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Raising the Bar: Innovative Healthcare Program Fosters Collaboration, Education
- 1. RAISING THE BAR Innovative Healthcare Program Fosters Collaboration & Education
- 2. Big Data, Big Discoveries HOST: GUEST: GUEST: Eric Kavanagh Dr. Anjum Khurshid Jim McNamara Sponsored by:
- 3. It’s a Complex Situation  Regulations in the Affordable Care Act (ACA)  Uninsured Americans  Legal challenges to the ACA
- 4. Emerging Solutions ď‚— Health Information Exchanges (HIEs) ď‚— Collaboration among health care institutions ď‚— Social Media for analysis, outreach and education
- 5. Dr. Anjum Khurshid Director, Health Systems Division Louisiana Public Health Institute
- 6. Anjum Khurshid, PhD, MD, MPAff Director, Health Systems Division Director, Crescent City Beacon Community Louisiana Public Health Institute February 27, 2013
- 7. Outline • Crescent City Beacon Community (CCBC) Goals – Clinical Quality Improvement – Transitions of Care through Greater New Orleans Health Information Exchange (GNOHIE) – Consumer Engagement and txt4health • CCBC-BioDistrict Collaboration and Future Opportunities
- 8. 17 Beacon Communities Bangor Beacon Community Western New York Brewer, ME Beacon Community Buffalo, NY Southeastern Beacon Community of Rhode Island Beacon Minnesota Beacon Inland Northwest Southeast Michigan Community Community Spokane, WA Beacon Community Providence, RI Rochester, MN Detroit, MI Central Indiana Keystone Beacon Beacon Community Community Danville, PA Utah Beacon Indianapolis, IN Greater Cincinnati Community Beacon Salt Lake City, UT Colorado Beacon Community Community Cincinnati, OH Grand Junction, CO Southern Piedmont Great Tulsa Health Beacon Community Access Network Beacon Concord, NC San Diego Beacon Community Community Tulsa, OK San Diego, CA Delta BLUES Beacon Community Hawaii County Crescent City Beacon Stoneville, MS Beacon Community Hilo, HI Community New Orleans, LA
- 9. Crescent City Beacon Community Goals Reduce the burden of chronic diseases, mainly diabetes and cardiovascular disease by : o Improving the quality of care for chronic disease patients in patient-centered medical homes, enabled by HIT o Reducing healthcare costs by decreasing preventable emergency department and inpatient visits through better coordination of care o Engaging consumers in the healthcare process by using innovative technologies and strategies
- 10. 3 Cs of CCBC Clinical Care Consumer Transformation Coordination Engagement Build & Improve Quality Innovate Strengthen HIT
- 11. Dynamic Framework for a Coordinated System of Care Population Patient Education/ Patient Engagement/ Risk Reduction Disease Management At-risk -- Low risk -- High risk -- Chronic -- Complex Specialty/ ED Visits Preventable Admissions Preventable Diagnostics Patient-Centered Medical Home Emergency (Primary Care System) Inpatient
- 12. Dynamic Framework for a Coordinated System of Care Population Innovations/Consumer Patient Education/ Patient Engagement/ Engagement Management Risk Reduction Disease At-risk -- Low risk -- High risk -- Chronic -- Complex Specialty/ ED Visits Preventable Admissions Preventable Chronic Care Diagnostics Management Transitions Patient-Centered Medical Home of Care Emergency (Primary Care System) Inpatient
- 13. Clinical Transformation Improved quality of clinical care for chronic disease patients through improved workflow and health IT population-based disease registries, risk stratification, care management/care team strategies, clinical decision support Clinical Practice Learning EMR QI Seminar Coaching Collaborative Optimization Innovations Series
- 14. Positive Trends on Adoption & Outcomes Number of Sites Using Care Management Processes - 2012 Total ED/IP Encounters at ILH 5000 14 14 14 4311 7/2/12 - 1/31/13 January July 12 4000 Sum of ED 11 Sum of IP 10 2842 2826 9 9 9 3000 7 7 2000 1593 1384 4 998 1000 789 720 619 645 575 581 238 295 304 243 148 110 45 67 0 Clinic Clinic Clinic Clinic Clinic Clinic F Clinic Clinic Clinic I Clinic J Care Management Individual Care Registries Stratify DM Care Management Care Management A B C D E G H Staff Plans Patients for DM Patients for CVD Patients Number of Unduplicated Lives in CDR Across the Community Q6 to Q7 Data as of 2/11/2013 Quality Outcomes (October 200,000 2012) 184,796 177,790 179,693 172,733 173,651 Diabetes: A1C testing 180,000 171,293 177,790 181,306 176,118 160,000 171,950 173,073 Diabetes: A1C control (<8.0%) 140,000 126,808 125,887 130,597 Diabetes: Lipid testing 120,000 127,008 # of Lives 124,509 126,341 100,000 Diabetes: Lipid control (<100mg/dL) 80,000 Diabetes: Blood Pressure Control (<130/80) 60,000 40,000 Ischemic Vascular Disease: Blood Pressure Control (<140/90) 20,000 Ischemic Vascular Disease: Complete Lipid Profile 0 Coronary Artery Disease: Drug Therapy for Lowering LDL-C * All data from QI Outcome Measure Reports
- 15. Care Coordination GNOHIE Mirth Mirth Mirth Mail Mirth Care Mirth Results Match (Secure (Care Analytics (CDR) (EMPI) Mail) Mgmt.) (EDW) Electronic Behavioral ED/IP Birth Specialty Health Analytics Notification Outcomes Care Referral Integration
- 16. GNOHIE Architecture Currently connects 23 primary practices and 2 hospitals in GNO
- 17. Data Security • Encrypted data • HIPAA compliant protocols • Role-based access Central security Data Repository • Restricted administrative access • Patient consent needed • Extensive Auditing capabilities
- 18. Transitions of Care o Emergency Department/Inpatient Notification: Alerts and clinical information are sent to primary care providers about patient visits to emergency departments and hospital admissions. o Electronic Specialty Care Referral: Referral requests and supporting documentation of the referring primary care provider are sent electronically to the specialist. Specialist’s consult summaries are, in turn, provided electronically to the primary care provider.
