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Are You Overlooking the Power of Technology to Address ...
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Page 1 DEC 3RD DEC 4TH DEC 6TH DEC 7TH DEC 10TH DEC 19TH FEB 22ND MAR 8TH MAR 27TH MAR 29TH Healthcare's industrial delivery model and its underlying business model are on the precipice of major change. In 2017, mega-mergers involving systems with at least $1 billion in annual revenue more than doubled — from four in 2016 to ten. The trend has connued with addional deals of similar size and complexity in 2018. Intensifying this changing market context is vercal integraon at an unprecedented pace, along with non-tradional market entrants such as the Amazon, Berkshire Hathaway and JPMorgan Chase partnership — all of which have the potenal to reshape the landscape and compeon. As these trends accelerate, providers may find them daunng. Yet, they also hold great promise to help solve many of healthcare’s most persistent challenges. One thing is certain: providers' informacs and technology plaorm is an essenal tool to advance market posion and move the needle on care cost, quality, outcomes and experience. Are You Overlooking the Power of Technology to Address Your Mission- Crical Imperaves? Authors: Dan Coate, Jody Cervenak and Shawna Schueller DEC JAN FEB MAR *Merger talks have since halted. CVS Health Advocate Health Care Optum Catholic Health Iniaves Ascension Humana Mercy Health Aetna Aurora Health Care DaVita Medical Group Dignity Health Providence St. Joseph Health* Kindred Healthcare Bon Secours Health System Cigna Jefferson Health Walmart Express Scripts Einstein Health Network Humana RECENT MEGA-MERGER ANNOUNCEMENTS HORIZONTAL AND VERTICAL INTEGRATION
Transcript of Are You Overlooking the Power of Technology to Address ...
Page 1
DEC 3RD DEC 4TH DEC 6TH DEC 7TH DEC 10TH DEC 19TH FEB 22ND MAR 8TH MAR 27TH MAR 29TH
Healthcare's industrial delivery model and its underlying business model are on the precipice of major change. In 2017, mega-mergers involving systems with at least $1 billion in annual revenue more than doubled — from four in 2016 to ten. The trend has continued with additional deals of similar size and complexity in 2018. Intensifying this changing market context is vertical integration at an unprecedented pace, along with non-traditional market entrants such as the Amazon, Berkshire Hathaway and JPMorgan Chase partnership — all of which have the potential to reshape the landscape and competition.
As these trends accelerate, providers may find them daunting. Yet, they also hold great promise to help solve many of healthcare’s most persistent challenges.
One thing is certain: providers' informatics and technology platform is an essential tool to advance market position and move the needle on care cost, quality, outcomes and experience.
Are You Overlooking the Power of Technology to Address Your Mission- Critical Imperatives? Authors: Dan Coate, Jody Cervenak and Shawna Schueller
DEC JAN FEB MAR
CVS Health
Aetna Aurora Health Care
Page 2
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Providers are facing new challenges, and the existing challenges are intensifying with:
Providers must rethink how to leverage informatics and technology to answer the pivotal strategic questions their organizations face:
Redefining IT Value to Address Pivotal Strategic Questions in Today’s Changing Landscape
Doing more of the same will not drive the necessary improvements in cost, quality, outcomes and experience. Instead, it is vital to use the power of data, analytics and informatics across all four critical strategic imperatives.
Market pressures driven by consolidation, alliances and new entrants that have the potential to reshape the nature of competition.
Cost pressures related to reduced reimbursements and rate pressure, value-based care payments and incentives, direct-to-employer contracts and competition from low-cost alternatives.
Legacy care and operational models that are not well-suited to transition towards value-based care and have resulted in unforeseen levels of physician burnout.
Increased competition from disruptive, technology-enabled competitors fueled by growing consumer expectations and demand for and evidence of the efficacy of digital health for preventive health, chronic care management and digital/virtual care delivery.
How do we
in the market?
pressures?
FINANCIAL
CARE MODEL
and effectiveness?
Page 3
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Four Levers to Harness the Power of Your Technology Platform Create a bold vision for how informatics and technology can be a game changer to your organization’s success and advancement of the mission. Use these four levers to do so.
