agilon health, an organization that partners with physician organizations in full risk contracts, needed a way to help its physician partners and care management staff quickly identify patients in danger of deteriorating health status and increased cost. However, taking a deeper look at the health status and costs associated with these patients was complicated by the slow manual review of data. By developing an analytics application, agilon health was able to turn its data into actionable insights, automate many manual processes, and ultimately provide targeted improvement interventions aimed at better care delivery.
Machine Learning / Predictive Analytics
This healthcare organization, comprised of a specialty hospital and multiple clinics, sought to improve safety for its patients, focusing on identifying wrong-patient order errors. To better understand and improve patient safety, the organization needed to move beyond passive surveillance. By using multiple detection methods for identifying wrong-patient errors and establishing triggers that identify when a wrong-patient order may have occurred, hospital and clinic staff are able to investigate instances.
Christiana Care Health System (CCHS) had used a machine learning model to inform population segmentation. The initial model used “black box” algorithms to predict risk that care managers didn’t have input on or understand. CCHS leaders and experts wanted an efficient model that they understood and trusted to predict 90-day inpatient admission. CCHS used a feature selection process to build the simplest model possible—and AI insight tools for selecting the best model, setting triggers for action, and explaining how the model worked.
Medical errors account for 10 percent of all deaths. To improve patient safety, Allina Health utilized its machine learning, analytics platform, and a trigger-based data-driven surveillance tool to identify and investigate a broader base of harm events, enabling the organization to:
With patients responsible for an increasing amount of their healthcare costs, self-pay accounts are now the top contributor to bad debt for hospitals and health systems—accounting for more than $55 billion annually. Allina Health partnered with Health Catalyst, using catalyst.ai™, to create a predictive model that could successfully support a propensity to pay strategy.
Hospital readmissions can impact the health outcomes for patients and result in costly readmission penalties from CMS. Learn how the data analytics teams at Westchester Medical Center Health Network and network member Bon Secours Charity Health System utilized its analytics platform, in coordination with a machine learning algorithm, to build a knowledgeable and accurate readmission risk model that better reflected its patient population.
In the U.S., 5.7 million adults have heart failure (HF), costing the nation an estimated $30.7 billion each year. Learn how MultiCare leveraged AI and machine learning to more accurately predict the readmission risk for patients with HF.
Hospital readmissions carry significant financial costs and are associated with negative patient outcomes. With the help of data analytics, Mission Health developed its own predictive model for assessing readmission risk, aimed at preventing readmissions and improving outcomes for patients.
Machine Learning, Predictive Analytics, and Process Redesign Reduces Readmission Rates by 50 Percent
The estimated annual cost of readmissions for Medicare is $26 billion, with $17 billion considered avoidable. Readmissions are driven largely by poor discharge procedures and inadequate follow-up care. Nearly one in every five Medicare patients discharged from the hospital is readmitted within 30 days.
The University of Kansas Health System had previously made improvements to reduce its readmission rate. The most recent readmission trend, however, did not reflect any additional improvement, and failed to meet hospital targets and expectations.
To further reduce the rate of avoidable readmission, The University of Kansas Health System launched a plan based on machine learning, predictive analytics, and lean care redesign. The organization used its analytics platform, to carry out its objectives.
The University of Kansas Health System substantially reduced its 30-day readmission rate by accurately identifying patients at highest risk of readmission and guiding clinical interventions:
39 percent relative reduction in all-cause 30-day.
52 percent relative reduction in 30-day readmission of patients with a principle diagnosis of heart failure.
Each year, more than 12,700 pediatric patients are diagnosed with diabetic ketoacidosis (DKA), a life threatening complication of diabetes. Texas Children’s Hospital sought a way to accurately predict risk of DKA in time for care team members to intervene before these patients suffered a severe episode.
The health system ultimately formed a multidisciplinary high risk diabetes team to devise pre- and post-discharge strategies, and DKA risk prediction tools aided by the Health Catalyst Analytics Platform built using the Late-BindingTM Data Warehouse.
30.9 percent relative reduction in recurrent DKA admissions per fiscal year.
90 percent of all patients with new onset type 1 diabetes at the Medical Center Campus have a documented RIPGC in their medical chart.
100 percent of patients with type 1 diabetes have a risk index for DKA documented every 6 months.
With nearly 20 percent of elderly patients released from a hospital being readmitted within 30 days, Allina Health is focused on providing patients optimum care and support post discharge to minimize readmissions. Focusing on 30-day potentially preventable readmissions (PPRs) as its global outcome measurement, Allina Health used key clinical variables to derive the clinical relationships between hospitalizations that determine PPRs. It further built analytic capabilities to identify opportunities for improvement in care management and to test quality improvement ideas.
Allina Health’s multipronged solution included redesigning care management processes, implementing predictive analytics to identify at-risk patients, using analytics to measure the impact of its interventions, and educating patients, families, and clinicians.
These efforts are driving measurable improvements including: 10.3 percent overall reduction in PPRs, 27 percent reduction in PPRs for patients with clinic follow-up within 5 days, and $3.7 million reduction in variable costs due to avoided readmissions.
Sepsis affects more than 750,000 hospitalized patients and results in 570,000 ED visits per year. Learn how this large medical center is tackling their sepsis care challenges by leveraging their EDW and healthcare analytics. They defined and built a sepsis registry and analytics platform in 10 weeks to measure 6 interventions and 4 outcome measures — including mortality rates, length of stay, total hospital stay and 30-day readmits.