- 19. Pre-ED/IP Notification 9/15/12 Diabetic Ketoacidosis HOSPITAL Discharged HOME Debbie Debbie Type 2 Diabetes Type 2 Diabetes 9/25/12 Hypoglycemia HOSPITAL Discharged HOME Debbie Debbie PRIMARY Type 2 Diabetes Type 2 Diabetes CARE 10/2/12 PRACTICE Foot infection HOSPITAL Discharged HOME Debbie Debbie Type 2 Diabetes Type 2 Diabetes 10/20/12 Kidney Infection HOSPITAL Discharged HOME Debbie Debbie Type 2 Diabetes Type 2 Diabetes
- 20. ED/IP Notification System 9/15/12 Diabetic Ketoacidosis HOSPITAL Discharged HOME Debbie Debbie Type 2 Diabetes Type 2 Diabetes 9/25/12 Hypoglycemia HOSPITAL Discharged HOME GREATER NEW Debbie Debbie Type 2 Diabetes Type 2 Diabetes ORLEANS PRIMARY 10/2/12 HEALTH CARE INFORMATION PRACTICE Foot infection HOSPITAL Discharged HOME EXCHANGE Debbie Debbie Type 2 Diabetes Type 2 Diabetes 10/20/12 Kidney Infection HOSPITAL Discharged HOME Debbie Debbie Type 2 Diabetes Type 2 Diabetes
- 21. Number of Unduplicated Patients in CDR as of 2/11/2013 200,000 184,796 177,790 179,693 172,733 173,651 180,000 171,293 176,118 177,790 181,306 160,000 171,950 173,073 140,000 125,887 126,808 130,597 120,000 # of Lives 127,008 124,509 126,341 100,000 80,000 60,000 40,000 20,000 0
- 22. Total ED/IP Encounters at ILH Sum of ED Sum of IP Since 5000 July ’12 7/2/12 - 1/31/13 – 3 sites 4500 4311 4000 Since Since 3500 Sept. ’12 July ’12 – 3 sites – 1 site 3000 2842 2826 2500 Since Since Sept. ’12 Nov. ’12 2000 – 2 sites – 3 sites 1593 Since 1384 Since 1500 Dec. ’12 Since Sept. ’12 Since – 1 site 998 Nov. ’12 – 1 site July ’12 1000 789 – 1 site Since – 1 site 720 645 581 Nov. ’12 619 575 500 304 – 1 site 238 295 243 110 148 67 45 0 Clinic A Clinic B Clinic C Clinic D Clinic E Clinic F Clinic G Clinic H Clinic I Clinic J Total ED Encounters = 15,769 Total IP Encounters = 3,564
- 23. Telemedicine Specialty Care Psychiatry Rheumatology Cardiology Dermatology Pulmonary 1 hospital – 11 General telemedicine Endocrinology Physical specialties with Diabetes Medicine & designated Rehab appointment slots Hepatitis C Pain Management Neurology Nephrology Total Specialty Consults in Q4, 2012 = 1,394 2
- 24. Patient Consent OPT-IN MODEL Exception = break the glass 1 consent form – applies across all GNOHIE participants PATIENT ENGAGEMENT PROVIDER PROVIDER AND ENGAGEMENT WORKFLOW EDUCATION
- 25. Examples of Patient Materials
- 26. Community Engagement Consumer Engagement Other CCBC Model Interventions Txt4health Campaign Integration of Other Settings Community Targeted to Actualize Provider “Health Home” Advisory Community Engagement Concept Group Engagement
- 27. Building Blocks: Text4Health Modules User sends HEALTH to 311 411 System collects: System categorizes: HEIGHT HIGH RISK WEIGHT (BMI) MEDIUM RISK AGE LOW RISK GENDER Enrollment ------------------------------- FAMILY HISTORY UNDERWEIGHT DIABETES DIAGNOSIS AT WEIGHT SMOKING STATUS OVERWEIGHT Development of Profile OBESE (Risk Categorization) Goal Setting/Tracking Education/Motivation Local Connections (Weight & Exercise) (According to Risk) (Care & Activities) Enrolled participants in 12 months ~ 1,400
- 28. Solution Offering and Value Proposition Care Management & Coordination System Solution Offering Value Proposition • Patient- • Chronic Care Improve Quality Centered Management Medical Home System •HEDIS measures for diabetes and cardiovascular People Process Improve Efficiency •Reduce hospital readmissions Data Analysis •Reduce Emergency Room Visits Technology & Information •Reduce Avoidable Hospital Admissions (EMR/HIE) Management •Reduce duplicate testing (e.g. imaging) • Health •Medication management •Engagement Information (Consumer, Prov Exchange ider,) Bend the Medical Cost Bend the Medical Cost Trend Trend • Reduction in per member per month cost
