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iHT² Health IT Summit Seattle - Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic - "Presentation Achieving Strategic Objectives Through BI"

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Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic …

Andrew Proctor, Sr. Director of Business Intelligence, Medical Operations Division, Cleveland Clinic

iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.

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  • 1. Achieving Strategic Objectives Through BI Andrew W. Proctor, MS
  • 2. Business Intelligence • The use of information that enables organizations to best decide, measure, manage, and optimize performance to achieve efficiency and financial benefit (Gartner) • Focus on operational process improvement and business use of information In 1989 Howard Dresner popularized "BI" as an umbrella term to describe a set of concepts and methods to improve business decision-making by using fact- based support systems.
  • 3. Clinic Access • Template Management • Appointment Days Wait • Appointment When Wanted • Same Day Access
  • 4. Digestive Disease Access Initiative 6 8 10 12 14 16 18 Q4 '07 Q1 Q2 Q3 Q4 '08 DaysWait 55% 60% 65% 70% 75% 80% Apptwhenwanted Days wait Appt when wanted
  • 5. Appointment When Wanted by Days Wait June 2010 through December 2012 Lowess Smoothed Regression Spearman Correlation: New Visits: -0.181, p < 0.001; Established Visits : -0.098, p < 0.001; New Institute Visits: -0.192, p < 0.001;
  • 6. Executive Quarterly Review • Align strategic objectives • Common scorecard platform • Transparency • Best practice sharing • Continuous Improvement
  • 7. Physician Name
  • 8. Main Campus Doctor Communication 61 0 20 40 60 80 100 2008 2009 2010 2011 Jan - Feb '13 %tile Peer (3) Peer (1) Peer (2) Peer (4) CC 50th
  • 9. Main Campus Overall Rating 93 0 20 40 60 80 100 2008 2009 2010 2011 Jan - Feb '13 %tile Peer (3) Peer (1) Peer (2) Peer (4) CC 50th
  • 10. Short Cycle • Near “real-time” • Quicker delivery to clinical managers • Summarized nursing unit performance
  • 11. Smoking Cessation %
  • 12. HF Education %
  • 13. SCIP: Hair Removal %
  • 14. SCIP: Normothermia %
  • 15. SCIP: Periop Beta-blocker %
  • 16. SCIP: VTE Prophylaxis Orders %
  • 17. Physician Name
  • 18. 30-Day Readmission Data Flow 30 minute updates 30 minute updates Patient readmitted to Cleveland Clinic ADT system captures readmission Web application captures readmission for review Aggregate monthly reports Short Cycle dashboard reports readmission in “real-time”
  • 19. ICU Operations • ICU Ops Team created in 2006 • Expanded in 2009 - Oversight committee formed - 30+ ICUs - 350 beds - 30,000 admissions/year
  • 20. ICU Hand Hygiene Compliance 60% 70% 80% 90% 2007 2008 2009 2010 2011 2012 Compliance Target
  • 21. ICU CLABSI Rate 0 1 2 3 4 5 2008 2009 2010 2011 2012 2013 Rate
  • 22. Blood Utilization • Scarce resource • High cost • Clinical risk
  • 23. Physician Names
  • 24. Example Physician
  • 25. Cleveland Clinic Blood Use per 1K patient days 2008 2009 2010 150 200 250 300 350 Oct Dec Feb Apr Jun Aug Oct Dec Feb Apr Jun Aug Oct Dec Units 2 2.1 2.2 2.3 2.4 2.5 CMI Blood use per 1K pt days Case Mix Index Linear (Case Mix Index)
  • 26. Predictive Analytics “declare the past, diagnose the present, foretell the future” - Hippocrates
  • 27. Predicting Length of Stay for Scheduled Surgeries • Reliable prediction of hospital length of stay for future patients • Generalizable framework for similar initiatives • Downstream strategic operational impact - Occupancy forecasting - Clinical decision support
  • 28. Modeling Perspective Hospital Admit Hospital Disch Physiology and clinical Surgery Demographics Prob List
  • 29. Population and Data • CC Main Campus TCI cases age >18 - 2010-2012 • Data source: EPIC medical record • Demographics, physiology, labs, comorbidities, CPTs, work RVU, readmit - All data ≤90 days prior to procedure • Surgical CPTs grouped using validated taxonomies (NSQIP)
  • 30. 1 1
  • 31. 2 2
  • 32. 3 3
  • 33. Estimating Relationships Among Key Performance Measures Measure #1 is below target If Measure #1 meets target, it positively influences Measure #2 and 3
  • 34. • CIO, CFO, CMOO • Meets monthly with Leadership Team • Critical for executing on strategy Executive Team • Executive Directors from IT, Finance, Medical Operations • Meets with Executive Team & Strategic Council • Manages BI resources & BI program overall Leadership Team • Representation from several clinical & operational areas • Meets with Leadership Team • Provides project ranking recommendations Strategic Council EBI Governance