improving clinical and operational outcomes by leveraging healthcare data analytics at the point of...

©Truven Health Analytics Inc. All Rights Reserved. 1

Sandeep Makhijani – Regional Director, APAC

Truven Health Analytics

Improving Clinical and Operational Outcomes by Leveraging Healthcare Data Analytics at the Point of Care


News Flash !!

There are currently about 7.1 billion

people on Earth, this number could rise

to about 9 billion by 2050 - and as many

as 25 billion by 2100 *

The population is not only growing it is

also living longer

Even another world war or a lethal

pandemic won't slow down the

population time bomb

Can we use Data and Analytics to

transform Healthcare for this

unstoppable population growth?

* http://toi.in/pQsD1b

http://toi.in/pQsD1b


Discussion Points

Healthcare Analytics

Using Data and Analytics to transform Healthcare

Role of Clinical Content and a Clinical Decision Support System to

support Healthcare Analytics

Leveraging Healthcare Analytics for Evidence based real-time Clinical

Surveillance

Using Healthcare Analytics to Improve Clinical, Operational and

Financial performance across the Continuum of Care



Healthcare Analytics is the systematic use of Patient Specific Data

and related insights developed through Applied Analytical Disciplines

to drive Evidence based Clinical Decision Making for patient safety,

care management, outcomes measurement and clinical learning.

Healthcare Analytics helps achieve the following Business Goals:

Healthcare Analytics Solutions will:

Provide Real-time Surveillance and Real-time Intervention capabilities

leveraging Evidence-based Clinical Content

Intervention Documentation Capability

Measurement, Analysis and Reporting Capability


Need for Healthcare Analytics

Providers Needs

Accelerated Demand for healthcare services – Growing and Ageing Population

Optimal Usage of healthcare resources

Improve Clinical Outcomes

Manage Cost of Care

Effective gathering, sharing and use of patient centric information across the continuum of care

Patient Needs

Higher Expectations from healthcare providers

More Educated about their health and healthcare needs

Greater Access to Information than ever before

Demanding increasing Accountability from their doctors, nurses and health plans.


An EMR is not enough….you need Data and Analytics

to Transform Healthcare!

Providers

Improve service delivery and operations

Provide means for measuring and evaluating critical organizational data

Expand access to healthcare, align pay with performance and help hold down growth in healthcare costs.

Help design and plan healthcare policy and programs

Improved effectiveness and efficiency of the Healthcare System

Patients

Better insights into Patient Data can help achieve better Clinical Outcomes

Improve Patient Safety

Aid exploration and discovery of new treatments and technologies

Personalized healthcare

Information leading to insight can help informed and educated consumers become more accountable for their own health


Role of Clinical Content and CDSS to

Support Healthcare Analytics


Medication Management

Process

Patient’s unique

physiology & values

Evidence-Based Medicine =

Clinical Content and CDSS

Clinical Expertise

Role of Evidence Based Medicine in the

Medication Management Process


Creating Evidence Based Clinical Content

CONTENT CREATION

PROCESS


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Clinical Decision Support System

Clinical Decision Support System (CDSS) provides clinicians with

knowledge and patient-specific information, intelligently filtered

and presented at appropriate times, to enhance the practice of

health care


Clinical Content and CDSS is the foundation of


Referential Evidence-based Clinical

Content

Non-Patient Specific, Facility

Specific

Cloud based access

Stand Alone

Patient Specific

Available at Point of Care

Integrated with EMR

Provides Interaction Alerts based on

Evidence-based Clinical Content

Patient Specific

Available at Point of Care

Integrated with EMR

Real-time Surveillance and Real-time Intervention

leveraging Evidence-based Clinical Content

Documentation Capability

Measurement, Analysis and Reporting

Healthcare

Analytics

Active CDSS

Passive CDSS


Leveraging Healthcare Analytics for Evidence

based Real-time Clinical Surveillance


Leveraging Healthcare Analytics for Evidence based Real-

time Clinical Surveillance to Identify Patients at Risk of an

Adverse Event

16

Evidence Based

Clinical Content

CDS Rules

Clinical Decision

Support


Pre-Built Evidence-Based Clinical Decision Support

Rules

• CDS Rules should be editable to match hospital-specific criteria

• Ability to create new profiles on demand

• Ability to query on a virtually unlimited number of data elements


Clinical Dashboard Helps Clinicians Improve Outcomes

and Manage Risk

Real -time

surveillance of

at-risk patients

Easy documentation

of intervention within

the workflow

Comprehensive

medication, lab

and report

information – with

integrated access

to evidence-

based content

Quick view of critical values with

automated interaction checking

and pharmacy tools and

calculators


The key is being able to intervene before risk increases

and expenses are incurred

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Healthcare Analytics for Evidence based Real-time

Clinical Surveillance

Data Aggregation for Analytics

Evidence-based CDS Rules

Timely and effective Alerts

Focused user-interface

Integrated, context-aware CDS knowledge

Documentation of Clinical Activity

Data-mining and Reporting capabilities

20


Improving clinical, operational and financial

performance across the continuum of care

using Healthcare Analytics


Malnutrition in Adult Patient Population Surveillance


Malnutrition in Adult Patient Population

• Adult malnutrition is a common problem, affecting as many as 60

percent of hospitalized patients in the U.S.

• A major contributor to poor patient outcomes, longer hospital stays,

and higher healthcare costs.