- 29. Advanced Analytics Use predictive modeling, propensity score matching, and other statistical techniques to investigate: • High use of Emergency Department Prescriptive • Avoidable hospital readmissions How can we achieve the best outcomes? • Duplicate procedures and tests Predictive modeling What will or could happen? • Preventable hospital admissions • High-cost patients • Variation in care Descriptive What happened? • Root cause analysis
- 30. CCBC-BioDistrict Collaboration • To promote research-community-industry collaboration • To develop a real-time, real- world, intelligent, learning system that connects researchers and clinicians • To provide a laboratory for innovation, social entrepreneurship, and translational medicine • To measure and demonstrate impact on patient outcomes and population health
- 31. Opportunities for Future • Use state-of-the-art health IT infrastructure to coordinate care and evaluate results • Involve leading research institutions and medical centers to use data to inform clinical practice • Develop Public-private partnerships to test new ideas, effective treatments, and innovative technologies • Promote economic development and job creation through workforce training and new business ventures
- 32. Strength of the System Ownership & Engagement Accountability Leveraging Trust Networks Stakeholder-defined use cases and provider-led design
- 33. Working Together
- 34. CCBC Receives 2013 “Healthcare Informatics Innovators Award” “A massive effort to improve the health status of the entire New Orleans metropolitan area” “What makes this collaboration worthy of Innovator Awards recognition is the combination of vision and scope on the one hand, and the successful leveraging of HIT to achieve those visionary goals, on the other” -- Mark Hagland Editor-in-Chief, Healthcare Informatics
- 35. Contact: Anjum Khurshid, PhD, MD, MPAff Director Health Systems Division Director Crescent City Beacon Community Louisiana Public Health Institute 1515 Poydras St, 1200 New Orleans, LA 70112 Phone: 504-301-9800 Email: akhurshid@lphi.org www.lphi.org www.crescentcitybeacon.org
- 36. Jim McNamara President & CEO BioDistrict New Orleans
- 37. RECONNECTING NEW ORLEANS A Sustainable Strategy for Job Growth, Economic Development and Better Health Outcomes
- 38. IbervilleTreme CNI BioDistrict French Quarter CBD
- 39. Vision BioDistrict New Orleans will become a thriving and highly livable business, education, science and healthcare destination, regarded throughout the City and the nation as the premier revitalized urban district of choice. The BioDistrict will be known for its walkable scale, new and historic neighborhoods, excellent schools and ecosystem support services, vibrant retail, accessible open space and transit, as well as a range of stable and well paying bioscience and healthcare industry jobs. The BioDistrict will become a national model for urban revitalization, job creation and economic and industry development.
- 40. An Amazing Collaboration working TOGETHER! Economic Development Jobs and training Sustainably Built Environment 10/12/12 Civic Leadership
- 41. Research with Industry value Bioscience Centers of Excellence  Peptides  HIV/AIDS  Infectious Diseases  Cancer  Diabetes and Cardiovascular  Biodefense  Neuroprotection and Rehabilitation  Nano-particle Drug Delivery  Health IT Emerging Centers  Translational Medicine  BioBanking
- 42. BioDistrict Areas of Concentration
- 43. • Economic Impacts — Over 20 years, the BioDistrict will generate: • 34,000 direct and indirect jobs created • 3600 annual construction jobs • $4 Billion in Capital Activity • $24 Billion in Economic Activity • $2.45 Billion in years 1-5 • $26.185 Billion in Personal Earnings • $2 Billion in increased Personal Earnings
- 44. • Economic Impacts — In 20 years, the BioDistrict will generate: • $3.352 Bn in Sate and Local Tax Generated, ($167 m per year) • $1.91 Bn -- State tax - $95 Million annually • $1.44 Bn -- Local tax - $72 Million annually • 11.6 Million Square Feet of New, Absorbed or Renovated Buildings • 2,000+ Housing Units
- 45. Thank you!