Healthcare Analytics & Managing Population Health

Transcription

1 Healthcare Analytics & Managing Population Health Victoria Tiase, MS, RN, Director Informatics Strategy, NewYork-Presbyterian Hospital Kathleen McGrow, MS, RN, PMP, Director Customer Marketing, Caradigm April 23, Caradigm. All rights reserved. Caradigm and the Caradigm Logo are trademarks or registered trademarks of Caradigm USA LLC. All other product names and logos are trademarks or registered trademarks of their respective companies.

2 Cost, Quality and Access to Appropriate Care The US spent $2.6 trillion on health in $432 billion on heart disease and stroke $212 billion on diabetes 2 30% of care delivered is not evidence-based and is not in accordance with the best clinical knowledge. 3 30% of the total annual US expenditure on healthcare spent on ineffective or redundant care. 3 Healthcare-associated infections kill more people every year than breast cancer and prostate cancer combined Kaiser EDU.org. U.S. Health Care Costs National Diabetes Fact Sheet 3. GE Healthcare. Clinical Decision Support Decision: Defining our Problem Statement NEMJ Care in US Hospitals July National Vital Statistics, CDC. Estimating HAIs and Deaths in US Hospitals, 2002, Klevens 2002

3 Reimbursement to Improve Quality The impact on Healthcare organizations Non-payment for never events and hospital-acquired conditions Meaningful Use incentives Value-based Purchasing Single payment for inpatient, outpatient, and post-acute care services Management of at-risk patients enables organizations to realize 50% or more of shared savings Hospital Readmissions Reduction Program $280 M in payment penalties based on readmission rates for AMI, HF and pneumonia added conditions in 2015

4 Shifting Risk to Providers The Impact on Healthcare Organizations Challenges of Cost and Quality Government Regulations and Initiatives New Payment Methods Provider Risk Models Need for Population Health The new demands of population health require solutions that facilitate collaboration, deliver insights and enable care teams to achieve integrated, accountable care. The Advisory Board. Survey results: Percentage of providers taking on risk doubled since June 2013.

5 Low RISK/REWARD LEVEL High Population Health Balancing risk and clinical programs Full risk Capitation Shared savings Bundled payment VBP Readmission penalties DRG U&C FFS Independent Coordinated CARE MODEL Integrated

6 Population Health Framework Four Capabilities for Success Population Health Data Control Healthcare Analytics Care Coordination and Management Wellness and Patient Engagement Make information accessible where and when you need it. Generate insights and drive better decisions. Drive improved outcomes for patient populations. Promote healthier lifestyles for your patients.

7 Freeing your data from information silos Patient Encounter Lab Results Claims Caradigm Intelligence Platform Data formats HL7 CCD CSV XML HOME PAYER HOSPITAL OUTPATIENT PRACTICE PHARMACY LAB GOVERNMENT

8 Amazing Things are Happening Here

9 About NewYork-Presbyterian Hospital (NYP) NYP is composed of six main facilities located in and around New York City Columbia University Medical Center Weill Cornell Medical Center 2,600 patient beds 2 million inpatient and outpatient visits US News & World Report Honor Roll - #1 in NYC

10 1 Use of EHR at NYP Main EHR for clinical care: Allscripts Sunrise Clinical Manager Computerized provider order entry: 81,000 orders per day Nurse charting, ancillary clinical documentation: 98,000 notes per week Provider documentation: 49,600 notes per week Active user accounts: 26,300 1,300 resident physicians, 1,300 medical students NYP successfully attested to Stage 1 and well-poised for MU Stage 2 Patient Engagement (mynyp.org) Clinical Analytics and Public Health reporting

11 Aggregating Data from Multiple IT Systems Discharge Summary Discharge Medications Stress Report Lab Report EKG Report & PDF of Tracing Surgery Report Near real-time data repository Echo Report Nursing Discharge Instructions Cath Report

12 NYP Regional Health Collaborative Medical Village Health Information Exchange Integration & Coordination of Community-based Programs and Services Targeted Care Initiative (TCI) Patient Centered Medical Homes Population Health Infrastructure / Capabilities

13 Care Coordination Tools Use of Patient Registry Disease Coordination Prevention of Readmissions Monitoring of DVT risk Use of Quality Reporting Dashboards Prevent CAUTI Monitor Pain Assessment Assess care management of patients on care pathways

14 Clinic Visits with a Diabetes Diagnosis

15 Last H1AC was >9 and have not had a visit in 3 months or longer

16 CHF Readmission Prevention

17 DVT Risk Monitoring

18 CAUTI Reduction

19 ACTIVE FOLEY NO = No active foley catheter order present in SCM YES = Active foley catheter order present APPROVED INDICATION NO = Indication for foley catheter is a non-approved indication (i.e. other: ) YES = Indication for foley catheter is approved indication DAILY REVIEW NO = Daily review for necessity not completed at some point in patient hospital stay YES = Daily review completed or those patients w/o a foley catheter order

20 Pain Assessment Pilot 2

21 Care Pathway Status Draft

22 Lessons Learned as the Journey Continues New demands for data analytics - regulatory and quality initiatives Data quality management process is key Incremental process care is complex and multi-faceted Priority, Patience, & the Patient

23 Thank You 2014 Caradigm. All rights reserved.