Dr. John Haughom explains 5 key Deming processes that can be applied to healthcare process improvement. These include 1) quality improvement as the science of process management, 2) if you cannot measure it, you cannot improve it, 3) managed care means managing the processes of care (not managing physicians and nurses), 4) the importance of the right data in the right format at the right time in the right hands, and 5) engaging the “smart cogs” of healthcare.
Learn more about Dr. John Haughom
John Haughom, MD is an experienced healthcare executive with proven expertise in technology-enabled innovation, developing results-oriented strategic plans, leading multifaceted organization-wide change, and directing complex operations. He has a strong record of turning vision into effective strategies and successfully implementing initiatives resulting in value including higher quality, safer care at the lowest possible cost. His broad knowledge of healthcare and emerging healthcare technologies is coupled with his recognized leadership abilities, strong communication skills, and demonstrated ability to contribute to organizational goals such as improved clinical outcomes, lower costs, improved access to care, and increased profitability. After practicing for 15 years as an internist and gastroenterologist, Dr. Haughom assumed a senior executive role with responsibilities for system-wide automation, budgeting, customer support, database administration, healthcare delivery, information technology, quality control, research, safety, and strategic planning. Dr. Haughom became President and CEO of a firm focused on health care transformation through consulting, strategic planning, mentoring inexperienced physician leaders, involvement in regional and national reform movements, membership on boards of leading edge organizations committed to improving the value of healthcare, and partnership with other like-minded organizations with similar aspirations and goals. As Senior Vice President of Clinical Quality and Patient Safety for the premiere health care system in the Northwest spanning three states (Oregon, Washington and Alaska), Dr. Haughom developed and implemented a system-wide quality improvement strategy, comprehensive patient safety plan, and comprehensive system-wide information technology strategy.
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Chief Nursing Officers (CNOs), essential members of health system C-Suite teams, need healthcare decision support to align nursing resources with systemwide goals.
Although nursing’s purpose hasn’t changed, the tools and skills needed to achieve it have. In today’s data-driven, increasingly complex care environment, nursing leaders rely on skills that extend beyond their initial training as nurses; they need expertise in finance, IT, and analytics, among other areas.
CNOs, like Faye of Pennington Health, depend on healthcare decision support systems for easy access to data that helps them identify and prioritize the best opportunities, address challenges, and improve outcomes.
CNOs who embrace the fact that advanced analytical tools are critical to improving care quality and reducing care costs are poised to effectively lead their systems toward achieving financial, strategic, clinical, and operational objectives.
Without daily access to healthcare decision support, health system COOs struggle to make rapid, meaningful decisions. Healthcare decision support systems are no longer optional for these highly visible leaders, who play critical roles in their organizations’ success, for many reasons:
Aggregates reliable, up-to-date information from all available sources.
Presents information in user-friendly, user-configurable ways.
Makes trends and important conclusions more recognizable and understandable.
Enhances C-Suite’s ability to drill down into data in search of a problem’s root cause.
Improves C-Suite communication and collaboration.
Unites C-suites around a common vision and strategy.
Healthcare COOs (and other C-Suites) need healthcare decision support to be data-driven problem solvers and collaborative leaders who achieve clinical, financial, and operational success for their systems. Given the industry’s increasing complexity, healthcare decision support is now an industrywide imperative.
Human decision making…ultimately, this is the component that drives outcomes improvement in healthcare. But the pathway to this decision making involves technology—machine learning and predictive analytics—as well as processes and people. Dr. David Wild, the Vice President of Lean Promotion at The University of Kansas Health System, along with Chris Harper, the system’s Director of Business Architecture and Analytics, will lead a case study breakout session at the 2017 Healthcare Analytics Summit to discuss this topic. Of particular note is this healthcare system’s results in reducing readmissions across the board in a very short period, which also contributed significantly to financial improvement. It will be an inside look at the successful blend of human and technological resources needed for broadly reducing readmissions and improving outcomes within a large healthcare system.
Healthcare Decision Support Helps CFOs Achieve Their Top Goal: Timely, Accurate, Agile Decision Making
Supporting decision making is a top goal for CFOs today, according to a 2017 Kaufmann Hall CFO survey. Healthcare decision support empowers CFOs and their finance teams to make accurate, agile, and timely decisions, from rolling forecasts of future trends to risk-adjusted scenario modeling.
