Thank you for taking time to read my letter and explore the knowledge center we've created for Lifespan. Below, I've selected resources I believe will resonate with your organization. I hope they will provide you with useful insights and perspectives as you think about how enterprise data warehousing and analytics can transform your organization. Lastly, I’d like to challenge every healthcare system in the country by asking a simple question: “What transformative data driven success stories will you be adding in the next 12 months?”
Suggested Content for Lifespan
Webinars & Events
Watch Dr. Jon S. Nielson, M.D. present his experiences using a Clinical Data Warehouse at North Memorial Hospital to improve Women and Newborn care.
The fundamental question of the future for population health management is, “How much will it cost our system to achieve a unit of improvement in this patient’s outcome?” At Health Catalyst, we call that Return on Engagement (ROE), and we measure the numerator and denominator, analytically. Engaging patients in their own care is not just an altruistic gesture. It is an economic imperative for healthcare organizations who are at financial risk for achieving clinical outcomes and value based care contracts.
Join Dale Sanders and Russ Staheli as they share their observations about population health management from across the industry and how those observations are influencing the Health Catalyst product roadmap. Simply put, achieving optimal care for a population of patients begins with providing optimal care for a single patient, then repeating that over and over again for an entire community of patients. What public health is for infectious disease, population health is to chronic disease; the same concepts for engaging patients in their socio-economic context are applicable to both.
In the last half of this webinar, Russ will demonstrate Health Catalyst’s Care Management suite. The five applications in the suite are powered by the Health Catalyst Analytics Platform and were designed by synthesizing concepts from Customer Relationship Management and social networking applications— blending data collection, suggestive and predictive analytics, and decision support into a seamless software experience— and applying that to population health management, one patient at a time.
Clinicians have to make difficult decisions on a regular basis. And when different clinicians within the same health system make markedly different decisions about medical treatment, significant waste and inconsistent outcomes arise.
What will be discussed?:
Establishing peer-reviewed and approved CPGs
Developing the CPG checklist
Engaging and collaborating with clinicians
Don’t miss hearing firsthand how Allina established a systemwide EBDM model and realized a five percent decrease in Stage 1 lung cancer treatment variation as well as a 20 percent decrease in the number of heparin protocols.
Dale Sanders will take a slide deck previously prepared in 2006, from a lecture entitled, “The Power of an Enterprise Data Warehouse in Clinical Decision Support”, presented to several informatics masters classes at Northwestern University and the University of Victoria. He won’t change anything about the slide deck, including the content and the old school graphics. The concept with this webinar is to give a “time capsule” perspective on past thinking and contrast that against current thoughts and trends in the market. Some of the information will be laughably wrong and naive, and some of the information will still be relevant. The hope is, by regularly reviewing our past, we will better inform our future.
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.
$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).
For patients with the severest form of sepsis, the chance of survival decreases by 7.6 percent for every hour that antimicrobial treatment is delayed. Coordinated team work and the speed with which recognition, diagnosis, and treatment of sepsis occur are critical. Health systems across the country have discovered that by successfully engaging clinicians in driving and maintaining best practice interventions they are able to save lives and improve patient outcomes. At Piedmont Healthcare, the work of educating clinicians on the importance of following sepsis care best practices had been done. The missing pieces were a well-resourced, systemwide improvement team to improve sepsis care, and a concise way to view and give timely feedback on performance based on accurate, trusted data. To fill in these missing pieces, Piedmont created a cross-representative sepsis improvement team and enabled tracking for compliance to best practices with an analytics application from Health Catalyst. Within just three months of deploying the Sepsis Improvement Application, Piedmont has accomplished significant improvements in efficiency—and completely won trust in the data. Piedmont has already identified early indications of patient outcome improvements. Initial achievements of its sepsis improvement team include deploying systemwide visibility into sepsis care performance and best practices compliance, improved acknowledgement of first alert by 19 percent across the system, and a reduction in manual data collection by 97 percent.
When healthcare information systems don’t talk to each other, countless inefficiencies and patient safety issues may arise.
