Post on 31-Jul-2020
WhiteCloud AnalyticsHarnessing the power of data to enable better healthcare.
Healthcare Analytics:
A Roadmap to Reform
October 2, 2012
Jane Cardoso
Healthcare Solutions Manager
2. WhiteCloud History & Team
WhiteCloud Confidential and Privileged
The WhiteCloud Team
AdvantageDatabase™
1990 20102000
(2nd largest software company)
(Largest software company)acquired by
acquired by
Team: Key
AccomplishmentsVA System #1 on #1… Clalit,
Joint Commission,
etc. > 1200 customers
40+ Industry Awards
for Innovation6 Key Patents
in Analytics
Mission: Harness
the power of data
to empower
better healthcare
Mission: Harness
the power of data
to empower
better healthcare
WhiteCloud Analytics
Business Intelligence
Consulting ServicesHarnessing the Power of Data
Analytic Applications
Strategic Outcomes
in Pursuit of the Triple Aim
• BI Optimization Planning
• Custom Solution Development
• Acute Foundations
• Clinical Integration Foundations
• Network Integrity Foundations
• PCMH Foundations
• Disease Management Foundations
• Revenue Cycle Optimization
Harnessing the Power of Data to Enable Better Healthcare.
WhiteCloud Confidential and Privileged
Objectives
• Demonstrate the power of automation:
– Automated data processing
– Automated analytics
• Demonstrate how WCA applications can empower
health systems on their reform journey
WhiteCloud Confidential and Privileged
Environment: Exploding Data Dilemma
TIME
Data
Fact Gap
Reports and Spreadsheets
Staff and Analysts
Opportunity:• Automate information analysis
• Accelerate and enhance
decision making
WhiteCloud Confidential and Privileged
Today’s Data Processes:
Reference
Data
Captured
Data
IT Person
or Analyst
Rows &
Columns
Report
Analyst or
Maker
Analyst or
Decision
Maker
Decision
Maker SpreadsheetSpreadsheetExcel
Gather Data Build Meaning Understand
6
•Manual
• Slow
• Laborious
• InconsistentWhiteCloud Confidential and Privileged
7
Cloud Data Processes
7
Analyze Engage ImproveAutomate
• Automated Online Access
• Advanced Analytics• Promotes Transparency
• Enables Simultaneous ImprovementWhiteCloud Confidential and Privileged
Volume Value
FFS Bundled Payments
MSSP
PCMH
ACO
• Want volume• Services-lines are
profit centers• Everything is in a silo• Low accountability
• Value = Quality / Cost• Paid for quality; rewarded
for reducing cost• Demands transparency• “Accountable care”
Massachusetts – Chapter 224• Accountable for spending growth
• Encouraging ACO structures
• Driving away from FFS
Environment: The Reform Continuum
“We are ushering in the end of the FFS care system in
Massachusetts in favor of better care at lower cost.”
Governor Deval PatrickWhiteCloud Confidential and Privileged
Three Systems, Same Journey
WhiteCloud Confidential and Privileged
Medium, ACOLarge, integratingSmall, integrating
Volume Value
FFS Bundled Payments
MSSP
PCMH
ACO
Improve Inpatient Outcomes: Increase Quality / Reduce Cost
Population Health Management &
Physician Integration
Population Health Management &
Physician Integration
AF
CI
WhiteCloud Solutions
Referral volume & growthKeep patients in system for health
management
Keep patients in system for health
managementNI
WhiteCloud Confidential and Privileged
Volume Value
FFS Bundled Payments
MSSP
PCMH
ACO
Improve Inpatient Outcomes: Increase Quality / Reduce Cost AF
WhiteCloud Solutions
WhiteCloud Confidential and Privileged
An analytical application that provides a compass
to identify variation and drive to model standard
Transform this…. to this….