In addition to helping CFOs make good decisions, healthcare decision support helps CFOs lead their teams and organizations improve in four key ways:
Data-driven growth and practice expansion.
Improved ability to negotiate favorable risk-based contracts with payers.
Effectively and fairly address important physician compensation issues.
Improve population health management.
With healthcare decision support, CFOs and their health systems have a distinct competitive advantage (e.g., shortened planning cycles and more accurate cost measurement). They can adjust to unexpected challenges and take advantage of new opportunities.
It’s no easy task to lead a real-time, outcomes-focused, high-performing health system. That’s why every chief medical officer (CMO) needs a healthcare executive dashboard—a decision support tool that helps these senior physician leaders ensure their organizations continue to achieve the seven key attributes of a high-performing health system:
Efficient provision of services.
Organized system of care.
Quality measurement and improvement activities.
Use of information technology and evidence-based medicine.
Compensation practices that promote the above-listed objectives.
Healthcare executive dashboards help CMOs integrate information, identify key issues and care gaps, and present information to their teams in a meaningful, data-driven, actionable format. Executive dashboards are an essential component of the CMO leadership toolset.
Healthcare CEOs and other C-Suite leaders can’t make quality decisions in today’s rapidly changing, complex environment without decision support.
Healthcare CEOs are starting to realize that executive dashboards with personally tailored views of key metrics are no longer a luxury, but an absolute necessity, for three key reasons:
Helps leaders analyze and digest large amounts of data relating to care quality, operations, contracting, and major purchasing decisions.
Gives leaders a clear understanding of the financial aspects of their systems, such as revenue streams, cost drivers, costs of capital, bundled payments, and payment reforms.
Facilitates conflict resolution and helps leaders work collaboratively—using a matrix management approach—with peers, direct reports, and system experts.
Today’s healthcare CEO must be skilled problem solvers, strategic and analytical thinkers, and collaborative leaders who understand both the clinical and financial sides of healthcare—goals made possible with an executive dashboard.
The Modern Care Management Team: Tools and Strategies Evolve, but the Outcomes Improvement Goal Remains
The care management team concept has evolved over the last decade to be more patient- and data-driven. Truly modern care management teams—those that represent the future of care management—provide team-based care that is carefully planned, comprehensive, highly coordinated, data driven, evidence based, seamless, and patient centric.
But what’s equally important as being patient-centric and patient-driven, is relying on a comprehensive, effective care management system—a suite of tools with features in five core competencies:
Patient stratification and intake.
As the industry’s care management teams continue to evolve (e.g., using predictive analytics to proactively identify patients), their primary goal remains: achieving optimal outcomes for the patients they serve.
Leading Wisely in Healthcare: Why the Next Generation Executive Decision Support System is an Industrywide Imperative
Healthcare leaders are struggling to make effective, data-driven decisions given the industry’s unexpected, complex, and rapidly changing challenges, from advancing healthcare reform to rising consumerism.
Fortunately, there’s hope with the next generation executive decision support system, which facilitates decision making in several key ways:
Aggregates reliable, up-to-date information from all available sources, and makes it readily accessible.
Enables leaders to break information down and view it in more user-friendly ways—often in the form of graphs that make important conclusions or trends more recognizable and understandable.
Supports a leader’s ability to drill down into the data in search of problems’ root causes.
Plays an important communication and collaboration role, helping leaders work with the intellectual assets of the organization to problem solve and align the organization around a common vision and strategy.
Managing change in today’s industry is a difficult endeavor, but an executive decision support system can help leaders navigate this complexity and make effective, data-driven decisions.
What do the best care management teams in the industry have in common? They engage and empower their patients to play a leadership role in their healthcare. After all, patients without the skills to manage their care incur costs up to 21 percent higher than engaged patients.
Engaging and empowering patients as the most important members of the care management team makes sense on many fronts—as health systems assume more responsibility and financial risks for patients’ outcomes and costs, there will certainly be more interest in expanding the role of patients in their care.
This blog explains why engaging patients like 68-year-old Abdel not only instills a gratifying sense of empowerment, but also improves outcomes and controls costs—the many benefits of an effective care management team.
Healthcare machine learning, predictive analytics, and artificial intelligence (AI) are starting to play a much bigger role in care management.
As care managers continue to have a growing number of patients like Ruth, who use digital devices at home, machine learning offers a solution to the resulting exponential increase in healthcare data.
