Read how The University of Kansas Health System embraced the implementation of an advanced analytics team to help the healthcare system unleash the data capabilities needed to become a data-driven organization.
An efficient accounting closing process delivers timely and accurate information to guide decisions and operational adjustments. Learn how UPMC implemented an analytics-driven cost management system, supporting a 50 percent reduction in the time needed to complete month-end close.
To address physicians’ concerns with value-based care requires timely and actionable data for generating insights and initiating improvement programs. Read how Acuitas Health utilized its analytics platform to support the development of practice intelligence profiles—comprehensive views of partner practices used by the practice intelligence team to increase provider engagement and strengthen improvement efforts.
Research shows that despite an increase in the number of improvements in clinical, cost, and operational outcomes, there is a lack of sustained improvements. Some of the key challenges can be access to the data and analytics, and adherence to data-driven clinical standards, things the Allina Health Spine Clinical Service Line (CSL) clinical leadership team experienced.
By providing widespread access to the data and analytics, the Spine CSL at Allina Health has been able to continue its reduction in LOS and further improve its reduction in complications, all while increasing cost savings and achieving pay-for-performance incentives.
$1 million in pay-for-performance incentives received.
More than $2 million in supply chain savings, a result of data-driven clinical standardization.
31 percent of expected complications avoided.
22 percent relative reduction in surgical site infections.
Publicly reported measures of healthcare quality includes the Hospital Safety Score Grades which award a letter grade representing performance for 30 evidence-based measures of patient safety. An “A” represents the best Hospital Safety Score, followed in order by “B,” “C,” “D,” and “F.” In the fall of 2014, Piedmont’s Hospital Safety Score Grade for its five hospitals included four “C’s” and a “D.” This demonstrated a need to change its approach to quality improvement and ensure proper resources were allocated and aligned with the value chain, enabling it to efficiently conduct surveillance activities, perform analysis, and facilitate sustained outcomes improvement.
To increase capacity for performing more value-added work, Piedmont leveraged its analytics platform to automate surveillance activities and monitor the effectiveness of quality improvement efforts. These tools helped Piedmont redesign its quality improvement efforts, resulting in a:
35 percent relative reduction in healthcare facility acquired infections per patient day.
50 percent reduction in the time required for peer review.
50 percent reduction in the time to implement improvement projects.
Effective practice management includes tracking and reporting patient outcomes, and effectively managing revenue cycle, as well as keeping an eye out for market changes and growth opportunities. Well-managed practices effectively balance supply and demand on a daily, weekly, and long-term basis, actively managing encounter volume, panel size and scope, timeliness of available appointments, and payer mix.
John Muir Health faced challenges in obtaining data that would provide leaders with strategic decision support information that fostered effective practice management. John Muir Health had attempted to use its EHR to obtain this information, but discovered it was unable to meet the complex demand. As a result, the organization relied on burdensome manual work processes, resulting in delays and a backlog of data requests, and limited ability to make well-informed, data-driven decisions.
After leveraging the information within its data warehouse and analytics platform to create a network leadership encounter application, John Muir Health acquired the following capabilities:
All leaders have on-demand access to performance data at multiple levels from the organization-wide performance down to the patient and provider level.
Senior leaders are making data-driven decisions for strategic responses across John Muir Health to shifts in market, growth opportunities, and emerging markets.
The regional management teams are using the application to inform:
By leveraging these new capabilities, John Muir Health has achieved:
Transparency of the data and accountability of the regional management teams for key performance indicators
14 percent improvement in completed physician encounters, resulting in faster revenue capture, when compared with the previous year.
Eliminating the encounter-associated report backlog.
Nearly half (46 percent) of all physicians report that they suffer from burnout, citing too many bureaucratic tasks as one reason. Providers want to find meaning in their work, and improvement on many current quality metrics do not predict better patient outcomes or experience of care. They are looking for tools to reduce their workload and improve their ability to provide excellent care, including having metrics and registries that are meaningful and informative.
Faced with the challenge of making quality measures meaningful, Partners HealthCare worked to redefine measures to be more relevant, create point-of-care registries to manage an all-payer population, created teams of Population Health Coordinators to support front-line teams in managing the registries, and used its analytics platform to monitor change and explore provider variation in order to improve quality. This resulted in:
85 percent of clinicians surveyed felt that the new metrics helped them take better care of their patients.
Quality improved at an unprecedented rate on an all-payer population five times bigger than the standard pay-for-performance population.
