyze improvement efforts. Don’t try to boil the ocean. Instead, be clear about what you hope to achieve. It’s better to accelerate progress on the most important objectives than to achieve small progress on a lot of goals. It’s also important to understand the significance of change management. If an organization’s culture doesn’t support change, you’ll need to build a culture that promotes learning, effective multi-disciplinary teamwork, adoption of data-driven improvement, and patient-centered care. Finally, strong leadership from the top is critical to the success of analytics programs aimed at improving population health. Senior leaders need to be fully engaged and committed to the necessary changes. They should ensure that quality improvement initiatives are aligned with the organization’s mission and strategic goals. They should also be willing to invest their own time and the organization’s resources in quality improvement.
Integrating Process and Informatics at CO Kaiser Permanente to Achieve Benchmark Cardiovascular Outcomes
John Merenich, MD, FACP, FNLA, Medical Director, CO Kaiser Permanente Clinical Informatics and Decision Support
Dr. John A. Merenich’s presentation included the Yogi Berra quote, “If you don’t know where you’re going, you’ll wind up someplace else.” Kaiser Permanente Colorado (KPCO) has known where it’s going since committing to improving cardiovascular outcomes 15 years ago. Dr. Merenich, KPCO’s Medical Director, described the last 15 years as KPCOs “20-mile march.” And their persistence continues to pay off. With the help of technology, people, and processes, KPCO developed a collaborative cardiac care service to improve the health of patients with coronary artery disease. Through coordinated care team collaboration and evidence-based interventions, it achieved benchmark cardiovascular outcomes. Although acknowledging the important role technology and analytics play in achieving outcomes, Dr. Merenich believes KPCO’s people have a much bigger impact: “Patients are the primary drivers of cardiovascular outcomes. Kaiser’s patient-centered focus—viewing patients as an integral part of the care team—is even more important than technology when it comes to achieving outcomes.”
$74M in Healthcare Operational Improvement: How Texas Children’s Hospital Is Delivery on Its Vision
Mark Mullarkey, Senior Vice President, Texas Children’s Hospital, President, Texas Children’s Physician Group
Mark Mullarkey, Senior Vice President at Texas Children’s Hospital (TCH) began his session by sharing the amazing growth TCH has experienced over the last few years. The organization has spent several million dollars on growth and construction, but in 2012 identified the need to improve their financial performance.
With government funding being reduced, the need for higher margins to support TCH’s growth and expansion, and increased competitive pressures, the team began an initiative, Delivering on the Vision. The goal? Improve quality of care, increase revenues, and decrease expenses.
The organization focused on improving five areas:
- Labor expenses
- Non-labor expenses
- Clinical Operations/LOS
- Clinical documentation improvement
- Physician services
The team integrated all their disparate data in to an EDW. Staff can self-serve and access the data pertinent to them at any time. The data is integrated and the entire organization can view each department’s information.
As a result of focusing on specific areas for improvement and integrating the data and analytics in to an EDW, TCH was able to recognize $74M in operational improvements, while continuing to deliver high-quality care.
How This ACO Is Using Actionable Data and an Integrated Care Program to Improve Outcomes
Ensor Transfeldt, MD, Orthopedic Spine Surgeon, Twin Cities Spine Center, Allina Integrated Medical Network
Zsa Zsa Gabor, an actress and socialite, was notorious for her many husbands. “The story goes that her ninth husband turned to her on the night of their marriage and said, ‘Madam, how can I make this interesting?’ I will try to do the same here.”
This was the promise Dr. Ensor Transfeldt made at the beginning of his session—and he delivered.
Dr. Transfeldt describes spine surgeons historically as “scalpel-wielding bandits in the spirit of the Wild West, ready to apply their instruments to anyone who has spine pain.” To tame that behavior, Allina Health created the Spine Program Development Group.
As chair of that group, Dr. Transfeldt’s mission is to transform spine surgery from a profit center to a true care center. He could not emphasize enough the credit he gives to Allina’s leadership for being willing to turn away from “a huge cash cow to pursue a nobler cause.”
Dr. Transfeldt got laughs for personal transparency. “We had a spine surgeon with great outcomes, but he was a laggard when it came to length of stay,” he said. “He wanted his patients to be comfortable, so he always found a way to justify why they needed to stay longer. That surgeon was me.”
It was the metrics, he said, that changed his behavior. He assured the audience that data and transparency were key to changing the behavior of any performance outliers.
“The changes we’re making are exciting,” he concluded. “I thought I’d be retired by now, but this new push toward quality has reenergized me.”