Defined as the practice of extracting information from existing data sets to determine patterns and predict future outcomes and trends, the advantages of using predictive analytics to improve care management are infinite, from chronic disease management to cost control.
Health systems must prioritize learning how to use healthcare machine learning to not only improve their care management programs, but also outcomes for patients like Ruth.
Patient-reported outcomes (PROs), defined as “any report of the status of a patient’s health condition that comes directly from the patient, without interpretation of the patient’s response by a clinician or anyone else,” are the future of healthcare.
In addition to helping people like 80-year-old-Ruth continue to live interpedently, PROs—interchangeable with the term patient-generated health data (PGHD)—have several benefits:
Effectively supplement existing clinical data, filling in gaps in information and providing a more comprehensive picture of ongoing patient health.
Provide important information about how patients are doing between medical visits.
Gather information on an ongoing basis—rather than just one point in time—and provide information relevant to preventive and chronic care management.
The new technologies that enable PROs and PGHD (e.g., sensors that detect whether Ruth takes food out of her refrigerator on a regular basis), generate important data outside of patients’ traditional care environments, sharing it with care teams to expand the depth, breadth, and continuity of information available to improve healthcare and outcomes.
How Care Management Improves Performance for Clinicians, Compliance with MACRA, and Outcomes for Patients Like Olivia
As the link between performance and reimbursement in healthcare continues to grow, effective care management is key. And two critical components of effective care management are analytical tools and a multidisciplinary approach:
Analytical tools help clinicians stratify patients by risk and need and make it easier to collaborate and coordinate care for patients (and monitor their progress over time).
A multidisciplinary approach broadens the support patients receive, engages both patients and their families in their care, and improves medication adherence (between 40 and 75 percent of older people do not take their medications at the right time or in the right amount).
Care management programs do more than make patients healthier and make it easier for clinicians to coordinate care for their patients—they also improve performance and compliance with MACRA: a quality payment model that requires physicians to focus on optimizing care of their chronic disease patients across the continuum in the inpatient and outpatient environment.
Ineffective communication between care providers is a major problem. According to the Joint Commission, 80 percent of serious medical errors involve miscommunication between caregivers during the transfer of patients. Care management teams need to place emphasis on good communication to effectively coordinate care and improve health outcomes. This point is illustrated by Keisha’s story, a patient who had a severe heart attack just two days after her catheterization was postponed due to incomplete information and miscommunication between her PCP, cardiologist, and nurse care manager.
The healthcare industry is increasingly focusing on care management, and it shows—patients with serious illnesses and injuries are experiencing better outcomes and living longer. But more needs to be done, as demonstrated by Carlos, the patient in this article who was headed toward invasive, expensive care because he had trouble being compliant with his diabetes plan. Care must be coordinated across the continuum, and tailored to the patient. The role of care management is expanding and can become more effective than ever.
The patient outcome benefits of effective care management programs are indisputable, as are the numerous economic factors driving the long overdue industrywide shift toward care management and value-based payment (VBP) models.
The National Health Expenditure Accounts (NHEA) estimates that U.S. healthcare spending reached $3.2 trillion in 2015 ($9,900 per person). And as of 2012, half of American adults (117 million people) had one or more chronic conditions—the most common, costly, and preventable of all health problems.
The key to addressing these alarming, unacceptable, rapidly increasing expenditures and saving the nation hundreds of billions of dollars in healthcare costs is better care management and the continued transition from fee-for-service to VBP models.
Patients with complex care needs, like Arline in this real-life story, account for the highest percentage of costs. Yet, they aren’t necessarily receiving the best care. A care management program for these patients can make all the difference by helping patients and caregivers more effectively manage their health conditions. It takes time, effort, and the implementation of new care delivery models and support systems to realize those benefits, however.
Evidence-based medicine is an important model of care because it offers health systems a way to achieve the goals of the Triple Aim. It also offers health systems an opportunity to thrive in this era of value-based care. In specific, there are five reasons the industry is interested in the practice of evidence-based medicine: (1) With the explosion of scientific knowledge being published, it’s difficult for clinicians to stay current on the latest best practices. (2) Improved technology enables healthcare workers to have better access to data and knowledge. (3) Payers, employers, and patients are driving the need for the industry to show transparency, accountability, and value. (4) There is broad evidence that Americans often do not get the care they need. (5) Evidence-based medicine works. While the practice of evidence-based medicine is growing in popularity, moving an entire organization to a new model of care presents challenges. First, clinicians need to change how they were taught to practice. Second, providers are already busy with increasingly larger and larger workloads. Using a five-step framework, though, enables clinicians to begin to incorporate evidence-based medicine into their practices. The five steps include (1) Asking a clinical question to identify a key problem. (2) Acquiring the best evidence possible. (3) Appraising the evidence and making sure it’s applicable to the population and the question being asked. (4) Applying the evidence to daily clinical practice. (5) Assessing performance.