Leverage technology to win in the market.
Use technology to address growing financial pressures.
Create the underpinning of the next generation care model to drive outcomes and value.
Capitalize on technology to improve operational performance and effectiveness.
Page 4
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Ensuring effective M&A and partnership planning and integration design to best
position the health system to accelerate synergies, scale and
efficiencies;
Extending the EHR platform to affiliates and regional partners to improve care network design and management through improved
connectivity and information sharing;
Creating a pragmatic digital health strategy to increase interactions and information exchange among caregivers
and patients;
modalities of care, self-service, service center planning
and design, and provider and customer relationship
management optimization; and
care;
and game changer to attract new patient populations, increase
access, find new revenue streams and reduce costs.
Leverage technology to win in the market.
Informatics, analytics and technology can materially extend reach and drive market differentiation. They can be leveraged for strategic growth, competitive position, differentiation, innovation and scale by:
Page 5
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
University of Mississippi Medical Center’s telehealth program has resulted in 500,000 encounters since 2003 with 200+ available specialists across 35 specialties and 200+ locations and extending the reach to Mississippi’s 82 counties, 53 of which are more than a 40-minute drive to specialty care.1
At Kaiser Permanente 52 percent of all patient interactions are now through digital health services, ranging from online physician chat to online drug refills, and daily digital transactions jumped 31 percent from 2016 to 2017. Additionally, they created market differentiation through on-demand asynchronous text- based chat launched November 2016 in Colorado and Washington in January 2018. In addition to market differentiation and patient satisfaction advantages, Kaiser Permanente has calculated chats to be 48 percent the cost of a nurse call, 10 percent of competing video eVisits and 2 percent of an ER visit. 2, 3
The Mayo Clinic Care Network uses technology and physician collaboration to deliver a full spectrum of medical expertise to patients and communities across the country and throughout the world, growing its membership to include 42 members covering 26 states and China, Mexico, the Philippines, Singapore and the United Arab Emirates.4
INDUSTRY EXAMPLES
University of Mississippi Medical Center’s telehealth program has resulted in
At Kaiser Permanente
physician chat to drug refills
%
Page 6
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Meaningful financial improvements can be achieved and sustained through informatics and technology. Technology can and should be leveraged to identify, accelerate and realize sustainable cost reductions by:
Accelerating M&A and partnership synergies and
efficiencies through IT integration, standardization and
interoperability;
Improving IT performance and cost efficiencies through
effective governance, portfolio and demand management, and
application and IT services management;
Enabling improvements in operational expense and clinical cost management and revenue
performance with revenue cycle and ERP technology and
operating models.
to achieve and sustain enterprise margin improvement and IT value
realization;
Page 7
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Advocate Health Care leveraged voice- to-text technology to document findings in the electronic health record without keyboard entry or telephone transcription, reducing transcription costs 50 percent in the first year, as well as improving physician satisfaction.5
Novant Health realized over $100 million in savings by optimizing their system, aligning revenue cycle and maximizing the use of analytics.6
Henry Ford Health System realized a $200 million return on investment on their clinical and revenue transformation program. This was through the development of ongoing clinical and revenue cycle-improvement playbooks and focusing on clinical efficiencies, revenue capture and cost optimization.6
Memorial Hermann, by implementing a ventilator acquired pneumonia bundle supported by clinical decision support, reduced preventable events related to mechanical ventilation and estimated that more than 100 lives were saved and cost avoidance of $48 million.7
INDUSTRY EXAMPLES Advocate Health Care
Memorial Hermann,
BY IMPLEMENTING A
reducing transcription costs
in the first year
S U P P O R T ED BY C L I N I C A L D EC I S I O N S U P P O R T, reduced preventable events related to mechanical ventilation
Page 8
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Create the underpinning of the next generation care model to drive outcomes and value.