Near real-time measurement using clinical data eliminated months-long delays, while run charts and provider and clinic-comparison views turbo charged quality improvement.
125 percent increase in user adoption of the analytic tool (99 unique users, 674 unique sessions, and rising).
One in three women delivers via cesarean in the U.S., and more than 90 percent of them have repeat operations in subsequent deliveries. Despite numerous evidence-based guidelines and established best practices for labor and delivery, clinical care varies widely for many practices. Labor and delivery care varied at Thibodaux Regional Medical Center, causing the organization to look for ways to standardize care.
To better understand variations in care, and opportunities to reduce its cost, the labor and delivery care transformation team at Thibodaux Regional used the Health Catalyst Labor and Delivery Advanced Application as well as the Financial Management Explorer application, which integrates data from billing and costing, and creates snapshots of current financial metrics.
Informing and educating providers with provider-specific data in conjunction with redesigned workflow, standardized supplies, and new, standardized protocols enabled the labor and delivery care transformation team at Thibodaux Regional to experience cost savings and improved outcomes, including:
24.4 percent relative reduction in the cost of care for uncomplicated vaginal delivery. Projected annual cost savings of $266,067.
22 percent relative reduction in the cost of care for cesarean deliveries. Projected annual cost savings of $346,856.
Allina Health needed to ensure the data it reported to regulatory agencies was timely and accurate. The integrated health system sees 100,000 inpatient hospital admissions annually, 340,000 emergency care visits, and 6,000 physicians and 1,600 nurses providing and documenting care. Due to the sheer volume of patients and employees, clinical data abstraction at Allina Health is not a small undertaking.
Looking to stay compliant while reducing resource utilization, Allina Health sought to change its workflow procedures for faster, more accurate clinical data abstraction. A large amount of clinical data required for compliance with CMS performance measures and Joint Commission Core Measure resides in unstructured data, such as narrative notes, which require manual data abstraction. With the help of data analytics, Allina Health was able to develop evidence-based standardized processes for clinical reporting and automate some clinical data abstraction.
76 percent relative improvement in time to data availability at each site. Data is typically available within 14 days of discharge, far exceeding the 30-day target.
95.5 percent accuracy for CMS validation.
Healthcare reimbursement continues to shift away from fee-for-service reimbursement models to value-based, risk-sharing agreements. This shift has resulted in organizations revising compensation strategies to engage physicians in value-based compensation arrangements. An effective value-based physician compensation plan is critically important, particularly in competitive environments where organizations must optimize the ability to recruit and retain highly skilled providers. One commonly used physician compensation approach includes a base salary and productivity incentives, coupled with additional compensation opportunities for achieving quality and service goals. The physician compensation package at John Muir Health is not only competitive, it is also complex, but the support process was burdensome, inefficient, and lacked transparency.
John Muir Health developed a plan to leverage the Health Catalyst® Analytics Platform, including the Late-Binding™ Data Warehouse and broad suite of analytics applications, to develop an automated process for physician compensation. The plan created efficiencies in time and effort across multiple domains and produced software to automate future work. The benefits included:
Saving 1,560 hours of time required to produce the data necessary to calculate physician compensation.
Successfully integrating more than ten different compensation models and 20 different data elements for more than 300 different providers into the physician compensation analytic application, automating the process.
With the current state of uncertainty facing healthcare organizations, survival requires unprecedented agility when it comes to acquiring and responding to meaningful, strategic information. After adopting the Health Catalyst Analytics Platform, including the Late-Binding™ Data Warehouse and broad suite of analytics applications, Partners HealthCare promoted a philosophy of expanded access to the enterprise data warehouse (EDW) to increase adoption and self-service analytics to improve patient care and outcomes.
Partners needed widespread adoption of the EDW so that information could be meaningfully incorporated into strategic, clinical and operational decision making to support patient care. This meant that users who had a legitimate need to access data to support their job function were encouraged to seek access to the EDW. The organization continues to focus on further increasing the effectiveness of this strategy by ensuring that users have the means to acquire the skills, knowledge, and support they need to effectively use data stored in the EDW.
243 percent increase in user base—achieved over a two-year period (700+ unique users).
More data available to a broader audience than ever before.
Physician time to access data reduced from weeks to clicks.
87 percent of user community satisfied with the effectiveness of communication provided to support their use of the EDW.