Reducing Waste at Intermountain Healthcare: The Vision, Mission, and Tools to Change Everything
Jay Bishoff, MD, FACS, Director, Intermountain Urological Institute, Intermountain Healthcare
Waiting more than three months to learn the results of a cancer screening might make a patient a little anxious. But urology patients with elevated PSA levels at Intermountain Health were going through this typical waiting period until Dr. Bishoff and his colleagues recognized the problem and began working on a process-improvement solution. They developed a prostate cancer calculator that, first of all, reduced the PSA biopsy rate from 4.5% to 0.5% of patients over a five-year period. Risk stratification resulted in a 30% decrease in the biopsy rate, while at the same time seeing a 23% increase in the prostate cancer detection rate. Biopsy savings ranged up to $550,000 a year. Ultimately, the mean wait time for a diagnosis went from 61 days to 7 days after just six months.
Part of the mission for the Intermountain Department of Urology is to deliver extraordinary urological care, based upon measured experience. So in the spirit of measuring, Dr. Bishoff asked the audience three pointed questions, namely whether their organization has a process in place to measure outcomes for prostate cancer including potency, continence, cancer control, and cost. A lopsided 89% answered “no.” Intermountain saved $300 million a year in costs as a result of their waste reduction efforts. Given the proven results that come with a systematic effort to measure experience and reduce waste, it’s pretty clear what was the primary lesson learned for most attendees.
Panel – How Community Hospital Thrive with Analytics
John Wadsworth, Vice President, Technical Operations, Health Catalyst
Gene Thomas, Vice President and Chief Information Officer, Memorial Hospital Gulfport
Greg Stock, Chief Executive Officer, Thibodaux Regional Medical Center
Jeffrey Vespa, MD, Vice President of Quality, North Memorial Health Care
The overall theme of the community hospital panel on thriving with analytics was “be more efficient.” Throughout the session the idea of hiring the right people came up again and again. And looking in less conventional places for analysts (think: outside of healthcare). Using these, and other methods, these community hospitals were able to achieve impressive results such as lower sepsis mortality rate to 7% (the national rate is 18 to 20%).
Quality Improvement in Healthcare: An ACO Palliative Care Case Study
Robert Sawicki, MD, Senior Vice President, Supportive Care, OSF HealthCare
Roopa Foulger, Executive Director, Data Delivery, OSF HealthCare
Linda Fehr, RN, Division Direction, Supportive Care, OSF HealthCare
Studies show that simply having a legal document—an advanced care directive—in place has zero impact on healthcare. What is required instead is an advanced care planning (ACP) process that creates a conversation among patients, their agents, and the care team. The result of effective ACP is an approach to care that addresses the patient’s and family’s physical, emotional, and spiritual needs.
Dr. Robert Sawicki kicked off this session by explaining why his organization, OSF Healthcare, has created a palliative (or supportive) care program currently focused on implementing ACP:
“Palliative care improves quality of life for patients and families. We’re working to dispel the myth that palliative care is only for the terminally ill. It’s appropriate at any age and at any stage of a serious illness. When done early on in the course of an illness, palliative care has been shown to improve quality and the patient experience, as well as to reduce cost. It can even improve life expectancy. Now, if I had a pill that could do that, I could retire a wealthy man.”
Dr. Sawicki and his team discussed key analytics and engagement strategies required to deploy ACP throughout the community. These include:
- Implement interdisciplinary collaboration (the secret sauce to effective palliative care).
- Look beyond just your healthcare system and engage in a community-wide initiative with a considerable focus on training providers.
- Establish targets and provide real-time visibility to results across the organization. This helps build healthy competition and drive outcomes.
Clinical Standards Work to Improve Evidence-based Care Delivery: A How-to Workshop
Charles Macias, MD, MPH, Chief Clinical Systems Integration Officer, Texas Children’s Hospital
Terri Brown, MSN, RN, CPN, Assistant Director, Clinical Outcomes & Data Support: Research Specialist, Center for Research and EBP, Texas Children’s Hospital
With over 800,000 medical articles published each year it is impossible for the mind to evaluate and translate all of the existing information to make a medical decision.
At Texas Children’s Hospital, a cross-functional team has developed a set of clinical practice guidelines, systematically developed statements or recommendations, which assist the practitioner and patient decisions about appropriate healthcare for specific situations. These guidelines have empowered clinicians to practice the “Art of Medicine” by reducing and controlling the complexity of care processes.
TCH has created an Evidence-based Outcomes Center that uses the PICO format (Population, Intervention, Comparison, Outcome of Interest) to identify questions that need to be asked and best practices available to answer the. The team searches existing scientific databases to create a standardized, evidence-based recommendation for their clinicians.
Clinicians can access the information via a Clinical Decision Support EMR portal. The results? Clinicians are making better, more informed decisions, and delivering higher-quality care at a lower cost.