Advancing population health management through effective
cohort segmentation and management and streamlined patient management and care
coordination;
capabilities to improve cost of care, quality and safety;
Using virtual care to extend and evolve the care management
model across primary care, chronic care, inpatient and post-
acute models;
Leveraging clinical variation management and clinical decision support to guide
decision making and optimize the care pathways portfolio real-time
for the entire system; and
Elevating the provider experience and enhancing
workflow, documentation and communication with patients
and other providers and ensuring top-of-licensure work;
Operationalizing innovation to integrate advances in patient
engagement and behavior platforms, digital therapy, robotics
and personalized medicine.
Health systems can leverage informatics and technology in service of the next generation of care models by:
Page 9
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
and lowering the
30-DAY readmission rate by
F O R T H E O -PAT PAT I EN T P O P U L AT I O N .
Geisinger Health System’s ProvenHealth Navigator model uses electronic devices and telemonitoring protocols for high-risk patients with certain diseases to support timely communication between patients and providers. Results included 18.2 percent reduction in risk-adjusted acute readmissions and 7.1 percent reduction in the total cost of care.8,9
Intermountain Healthcare used evidence-based protocols to reduce inappropriate induction from 28 percent to 2 percent, resulting in a $50 million annual savings and creating capacity for 1,500 additional newborns per year without the addition of beds or nurses.10
Parkland Health Hospital System used care at home to transform its outpatient parenteral antibiotic therapy (O-PAT) to self-administered care at home, saving $40 million, avoiding 27,000+ inpatient days and lowering the 30-day readmission rate by 47 percent for the O-PAT patient population.11
Nebraska Medicine leveraged its EHR to improve care outcomes and value: saving 18 women from dying of breast cancer (cost avoidance: $7.7 million), preventing 11 cases of pneumonia and five cases of invasive pneumococcal disease (cost avoidance: $1.1 million), and 39 lives at less risk from colon cancer death (cost avoidance: $26.5 million).12
INDUSTRY EXAMPLES Intermountain Healthcare
Parkland Health Hospital System
used evidence-based protocols to reduce inappropriate induction from
used care at home to transform its outpatient parenteral antibiotic therapy (O-PAT) to
self-administed care at home,
annual savings
creating capacity forR E S U LT I N G I N A
additional newborns per year without the addition of beds or nurses.
avoiding 27,000+ inpatient days
Page 10
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Technology is foundational to achieving high performance and operational effectiveness. Health systems can improve their operational performance and effectiveness by:
Evolving IT performance to a next generation IT model,
where success is measured by how the organization achieves
efficiencies, higher performance and measurable value;
Organizing informatics programs to achieve system-
wide consistency in care delivery and documentation, quality and
efficiency improvements and cost of care reductions;
Preparing organizations to perform at their highest levels
through effective change management and operational
readiness strategies for EHR and other deployments;
Laying a solid data governance and analytics structure to create
confidence in the data and catalyze a culture of data-driven
performance measurement, monitoring and continuous
improvement; and
optimization to improve quality, outcomes and the experience;
Ensuring appropriate cybersecurity and risk
management to protect information assets.
Capitalize on technology to improve operational performance and effectiveness.
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Johns Hopkins’ medical intensive care unit created an early rehabilitation program with dedicated physical and occupational therapists. Average length of stay decreased 23 percent, from 6.5 days to 5 days, resulting in a net cost savings for the hospital of ~$818,000 per year after the investment.13
Cleveland Clinic created an automated early warning system to address high- acuity patients. Some facilities reduced the number of patient hours at high acuity by one-third to one-half, and in most cases, patients at risk were assessed 50-70 percent sooner.14
Geisinger Health System used predictive analytics to tackle capacity management, reducing the in-observation patient population by 20 percent, decreasing LOS for observation patients to 16 hours, creating a new ED at one hospital and expanding bed capacity at another.15
INDUSTRY EXAMPLES Johns Hopkins’
Medical Intensive Care Unit created an early rehabilitation program with dedicated physical and occupational therapists.
used predicitive analytics to tackle capacity management,
AVERAGE LENGTH OF STAY DECREASED
THE TIME IS NOW — leverage the sizable investments your organization has made
and use informatics and technology as a game changer.
DAYS TO
Page 11
R E S U LT I N G I N A NET COST SAVINGS for the hospital of per year after the investment.
hours,
creating a new ED at one hospital
decreasing LOS for observation patients to
Page 12
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Sources 1 Adcock, M. (2018, March). Innovative Uses of Telehealth. Presented at HIMSS18, Las Vegas, NV.
