Transforming Care: How to Modify Provider Behavior

to Improve Clinical Outcomes

September 2014

www.whitecloudanalytics.com/transforming-care

Featured Speakers

Geoffrey SwansonPresident, St. Luke's Health Partners & VP, Clinical IntegrationSt. Luke's Health Systemdoctor.gswanson@gmail.com

Keith BrownSenior PartnerWhiteCloud Analyticskeithb@whitecloudanalytics.com 

Nobody…

Wakes up the in the morning…

…and says I am going to do a ‘mediocre’ job.

Meaningful

OpportunityGreat Team

Navigating a Chaotic Market

Value-Driven

Full Risk

Volume-Driven

Fee-for-Service Payment System

Quality, Cost, Efficiency

Margins & Volume

Bundled Payments

Shared Savings

Shared Risk Contracts

Today

Tomorrow

Del

iver

y Sy

stem

Increased Risk

Evolve Organizational Model

Increased Risk

You Can’t Improve What You Can’t Measure

• That I am a great care provider?• That I have a fully engaged team?• That my network/system is outperforming the

market?• Etc…

What barometer do you use?

How do you know?

What You Probably Have

• Point of care systems (EHR)

• Operations reports (static)

• Static Quality Reports (analyst produced)

• National Benchmarks (usually dated)

Are these the right tools?

What You Probably Don’t Have….

• A system that drives provider behavioral change– Personalization, Transparency– Socialization, Role-based analytics

• Integrated oversight tools (future webinar)– Summarizes clinical cost and quality goals– Management insight into your overall risk & organizational

strategy

Audience Poll Question

How important is it for your organization’s execution of strategic initiatives to influence provider behavior?

St. Luke’s Health System & St. Luke’s Health Partners

Who we are and where we’re going…

• Largest health system in Idaho• Approaching the market as a Clinically

Integrated Network (SLHP)• Geographic medical catchment area

– 1800 total active Physicians– $4 billion total medical expense– 800,000 people

• Moving from volume to value• Managing populations for a budget

Driving market differentiation.

Clinical Transformation

OrganicExperimentation

Opportunity Review & Plan

Oversight &Accountability

StakeholderAlignment

Success FactorsExec Leadership

Governance

Financial Management

IT/Data

Performance Management System

Two Distinct Organizational Models

?Top-Down Management

E PP

P

P

P

P

Autonomous and Self-Directed

Centrally-led ChangeTraditional performance management.

The way we used to do it: Centrally–led programs Multiple, monthly meetings PowerPoints and email

Top-Down Management

E

Provider-led ChangeEmpowering physicians as change agents.

PP

P

P

P

P

Autonomous and Self-Directed

Providers control 80+% of spend. Highly motivated Geographically dispersed Independent decision makers

Clinical Transformation Requires…

AndTop-Down Management

E PP

P

P

P

P

Autonomous and Self-Directed

Performance Management System

400+ healthcare metrics Includes benchmarked and risk adjusted metrics

Actionable Patient Registries Disease, high risk, etc..

Plug-and-play metrics

Automated Analytics

Role-Based and Actionable Information

Data Sources

IP EMR

Pharm

OP EMR

Claims

CAHPS

TBD

• Align providers• Establish common metrics• Distribute to teams• Set action plans

Clinical Transformation

OpportunityReview & Plan

Oversight &Accountability

StakeholderAlignment

Performance Management Process

OrganicExperimentation

Program AdministratorOrtho Medical Director

Surgeon

Anesthesiologist

Provider Alignment

Service Line/Unit Provider/Team

Scalability of Performance Metrics

System/Network Hospital/Region

Clinic/ Practice

Specialty/Department

Explain How Things Will Be Measured

Set Action Plans

Real Results of Self-Directed Change

• Personalized data experience

• Peer-to-peer collaboration

Clinical Transformation

Oversight &Accountability

StakeholderAlignment

PP

P

PP

P

OpportunityReview & Plan

OrganicExperimentation

Why is Viral Change Critical?

Harness the power of providers. Reduce analysis fatigue Foster unconstrained experimentation Create dialogue and best practice collaboration

PP

P

P

P

P

Autonomous and self-directed

Provider Engagement is Attainable if…

• Personalized• Transparent• Easy to use

PP

P

P

P

P

Autonomous and self-directed

My Practice, My Performance, My Patients

Provider Engagement is Attainable if…

• Personalized• Transparent• Easy to use

PP

P

P

P

P

Autonomous and self-directed

My Performance, My Peers

Provider Engagement is Attainable if…

• Personalized• Transparent• Easy to use

PP

P

P

P

P

Autonomous and self-directed

Readmissions by Service Line

Readmissions – Medicine Readmissions – Timeline

Automated Root Cause AnalysisGuided Navigation

Based on 5+ years of provider research.

Visualization

Compelling and intuitive displays of information surface patterns and spatial relationships.

Application Usage(Trailing 12 Months)

0

5,000

10,000

15,000

20,000

25,000

Pull Usage Trend – Directly by Provider Community

Modifying Behavior to Optimize Outcomes

Opportunities, Accountability & Populations

Oversight &Accountability

StakeholderAlignment

Performance Management System

Geoff Swansondoctor.gswanson@gmail.com

Keith Brownkeithb@whitecloudanalytics.com

OpportunityReview & Plan

OrganicExperimentation

Audience Poll Question

What is the most strategic or important objective of your organization for the next 2 to 3 years?• Develop risk-based reimbursement models• Quality and safety improvement• Optimize efficiency• Coordination of clinical care• Market Differentiation

Questions?

www.whitecloudanalytics.com/transforming-care

Geoffrey Swansondoctor.gswanson@gmail.com

Keith Brownkeithb@whitecloudanalytics.com