Data Driven Improvement

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© 2015 Health Catalyst www.healthcatalyst.com Proprietary and Confidential Proprietary and Confidential © 2015 Health Catalyst www.healthcatalyst.com November 5, 2016 Data Driven Improvement Abbott Northwestern Innovation Summit

Transcript of Data Driven Improvement

Page 1: Data Driven Improvement

© 2015 Health Catalyst

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© 2015 Health Catalyst

www.healthcatalyst.com

November 5, 2016

Data Driven ImprovementAbbott Northwestern Innovation Summit

Page 2: Data Driven Improvement

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We believe that with the right

evidence, analytics, and methods,

providers can transform healthcare.

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Components of a Data Driven Organization

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• Enterprise Data Warehouse

• Actionable Metrics

• Predictive Models

• Checklists

• Protocols

• Interventions

• Adaptive Leadership

• Governance

• Improvement Teams

• Clinical Outcomes

• Cost Outcomes

• Experience Outcomes

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Transitioning to Value-based Payments

• Tracking quality measures and

improving performance

• Need analytics to measure

cost and quality for each

patient population so

providers can take action

• If a provider or facility is not

meeting quality standards we

need ability to pinpoint the

cause

• Reducing care variation

• Eliminating waste

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Measure Name Hospital A Hospital B Hospital C Benchmark $ at-risk*

Communication with nurses 48.0 84.0 92.0 86.68

Communication with doctors 80.0 91.0 84.0 88.51

Responsiveness of hospital staff 51.0 86.0 94.0 80.35

Pain management 56.0 91.0 93.0 78.46

Communication about meds 52.0 81.0 92.0 73.66

Overall rating of hospital 71.0 89.0 56.0 84.58

3-Item Care Transitions Measure 80.0 85.0 68.0 62.44

PSI-90 Composite 0.76 0.92 1.06 0.40

CLABSI 0.77 N/A N/A 0.00

CAUTI 0.57 N/A N/A 0.00

SSI Colon 2.36 N/A N/A 0.00

SSI Hysterectomy N/A N/A N/A 0.00

C.Diff 0.84 2.91 1.09 0.00

MRSA 0.00 N/A N/A 0.00

PC-01 Elective Delivery 0.00 0.00 30.43 0.00

PSI-90 Composite 1.03 0.92 1.07 0.81

CLABSI 0.67 N/A N/A 0.50

CAUTI 0.67 0.00 1.40 1.07

SSI Colon 1.47 N/A N/A 0.95

SSI Hysterectomy 1.98 N/A N/A 0.95

C.Diff 0.87 1.10 0.79 TBD

MRSA 0.19 N/A N/A TBD

30-Day AMI Readmissions 0.74 0.00 0.52 1.00

30-Day HF Readmissions 0.86 0.61 0.73 1.00

30-Day PN Readmissions 1.21 1.41 0.57 1.00

30-Day COPD Readmissions 0.97 0.94 0.74 1.00

30-Day THA/TKA Readmissions 0.80 0.47 1.33 1.00

30-Day CABG Readmissions 0.53 N/A N/A 1.00

$23,725,072

Medicare Pay-for-Performance Scorecard FY 2018

Val

ue

Bas

ed

Pu

rch

asin

g

$8,908,000

HA

C R

edu

ctio

n P

rogr

am

$4,454,268

Rea

dm

issi

on

s

Red

uct

ion

Pro

gram

$10,362,804

Total

*Not actual dollars, scorecard as example only

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Partnership with Health Catalyst

• Accelerated outcomes

improvement

• Access to catalog of Health

Catalyst technology and clinical

content

• Team of analytical professionals

• What drives us:

Healthcare Analytic Adoption Model

Allina 2008

Allina 2010

Allina 2014

Allina +

Catalyst

Working with teams across Allina

Health to turn data into information

and information into action

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Practical Examples

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Reducing Care Variation

Outlier Reduction

Reduce outlier practices in a smaller number of facilities or providers

Provides more immediate results, but diminishing returns over time as outliers are reduced

Shifting The Mean

Requires a change in practice

amongst the majority

Continuous focus on improvement:

takes longer to achieve but drives

long term results

Opportunity Cases

Source: Advisory Board -

https://www.advisory.com/-/media/Advisory-

com/Technology/Crimson-Continuum-of-

Care/Success-

Pages/CCC_CareVariation_CG_011615.pdf

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Improving Patient Care

Improving Spine Care Outcomes by Decreasing Care Variation

Low back pain is a common and expensive problem. Allina recognized their spine care could be improved. Through the establishment of a spine care governance program, the development of standard care guidelines, and use of analytic dashboards to drive behavior change, Allina dramatically improved the care processes and outcomes for patients receiving spine care.