2 Melmed, A. (2018, March). Chat with a Doctor: On-Demand, Asynchronous Physician Advice. Presented at HIMSS18, Las Vegas, NV.
3 (2017, February). Daily Digital Transactions Jump 31% for Kaiser Permanente. Digital Commerce 360.
4 (2018, April). https://www.mayoclinic.org/about-mayo-clinic/care-network.
5 (2018, March). Leveraging Health IT to Achieve Patient, Physician and Cost Benefits. Healthcare Information and Management Systems Society.
6 Allard, D., Neaves, R., Patefield, A. and Patterson. G. (2018, March). Enterprise-Wide Value Realization through IT: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
7 Hargrave, T., Logue, A., McInnis-Cole, T., Thomas, J. (2018, March). Standardizing Use of Clinical Best Practice with Information and Technology: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
8 Maeng, D., Khan, N., Tomcavage, J., Graf, T., Davis, D., Steele, G. (2015). Aging & Health Reduced Acute Inpatient Care Was Largest Savings Component Of Geisinger Health System’s Patient-Centered Medical Home. Health Affairs, 34(4), 636-644. doi: 10.1377/hlthaff.2014.0855.
9 Tomcavage, J., & Graf, T., MD. (2013). ProvenHealth Navigation at Geisinger Health System. HPOE. Retrieved March 20, 2018, from http://www.hpoe.org/resources/case-studies/1297.
10 James, B.C., & Savitz, L.A. (2011). How Intermountain Trimmed Health Care Costs Through Robust Quality Improvement Efforts. Health Affairs, 30(6), 1185-1191. doi:10.1377/hlthaff.2011.0358. Retrieved March 20, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/21596758.
11 Castro, G.J., Humphry, J., Kull, M. and Longo, J. (2018, March). Innovative Use of Technology in the Home to Improve Diagnosis and Care: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
12 Cloyed, D., Rohrbach, R., Thomas, M. and Winterboer, T. (2018, March). Improving Quality Outcomes in a Risk-Based World: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
13 Lord, R.K., AB, Mayhew, C.R., BS, Korupolu, R., MBBS, MS, Mantheiy, E.C., BA, Friedman, M.A., PT, MBA, Palmer, J.B., MD, & Needham, D.M., FCA, MD, PhD. (2018). ICU Early Physical Rehabilitation Programs: Financial Modeling of Cost Savings. Critical Care Medicine, 41(3), 717-724. Retrieved March 20, 2018, from https://journals.lww.com/ccmjournal/ Abstract/2013/03000/ICU_Early_Physical_Rehabilitation_Programs__.3.aspx.
14 Basit, M., Burns, K., Fink, S. and Willett D. (2018, March). Using Data for Evidence Based Decision-Making: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
15 Reich, E. and Yin, S. (2018, March). Improving Hospital Capacity Management Through Monte-Carlo Simulation. Presented at HIMSS18, Las Vegas, NV.
Page 13
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
About the Authors
Dan Coate Director, I&T Practice 954.232.7422 [email protected]
Dan Coate is a Director with The Chartis Group and a Practice Lead for Informatics and Technology. Mr. Coate has more than 25 years of experience in healthcare strategy, performance improvement and information technology. He advises clients on IT strategy and special studies and leads and manages large-scale process and technology programs. He has served large integrated delivery systems, academic health systems and national payors. Mr. Coate co-founded Aspen Advisors, a top healthcare IT advisory services firm that joined The Chartis Group in 2014.
Jody Cervenak Director, I&T Practice 412.370.0995 [email protected]
Jody Cervenak is a Director with The Chartis Group and a Practice Lead for Informatics and Technology. She has over 20 years of health system information technology leadership and consulting experience supporting academic medical centers, schools of medicine, integrated health systems, hospitals, post-acute and managed care organizations. Ms. Cervenak has led consulting engagements in the areas of integrated strategic planning, digital health strategy supporting operational and clinical process transformation, enterprise EHR and revenue cycle system implementation planning and value driven implementation.
