redesigning clinical care with analytics · 2019-02-08 · redesigning clinical care with analytics...

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Redesigning Clinical Care with AnalyticsSession #142, February 13, 2019

Paul J. Lampi

Director, Enterprise Analytics and Reporting

Memorial Hermann

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• Memorial Hermann Intro

• Clinical Care Redesign Overview

• Healthcare Analytics Strategy

• Developing Analytics Solutions

• Benefits and Impact

• Looking to the Future

Agenda

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• Deliver high quality care thru clinical care re-design

• Reduce waste and operational inefficiencies to drive measurable savings

• Deploy actionable insights from analytics to drive a ‘data driven culture’

Learning Objectives

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• Memorial Hermann Intro

• Clinical Care Redesign Overview

• Healthcare Analytics Strategy

• Developing Analytics Solutions

• Benefits and Impact

• Looking to the Future

Agenda

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MHHS by the Numbers

$6.0B Total Assets1

$5.3B Net Operating Revenue1

24,000 Employees; 5,000 Physicians

Greater Houston MSA 6.6 million population, projected to 7.1 million (2020)

• 16 Hospitals

• 267 Care Delivery Sites

• 3,800+ Licensed Beds

• 844k+ Inpatient Days

• 154k+ Inpatient Admissions

• 1.2M Diagnostic & Therapeutic Visits

• 550k+ Annual Emergency Visits

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• Memorial Hermann Intro

• Clinical Care Redesign Overview

• Healthcare Analytics Strategy

• Developing Analytics Solutions

• Benefits and Impact

• Looking to the Future

Agenda

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• Why did we need to implement this strategy?

• Increasing Costs

• Inefficient and Inconsistent Processes

• Waste

• Supply Chain

• Decreasing Revenue

• Regulations

• Insurance Reductions

• Recipe for Disaster

Clinical Care Redesign Challenges

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Clinical Care Redesign Focus

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How to Achieve Our Goal

• Data!!!

• Needs

Wide dissemination of data

Various levels of detail

Utilization of MANY different data sources

Ease of interpretation

Users with varying roles and responsibilities

Ability to see high level and drill down to detail

One stop shop

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• Memorial Hermann Intro

• Clinical Care Redesign Overview

• Healthcare Analytics Strategy

• Developing Analytics Solutions

• Benefits and Impact

• Looking to the Future

Agenda

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• Self-service

– Data Power to the People

– Tools to educate and empower

– Teach to fish…100+ dashboard creators

• Right data at the Right time for the Right role

• Spend time telling and interpreting the story…NOT putting it together

• Data Warehouse…one source of truth

Healthcare Analytics Strategy

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Paid Claims On-site BiometricsEMRs

SmartData EDW

Applications AnalyticsAlgorithms

• Sepsis

• TOC

• Readmissions

• HCC Suspected

• 3M

• Truven

Consumer

Healthcare Analytics Strategy

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• Memorial Hermann Intro

• Clinical Care Redesign Overview

• Healthcare Analytics Strategy

• Developing Analytics Solutions

• Benefits and Impact

• Looking to the Future

Agenda

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Care Redesign Solution Lifecycle

• Waste

Identification

• Key Drivers

• Solutions

• Metrics

• Key Indicators

• Actionable

Metrics

• Performance

Improvement

• Financial

Impact

• Budget

Comparison

• Realized

Savings

• Next

Opportunity

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Opportunity Exploration• Balanced scorecard to find

improvement opportunities

• Compare:

• ALOS

• Cost per Case

• Readmissions

• Patient Satisfaction

IMPACT

Identified opportunities based on benchmarks to save $200M in Care Variation

Opportunity by ALOS, Cost, Mortality and Readmissions

**Sample Data Only – Visualizations provided for concept and format purposes only.

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Ortho Monitoring

**Sample Data Only – Visualizations provided for concept and format purposes only.

IMPACT

Orthopedic Joints: reduced average LOS from 2.39 to 2.25 days

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Ortho Monitoring

**Sample Data Only – Visualizations provided for concept and format purposes only.

IMPACT

Joints: reduced utilization of Bone Cement with Antibiotic for elective primary cases from 46% to 27%

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Medical Power Plan (MPP) Utilization

**Sample Data Only – Visualizations provided for concept and format purposes only.

IMPACT

Net increase of 2% overall execution of Medical Power Plans with many increasing ~4-10% in 7 months

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Sepsis Monitoring – Roll-up

**Sample Data Only – Visualizations provided for concept and format purposes only.

IMPACTS

Reduced Sepsis ALOS across the System from 5.74 to 5.64 days

Decreased mortality from 9.4% to 8.6%

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Sepsis Monitoring – Patient Level

**Sample Data Only – Visualizations provided for concept and format purposes only.

Patient level view of ED to Unit timeline with various treatment milestones in a visualization to identify areas for improvement.

IMPACT

Detailed view of patient details in support of Sepsis Care Pathway for actionable insights

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CABG* Monitoring

*CABG = Coronary Artery Bypass GraftOutliers

Targets

**Sample Data Only – Visualizations provided for concept and format purposes only.

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CABG* Monitoring

*CABG = Coronary Artery Bypass Graft

Outliers

**Sample Data Only – Visualizations provided for concept and format purposes only.

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CABG* MonitoringIMPACT

Detailed view of patient details in support of CABG milestones in Care Pathway for actionable insights

*CABG = Coronary Artery Bypass Graft**Sample Data Only – Visualizations provided for concept and format purposes only.

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Trach/Vent* MonitoringIMPACT

Southwest Clinical Pathway Pilot study reduced ALOS from 34.7 to 28.0 days

Southwest ICU reduced ALOS from 26.5 to 15.2

*Trach/Vent = Tracheostomy and Ventilator

**Sample Data Only – Visualizations provided for concept and format purposes only.

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Women’s LOS Monitoring

**Sample Data Only – Visualizations provided for concept and format purposes only.

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Women’s LOS Monitoring

IMPACTS

Reduced ALOS from 4.6 to 2.7 days

$479,965 FY18 annualized savings

**Sample Data Only – Visualizations provided for concept and format purposes only.

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Benefit Model/Cost Comparison Overview

**Sample Data Only – Visualizations provided for concept and format purposes only.

Wo

rks

tre

am

s

Facilities

Key focus area

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Mean Summary by APR DRG

Drill Down to Details

**Sample Data Only – Visualizations provided for concept and format purposes only.

Benefit Model/Cost Comparison Overview

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• Memorial Hermann Intro

• Clinical Care Redesign Overview

• Healthcare Analytics Strategy

• Developing Analytics Solutions

• Benefits and Impact

• Looking to the Future

Agenda

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Benefits and Impact

Culture change

at EVERY Level

Data-driven Decision Making

Tell the Story

and Change It!

New way of life!

FY18 Budget Savings: $40M

FY18 Savings Achieved: $44M

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• Memorial Hermann Intro

• Clinical Care Redesign Overview

• Healthcare Analytics Strategy

• Developing Analytics Solutions

• Benefits and Impact

• Looking to the Future

Agenda

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Lessons Learned

• Don’t boil the ocean…crawl, walk, run

• Don’t let PERFECT be the enemy of GOOD

• Agile development

• Definitions/Data Governance

• Only as good as data you have…never too early to start

• It takes a village…education to “Think Data and actionable insights”

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Roadmap for the Future

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Paul J. Lampi

Director, Enterprise Analytics and Reporting

Memorial Hermann

Paul.Lampi@memorialhermann.org

Questions