Five Months to Improvement: How Stanford Built an Improvement Program the Gets Results
David Larson, MD, MBA, Associate Professor of Radiology, Stanford University Medical Center
Jake Mickelsen, Lean Six Sigma-Black Belt, Quality Improvement Education Manager, Department of Radiology, Stanford University
Another name for Stanford Health Care might be Improvement U. given the amount of education dedicated to quality, performance, and project improvement among executive and clinical staff. You may have heard or read elsewhere about the highly-regarded Stanford Operating System (SOS) at Stanford Health Care, which uses Lean principles as part of their management philosophy. In this breakout session, we heard from Dr. David Larsen and Jake Mickelsen who lead performance and process improvement education for the Radiology Improvement Team Education program at Stanford Medicine.
This program is responsible for providing “practical education in quality improvement using a team and project based model that produces sustainable results and processes.” Improving, for example, the percent of exams with adequate clinical histories from a mean of 16% of total audited exams to a sustained mean of 94% over a mere five months. Not too shabby. How about increasing the percent of patients waiting less than 15 minutes for inpatient transfer from 74% to a sustained 97% within five months. Do we have your attention? Then there’s the improvement in ED stroke code response times from a mean of 21 minutes to just under 10 minutes over the course of 67 stroke code events. Now, THAT’S improvement…and saving lives.
Are you seeing progress with conducting a project-based improvement course in your organization? Two thirds of poll respondents during the session indicated they’ve been mostly, somewhat, or very successful in their efforts.
Breaking Down Silos: Resolving Academic, Medical, and Research Interests Once and for All
Samuel Volchenboum, MD, PhD, Assistant Professor of Pediatrics, Director, Center for Research Informatics, Associate Chief Research Information Officer, University of Chicago Medicine
The Center for Research Informatics at the University of Chicago is taking an innovative approach to the way academic medical centers do research; rather than investing in a single person, it invested in a team of people. While the norm for academic medical centers is to hire a single researcher to start a lab, the Center put its money into the expertise of a collaborative, transparent, multidisciplinary team charged with finding, managing, and analyzing data. Dr. Samuel L. Volchenboum, the Center’s Associate Chief Research Information Officer, attributes the Center’s success to its unique, team-based approach to research: “All data requests come through the Center, which helps us avoid a common problem at other academic medical centers: siloes.” Created in 2011, the Center’s mission is to provide informatics services, support high-quality research, and promote informatics education. And it’s executing this mission by developing the Center’s brand, establishing clear data governance, hiring leaders with business acumen, and getting leadership buy-in.
Panel – Data Governance in Healthcare
Dale Sanders, Executive Vice President, Product Development, Health Catalyst
Joseph Pollman, Executive Director, Business Knowledge Management, Community Health Network
Chris Harper, Director of Business Architecture and Analytics, The University of Kansas Hospital
Rich Pollack, MS, CHCIO, FHIMSS, Vice President and Chief Information Officer, VCU Health System
Dale opened the panel session by asking “Have you ever felt like McMurphy from One Flew Over the Cuckoo’s Nest? And someone in your organization is Nurse Ratched?” That gathered a few knowing laughs. He then went on to say that it makes sense to make sure your culture is ready for data governance. Data quality means clinical quality, but all is lost without buy-in from the organizational team, from executives on down. Chris Harper emphasized that “Data is team sport.” And starting a data governance programs requires a high pain threshold.
How One ACO Is Using Analytics to Position Itself for Population Health Management and Shared Savings
James Dearing, DO, FACOFP, FAAFP, Vice President, Chief Medical Officer, Accountable Care Organization, Honor Health
Good data is essential in order to ask the right questions and focus improvement resources where they are most important.
Dr. James Dearing shared an example that backed up this claim. Honor Health’s data showed that a disproportionate number of readmissions were occurring on Friday nights. Focus groups with these frequent readmits revealed the following: These people came in on Friday nights because Meals on Wheels only came by on weekdays. They were coming to the hospital to eat. Honor Health partnered with the local foodbank, and readmissions went down.
Using data to improve care requires a level of teamwork that is new to physicians. “Physicians are trained to be rugged individualists,” Dearing said. “If we don’t beat the guy next to us in med school, we don’t get the residency we want … and so on. We’re trained to work in a silo.” Luckily, physicians are competitive and like data. Therefore, engaging them with data is key to gaining physician buy-in. New ways of delivering care won’t work, of course, without incentivizing physicians to be team players instead of rugged individualists.
Teamwork requires bringing different stakeholders to the table, and analysts are one of those key stakeholders. “I couldn’t even spell ‘analysts’ when I started this job. Now I can’t do without them. They look at things differently than physicians do. They help us make our data actionable. They drive the vehicle that allows us to work as a team.”