Shawna Schueller I&T Practice Manager 612.850.0825 [email protected]
Shawna Schueller is a Practice Manager for The Chartis Group. She is a leader in the Informatics and Technology practice area focused on helping healthcare organizations leverage the power of information and technology to advance market position and move the needle on care cost, quality, outcomes and experience. Ms. Schueller is a HIMSS Fellow and has been honored nationally with both the HIMSS Chapter Leader of the Year and Advocacy Liaison Roundtable Advocate of the Year awards.
Atlanta | Boston | Chicago | Minneapolis | New York | San Francisco
© 2018 The Chartis Group, LLC. All rights reserved. This content draws on the research and experience of Chartis consultants and other sources. It is for general information purposes only and should not be used as a substitute for consultation with professional advisors.
About The Chartis Group
DEC 3RD DEC 4TH DEC 6TH DEC 7TH DEC 10TH DEC 19TH FEB 22ND MAR 8TH MAR 27TH MAR 29TH
Healthcare's industrial delivery model and its underlying business model are on the precipice of major change. In 2017, mega-mergers involving systems with at least $1 billion in annual revenue more than doubled — from four in 2016 to ten. The trend has continued with additional deals of similar size and complexity in 2018. Intensifying this changing market context is vertical integration at an unprecedented pace, along with non-traditional market entrants such as the Amazon, Berkshire Hathaway and JPMorgan Chase partnership — all of which have the potential to reshape the landscape and competition.
As these trends accelerate, providers may find them daunting. Yet, they also hold great promise to help solve many of healthcare’s most persistent challenges.
One thing is certain: providers' informatics and technology platform is an essential tool to advance market position and move the needle on care cost, quality, outcomes and experience.
Are You Overlooking the Power of Technology to Address Your Mission- Critical Imperatives? Authors: Dan Coate, Jody Cervenak and Shawna Schueller
DEC JAN FEB MAR
CVS Health
Aetna Aurora Health Care
Page 2
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Providers are facing new challenges, and the existing challenges are intensifying with:
Providers must rethink how to leverage informatics and technology to answer the pivotal strategic questions their organizations face:
Redefining IT Value to Address Pivotal Strategic Questions in Today’s Changing Landscape
Doing more of the same will not drive the necessary improvements in cost, quality, outcomes and experience. Instead, it is vital to use the power of data, analytics and informatics across all four critical strategic imperatives.
Market pressures driven by consolidation, alliances and new entrants that have the potential to reshape the nature of competition.
Cost pressures related to reduced reimbursements and rate pressure, value-based care payments and incentives, direct-to-employer contracts and competition from low-cost alternatives.
Legacy care and operational models that are not well-suited to transition towards value-based care and have resulted in unforeseen levels of physician burnout.
Increased competition from disruptive, technology-enabled competitors fueled by growing consumer expectations and demand for and evidence of the efficacy of digital health for preventive health, chronic care management and digital/virtual care delivery.
How do we
in the market?
pressures?
FINANCIAL
CARE MODEL
and effectiveness?
Page 3
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Four Levers to Harness the Power of Your Technology Platform Create a bold vision for how informatics and technology can be a game changer to your organization’s success and advancement of the mission. Use these four levers to do so.
Leverage technology to win in the market.
Use technology to address growing financial pressures.
Create the underpinning of the next generation care model to drive outcomes and value.
Capitalize on technology to improve operational performance and effectiveness.
Page 4
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Ensuring effective M&A and partnership planning and integration design to best
position the health system to accelerate synergies, scale and
efficiencies;
Extending the EHR platform to affiliates and regional partners to improve care network design and management through improved
connectivity and information sharing;
Creating a pragmatic digital health strategy to increase interactions and information exchange among caregivers
and patients;
modalities of care, self-service, service center planning
and design, and provider and customer relationship
management optimization; and
care;
and game changer to attract new patient populations, increase
access, find new revenue streams and reduce costs.
Leverage technology to win in the market.
