Quality Metrics Tracking

Success Stories

Clinical Data Abstraction as a Service Improves Accuracy and Efficiency

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.
Results:

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.

Read more
My Folder

Mission Health Receives 100 Percent of At-Risk Dollars in Payer Incentive Program

Since 2004, the US healthcare system has annually ranked last relative to 10 other developed nations in quality, access, efficiency, equity, and health outcomes. In an effort to improve the quality of care and patient outcomes in the U.S., the Center for Medicare and Medicaid (CMS) launched a series of quality incentive programs designed to generate a shift from volume to value-based reimbursement.  The health insurance industry soon followed their lead, and started writing contracts with hospitals in which a percentage of payment was based on performance on selected quality metrics.
Faced with the challenge of reporting on numerous incentive programs with differing expectations, Mission Health leveraged their enterprise data warehouse to aggregate the data needed to track the quality measures. With millions of dollars on the line with one particular payer, Mission developed an analytics application to monitor performance on the metrics in that contract.  The application was used to analyze whether performance feedback and workflow changes would lead to improved performance on the metrics, thus ensuring that they would maximize reimbursement, while improving care for patients.
Results:

Achieved 100 percent of all at risk dollars.
100 percent of the ambulatory metric targets were exceeded, some by as much as 19 percent.
All five hospitals exceeded targets for 80 percent or more of their inpatient metrics.

Read more
My Folder

Improving Diabetic Care in the Ambulatory Environment

Diabetes is the most common life-threatening, chronic illness in children who live in developed countries. With effective management of diabetes, children with diabetes can live long, healthy, and active lives.
Texas Children’s Hospital believes that diabetes patients and their families are most successful in managing their disease if they receive standardized, family-centered, multidisciplinary care in both inpatient and outpatient settings.
Texas Children’s created a new Clinic Care Process Team (CPT) which developed a comprehensive approach to standardizing diabetes care by automating best practice alerts that help clinicians recognize the need for testing, so they order labs more quickly.
Within one month of implementation Texas Children’s saw measurable improvements:

Screening percentages for each test improved to >80 percent.
28.2 percent relative improvement in the percentage of patients receiving recommended annual thyroid-stimulating hormone (TSH) testing, with current performance greater than 90 percent.
23 percent relative improvement in the percentage of patients receiving recommended annual lipid testing, with current performance greater than 90 percent.
54.1 percent relative improvement in the percentage of patients receiving annual retinal examinations, with current performance at 94 percent.
Patient satisfaction is on an upward trend.

Read more
My Folder

40,000 Covered Lives: Improving Performance on ACO MSSP Metrics

The U.S. healthcare system is the most expensive in the world, but data consistently shows the U.S. underperforming relative to other countries on most dimensions of performance. The Centers for Medicare & Medicaid Services’ (CMS’s) accountable care organization (ACO) model is aimed at addressing that issue by offering financial incentives for providers to improve the health of populations and reduce costs through greater efficiencies and a focus on preventive care.
Mission Health formed a Medicare Shared Savings Program (MSSP) ACO called Mission Health Partners (MHP), which is responsible for 40,000 patient lives. MHP knew that its manual approach to data collection and reporting would not be sufficient for the required ACO quality metrics. By leveraging a previously implemented enterprise data warehouse platform and implementing an ACO MSSP analytics application, MHP was able to automate the processes of data-gathering and analysis and align the data with ACO quality reporting measures. The visibility and transparency of near real-time, online performance data coupled with focused process improvement has resulted in subsequent improvement in all 33 of the ACO performance metrics. Specifically, improvements have included:

9.6 percent increase in compliance over all reported ACO metrics, with 23,000 more patients receiving recommended treatment or screenings.
98.9 percent of eligible patients received screenings for clinical depression and follow up.
40 percent increase in number of patients receiving any cancer screening; 46 percent improvement in the number of patients receiving colorectal cancer screening.
456 percent increase in the number of patients getting fall risk screening.

Read more
My Folder

Reducing HAC Rates to Keep Kids Safe and Healthy

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)

Read more
My Folder

How to Avoid PQRS Penalties and Earn Potential Incentives with Accurate Submission of Quality Measures

CMS has recently transitioned its Physician Quality Reporting System (PQRS) program from a pay-for-reporting program to a program that will now apply a negative payment adjustment to providers who do not satisfactorily report data on quality measures. Memorial Hospital faced a significant problem when its PQRS reporting process was hampered by its transition to a new EHR system. They needed a solution. Learn how Memorial successfully used their enterprise data warehouse to submit the necessary data to a certified registry, avoiding a four percent Medicare reimbursement adjustment, and providing them with the potential to earn an incentive payment. They also now have several patient registries that can be used for quality improvement initiatives in clinical care, patient safety, and care coordination.

Read more
My Folder

Using Advanced Analytics to Manage Population Health in Primary Care Clinics

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.

Read more
My Folder

Measuring and Reporting The Joint Commission’s Perinatal Core Measures using Clinical Analytics

Addressing The Joint Commission (TJC) core measures is a challenge for healthcare organizations. Hospital EMR data issues are well known by quality and patient safety, and clinical quality improvement clinicians. Read how this healthcare organization is using their healthcare enterprise data warehouse and clinical analytics to establish accurate baseline measures and ongoing near real time performance tracking for their TJC perinatal core measures.

Read more
My Folder

Community Care Physicians Deliver Effective Population Health Management with Clinical Analytics

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.

Read more
My Folder