Diagnosing patient careGetting healthy withbenchmarking andbusiness intelligenceSteven Lugard – Dublin, March 2013
AgendaCentral theme:How can Irish hospitals benefit from benchmarking?And what is required to get there? Is it possible to...
Some background information:Cost per patient in theDutch DRG System
Hospital financing in Netherlands  Until 2005 budget system       Limited impulses for volume/quality/efficiency  Need for...
Cost benchmarking in Netherlands Trusts have own responsibility for financial performance, thus for adequate management in...
About Benchmarking
Cost breakdown of a DRG
Savings in protocols     What can we reach with influencing the clinician’s behaviour?                                   P...
Savings in unit costs  Improving productivity and purchasing conditions adds 10%                 Protocol                 ...
Our new cost breakdown
Getting there:Technology &implementation
Cost breakdown of a DRG     Non-Hipe                          Hipe
Technology: current data flow                                     Dashboard                       Benchmark reports       ...
Future data flow in hospital                                     Dashboard                       Benchmark reports        ...
Management Don’t wait for everything to be perfect Take (financial) control at local level Benchmarking is more than techn...
Summary How can Irish hospitals benefit from benchmarking?    Get into financial control    Perform better despite budget ...
Sweelincklaan 1        5 Fitzwilliam Square3712 JA Bilthoven      Dublin 2The Netherlands        Ireland+31 30 233 3872   ...
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Steven Lugard

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Diagnosing Patient Care

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Steven Lugard

  1. 1. Diagnosing patient careGetting healthy withbenchmarking andbusiness intelligenceSteven Lugard – Dublin, March 2013
  2. 2. AgendaCentral theme:How can Irish hospitals benefit from benchmarking?And what is required to get there? Is it possible today? Background: Cost per patient in the Dutch DRG System What is benchmarking? Implementation: Technology & management
  3. 3. Some background information:Cost per patient in theDutch DRG System
  4. 4. Hospital financing in Netherlands Until 2005 budget system Limited impulses for volume/quality/efficiency Need for cost containment and quality impulse felt strongly by 2002 Waiting lists Exploding costs (exploding hospitals) Design of new system: Money Follows the Patient (MFtP) Case based financing introduced in 2005 Starting 2005, prudent growth model 2007: 18% (Hip/Knee/Cataract) 2013: 80% of hospital care First Diagnostics Theatre Discharge consultation Inpatient stay Check-up
  5. 5. Cost benchmarking in Netherlands Trusts have own responsibility for financial performance, thus for adequate management information. Need to know own performance vis-à-vis peers Where are we more expensive or more efficient than our peers? What is causing us to be more/less expensive? Understanding drivers of these costs. Taking action; lowering cost prices or lowering activity levels for treating patients Forecasting costs; budgeting based on contracted production amounts & benchmark Early adapters in the Netherlands are now the most successful trusts Continuous focus on benchmark, but what is it?
  6. 6. About Benchmarking
  7. 7. Cost breakdown of a DRG
  8. 8. Savings in protocols What can we reach with influencing the clinician’s behaviour? Protocol Own 289 patientsCategory Own Peers Best Potential Unit Unit costs Protocol savingsImplant 1 1 1 - units € 3,156 € -In patient days 8.3 6.9 6.9 405 bed days € 321 € 129,877Theatre hours 1:47 1:30 1:30 81:53 hours € 970 € 79,427Laboratory tests 20 32 20 - tests € 13 € -Radiology exams 2.5 4.2 2.5 - exams € 102 € -Physiotherapy 6.3 4.7 4.7 462 sessions € 48 € 22,019Other treatments 4 3 3 289 sessions € 18 € 5,058 € 236,380Cost per patient € 8,426 € 7,932 € 7,608 € 818Savings % 6% 10%
  9. 9. Savings in unit costs Improving productivity and purchasing conditions adds 10% Protocol Unit costs 289 patientsCategory Best Unit Own Benchmark Best Total savingsImplant 1 units € 3,156 € 2,670 € 2,670 € 140,454In patient days 6.9 bed days € 321 € 289 € 289 € 193,688Theatre hours 1:30 hours € 970 € 900 € 900 € 109,772Laboratory tests 20 tests € 13 € 15 € 13 € -Radiology exams 2.5 exams € 102 € 76 € 76 € 19,074Physiotherapy 4.7 sessions € 48 € 60 € 48 € 22,019Other treatments 3 sessions € 18 € 30 € 18 € 5,058 € 490,064Cost per patient € 7,608 € 7,608 € 6,730Savings % 10% 10% 20% !!!
  10. 10. Our new cost breakdown
  11. 11. Getting there:Technology &implementation
  12. 12. Cost breakdown of a DRG Non-Hipe Hipe
  13. 13. Technology: current data flow Dashboard Benchmark reports Cost Analysis model TTP Benchmark database The data is there. Just connect it. Performation is currently executing this successfully in Irish hospitals Connect and transform C&T C&T C&T C&T C&T C&TRegistration systems HIPE Caredos PAS Lantis ….. Excel
  14. 14. Future data flow in hospital Dashboard Benchmark reports Cost Analysis model TTP Benchmark database Data ware house Structurally assure management information Data ware house Connect and transform C&T C&T C&T C&T C&T C&TRegistration systems HIPE Caredos PAS Lantis ….. Excel
  15. 15. Management Don’t wait for everything to be perfect Take (financial) control at local level Benchmarking is more than technology Implementation is key Top management commitment Use benchmarking as base for budget allocations Discussions & workshops with doctors Build business cases based on benchmarks The clinician has to do at least 50% Speak the right language!
  16. 16. Summary How can Irish hospitals benefit from benchmarking? Get into financial control Perform better despite budget restraints And what is required to get there? Costing of the full patient cycle Use all production data sources (Hipe, theatre, pathology, radiology) Technology should be sound: IT and cost model Use the benchmark results in day to day management Top management should carry the implementation Is it possible today? Yes, it is possible today in Ireland
  17. 17. Sweelincklaan 1 5 Fitzwilliam Square3712 JA Bilthoven Dublin 2The Netherlands Ireland+31 30 233 3872 +353 1 662 8280www.performation.com

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