Informatics, analytics and technology can materially extend reach and drive market differentiation. They can be leveraged for strategic growth, competitive position, differentiation, innovation and scale by:
Page 5
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
University of Mississippi Medical Center’s telehealth program has resulted in 500,000 encounters since 2003 with 200+ available specialists across 35 specialties and 200+ locations and extending the reach to Mississippi’s 82 counties, 53 of which are more than a 40-minute drive to specialty care.1
At Kaiser Permanente 52 percent of all patient interactions are now through digital health services, ranging from online physician chat to online drug refills, and daily digital transactions jumped 31 percent from 2016 to 2017. Additionally, they created market differentiation through on-demand asynchronous text- based chat launched November 2016 in Colorado and Washington in January 2018. In addition to market differentiation and patient satisfaction advantages, Kaiser Permanente has calculated chats to be 48 percent the cost of a nurse call, 10 percent of competing video eVisits and 2 percent of an ER visit. 2, 3
The Mayo Clinic Care Network uses technology and physician collaboration to deliver a full spectrum of medical expertise to patients and communities across the country and throughout the world, growing its membership to include 42 members covering 26 states and China, Mexico, the Philippines, Singapore and the United Arab Emirates.4
INDUSTRY EXAMPLES
University of Mississippi Medical Center’s telehealth program has resulted in
At Kaiser Permanente
physician chat to drug refills
%
Page 6
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Meaningful financial improvements can be achieved and sustained through informatics and technology. Technology can and should be leveraged to identify, accelerate and realize sustainable cost reductions by:
Accelerating M&A and partnership synergies and
efficiencies through IT integration, standardization and
interoperability;
Improving IT performance and cost efficiencies through
effective governance, portfolio and demand management, and
application and IT services management;
Enabling improvements in operational expense and clinical cost management and revenue
performance with revenue cycle and ERP technology and
operating models.
to achieve and sustain enterprise margin improvement and IT value
realization;
Page 7
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Advocate Health Care leveraged voice- to-text technology to document findings in the electronic health record without keyboard entry or telephone transcription, reducing transcription costs 50 percent in the first year, as well as improving physician satisfaction.5
Novant Health realized over $100 million in savings by optimizing their system, aligning revenue cycle and maximizing the use of analytics.6
Henry Ford Health System realized a $200 million return on investment on their clinical and revenue transformation program. This was through the development of ongoing clinical and revenue cycle-improvement playbooks and focusing on clinical efficiencies, revenue capture and cost optimization.6
Memorial Hermann, by implementing a ventilator acquired pneumonia bundle supported by clinical decision support, reduced preventable events related to mechanical ventilation and estimated that more than 100 lives were saved and cost avoidance of $48 million.7
INDUSTRY EXAMPLES Advocate Health Care
Memorial Hermann,
BY IMPLEMENTING A
reducing transcription costs
in the first year
S U P P O R T ED BY C L I N I C A L D EC I S I O N S U P P O R T, reduced preventable events related to mechanical ventilation
Page 8
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Create the underpinning of the next generation care model to drive outcomes and value.
Advancing population health management through effective
cohort segmentation and management and streamlined patient management and care
coordination;
capabilities to improve cost of care, quality and safety;
Using virtual care to extend and evolve the care management
model across primary care, chronic care, inpatient and post-
acute models;
Leveraging clinical variation management and clinical decision support to guide
decision making and optimize the care pathways portfolio real-time
for the entire system; and
Elevating the provider experience and enhancing
workflow, documentation and communication with patients
and other providers and ensuring top-of-licensure work;
Operationalizing innovation to integrate advances in patient
engagement and behavior platforms, digital therapy, robotics
and personalized medicine.
Health systems can leverage informatics and technology in service of the next generation of care models by:
Page 9
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
and lowering the
30-DAY readmission rate by
F O R T H E O -PAT PAT I EN T P O P U L AT I O N .