ALOS, Charges, QualityALOS, Charges, Quality
Provide information to all decision-making levels and across silos
Hospitals
SpecialistsNursing
Units
Physician Groups
Hospital Services
Executives
Administrators/ Medical Directors
Chiefs/Physicians
Care Teams
Acute Foundations
WhiteCloud Confidential and Privileged
Metrics*
• ALOS
• Excess Days
• Charge Analysis
• Mortality
• HACs
• PSIs
• Readmissions
• Nursing Quality
• Core Measures
• Patient Satisfaction
• Care Transition Measures
Points of Responsibility
• Hospital
• Nursing Unit
• Hospital Service
• Physician
• Specialty Groups
• DRG, DRG Group, DRG Triad
Acute Foundations
* Takes ~ 12 hours for data team to load administrative data.
WhiteCloud Confidential and Privileged
Discover
Model
Improve
Monitor
Acute Foundations
Live Demo WhiteCloud Confidential and Privileged
Impact 14 months after deployment:
� 36% improvement in Risk Adjusted Mortality Index
� 46% improvement in Complication Rate
� 5.74% increase in Perfect Care (53.7% decrease in Imperfect Care)
� 3.16% increase in HCAHPS “Always” responses
� Readmissions – 45 fewer readmissions in Cardiology, Substance Abuse and Sepsis; $726K avoided charges
� $101.6M Variation Identified in Top 10 DRGs
Acute Foundations Results
WhiteCloud Confidential and Privileged
Volume Value
FFS Bundled Payments
MSSP
PCMH
ACO
Improve Inpatient Outcomes: Increase Quality / Reduce Cost
Population Health Management &
Physician Integration
Population Health Management &
Physician Integration
AF
CI
WhiteCloud Solutions
WhiteCloud Confidential and Privileged
Better
Care
Better
Health
Lower
Cost
Clinical Integration Foundations
Clinical
Integration
Clinical
Integration
WhiteCloud Confidential and Privileged
WhiteCloud Analytics confidential and privileged 18
Triple Aim
• Better Health• Prevention & Screening
• Disease Management
• Better Care• Patient Safety
• Readmissions
• Clinical Quality
• Patient Satisfaction
• Lower Cost • Pharmacy
• Supply Chain
• Physician Productivity
Audience
• Physician Executives
• Medical Directors
• Chiefs
• Physicians
Clinical Integration Foundations
WhiteCloud Confidential and Privileged
Clinical Integration Foundations
Department
Director View
WhiteCloud Confidential and Privileged
Individual
Physician View
Clinical Integration Foundations
WhiteCloud Confidential and Privileged
Clinical Integration Foundations
WhiteCloud Confidential and Privileged
Clinical Integration Foundations
Patient
Detail
WhiteCloud Confidential and Privileged
Clinical Integration Foundations
Self
Reporting
WhiteCloud Confidential and Privileged
Supports reform and accountable care structures
PCMH, Disease Management
Clinical Integration, ACO, VBP MSSP – 33 metrics
Clinical Integration Foundations
WhiteCloud Confidential and Privileged
Volume Value
FFS Bundled Payments
MSSP
PCMH
ACO
Improve Inpatient Outcomes: Increase Quality / Reduce Cost
Population Health Management &
Physician Integration
Population Health Management &
Physician Integration
AF
CI
WhiteCloud Solutions
Referral volume & growthKeep patients in system for health
management
Keep patients in system for health
managementNI
WhiteCloud Confidential and Privileged
Transition from “the hospital” to
“the integrated health care delivery system”
Network Integrity Foundations
• Identify where and why service lines are losing business
• Improve patient/physician satisfaction while achieving a
healthier bottom line
• Facilitate care coordination and population health
management
WhiteCloud Confidential and Privileged
Charles Smith, MD | My Account | Log Out
Integrated Care Network
Home
Network Health
Utilization Gaps
Providers
Provider Groups
Providers
PI Plans
Service Line
Getting Started Guide
Utilization Gaps
Last 12 Months
$2.1B
Volume
$3.1B
Potential Volume
$148M
$95M
Direct Leakage
Indirect
Leakage
In the last 12 months, volume is increasing, and the gap as a percent of total volume is flat.