• Malnutrition is often present on hospital admission,

• Early Identification of malnourished patients, or those at risk of being

malnourished can be treated appropriately, leading to better

outcomes


This is a Problem in Singapore too… 1 in 3 elderly

Singaporeans not eating right

1 in 3 elderly Singaporeans not eating right

Thursday, 14 l 07 l 2011 Source: The Straits Times

By: Feng Zengkun

Lack of proper diet can put senior citizens at high risk of malnutrition

WHETHER out of a diminished enjoyment of food or the fact that they live alone, one in three elderly people is not taking in enough calcium,

carbohydrates and fibre. The upshot of their poor food choices? They are at high risk of malnutrition, a condition caused by a diet of too much or

too

few nutrients such as zinc or iron.

The findings were published recently in two separate studies by Tan Tock Seng Hospital and health-care company Abbott Nutrition. Together,

the studies surveyed about 700 elderly people in Singapore aged 50 and older. The Abbott study also found that the elderly living in one- and

two-room flats have a higher risk of malnutrition. Experts The Straits Times spoke to said the poor attention many elderly people paid to their diet

could lead to more frequent falls, slower recovery from injuries and a host of diet-related complications such as fragile bones.

At a nutrition seminar in Singapore yesterday, Professor Jean-Pierre Michel, 51, head of the geriatric ward at the Geneva Medical School and

University Hospitals, called the findings “serious”. He said the lack of a proper diet was linked to a condition called sarcopenia, which causes

people to lose muscle mass and strength. This could lead to the elderly becoming weaker and more prone to falls, he

added, noting that about 20 per cent of people who suffer hip fractures die within a year of the injury. “Half of them never regain their former

mobility,” he said.

Experts The Straits Times spoke to said reasons for the elderly’s poor diet ranged from a lack of interest in food to their living environment.

Dietitian Teo Soo Lay at the Singapore General Hospital said elderly people who live alone have no motivation to cook for themselves. “Most of

the time, they will just eat biscuits or plain bread for their main meals, which is very poor nutrition,” she added. Others said natural consequences

of ageing, such as problems with chewing and swallowing, also put the elderly off their food.

Mr Kavin Seow, director of Touch Home Care, which delivers meals to the elderly, said it makes sure the food comes in small pieces to aid

digestion. “We don’t serve hard and deep-fried food either,” he added. ……..

http://www.healthxchange.com.sg/News/Pages/Elderly-Singaporeans-not-eating-right.aspx











Freeman Health System

• 517 beds, 3 hospital

system

• Serves an area of

450,000 people from

Missouri, Arkansas,

Kansas, and Oklahoma

• U.S. News & World

Report recently ranked

Freeman as the #1

hospital in Southwest

Missouri and #4 hospital

in the state of Missouri.


Problem of tracking Malnourished Patients at Freeman

Coders spent significant time each day manually reviewing patient

records to identify patients with signs of malnutrition

Once identified in the hospital, a nutrition support pharmacist would

ensure intervention

Charts were reviewed once more for coding accuracy to check for

reimbursement.

Process was time-consuming, inefficient, and challenging to identify

malnourished patients early enough to avoid complications, as well as

prior to hospital discharge


Using Healthcare Analytics to track Malnourished

Patients

Implement a real-time, enterprise-wide clinical surveillance technology

solution

CDS profile identifies patients who have early warning signs of

malnutrition.

Real-time surveillance of structured and unstructured patient data

Alerts to Clinicians on Patients identified

Leverage built-in evidence-based guidelines to address the warning

signs and avoid complications

Easy to use tools to document the clinical intervention


Malnutrition Surveillance Profile

Created a clinical

profile within

Micromedex 360

Care Insights to

identify

malnourished

patients during

hospitalization


Results of Malnutrition Interventions

Improved Patient Care

Identification and treatment of malnutrition in the hospital results in improved patient outcomes and decreased lengths of stay

Time Savings

Healthcare Analytics solution automated the extensive clinical data review required to accurately identify patients

After building the Malnutrition profile, their pharmacist ran a list every morning, which takes 3 minutes.

Cost Savings Between August 2013 - January 2014, Freeman’s Malnutrition profile

has resulted in 13 interventions, for a total dollar revenue of $30,600.

Average increased reimbursement of $2300 per identified case Estimate over $115,000 per year in increased reimbursement


Ebola Virus Disease (EVD) Surveillance


CDC Case Definition for Ebola Virus Disease (EVD)

• Suspected Case

Illness in a person who has both consistent symptoms and risk factors as follows:

o Clinical criteria, which includes fever of greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit, and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage; AND

o AND - Epidemiologic risk factors within the past 3 weeks before the onset of symptoms, such as contact with blood or other body fluids of a patient known to have or suspected to have EVD; residence in—or travel to—an area where EVD transmission is active; or direct handling of bats, rodents, or primates from disease-endemic areas.

Malaria diagnostics should also be a part of initial testing because it is a common cause of febrile illness in persons with a travel history to the affected countries.

• Confirmed Case

A suspected case with laboratory-confirmed diagnostic evidence of ebola virus infection.

31

Source: Centers for Disease Control, Health Alert Network, August 1, 2014, HAN 00364 at: http://emergency.cdc.gov/han/han00364.asp

http://emergency.cdc.gov/han/han00364.asp

http://emergency.cdc.gov/han/han00364.asp


Ebola Surveillance Profile


Final Thoughts….

The world’s population is not only growing but living longer

Expectations from Healthcare Service Providers have changed

dramatically

Clinicians need tools and resources at the point of care to provide the

best possible care tailored to the unique needs for their patients

There is an increased risk for communicable disease and infection

due to crowding and antibiotic over-utilization resulting in less efficacy

We have to leverage Technology in the form of Healthcare Analytics

to Improve Clinical and Operational Outcomes

….Don’t forget we are All Future Patients!


Thank You

Questions and Comments

[email protected]

Cell: +65-96863797

mailto:[email protected]

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