Community Health Network (CHNw) believes in delivering outstanding care to every patient. In order to minimize patient safety risks and inefficiencies resulting from using different EHRs, CHNw embarked on a journey to integrate its healthcare information technologies. After implementing a Late-Binding™ Data Warehouse from Health Catalyst that integrates all key data sources, CHNw now has a consistent and comprehensive perspective for multiple patient encounters across the enterprise. It has achieved the following results:
Data from multiple EHR vendors, including four inpatient EHRs and two ambulatory EHRs, plus five transactional systems—HR, patient experience, patient safety, finance, and supply chain— were integrated within 12 months.
More than 55,000 data elements and over 18 billion rows of data were incorporated.
Patient-to-patient matching was implemented for over one million patients across the four inpatient EHRs. This is vital for managing patient populations.
Operational efficiency was improved by 70 percent, with data architects spending an estimated 15 percent of time supporting interfaces compared to an estimated 40-50 percent before the integration. In one example, CHNw linked its ERP/costing system to the EDW’s EHR source marts with just a single interface; previously, this would have required building separate interfaces for all six EHRs.
Hospital-acquired conditions (HACs)—such as central line-associated blood stream infections (CLASBIs) and pressure ulcers (PUs)—cause harm and adversely affect patients’ lives, while also increasing hospital length of stay (LOS) and total hospital costs. In fact, each case of CLABSI alone costs up to $55,000 to treat and makes health systems vulnerable to reimbursement penalties.1
Children’s Hospital of Wisconsin (CHW), a nationally ranked pediatric center with two hospitals and a surgery center, recognized that reducing the rate of HACs in its facilities would require major systematic changes. CHW’s approach to transforming care to prevent HACs included cultural changes with an emphasis on staff education and engagement and a new governance structure to support the initiative. These changes were powered by high-tech tools and quicker access to new types of data that CHW didn’t have in the past.
The hospital’s implementation of its comprehensive and collaborative HAC reduction plan has resulted in measurable quality of care improvements and cost reductions, including:
$1.6 million savings realized to date as a result of a 30 percent reduction in the overall number of HACs
23 percent reduction in central line-associated blood stream infections (CLABSIs)
74 percent reduction of pressure ulcers (PUs)
68 percent reduction in venous thromboembolisms (VTEs)
A hospital’s core mission is to provide the best care possible. To continue to do so, however, hospitals must be paid promptly. Discharged not final billed (DNFB) cases—where bills remain incomplete due to coding or documentation gaps—represent an ongoing challenge for hospitals around the country.
Thibodaux Regional Medical Center, like other hospitals, faces a myriad of new government regulations that have made hospital bill collection efforts more onerous. Its leaders recognized their inadequate manual DNFB process left hospital staff overburdened and put at risk the necessary cash flow to best serve patients.
The hospital automated and streamlined this process to relieve the burden on physicians, provide an integrated view of data, optimize visibility and workflow, and reduce the need to “downcode” reimbursements due to missing documentation. The hospital leveraged analytics to provide actionable feedback to continuously improve the process.
Thibodaux has already achieved significant improvements to cash flow and operational efficiency:
44.4 percent improvement in delinquency rate
8.2 days reduction in A/R days
70.5 percent decrease in the number of billhold accounts outstanding
50 percent decrease in physician portion of DNFB dollars
97 percent improvement in operational efficiency
MultiCare Health System, an IDS serving communities throughout Washington State, recently undertook an initiative to improve the care of, cost of, and experience for pneumonia patients. This initiative included the building of evidenced-based order sets (and driving their adoption), assigning a team of social workers called “personal health partners” to research and improve patient follow-up and communication, and deploying an analytics application to provide near real-time feedback on compliance and performance while offering a single view of patient-specific data across multiple visits and care settings, such as medication and readmission histories. Through these efforts, MultiCare has realized significant outcome improvements including reducing pneumonia readmissions by 23 percent, a 28 percent reduction in mortality rate, a 2 percent decrease in LOS, and a 6.4 percent reduction in average variable cost per patient.
Improving clinical outcomes is good for patients and good for health systems. In fact, Allina Health’s focus on data-driven outcomes improvement realized a total financial improvement of $125 million in a single year.
Allina embraced the mandate of achieving the Triple Aim: improving the quality and cost of care, as well as the patient experience. To achieve this goal, Allina’s leaders recognized that they would need to realign their strategies, organizational structures, and management practices. Confident that data would help the health system improve the quality of patient care and reduce costs, they implemented a data-driven performance improvement strategy.
