600 East Superior Street, Suite 404 I Duluth, MN 55802 I Ph. 800.997.6685 or 218.727.9390 I www.ruralcenter.org Framing Rural Health Value Webinar Series Data Measurement, Outcomes and Impact Kami Norland Community Specialist II July 2014
Today s Learning Objectives Understand the benefits of using a systems-based framework at a critical access hospital (CAH) or State Flex Programs to manage information and strategic knowledge Review the purpose of gathering and using data to improve health and safety of patients and CAH financial awareness
Today s Learning Objectives Learn impactful initiatives CAHS are utilizing in response to the Medicare Beneficiary Quality Improvement Project (MBQIP) data Review the purpose of gathering and using data to demonstrate impact and improve outcomes of the State Flex Program
Current US Health Outcomes Highest cost Lowest quality Most limited access Highest rate of chronic illness Shortest life expectancy Sustainable Institute of Medicine, 2013
What s the matter? The Challenge: Crossing the Shaky Bridge What matters to you? Source: http://www.flickr.com/photos/67759198@n00/2974261334/sizes/o/in/photostream/
Goal: Make a Difference 6
Performance Excellence Framework Strategic Planning Workforce Leadership Community, Customers & Population Health Processes for Improved Outcomes Impact and Outcomes Measurement, Feedback & Knowledge Management Modified from Baldrige Performance Excellence Framework
Measurement, Feedback, & Knowledge Management If you don t have data, mythology wins.
Measurement, Feedback, & Knowledge Management Use a strategic framework to manage information and knowledge Gather and use data to enhance process improvements Evaluate strategic progress regularly
Strategies for Translating Data into Action Understand why change is needed Build a guiding team internally Partner with the QIO, Public Health, Community Establish collaborations with various stakeholders Create a shared vision and strategy
Strategies for Translating Data into Action Identify quick wins Measure and monitor success Persevere Celebrate successes
The only way to remain relevant is to define excellence and achieve it. Impact & Outcomes
Impact & Outcomes Publically report and communicate outcomes internally and externally Document value in terms of cost, efficiency, quality, satisfaction, and population health outcomes
Panel Members Kami Norland National Rural Health Resource Center Community Specialist II Email: knorland@ruralcenter.org Melissa Van Dyne Office of Primary Care and Rural Health Director and Flex Coordinator Email: melissa.vandyne@health.mo.gov Sue Deitz Critical Access Hospital Network, Eastern Washington Director Email: suefox@sandpoint.net
THE CRITICAL ACCESS HOSPITAL NETWORK S RURAL HEALTH INFORMATION TECHNOLOGY PROJECT Sue Deitz, MPH
Rural Network in Eastern Washington Established in 2002 with HRSA Network Development Grant Program
Our Members 7 Public Hospital Districts 7 Rural Hospitals, of which 6 are Critical Access Hospitals 12 Rural Health Clinics Mission - To improve the health of our communities by creating an infrastructure designed to stabilize and strengthen the local rural health system. Columbia County Health System
Purpose of CAHN Collaborate/share limited resources. Capitalize on economies of scale. Strengthen care coordination among rural and urban settings. Leverage health information technology to improve quality of health care service delivery and patient experience. Aggregate data to learn from each other.
Rural Health Disparities Health Disparities in Rural Network Counties compared to Urban/State (2012) In percent WA Lincoln Pend Grant Garfield Columbia Spokane Oreille (urban) Percent 65 or older 13 22 21 12.1 23 24.8 13 Median Age 37 47 47 31.6 49 48 36 Have Bachelor degree 31 19 17 14.6 24.6 18.7 29 WA Lincol n Pend Oreill e Grant Garfiel d Columbi a Spokan e (urban) Unemployment 6.6 7.6 10.9 9.6 7.8 10.2 7.3 Diabetes 8 12 9 8 17 16 9 Heart disease 5 9 8 7 10 9 6 Obesity (BMI= >30) 27 32 31 38 31 38 28 High cholesterol 40 47 45 43 50 48 39
Our Initiatives Target Care Coordination and Care Transitions Patient Centered Medical Home Tele Health Services Primary Care and Behavioral Health Integration County Coalitions and Regional Collaborations Chronic Disease Management and Measurement Performance Reporting
Regional Infrastructure to Compare Data De-Identified Aggregated Central Data Repository
Population Health Tools Disease Registries
Local and Regional Dashboards Measures Lipid Control ACE or ARB Therapy Med Reconciliation Fall Risk Screening A1c Poor Control High BP Control LDL Control A1c Control Aspirin or Antiplatelet Tobacco Non-use Beta Blocker for LVSD Controlling High BP Lipid Panel & LDL-C Cervical Cancer Screening Aspirin or Antiplatelet Breast Cancer Screen Colorectal Cancer Influenza Immunization Pneumococcal Vaccination BMI Screening Tobacco Use Screening High BP Depression Screening Diabetes: Low-level - Lipoprotein Diabetes: Foot Exam Sort by Demographics : Age, gender, race Practice Location Provider Payer Timeframe Benchmarks
Impact/ ROI Population Health Data Population based benchmark/goals chronic disease management (e.g. LDL, BP, A1c) Inpatient admission rates/ed visits for populations with chronic diseases Readmission rates after 30 days discharge Provider satisfaction towards project interventions Per visit revenue from increase in preventive procedures, labs and screenings triggered by CINA
Thank you Sue Deitz, MPH Director, Critical Access Hospital Network suefox@sandpoint.net (208) 610-0937
Critical Success Factor: Share Information 30
Next Events Applied exercise #3 due: Monday, July 21, 2014 by 5:00 p.m. Central Time Cohort webinars: Week of July 22, 2014 Please attend the group that you indicated during registration for the webinar series Webinar series wrap-up event: Monday, August 11 2:00-3:00 pm CDT
Kami Norland Community Specialist II 600 East Superior Street, Suite 404 Duluth, MN 55802 (218) 727-9390 ext. 223 knorland@ruralcenter.org www.ruralcenter.org 32