The top 34 physicians make up 51% of the gap ($100.4M)
The top 10 offices make up 51% of the gap ($120.9M)
The top 3 subspecialties make up 60% of the gap ($150.2M)
The top 2 regions make up 72% of the gap ($115.3M)
Alyson Erwin
Network Integrity Foundations
WhiteCloud Confidential and Privileged
Charles Smith, MD | My Account | Log Out
Integrated Care Network
Home
Network Health
Utilization Gaps
Providers
Provider Groups
Providers
PI Plans
Service Line
Getting Started Guide
Provider Groups
The providers might be using out of network specialists in these areas.The providers appear to be using hospital services at an appropriate
level.
Family Medicine Clinic
Family Medicine ClinicFull Utilization
Network Integrity Foundations
WhiteCloud Confidential and Privileged
Charles Smith, MD | My Account | Log Out
Integrated Care Network
Home
Network Health
Utilization Gaps
Providers
Provider Groups
Providers
PI Plans
Getting Started Guide
Providers
The providers might be using out of network specialists in these areas.The providers appear to be using hospital services at an appropriate
level.
Family Medicine Clinic
Julie Brown, MDFull Utilization
Julie Brown, MD
Network Integrity Foundations
WhiteCloud Confidential and Privileged
Charles Smith, MD | My Account | Log Out
Integrated Care Network
Home
Network Health
Utilization Gaps
Providers
Provider Groups
Providers
PI Plans
Service Line
Getting Started Guide
Total Utilization
$90M
$0
$60M
$30M
$120M
NetworkNonNetwork
Total charges: 85.1M
Network: 74.1M
Nonnetwork: 11.0M
+4.1%
+3.9%
1.5%
Overview
Events
Acquired Mountain View Tumor Institute
Add event
This increased volumes in oncology by about 30%, starting in
January.
More events (4)
A
Change
3 Months
AB
C
D
Jul Oct Jan JulApr Oct Jan
20092008 2010
E
Last 3 Months
Service Volume
Inpatient
Outpatient + Clinic$42.1M
$35.6M +0.4%
+1.4%
24 Month Trend Mar 2010
Change Last
3 Months
Service Mix
+0.9%Inpatient
44.2%
0.9%Outpatient + Clinic
55.8%
Mar 2010
Network Integrity Foundations
WhiteCloud Confidential and Privileged
Network Integrity Foundations
“Since this was deployed, we have found areas of improvement
around capacity and satisfaction issues. Long wait times and
customer service issues were negatively impacting our care
coordination efforts.”
$80M in identified services leaking from the system
$24M opportunity in the following areas:
– Outpatient imaging
– Cancer care services
– Surgical services
– Cardiovascular services
WhiteCloud Confidential and Privileged
Volume Value
FFS Bundled Payments
MSSP
PCMH
ACO
Improve Inpatient Outcomes: Increase Quality / Reduce Cost
Population Health Management &
Physician Integration
Population Health Management &
Physician Integration
AF
CI
WhiteCloud Solutions
Referral volume & growthKeep patients in system for health
management
Keep patients in system for health
managementNI
WhiteCloud Confidential and Privileged
Clinical Integration
Accountable Care
Profiling
Acute Foundations
High Risk Care
Commercial ACO
Analytics Roadmap
Network Integrity
“WhiteCloud applications answer questions you
haven’t thought of, not just those you have”
CMO, Top 10 U.S Hospital
PCMH
WhiteCloud Confidential and Privileged
Contact Info
Jane Cardoso
Healthcare Solutions Manager
jcardoso@whitecloudanalytics.com
For More Information:
www.whitecloudanalytics.com
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Appendix
ACOs in the United States