tech-fueled performance improvement...oct 11, 2018 · priorities of healthcare executives •...
TRANSCRIPT
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Tech-fueled
Performance ImprovementCost-effective, collaborative solutions for us all
Washington State Hospital Association Annual Meeting
10.11.18
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Norderstedt, Germany
Prague, Czech Republic
Moscow, Russia
Wokingham, UK
Zuchwil, Switzerland
Recife, Brazil
São Paulo, Brazil
Bogota, Colombia
North Ryde, Australia
Beijing, China
Shanghai, ChinaOsaka, Japan
Tokyo, Japan
Fukushima, Japan
Chennai, India
Mumbai, India
Singapore
Irvine, California
Cincinnati, Ohio
Jacksonville, Florida
West Chester, PennsylvaniaSomerville, New Jersey
Raynham, Massachusetts
Palm Beach Garden, Florida
Seoul,
South Korea
o 26 state-of-the-art facilities
o On-demand, online learning
modules
o Virtual reality training
o Over 210,000 surgeons trained
annually
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Priorities of Healthcare Executives
• Managing costs – 65% of executives plan to increase efforts to control the cost of care management.
• Engaging and satisfying consumers – Nearly 60% of those surveyed plan to broaden the scope of telehealth;
45% want to increase investment into patient engagement initiatives such as mobile apps.
• Clinical quality – Half of executives indicate their organizations would be increasing their quality reporting to
CMS, and 36% said they’d be increasing their reporting to private payors.
• Data analytics – 53% of executives are exploring ways to improve patient care and supply chain management
via advanced data analytics.
• Population health – To improve patient outcomes, 45% plan on expanding post-acute care services via
community partnerships, and 40% plan on expanding the care team by working with various healthcare
professionals, such as nurse practitioners, care coordinators and pharmacists.
3Source: Premier, Inc.
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400,000
James J Patient Safety 9:122, 2013 4
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The High Cost of Medical ErrorsNUMBERS ARE ESTIMATES FROM 2008
2,500
Excess deaths
$10MILLION
Average cost
of missed days
of work
$13THOUSAND
Average cost
per medical error
$19.5BILLION
Total medical
mortality and
short-term
disability costs
Source: Jon Shreve et. al., The Economic Measurement of Medical Errors
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Disproportionate Share Hospitals
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How is a hospital to invest in quality
improvement given the pressures
and state of the market?
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To partner with patients with kidney disease and their caregivers to achieve
health, longevity and quality of life equivalent to the general population.
By harnessing the inherent motivation and expertise of all stakeholders
to improve care, spawn innovation and conduct research that improves
health and outcomes.
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Pediatric IBD Learning Health Network
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PROPORTION OF PATIENTS IN REMISSION
87 GI Care Centers
>25,000 patients
> 750 physicians
>40% of all patients with
IBD
APR 2007 OCT 2008 AUG 2010 AUG 2012 JUN 2015
APRIL2016
80%
59%
Centers >75% registered
Source: Improved Outcomes in a Quality Improvement Collaborative for Pediatric Inflammatory Bowel Disease.
Pediatrics. 2012; 129: 1030-41
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Outcome Bottom vs. Top Quartile
Operative Times 40% Longer
Complications & Readmissions 3X Greater
Mortality 5X Greater
The Problem
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“…responsibility for training, credentialing, and
privileging surgeons to use new technologies belongs
to physicians and the hospitals where they work.”
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Objective Structured Assessment of Technical Skills
(OSATS)
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24 hrs vs. 24 days!
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C-SATS Expert-only OSATS
Accuracy Excellent Excellent
Speed Hours Weeks to Months
Cost $2.50 - $5.00/Hour $250 - $500/Hour
Objectivity Unbiased Subject to bias
Scalability Millions of
crowdworkers available
24/7/365
Difficult given time and
cost limitations of
experts
Crowdsourced Skills Assessment Beats Standard
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.98 correlation
21CONFIDENTIAL 21
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C-SATS is an online performance
management system for accurately
appraising and improving professional
technique in 1/10th the time and cost of
traditional peer review.
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How C-SATS Works
Private, Secure Website
ReviewersMachine Learning
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C-SATS Hardware
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Experts Participate in the Reviewer Pool
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Within minutes, C-SATS analyzes 300
to 500 data outputs for each video
performance and presents reports with
data visualizations and actionable
insights to managers and practitioners.
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Personalized Surgeon Dashboard
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MONITOR TRENDS, COMPARE RESULTS AND RECEIVE SUGGESTIONS
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Learning Opportunity:
watch a high-scoring
video alongside your own
Learning Opportunity: watch a
video of an Expert’s case to
identify opportunities to improve
Expert Comments: qualitative,
actionable feedback
Personalized Feedback
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Personalized Feedback
“One thing that I have found to help improve my efficiency in this step of the case; when using a right
handed needle driver, it's faster to start at the left cuff. Place the stitch and bring it all the way through
until the anterior vaginal wall stops the stitch at the loop. That will stabilize the loop and make it much
easier for the surgeon to place the needle through the loop. Use your 3rd arm to actually follow the
stitch. You have created a great anterior vaginal cuff, so you really don't need to grab that with the 3rd
arm. Keep traction on the stitch with the 3rd arm and it will manage your cuff for you. Also, the needle
is big. You did a good job holding it in the middle of the needle, but right at the very end you were
trying to go through both anterior and posterior cuffs with one throw...That will often lead to the needle
going off to the side, and frustration. If you really want to try to go through both at once, place the
point of the needle where you want it, then move your whole arm until the point comes out where you
want it, then rotate your wrist.”
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Insights from Artificial Intelligence
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32CONFIDENTIAL
Computer Vision AI
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Video Library
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HIPAA-SECURE ACCESS TO YOUR CASE VIDEOS ANYTIME, ANYWHERE
Access C-SATS Video Library
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Training Opportunities
C-SATS offers several learning mechanisms…
• Objective qualitative feedback from reviewers
• Best-in-class video review broken down by procedure steps
• Customized simulation curriculum tailored to the surgeons’ GEARS score
• Access to expert case studies
• C-SATS Academy
• Opportunities for Tele-mentoring
POST-ASSESSMENT PERFORMANCE IMPROVEMENT
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Organizational Dashboard
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SEE TRENDS AND RANKINGS ACROSS YOUR SURGICAL TEAM
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Outcomes Impact
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TOP QUARTILE VS. BOTTOM QUARTILE
37%
69 mins.lower
Operative
timeIntra-operative
direct costs
33%
$1,800lower
Total
procedure cost
26%
$2,600lower
Inpatient
length of stay
33%
1.9 daysfewer
46%lower risk
30-day
readmissionComplications
20%fewer
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Improvement
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Improvement
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Improvement
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Reduction in Variation
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Reduction in Variation
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Representative Customers
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Robotics
Open SurgeryLaparoscopic
Surgery
Beyond Surgery
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Beyond Surgery
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Better Together
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Questions?Derek Streat | [email protected]
Vice President of Performance Improvement Solutions,
Johnson & Johnson Institute
Co-Founder & CEO, C-SATS
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Thank you.
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