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Health Datapalooza 2013: Delos Cosgrove
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Health Datapalooza 2013: Delos Cosgrove

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Keynote Address: Delos Cosgrove

Keynote Address: Delos Cosgrove
President and Chief Executive Officer, Cleveland Clinic

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  • Drivers for Changes in PaymentIncrease in cost of health care and percentage of the GNPDefined as unsustainable not correlated with outcome or quality based upon several National metricsInstitute of Medicine To Err is Human 1999Disparity in Health Care Dartmouth Atlas30 Million un-insured AmericansAffordable Health Care Act2009 - 2012All Americans can be receive coverage for health carePay for performanceDecreasing reimbursement for all servicesTransparency of outcome“Doing less, delivering more” Driving down the cost of care
  • HCAHPS survey Doctor Communication domain scores.Scores in green reflect performance at or above national 90th scoring %ile

Health Datapalooza 2013: Delos Cosgrove Health Datapalooza 2013: Delos Cosgrove Presentation Transcript

  • Health Care Modelfor the 21st CenturyHealth Datapalooza IVJune 4, 2013
  • CCHS Mission• Care for the sick• Investigate theirproblems• Educate thosewho serveDr. William E. Lower Dr. John PhillipsDr. Frank E. Bunts Dr. George W. Crile
  • Organization Structure• Not for Profit• Group Practice• Physician Leadership• Salaried• Annual Professional Review• 1 Year Contract
  • 6.4 Million PatientsClevelandClinicHFairview HospitalLakewood HospitalHLutheran HospitalHAshtabula CountyMedical CenterHEuclid HospitalHHillcrest HospitalHSouth PointeHospitalHMarymount HospitalHClevelandClinicFloridaHMedinaHospitalHLorain Family HealthAnd Surgery CenterFHCElyria FamilyHealth CenterWestlake FamilyHealth CenterFHCFHC LakewoodFamily HealthCenterFHCStrongsville Family Healthand Surgery CenterFHCBrunswick FamilyHealth CenterFHCWooster FamilyHealth CenterFHCIndependence FamilyHealth CenterFHCSolon FamilyHealth CenterFHCChagrin Falls FamilyHealth CenterFHCBeachwood FamilyHealth and Surgery CenterFHCWilloughby HillsFamily Health CenterFHCFHCR.E. JacobsHealth CenterLou Ruvo Centerfor Brain HealthLas Vegas, NevadaFHCClevelandClinicTorontoFHCS.T.J.Health CenterHCTwinsburg FamilyHealth CenterFHC
  • Transport Team
  • Hospital Transfers05,00010,00015,00020,00025,0002005 2006 2007 2008 2009 2010 2011 2012#
  • "There are decades wherenothing happens;and there are weekswhere decades happen."Lenin
  • EconomicsInflectionPoint
  • Transparency - Castlight9
  • Hospital RankingsA Patient’s View
  • “This willtake courageto do…”Nancy Pelosi
  • • ACCESS• Quality• Cost
  • CCHS Emergency DepartmentsDoor to Doctor#Minutes2010503010Target = 30 minutes14.52011 2012 2013
  • Nurse on Call200,000
  • 0250500750100012502008 2009 2010 2011 2012#thousandsSame Day Visits
  • Hospital Transfer Dashboard
  • MyChart Users02004006008001,0001,2001,4001,6002002 2004 2006 2008 2010 2012#thousands1.5 M
  • iPhone App:• Test Results• Messages• AppointmentsFuture / Past• Preventive Care• Health Summary-Meds, Allergies,Problems,ImmunizationsMyChartMyChart23
  • Cleveland Clinic iTriage
  • DrConnect Physicians01,0002,0003,0004,0005,0006,0002005 2006 2007 2008 2009 2010 2011 2012#4,800
  • Referring Physician Hotline01,0002,0003,0004,0005,0006,0002013201120112011 2012#/Month100,000 k
  • Online Appointment Requests010,00020,00030,00040,00050,0002000 2002 2004 2006 2008 2010 2012#
  • • Access• QUALITY• Cost
  • Graft Patency%PatentIMASV601009080702 13864Years1210
  • Survival%SurvivalIMA82.6%SV71%p < 0.0001601009080702 10864Years
  • 20406080100CCleveland ClinicSTS NationalNEJM ArticleInternal Mammary Artery UsagePrimary Cardiac Bypass%19981986 2012
  • BIG DATAExplorys• 14 Healthcare systems• 40 million lives• 200 Hospitals• 100,000 providers• Predictive modeling for PCI
  • Watson Goes toMedical School
  • University Hospital Consortium QualityRank3040506070801Rank10180th2010♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦ ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦ ♦♦ ♦♦♦♦♦♦ ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦ ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦49th201120th201250 7525
  • 506070802008 2009 2010 2012 National(AHRQ)Patient Safety Survey%78
  • 15202530CCHS Heart Failure Readmissions< 20%21%%20112010 2012 2013
  • 0100200300102#PerMonthCCHS Patient Safety Indicators≤8320112010 2012 2013
  • ChiefExperienceOfficerDr. Jim Merlino
  • CC Experience
  • Open Medical Record
  • Patient Greeters
  • Art In Medicine
  • Diane Von FurstenbergPatient Gown
  • Physician HCAHPS Scores
  • 0204060801002008 2009 2010 2011 2012 2013Patient SatisfactionRate Hospital%ileRank7490th %ile
  • •Access•Quality•COST
  • ProstatectomyAll Cases4,0005,0006,0007,0008,0002009 2010 2011$perCase23%
  • Lab Tests Avoided02,0004,0006,0008,00010,00012,00014,0002011 Feb Apr Jun Aug Oct Dec#thousands12,0825,3880246810121420122011$1.2 Million
  • Newborns121032 2 2051015Fairview Hillcrest Main Huron Lakewood MarymountAvg #perDay
  • Ashtabula County Medical CenterHEuclid HospitalHMarymount HospitalHObstetricsHClevelandClinicLakewood HospitalHHHFairview HospitalHLutheran HospitalHSouth PointeHospitalHHillcrest HospitalHHHuron HospitalHH
  • Virtual Home Visit
  • Premature MortalityBehavior40%Medical Access 10%Genetics30%Social15%Environment5%• Obesity• Sedentary Life• Smoking
  • Smoking RatesCuyahogaUSAOhio W/OCuyahoga14242003 2004 2005 2006 2007 2008 2009RateCuyahogaUSAOhio
  • TransFats
  • Curve MembershipFitness CenterYoga ClassesWeight Watchers
  • Weight Management• Weight Watchers• Curves• Shape Up & Go• Fitness Centers• Yoga• Farmer’s Markets• Vending Machines• GO! Foods360,000 LBS Lost
  • Employee Health PlanPMPM Costs220260300340380420Q104Q204Q304Q404Q105Q205Q305Q405Q106Q206Q306Q406Q107Q207Q307Q407Q108Q208Q308Q408Q109Q209Q309Q409Q110Q210Q310Q410Q111Q211Q311Q411Q112Q212Q312Q412**Q1 04 to Q4 09 PMPM Q1 10 to Q3 12 PMPMExpon. (Q1 04 to Q4 09 PMPM) Expon. (Q1 10 to Q4 12 PMPM)Average yearly increase PMPM 2004 – 2008: 7.6%Average yearly increase PMPM 2009 – 2012: 2.0%$2004 2005 2006 2007 2008 2009 2010 2011 2012
  • “No one careshow muchyou know,until they knowhow muchyou care.”Theodore Roosevelt