The results are astounding. This strategy has achieved financial improvements for the health system of $100+ million per year, four years running, while also advancing Allina Health’s Triple Aim goals of improved clinical outcomes and a better patient experience through dozens of improvement initiatives.
Achieve Reduced Heart Failure Readmission Rates: One Healthcare Organization’s Care Coordination Strategy
Heart failure (HF) sends more US adults over 65 to the hospital than any other cause—costing Medicare alone more than $17 billion annually—with readmissions significantly contributing to the issue. For large integrated networks like Allina Health, efforts to reduce readmissions for HF patients are challenged by the need for coordinated care and consolidated data across the care continuum. Allina implemented a multidisciplinary HF management program with a nurse care coordinator and nurse practitioners who assure patient engagement and provide a “bridge” between different points in the care continuum. These important people and processes are aided by access to data from an enterprise data warehouse that merges data across the health system and gives providers insight into HF care and performance metrics. The program has helped Allina achieve a 30-day HF readmission rate well below the national average —17 percent in 10 of 11 hospitals doing cardiac care.
The need to effectively manage the health of populations is largely driven by the fact that 5 percent of the population accounts for 50 percent of healthcare costs. Being able to identify these patients, provide high-quality care and reduce their utilization is a pressing goal for many of today’s primary care providers (PCPs). Learn how this healthcare organization used a healthcare enterprise data warehouse and analytics to better manage their individual patients and patient population, integrate regulatory and performance reporting, and allow PCPs to spend more time with patients and less time collecting data.
Have you ever had one of those “wake up moments” where you literally learn a lesson that impacts and changes the trajectory of your life? Read this personal story by Dr. Bryan Oshiro of his “wake up” call where he learned the importance of data to save lives. He learned this first-hand when he saw rows of babies on ventilators in the neonatal unit and realized that they had all been electively delivered before 39 weeks. But he didn’t have the data compiled to make a compelling case to his physicians to stop elective pre-39 week deliveries. Working with his technology team, he gathered the data, analyzed it, and successfully engaged his physician team in a quality improvement project to reduce these elective deliveries.
Improving provider productivity to enhance access to care and positively impact the bottom line is one of the most important tasks facing healthcare organization today. Historically the approach to evaluating provider productivity was complicated, time-consuming and inconsistent. This left providers struggling to effectively manage in their areas of responsibility. Learn how section chiefs, providers and operational leaders at one healthcare organization now have access to near real-time data, a single source of truth, and national benchmarks that enable them to optimize productivity—which resulted in their ability to see more patients and increase revenue per clinical FTE, contributing $20M in organizational savings.
Population health management in a value-based model requires reengineering care delivery to provide higher quality of care at a lower cost. To address this challenge, organizations need to take a system-wide, strategic approach to defining their structures and processes. Learn how Partners Healthcare, an Integrated Healthcare Delivery System and ACO, developed and successfully implemented a strategic framework —guided by strong leadership and meticulous change management—for managing its half a million risk-contracted lives. The framework enables collaboration and aligns providers across the care continuum, using a unified set of performance targets for all contracts. The framework includes a robust analytics system that provides metrics to deliver the best patient care, while meeting the disparate requirements of multiple external contracts. Partners Healthcare has developed an internal performance framework that can serve as a population health management model for health systems throughout the United States.
Up to 50 percent of all hospital deaths in the United States are linked to sepsis. That sepsis mortality statistic was not lost on Piedmont Healthcare, a system of six hospitals and more than 100 physician and specialist offices across greater Atlanta and North Georgia. Sepsis accounted for half of Piedmont’s mortality rate, despite years of progress in sepsis care.
Piedmont leaders recognized that they needed an innovative quality improvement methodology to spread best practices and sustain improvement, supported by an accessible source of timely, reliable, and actionable information. They therefore implemented a “core and spread” team structure to promote enterprise-wide adoption of best practices. The health system also deployed a sepsis prevention analytics application to deliver performance insight to all levels of the organization, and discovered a high correlation between better patient and financial outcomes and the number of bundle elements the patient received. Being able to tie outcomes to interventions, along with the incorporation of nurse driven protocols, resulted in sustained practice change and greater engagement from physicians, nursing and frontline staff, all the way to the Board level.