Intravenous (IV) heparin is widely used to prevent thrombosis in a variety of clinical settings, yet it is considered one of the highest-risk medications used in the inpatient setting because of the potential for dosing errors. Allina Health identified multiple IV heparin protocols among its hospitals, a variation that increased the risk of errors. Standard practices that addressed patients’ clinical needs in a disease-specific way were lacking. Over the course of 1.5 years, more than 9,000 patients at Allina Health had an IV heparin protocol ordered, so IV heparin safety was of utmost concern.
To address this quality issue and improve clinical value, Allina Health created a systemwide interdisciplinary team to standardize IV heparin therapeutic guidelines and monitor the impact of the standard guideline on patient outcomes. Allina Health engaged multiple physician stakeholder groups to review proposed protocols and provide critical feedback to help ensure the best possible patient care and safety. To effectively monitor IV heparin outcomes, patient safety, and the impact of the new, standard guidelines and protocols, Allina Health developed an anticoagulation safety analytics application, using the Health Catalyst Analytics Platform, including the Late-Binding™ Data Warehouse and broad suite of analytics applications. These outcomes improvement efforts resulted in:
A seven percent relative improvement in the percentage of patients therapeutic within 24 hours of protocol initiation.
Paring 20+ site-based documents (e.g., policies, protocols, and order sets) to one systemwide guideline and four systemwide protocols.
Effective data integration enables high value through more strategic, data-driven decision-making, while faster data acquisition feeds and speeds up the process. Orlando Health, one of Florida’s most comprehensive private, not-for-profit healthcare networks, recognized the need for effective data integration to successfully manage to the organization’s changing business needs. The health system needed the ability to rapidly acquire and link disparate healthcare data sources in various ways in order to answer clinical and business questions.
Leaders at Orlando Health needed a data warehouse that better met their needs. They determined that switching from an early binding data process to a late-binding process would provide greater flexibility and expand their access to critical data, with shorter data acquisition times.
With the new EDW, Orlando Health achieved the following efficiencies:
245 fewer days and 1.0 less full time employee (FTE) needed to integrate encounter billing summary system data.
56 fewer days and 0.4 less FTE needed to integrate Infection control system data.
99 percent reduction (90 days saved) in the amount of time needed to implement system enhancements.
98 percent reduction in the work hours needed to incorporate system enhancements.
Between 2007 and 2014, U.S. healthcare costs per capita increased by almost 25 percent. The way in which health systems are typically organized, managed, and budgeted (as departments and units within separate hospitals) works against them when they attempt to improve population health and decrease costs. The University of Pittsburgh Medical Center (UPMC), a large health system with more than 20 hospitals and 500 clinics, was keenly aware of this challenge as it embarked on population health and value-based care initiatives that spanned the entire organization.
The health system determined that it needed to break down the virtual walls between care centers and standardize service lines across the enterprise. By extension, this organizational change mandated the need for activity-based costing in healthcare that would deliver the insight necessary to run a service line effectively. UPMC organized six service lines within the health system, each spearheaded by clinical, operational, and financial leadership. Each service line uses the health system’s innovative, data-driven activity-based costing methodology to understand the true cost of care.
Notable, measurable results of UPMC’s service lines and activity-based costing methodology to date include:
$42 million of cost reduction opportunities (approximately 2 percent of targeted service line cost)
$5 million in supplies savings
Transparency toward identification of contribution margin variation for specific procedures
Up to 97 percent improvement in time to access information
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.
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.
As a Pioneer ACO, Partners HealthCare knew that understanding the healthcare business drivers of hospital volume and other strategic business trends was critical to its success. To increase this understanding, Partners recognized that it needed an advanced population health management analytics application that addressed strategic questions, could be deployed quickly, and would enable users to engage with the application to contribute toward real improvement. By emphasizing strategic questions rather than the technology solution itself, adopting Agile development methodologies, and working with stakeholders to drive adoption, Partners has developed an effective analytics platform that consists of an enterprise data warehouse (EDW) and advanced population health analytics applications. These efforts have resulted in an increase of up to 75 percent in operational efficiency, strategic questions answered up to 10 times faster, and perhaps most importantly, a cultural transformation where data helps drive strategy.