Panel—Best Practices in Achieving Physician Engagement
Bryan Oshiro, MD, Chief Medical Officer, Health Catalyst
John Merenich, MD, FACP, FNLA, Medical Director CO Kaiser Permanente Clinical Informatics and Decision Support
Jay Fakier, MD, Radiologist, Thibodaux Regional Medical Center
Angela Wills, Vice President, Clinical Programs, Ambulatory Quality, Acute Medicine, Mission Health
Dr. Oshiro opened the panel discussion asking, “How can I get my physicians engaged?”
Dr. Merenich said physicians are hired believing they will be team players and be the chief negotiator and go-to person. Older physicians are more challenging to engage as they tend to display a “been there, done that” attitude. The key to engaging them is finding very competent and very engaged physicians and ask they influence other doctors.
Angela Willis agreed. She added that strategic alignment is key, but even more critical if the relationship between senior leaders, doctors, and nurses. Data is critical. Let the data talk by sharing the successes of others by seeking out those who have great outcomes.
Dr. Faiker shared the biggest barrier to engagement in his organization is the perceived negativity of past experience. Younger physicians got on board quickly, but older doctors (those close to retirement) very skeptical. The team chose to focus and engage physicians with ten or more years of experience.
Dr. Merenich concurred. Physician-to-physician engagement is crucial as is using data to make the case for engagement. He stressed the need to use analytics as a carrot, never as a stick, and to ensure the data is shared at a team level.
Dr. Fakier closed the session sharing that in his experience physicians who understand how changes will impact them, are more likely to engage. He also stressed the need to communicate, communicate, and communicate. It takes great doctors to make a great hospital, but it takes a great hospital too.
Panel—Precision Medicine and Embracing Variability
Eric Just, Vice President of Technology, Health Catalyst
David Fenstermacher, PhD, Chief Research Information Officer, Professor of Biomedical Informatics, Virginia Commonwealth University
Samir Courdy, MBA, Chief Research Information Officer, Director of Research Informatics at Huntsman Cancer Institute, University of Utah
Samuel Volchenboum, MD, PhD, Assistant Professor of Pediatrics; Director, Center for Research Informatics; Associate Chief Research Information Officer, University of Chicago Medicine
Shawn Murphy, MD, PhD, Medical Director of Research Computing and Informatics, Partners HealthCare
72% of attendees at this panel discussion believe that precision medicine is the future of medicine and is achievable in the next 10-15 years. So we’d better get busy. This audience heard a variety of definitions about what precision medicine is: it’s about how we tailor treatments to individuals based on variation in genes, environment, and lifestyle. It allows us to stratify patients into particular groups, to know if they are going to respond to a certain treatment, a key component of value-based purchasing and population health.
In addition to the promise of precision medicine, the panelists discussed the challenges and how precision medicine is tied to research: we need to be more systematic and get better about how we collect data; we need a much better engine for integrating data, so we can visualize it together; researchers will need to change the way they interact with clinicians. Technologists will need to be embedded with analysts and clinical teams, because they can’t be asked to build a data warehouse without knowing why it needs to be built.
Patients are becoming savvier with the proliferation of wearable devices and affordable gene testing. They are coming in with suggestions about their own care and with their own genetic tests. Providers will need to be careful with this and council families on why certain tests are necessary and what will be done with the results. It’s changing the landscape of the patient experience.
Ultimately, precision medicine fits into the population health model because it promises to do a much better job of taking care of patients, but we must be careful how we use it. This is a singular opportunity to look at whole populations and groups, given the torrent of incoming data. As providers, we just need to figure out how to use it.
Improving Workflow: How Stanford Uses Analytics and Process to Ease Hospital Crowding
Wes Elfman, Visualization Developer, Clinical and Business Analytics, Stanford Heath Care
Terrill Wolf, Manger, Data Architecture, Clinical and Business Analytics, Stanford Health Care
Stanford Health Care was determined to find a solution to its hospital crowding problem. So it turned to a team of analysts lead by Wes Elfman, Visualization Developer, and Terrill Wolf, Data Architect, to build a solution that was not only effective but also usable. The goal behind their efforts was simple: don’t turn patients away who want or need care. But with a fixed bed count and hospital crowding during the winter surge, many OR cases had to be canceled the day of surgery. With the support of a coordinated, multidisciplinary leadership team, they partnered with users to thoroughly understand the overflow problem and built a solution that matched the need. The solution was effective because it matched the need and the users’ data literacy. After all, a solution is only effective if it gets used.The team focused on building a solution users would find understand and be motivated to use on a daily basis. A year later, Stanford reduced crowding-related canceled OR cases and ED triage tent use. By making the solution user friendly, it became an effective decision-support tool that facilitated patient flow discussions and improvements.