As a result, Piedmont achieved the following impressive outcomes:
5.8 percent reduction in mortality for all patients with severe sepsis and septic shock, translating to 26 lives saved in one year.
2.5 percent reduction in total inpatient length of stay (LOS).
8.2 percent reduction in variable cost per case, equating to $4.3 million saved in one year.
A stay in the intensive care unit (ICU) is both costly and risky. In a sobering example of the latter, nearly one third of patients admitted to the ICU experience delirium, a state of cognitive impairment that can increase risk of death in the hospital. Still, many cardiovascular patients need intensive care that can only be provided safely in an intensive care unit, requiring hospitals to assure enough beds and skilled ICU staff for these patients—while quickly identifying which patients can receive care as good or better in another unit.
Allina Health has achieved this dual objective with a concerted ICU avoidance strategy for specific complex sub-populations of cardiovascular (CV) patients. The foundation of this strategy is risk-informed decisions about which patients can avoid the ICU; clinical staff education; and an analytics platform and enterprise data warehouse (EDW) from Health Catalyst that enables CV care leaders to monitor safety metrics for those patients who avoid a stay in the ICU. So far, Allina Health’s efforts have resulted in the following achievements:
636 additional ICU days made available for more critically ill patients by employing ICU avoidance strategies
One-day reduction length of stay (LOS) for Transcatheter Aortic Valve Replacement (TAVR) patients
$589,000 cumulative cost savings
Introducing the New Health Catalyst Care Management Suite: Solving the Patient Engagement and Outcomes Challenge with Innovative Data-driven Workflow
Earlier this year Russ Staheli, SVP and Product Line Manager – Population Health presented a vision around how Care Management can help drive your system to this triple aim. He is back to discuss the formal release of our brand new suite of tools that represent the first end-to-end care management solution in the industry and the first to enable discovery of an otherwise invisible subset of patients – those who will benefit most from care management and who can be engaged most effectively to lower the cost of care.
Please join Jared Crapo, Vice President, as he covers important basics including who Health Catalyst is, what we provide and how we deliver our products. This is an education-oriented webinar about the basics of who we are and what we do. Jared will provide an easy-to-understand discussion regarding the key analytic principles of adaptive data architecture.
Some specific items he will cover are:
The industry challenges that warranted the creation of Health Catalyst.
The use of Health Catalyst’s data analysis tools and applications that enable organizations to quickly uncover care improvement and cost reduction opportunities.
Implementation best practices including how the Health Catalyst Platform is delivered, installed, and typical implementation schedules.
Attendees will understand who in your organization needs to be involved and the secrets to success and pitfalls to avoid.
The discussion will include the key analytic principles of an adaptive data architecture including data aggregation, normalization, security, and governance. He will also address the basic requirements for implementation of the measurement platform of a data warehouse, such as team creation, roles, and reporting.
Finally, Jared will demonstrate several of the key tools necessary to move the analytics strategy forward including applications used to organize patient populations, others used to monitor and measure care results and still others that are specific to advanced areas of care.
We hope you’ll join us.
Percutaneous Cardiac Intervention (PCI) is a minimally-invasive alternative to open heart surgery—a procedure that approximately 600,000 U.S. patients will undergo this year.
Allina Health, a non-profit health system with 90+ clinics and 13 hospitals with locations throughout Minnesota and western Wisconsin, is a leading provider of the procedure in Minnesota. Allina Health discovered that major bleeding events following PCI procedures (the most common non cardiac complication of PCI), though not affecting mortality, were increasing length of stay (LOS) and cost.
To improve the quality of its PCI procedures and decrease costs, Allina Health recognized the need to accurately assess bleeding risk and then implemented best-practice interventions to prevent major bleeding events.
Already, physicians and patients have seen that these new interventions, which includes a bleeding risk assessment tool, allows clinicians to focus interventions based on risk and reduce complications. The top results from Allina Health’s interventions include:
5.3 percentage point reduction (a 21.7 percent relative reduction) in complication rate.
$1.8M cost savings.
1.4 percentage point reduction (a 36.5 percent relative reduction) in LOS for patients at high risk for bleeding who receive a closure device.