Geisinger Health System’s ProvenHealth Navigator model uses electronic devices and telemonitoring protocols for high-risk patients with certain diseases to support timely communication between patients and providers. Results included 18.2 percent reduction in risk-adjusted acute readmissions and 7.1 percent reduction in the total cost of care.8,9
Intermountain Healthcare used evidence-based protocols to reduce inappropriate induction from 28 percent to 2 percent, resulting in a $50 million annual savings and creating capacity for 1,500 additional newborns per year without the addition of beds or nurses.10
Parkland Health Hospital System used care at home to transform its outpatient parenteral antibiotic therapy (O-PAT) to self-administered care at home, saving $40 million, avoiding 27,000+ inpatient days and lowering the 30-day readmission rate by 47 percent for the O-PAT patient population.11
Nebraska Medicine leveraged its EHR to improve care outcomes and value: saving 18 women from dying of breast cancer (cost avoidance: $7.7 million), preventing 11 cases of pneumonia and five cases of invasive pneumococcal disease (cost avoidance: $1.1 million), and 39 lives at less risk from colon cancer death (cost avoidance: $26.5 million).12
INDUSTRY EXAMPLES Intermountain Healthcare
Parkland Health Hospital System
used evidence-based protocols to reduce inappropriate induction from
used care at home to transform its outpatient parenteral antibiotic therapy (O-PAT) to
self-administed care at home,
annual savings
creating capacity forR E S U LT I N G I N A
additional newborns per year without the addition of beds or nurses.
avoiding 27,000+ inpatient days
Page 10
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Technology is foundational to achieving high performance and operational effectiveness. Health systems can improve their operational performance and effectiveness by:
Evolving IT performance to a next generation IT model,
where success is measured by how the organization achieves
efficiencies, higher performance and measurable value;
Organizing informatics programs to achieve system-
wide consistency in care delivery and documentation, quality and
efficiency improvements and cost of care reductions;
Preparing organizations to perform at their highest levels
through effective change management and operational
readiness strategies for EHR and other deployments;
Laying a solid data governance and analytics structure to create
confidence in the data and catalyze a culture of data-driven
performance measurement, monitoring and continuous
improvement; and
optimization to improve quality, outcomes and the experience;
Ensuring appropriate cybersecurity and risk
management to protect information assets.
Capitalize on technology to improve operational performance and effectiveness.
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Johns Hopkins’ medical intensive care unit created an early rehabilitation program with dedicated physical and occupational therapists. Average length of stay decreased 23 percent, from 6.5 days to 5 days, resulting in a net cost savings for the hospital of ~$818,000 per year after the investment.13
Cleveland Clinic created an automated early warning system to address high- acuity patients. Some facilities reduced the number of patient hours at high acuity by one-third to one-half, and in most cases, patients at risk were assessed 50-70 percent sooner.14
Geisinger Health System used predictive analytics to tackle capacity management, reducing the in-observation patient population by 20 percent, decreasing LOS for observation patients to 16 hours, creating a new ED at one hospital and expanding bed capacity at another.15
INDUSTRY EXAMPLES Johns Hopkins’
Medical Intensive Care Unit created an early rehabilitation program with dedicated physical and occupational therapists.
used predicitive analytics to tackle capacity management,
AVERAGE LENGTH OF STAY DECREASED
THE TIME IS NOW — leverage the sizable investments your organization has made
and use informatics and technology as a game changer.
DAYS TO
Page 11
R E S U LT I N G I N A NET COST SAVINGS for the hospital of per year after the investment.
hours,
creating a new ED at one hospital
decreasing LOS for observation patients to
Page 12
Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
Sources 1 Adcock, M. (2018, March). Innovative Uses of Telehealth. Presented at HIMSS18, Las Vegas, NV.
2 Melmed, A. (2018, March). Chat with a Doctor: On-Demand, Asynchronous Physician Advice. Presented at HIMSS18, Las Vegas, NV.
3 (2017, February). Daily Digital Transactions Jump 31% for Kaiser Permanente. Digital Commerce 360.
4 (2018, April). https://www.mayoclinic.org/about-mayo-clinic/care-network.
5 (2018, March). Leveraging Health IT to Achieve Patient, Physician and Cost Benefits. Healthcare Information and Management Systems Society.