Key results of the effort to date include:

• 16% reduction in LOS, decreasing from an average of 4.26 days to 3.6 days

• 3.6% reduction in post-op complications

• $2.7M projected savings achieved through supplies standardization

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Improving Patient Care

Bleeding Risk Assessment Decreases Complications and Costs

Bleeding is common in PCI and increases length of stay (LOS), costs and mortality. The literature has shown that the use of closure devices decreases bleeding complications in patients at high risk for bleeding.

Key results of the effort to date include:

• Closure device usage for high risk patients increased from 39% to 78%

• Length of stay for high risk patients with closure devices decreased from 3.81 to 2.42 days

• Complication rate decreased from 23.3% to 18.0%

• $1.8M cost savings since implementation

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Drug Cost Opportunity in Total Knee Replacements (345k)

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Selections: July 2015 – June 2016, Inpatients only, Outliers removed, Case

min 10, Knee Replacemnt HARs

Reducing average (avg) drug costs for those using Ropivacaine to $500 through the elimination of pain pump

use creates opportunity equal to ($2,800 - $500) * 150 = $345,000.

Provider VolumeSeverity 1&2 %

Severity 3&4 %

Performance to Geometric Mean

Length of Stay (LOS)Avg Drug

Costs

PPR A/E Ratio (Excess)

PPC A/E Ratio (Excess)

A 17 100% 0% 97% $3,038 0.00 (-0.3) 0.00 (-1.1)

B 97 96% 4% 90% $2,832 1.03 ( 0.1) 0.29 (-5.0)

C 36 97% 3% 87% $2,711 0.00 (-0.7) 0.00 (-2.5)

D 172 92% 8% 93% $500 0.84 (-0.6) 0.54 (-5.8)

E 104 91% 9% 94% $493 0.86 (-0.3) 0.36 (-5.4)

F 125 95% 5% 88% $490 0.85 (-0.4) 0.12 (-7.5)

Using

Ropivacaine

Not using

Ropivacaine

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Analyzing average cost by drug for the top providers shows that Ropivacaine is driving up costs.

Med Breakout for Total Knee Replacements

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Lumbar Posterior Fusion DecompressionSeverity of Illness (SOI) level 2, smoker, diabetic, or >75yo(Supply Opportunity $245K)

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Responsible Provider N- size Avg Supply Cost %PGMLOS

PPC A/E (excess)

PPR A/E (excess)

A 14 $ 15,431 105% 0.00 (-2.0) 0.00 (-0.6)

B 13 $ 12,943 128% 0.56 (-0.8) 1.90 (0.5)

C 36 $ 11,830 90% 0.00 (-5.0) 0.00 (-1.5)

D 11 $ 11,216 102% 0.00 (-1.6) 0.00 (-0.5)

E 51 $ 10,204 102% 0.14 (-6.1) 0.00 (-2.1)

F 41 $ 10,251 102% 0.00 (-5.8) 0.58 (-0.7)

G 15 $ 9,292 98% 0.00 (-2.2) 0.00 (-0.6)

H 22 $ 9,026 115% 0.33 (-2.1) 1.10 (0.1)

I 19 $ 9,571 105% 0.40 (-1.5) 1.36 (0.3)

J 24 $ 8,325 119% 0.64 (-1.1) 2.25 (1.1)

K 19 $ 7,800 115% 1.13 (0.3) 0.00 (-0.8)

L 27 $ 7,933 100% 0.00 (-3.8) 0.00 (-1.1)

M 58 $ 7,371 112% 0.49 (-4.2) 0.42 (-1.4)

N 21 $ 6,680 107% 0.00 (-2.9) 0.00 (-0.8)

• A & B have higher utilization of expensive products compared to colleagues driving overall supply opportunity

(see products to right).

• K has higher utilization of Brand X BONE MATRIX OSTEOAMP PUTTY, MIX, OR SPONGE products compared

to colleagues.

Population: Fusion decompression; lumbar; posterior approach; 1-2 levels; SOI 2, smoker,

diabetic, or >75yo; excl outliers

Selections: July 2015 – June 2016, Providers with >= 10 cases. 91% of supply opportunity is

associated with the above providers.

• Brand Y BONE MATRIX INFUSE BMP

• Brand Y BONE MATRIX MAGNIFUSE DBM

• Brand Y Brand Y SEALER TISSUE AQUAMANTYS

BIPOLAR

• Brand Y BONE MATRIX GRAFTON PUTTY DBM

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