Introducing the Accelerated Practices (AP) Program: An Innovative Way to Help Health Systems Accelerate and Sustain Outcomes Improvement
We are excited to announce the launch of Health Catalyst University’s Accelerated Practices (AP) Program. This program is a highly immersive, project-based learning experience that healthcare industry experts have spent a lot of time developing. The goal of the program is for participants to leave with the tools and knowledge they need to achieve significant improvements in a short amount of time for their organizations. They will also learn how to communicate the need for change in this new value-based care environment by using data and proven leadership principles.
Lots of great presentations during Day Two at HIMSS 2015, including a fantastic one about CMS. The day started an educational session entitled “The Intersection of Quality and Innovation at CMS” from Dr. Patrick Conway, the CMS Deputy Administrator for Innovation and Quality and the Chief Medical Officer. CMS sums up the vision for improving healthcare delivery in three words: better, smarter, and healthier. Next, Sarah Kadish from the Dana Farber Cancer Institute at Harvard University, presented on transforming process improvements through real-time locating systems (RTLS) data. Using this data patient clinic flows and staff workflows can be carefully mapped and analyzed. And last, Ken Congdon, Editor in Chief at Health IT Outcomes, spoke about driving health IT ROI with data analytics. Ken argued that the ultimate end game of healthcare IT initiatives would be predictive analytics and personalized care.
Day One at HIMSS 2015 had several interesting educational sessions. The first was a fantastic and touching presentation from Texas Children’s Hospital covering managing population health with science, analytics, and quality improvement. Next, Susquehanna Health showed how it uses perioperative analytics to reach the triple aim, and the results were amazing (for example, a new patient flow model eliminated 90 minutes of waiting time). Advocate Health Care presented on data-enabled strategic resource allocation in ACOs. As a 13-hosptial system, Advocate operates the largest ACO in the country. Finally, we heard from the Cleveland Clinic and Healthcore/Anthem on leveraging clinical data for risk adjusting bundled payments. The model they used seemed to be quite accurate. Looking forward to Day Two.
The HIMSS 2015 finale featured presentations from Marshfield Clinic, the Military Health System, and MultiCare Connected Health. Kori Krueger, MD and Kate Konitzer, MMI from Marshfield Clinic started the day talking about population health management. They explained the many stages to PHM and the challenges within each. Next, Colonel Bonnema, MD from the Information Delivery Division in the Defense Health Agency showed the Department of Defense’s healthcare management systems modernization project, which includes an $11B contract to upgrade to a single EHR. Finally, Christopher Kodama, MD, president of MultiCare Connect Health, showed how MultiCare developed an ACO and CIN in response to health reform and market-driven opportunities.
Healthcare organizations are facing unprecedented challenges to improve quality and reduce waste. The traditional encounter-based delivery model is overwhelmed due to aging Baby Boomers and the increasing prevalence of chronic disease. To tackle these challenges, more disruptive innovation is needed in healthcare. We already have development of new diagnostic procedures, therapies, drugs, and medical devices, but healthcare needs more innovation around prevention and personalized care. Sensors, wearable technology, and big data offer ways for healthcare to start exploring new possibility and opportunities in this realm.
Vast new pools of patient data will become available to physicians over the next few years. This data will change our understanding of health and disease, providing a rich new resource to improve clinical care and maximize patient health and well-being. Three ways physician will use this data to drive transformation include: 1. Efficient and effective operations (reducing wasteful spending); 2. Manage population health; and 3. New technology-enabled care and personalized medicine. The impact of new data on healthcare costs will be immense.
The Changing Role of Healthcare Data Analysts—How Our Most Successful Clients Are Embracing Healthcare Transformation (Executive Report)
The healthcare industry is undergoing a sea change, and healthcare data analysts will play a central role in this transformation. This report explores how the evolution to value-based care is changing the role of healthcare data analysts, how data analysts’ skills can best be applied to achieve value-based objectives and, finally, how Health Catalyst’s most successful health system clients are making this cultural transformation happen in the real world.