In order to thrive in an ever-increasing risk-based contracting environment, accountable care organizations like Partners HealthCare need to deliver high-quality, safe care with minimal risk. Integrated data that reveals cost reduction and care improvement opportunities are necessary to be successful in a risk-based environment, and has historically been fragmented and limited in interoperability in healthcare organizations. To merge, house, and analyze the necessary financial, operational, and clinical data required for risk-based contracting, Partners deployed a late-binding enterprise data warehouse (EDW) and population health management analytics. The EDW and analytics applications are making information accessible to managers as soon as it is released, along with enhanced visualizations that enable data-driven insights. In addition, the analytics application is helping to drive physician awareness and engagement in understanding and managing cost trends.
U.S. healthcare is shifting from procedure and visit approaches to a longitudinal view of patient care. The Centers for Medicare & Medicaid Services (CMS) is supporting this change with their “Bundled Payments for Care Improvement Initiative.” Under the initiative, healthcare organizations enter into payments arrangements with financial and performance accountability for 48 episodes of care. This requires health organizations to integrate data from a combination of sources in order to identify the bundles with the highest costs and the sources of variation. Learn how Partners HealthCare, an Integrated Healthcare Delivery System and ACO, successfully integrated hospital, provider, and claims information for the first time—and how they can now easily evaluate and compare clinical and financial performance for the 48 CMS episodes of care.
Advancing women’s health is a key part of the nation’s healthcare quality improvement and population health management agenda. Mission Health has embarked on a journey to standardize its best practices and develop a more systematic method for collecting and analyzing data related to perinatal care. With an EDW serving as its analytics platform, and a newly implemented clinical improvement model, Mission is able to monitor performance on several evidence-based practices designed to improve maternal and newborn care. Learn how they have sustained a zero elective delivery rate, and how they have reduced the time they spend manually collecting data and calculating rates.
In an era of steadily declining operating margins, hospitals are seeking ways to increase their profitability. Learn how one hospital system integrated financial and operational data in near real-time, giving their leaders visibility into how their decisions are impacting the bottom line. Leadership is now making more informed decisions and they are addressing problems as they arise. Budgets are consistently being managed close to target and variances for each cost center are readily explained with drill-down capabilities into the general ledger. A significant manual effort associated with over 1,000 cost center spreadsheets has been eliminated and the organization has saved $12 million in labor savings.
Patient Identification and Matching—An Essential Element of Using an Enterprise Data Warehouse to Manage Population Health
In a healthcare industry transitioning to value-based reimbursement and population health management (PHM), matching patients accurately to their care events across multiple sites of care and sources of information is becoming ever more important. Being able to accurately track utilization of services for a particular patient, patient population, or provider is fundamental to the strategies underlying effective population health management. Partners HealthCare developed an effective patient matching solution for more than 10.5 million patients achieving a 20 percent improvement in patient matching accuracy and a 96-99 percent high-risk patient matching rate. This has allowed the organization to accurately “flag” high risk patient populations and better manage risk under risk-based contracts.
As the healthcare industry rapidly evolves, implementing an enterprise data warehouse has become essential both for population health management and economic survival. While this requires building analytics competency across the enterprise, once adopted, the benefits are abundant—from improved patient outcomes to reduced waste and costs. To rapidly gain value from this platform, healthcare organizations should follow an implementation strategy that, before anything else, identifies the problems analytics is intended to solve. It should also place as much emphasis on people and processes as it does technology. Partners HealthCare is an example of how implementing a data warehouse can quickly leverage analytics across the enterprise to achieve value with high end-user engagement and satisfaction.
The Enterprise Data Warehouse (EDW): Creating the Foundation for Effective Healthcare Improvement Analytics
Population health management and value-based care has arrived. However, many healthcare organizations don’t have a single source of truth for their data, nor can they easily access their information. In the absence of integrated data visibility, many hospitals are relying on manual workarounds that can take months, and sometimes even years to implement—and in the end, may still fall short of delivering the level of insight needed. Learn how Partners HealthCare consolidated its disparate data warehouses, incorporating more than 27,000 data elements from multiple sources systems—and implemented on time and on budget. Partners’ enterprise data warehouse now serves as the analytics foundation for its overall value strategy.
Sepsis, a serious complication that strikes quickly and is often fatal, is the single most expensive condition to treat in the hospital, in part because of the longer than average stay. To reduce sepsis mortality rates, which are between 20 and 50 percent, many hospitals have established evidence based bundles comprised of antibiotic administration, lactate level monitoring and other elements of care. However, without analytics, hospitals rely on manual processes to track sepsis rates and bundle compliance. Learn how Mission Health has streamlined surveillance by 75% while experiencing a 2.6% reduction in sepsis mortality rates and an 18% reduction in length of hospital stay.