Population Explorer

Unprecedented changes in the healthcare payment system have resulted in health organizations across the country investing in the pursuit of the Institute for Healthcare Improvement’s (IHI’s) Triple Aim to improve population health, improve patient experience and outcomes, and reduce costs per capita. Health organizations must develop effective population health management strategies, and they need the right data and analytics to inform their initiatives.
Once armed with the information to make data-driven decisions, leading healthcare providers are implementing care management programs, which have proven to be helpful mechanisms for achieving the Triple Aim. Many healthcare organizations have identified specific patient cohorts to monitor the impact of care management interventions on individual and population health outcomes.
Data-driven care management programs that target high-risk and rising-risk patients can achieve impressive results, including:

Up to 20 percent lower rates of hospitalization in mature care management programs.
Lower rates of emergency department utilization.
Decreased costs.

Clinical variation can be frustrating for patients and their families, often leaving the impression that healthcare team members are not on the same page and don’t agree on the plan for the patient’s diagnosis or treatment. It is also costly—the Institute of Medicine estimates that $265 billion (30 percent) of healthcare spending is waste that directly results from clinical variation.
To reduce unwanted variation, Texas Children’s Hospital invested considerable resources to develop clinical standards tools, including evidence-based order sets; however, demonstrating the effectiveness and utilization of those guidelines, pathways, and order sets had been daunting. To that end, Texas Children’s deployed an analytics platform from Health Catalyst to aggregate and analyze the data needed to perform both of these critical functions.
Results:

$2,401 reduction in cost per patient with order set utilization, and an 8.4-day difference in average length of stay (LOS).
$15 million reduction in total direct variable costs in Fiscal Year 2015, $32 million anticipated reduction in Fiscal Year 2016 at the current order set usage rate, and a potential $64 million annual reduction with a hypothetical 80 percent order set usage rate.
1,629 percent return on investment (ROI).

U.S. hospital stays cost the health system at least $377.5 billion per year. In today’s value-based care environment, hospitals are under increasing pressure to avoid patient harm and maintain quality while also lowering costs. Reducing hospital length of stay (LOS), especially as it relates to avoiding unnecessary hospital-acquired conditions (HACs), is a primary indicator of a hospital’s success in achieving these goals.
El Camino Hospital, a 395-bed multi-specialty community hospital in Mountain View, Calif., places a high priority on keeping patients safe. However, when it came to its goal of reducing LOS, leaders recognized that they faced some major challenges, including:

The complexity of implementing a multi-layered, multi-disciplinary approach to improving the patient discharge process.
Identifying what issues were contributing the most to increased LOS so that they could be addressed.

By implementing analytics and protocols that provide access to actionable data, the LOS reduction team was able to identify patients at high risk for increased LOS so that they could develop and track critical interventions. El Camino’s patient-centered approach to tackling LOS reduction also included multi-disciplinary cooperation, leadership buy-in, and additional resources to enhance discharge care coordination.
This innovative, systematic approach resulted in not only a better than anticipated reduction in ALOS of 7.8 percent, but also:

14.8 percent reduction in readmissions
55 percent reduction in healthcare acquired conditions (HACs)
32 percent reduction in incidence of AHRQ patient safety indicators (PSIs).
$2.2 million projected annual cost savings

One in three pregnant women give birth via cesarean section in the United States, which is more than double the rate the World Health Organization (WHO) recommends. And instead of decreasing, the overall C-section rate in Washington State increased 73 percent from 1996 to 2009. C-section rates are just one area of maternal care where our practice in the U.S. lags behind the science and knowledge of best practice. MultiCare Health System believes that all of its female patients should experience the same high-quality care across its integrated delivery system. The health of the next generation depends on it.
MultiCare recognized that it had to standardize care across its system to meet quality standards, improve its patients’ experiences and outcomes, and maintain its market share. The health system launched a Women’s Collaborative, the sole purpose of which was to improve clinical care and patient outcomes for women’s services systemwide.
By working with clinicians to implement standards of care, and using analytics to measure performance, the Women’s Collaborative achieved the following:

NTSV (low-risk, rst-time mother) C-section rate 9 percent less than the national average and already below the 2022 national goal of 23.9 percent
Six-point increase in market share for inpatient OB/GYN services
Improvements in care delivery:

63 percent reduction in episiotomy rate

11 percent reduction in SSI rate for C-sections
14 percent reduction in 3rd or 4th degree perineal laceration rate
Non medically indicated induction rate consistently less than a quarter of one percent
6.7 percent reduction in the percentage of abdominal hysterectomies

People with disabilities face daunting challenges in accessing basic healthcare. As a result, they frequently use hospitals and emergency rooms, and are four times as likely to be hospitalized compared to the general population.
Allina Health has deployed an effective “primary care medical home” model that gives patients with disabilities the care and support they need outside of the hospital setting. Key strategies of the model include assigning dedicated care coordinators to each patient; strengthening care coordination across the continuum of services; and an analytics platform from Health Catalyst to target opportunities for improvements and savings.
Allina’s data-driven efforts to strengthen care of patients with disabilities have made a clear and meaningful impact; most importantly, on patient outcomes. They have achieved: 30% reduction in hospitalizations and 66% reduction in hospitalization days; 79% reduction in 30-day readmissions days; significantly improved access to care; and saved $4.5 million over a one-year period.

Like most large healthcare systems throughout the country, Allina Health’s financial health improves dramatically by optimizing inpatient care for the patients it serves.
Allina recognized optimizing length of stay (LOS) was one of the key drivers of its inpatient financial performance and developed the technical infrastructure and analytic capabilities to understand LOS performance by the minute and not the day; adjust LOS to account for patient acuity and compare performance to national benchmarks; make LOS data available to clinicians across the organization in near real-time; and estimate the financial impact of LOS opportunities to enable targeted interventions for improvement.
Allina leveraged its enterprise data warehouse (EDW) and analytics platform and optimized LOS, yielding the following results in the first two years of its improvement efforts:

26,000+ inpatient days saved
$13.4 million in direct operating expenses saved
Hospital capacity (bed availability) created for 5,000+ admissions
Avoided adverse patient events and reduced the total cost of care

To tackle the variation and waste that can arise from different treatment decisions, Allina Health developed a solid framework to establish and deploy standard, evidence-based practices across the enterprise. The transition to a standard evidence-based decision-making process required collaboration and buy-in from multiple stakeholders and physicians. Allina’s established quality governance structure reviewed and approved system-wide clinical practice guidelines for Stage 1 lung cancer treatment and IV heparin treatment. To sustain and improve on this new model of care, a comprehensive checklist was developed to ensure that all future guidelines are based on patient subgroups and preferences, available evidence, stakeholder review, and other important criteria including IOM standards. Adherence to guidelines is monitored with metrics based on data extracted from Allina’s enterprise data warehouse and from the electronic health record. Results to date already indicate notable improvements in variation and cost, including the following: the establishment of a system-wide EBDM model and policy, 20 system-wide approved evidence-based guidelines developed months faster, a 5 percent decrease in Stage 1 lung cancer treatment variation, and a 20 percent decrease in the number of heparin protocols.

Crystal Run Healthcare—a physician-led Accountable Care Organization (ACO) and one of the first ACOs to participate in the Medicare Shared Savings Program—is experiencing the long-anticipated shift toward more value-based reimbursement.  To ensure financial stability as they assume more risk, Crystal Run is implementing a strategy focused on rapid growth and aligning physician reimbursement with favorable patient outcomes. To effectively execute on this strategy they knew they needed to become more data-driven.  Learn how this ACO is using advanced analytics to execute on their population management and growth strategies with a focus on continuous improvement in the following areas: 1) Ensuring patient care aligns with evidence based practices, 2) reducing clinical variation, 3) enhancing operational efficiency, analyzing data from a “single source of truth” integrated from their EMR, billing, costing, patient satisfaction and other operational system, and 5) making “self-service analytics” available to decision-makers to decrease time to decision.

Learn how Community Care Physicians used clinical analytics to drive a 75 percent reduction in patient navigator reporting and chart abstraction time. Now RNs can spend more time focused on quality improvements.  Patients also receive timely outreach for overdue treatment and upcoming reminders. View sample regulatory and patient level visualizations and learn how these graphical visuals — including clinic and provider comparison metrics — helped drive provider engagement.

What do you get when you combine an enterprise data warehouse with analytics applications? Texas Children’s Hospital used this dynamic duo to help them identify and implement improvement programs that drive measurable — and sustainable — results.