6 Allard, D., Neaves, R., Patefield, A. and Patterson. G. (2018, March). Enterprise-Wide Value Realization through IT: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
7 Hargrave, T., Logue, A., McInnis-Cole, T., Thomas, J. (2018, March). Standardizing Use of Clinical Best Practice with Information and Technology: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
8 Maeng, D., Khan, N., Tomcavage, J., Graf, T., Davis, D., Steele, G. (2015). Aging & Health Reduced Acute Inpatient Care Was Largest Savings Component Of Geisinger Health System’s Patient-Centered Medical Home. Health Affairs, 34(4), 636-644. doi: 10.1377/hlthaff.2014.0855.
9 Tomcavage, J., & Graf, T., MD. (2013). ProvenHealth Navigation at Geisinger Health System. HPOE. Retrieved March 20, 2018, from http://www.hpoe.org/resources/case-studies/1297.
10 James, B.C., & Savitz, L.A. (2011). How Intermountain Trimmed Health Care Costs Through Robust Quality Improvement Efforts. Health Affairs, 30(6), 1185-1191. doi:10.1377/hlthaff.2011.0358. Retrieved March 20, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/21596758.
11 Castro, G.J., Humphry, J., Kull, M. and Longo, J. (2018, March). Innovative Use of Technology in the Home to Improve Diagnosis and Care: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
12 Cloyed, D., Rohrbach, R., Thomas, M. and Winterboer, T. (2018, March). Improving Quality Outcomes in a Risk-Based World: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
13 Lord, R.K., AB, Mayhew, C.R., BS, Korupolu, R., MBBS, MS, Mantheiy, E.C., BA, Friedman, M.A., PT, MBA, Palmer, J.B., MD, & Needham, D.M., FCA, MD, PhD. (2018). ICU Early Physical Rehabilitation Programs: Financial Modeling of Cost Savings. Critical Care Medicine, 41(3), 717-724. Retrieved March 20, 2018, from https://journals.lww.com/ccmjournal/ Abstract/2013/03000/ICU_Early_Physical_Rehabilitation_Programs__.3.aspx.
14 Basit, M., Burns, K., Fink, S. and Willett D. (2018, March). Using Data for Evidence Based Decision-Making: A Davies Story. Presented at HIMSS18, Las Vegas, NV.
15 Reich, E. and Yin, S. (2018, March). Improving Hospital Capacity Management Through Monte-Carlo Simulation. Presented at HIMSS18, Las Vegas, NV.
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Are You Overlooking the Power of Technology to Address Your Mission-Critical Imperatives?
About the Authors
Dan Coate Director, I&T Practice 954.232.7422 [email protected]
Dan Coate is a Director with The Chartis Group and a Practice Lead for Informatics and Technology. Mr. Coate has more than 25 years of experience in healthcare strategy, performance improvement and information technology. He advises clients on IT strategy and special studies and leads and manages large-scale process and technology programs. He has served large integrated delivery systems, academic health systems and national payors. Mr. Coate co-founded Aspen Advisors, a top healthcare IT advisory services firm that joined The Chartis Group in 2014.
Jody Cervenak Director, I&T Practice 412.370.0995 [email protected]
Jody Cervenak is a Director with The Chartis Group and a Practice Lead for Informatics and Technology. She has over 20 years of health system information technology leadership and consulting experience supporting academic medical centers, schools of medicine, integrated health systems, hospitals, post-acute and managed care organizations. Ms. Cervenak has led consulting engagements in the areas of integrated strategic planning, digital health strategy supporting operational and clinical process transformation, enterprise EHR and revenue cycle system implementation planning and value driven implementation.
Shawna Schueller I&T Practice Manager 612.850.0825 [email protected]
Shawna Schueller is a Practice Manager for The Chartis Group. She is a leader in the Informatics and Technology practice area focused on helping healthcare organizations leverage the power of information and technology to advance market position and move the needle on care cost, quality, outcomes and experience. Ms. Schueller is a HIMSS Fellow and has been honored nationally with both the HIMSS Chapter Leader of the Year and Advocacy Liaison Roundtable Advocate of the Year awards.
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© 2018 The Chartis Group, LLC. All rights reserved. This content draws on the research and experience of Chartis consultants and other sources. It is for general information purposes only and should not be used as a substitute for consultation with professional advisors.
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