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Improving Clinical and Operational Outcomes by Leveraging Healthcare Data Analytics at the Point of Care

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Presented by Mr. Sandeep Makhijani, Regional Director for Asia Pacific (APAC), Truven Health Analytics at ISS Seminar: How Analytics is Transforming Healthcare on 31 Oct 2014.

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Improving Clinical and Operational Outcomes by Leveraging Healthcare Data Analytics at the Point of Care

  1. 1. ©Truven Health Analytics Inc. All Rights Reserved. 1 Sandeep Makhijani – Regional Director, APAC Truven Health Analytics Improving Clinical and Operational Outcomes by Leveraging Healthcare Data Analytics at the Point of Care
  2. 2. ©Truven Health Analytics Inc. All Rights Reserved. 2 News Flash !!  There are currently about 7.1 billion people on Earth, this number could rise to about 9 billion by 2050 - and as many as 25 billion by 2100 *  The population is not only growing it is also living longer  Even another world war or a lethal pandemic won't slow down the population time bomb  Can we use Data and Analytics to transform Healthcare for this unstoppable population growth? * http://toi.in/pQsD1b
  3. 3. ©Truven Health Analytics Inc. All Rights Reserved. 3 Discussion Points  Healthcare Analytics  Using Data and Analytics to transform Healthcare  Role of Clinical Content and a Clinical Decision Support System to support Healthcare Analytics  Leveraging Healthcare Analytics for Evidence based real-time Clinical Surveillance  Using Healthcare Analytics to Improve Clinical, Operational and Financial performance across the Continuum of Care
  4. 4. ©Truven Health Analytics Inc. All Rights Reserved. 4©Truven Health Analytics Inc. All Rights Reserved. 4 Healthcare Analytics
  5. 5. ©Truven Health Analytics Inc. All Rights Reserved. 5 Healthcare Analytics  Healthcare Analytics is the systematic use of Patient Specific Data and related insights developed through Applied Analytical Disciplines to drive Evidence based Clinical Decision Making for patient safety, care management, outcomes measurement and clinical learning.  Healthcare Analytics helps achieve the following Business Goals:  Healthcare Analytics Solutions will:  Provide Real-time Surveillance and Real-time Intervention capabilities leveraging Evidence-based Clinical Content  Intervention Documentation Capability  Measurement, Analysis and Reporting Capability
  6. 6. ©Truven Health Analytics Inc. All Rights Reserved. 6
  7. 7. ©Truven Health Analytics Inc. All Rights Reserved. 7
  8. 8. ©Truven Health Analytics Inc. All Rights Reserved. 8 Need for Healthcare Analytics Providers Needs  Accelerated Demand for healthcare services – Growing and Ageing Population  Optimal Usage of healthcare resources  Improve Clinical Outcomes  Manage Cost of Care  Effective gathering, sharing and use of patient centric information across the continuum of care Patient Needs  Higher Expectations from healthcare providers  More Educated about their health and healthcare needs  Greater Access to Information than ever before  Demanding increasing Accountability from their doctors, nurses and health plans.
  9. 9. ©Truven Health Analytics Inc. All Rights Reserved. 9 An EMR is not enough….you need Data and Analytics to Transform Healthcare! Providers  Improve service delivery and operations  Provide means for measuring and evaluating critical organizational data  Expand access to healthcare, align pay with performance and help hold down growth in healthcare costs.  Help design and plan healthcare policy and programs  Improved effectiveness and efficiency of the Healthcare System Patients  Better insights into Patient Data can help achieve better Clinical Outcomes  Improve Patient Safety  Aid exploration and discovery of new treatments and technologies  Personalized healthcare  Information leading to insight can help informed and educated consumers become more accountable for their own health
  10. 10. ©Truven Health Analytics Inc. All Rights Reserved. 10©Truven Health Analytics Inc. All Rights Reserved. 10 Role of Clinical Content and CDSS to Support Healthcare Analytics
  11. 11. ©Truven Health Analytics Inc. All Rights Reserved. 11 Medication Management Process Patient’s unique physiology & values Evidence-Based Medicine = Clinical Content and CDSS Clinical Expertise Role of Evidence Based Medicine in the Medication Management Process
  12. 12. ©Truven Health Analytics Inc. All Rights Reserved. 12 Creating Evidence Based Clinical Content CONTENT CREATION PROCESS
  13. 13. ©Truven Health Analytics Inc. All Rights Reserved. 13 7 Clinical Decision Support System  Clinical Decision Support System (CDSS) provides clinicians with knowledge and patient-specific information, intelligently filtered and presented at appropriate times, to enhance the practice of health care
  14. 14. ©Truven Health Analytics Inc. All Rights Reserved. 14 Clinical Content and CDSS is the foundation of Healthcare Analytics  Referential Evidence-based Clinical Content  Non-Patient Specific, Facility Specific  Cloud based access  Stand Alone  Patient Specific  Available at Point of Care  Integrated with EMR  Provides Interaction Alerts based on Evidence-based Clinical Content  Patient Specific  Available at Point of Care  Integrated with EMR  Real-time Surveillance and Real-time Intervention leveraging Evidence-based Clinical Content  Documentation Capability  Measurement, Analysis and Reporting Healthcare Analytics Active CDSS Passive CDSS
  15. 15. ©Truven Health Analytics Inc. All Rights Reserved. 15©Truven Health Analytics Inc. All Rights Reserved. 15 Leveraging Healthcare Analytics for Evidence based Real-time Clinical Surveillance
  16. 16. ©Truven Health Analytics Inc. All Rights Reserved. 16 Leveraging Healthcare Analytics for Evidence based Real- time Clinical Surveillance to Identify Patients at Risk of an Adverse Event 16 Evidence Based Clinical Content CDS Rules Clinical Decision Support
  17. 17. ©Truven Health Analytics Inc. All Rights Reserved. 17 Pre-Built Evidence-Based Clinical Decision Support Rules • CDS Rules should be editable to match hospital- specific criteria • Ability to create new profiles on demand •Ability to query on a virtually unlimited number of data elements
  18. 18. ©Truven Health Analytics Inc. All Rights Reserved. 18 Clinical Dashboard Helps Clinicians Improve Outcomes and Manage Risk Real -time surveillance of at-risk patients Easy documentation of intervention within the workflow Comprehensive medication, lab and report information – with integrated access to evidence- based content Quick view of critical values with automated interaction checking and pharmacy tools and calculators
  19. 19. ©Truven Health Analytics Inc. All Rights Reserved. 19 The key is being able to intervene before risk increases and expenses are incurred 19
  20. 20. ©Truven Health Analytics Inc. All Rights Reserved. 20 Healthcare Analytics for Evidence based Real-time Clinical Surveillance  Data Aggregation for Analytics  Evidence-based CDS Rules  Timely and effective Alerts  Focused user-interface  Integrated, context-aware CDS knowledge  Documentation of Clinical Activity  Data-mining and Reporting capabilities 20
  21. 21. ©Truven Health Analytics Inc. All Rights Reserved. 21©Truven Health Analytics Inc. All Rights Reserved. 21 Improving clinical, operational and financial performance across the continuum of care using Healthcare Analytics
  22. 22. ©Truven Health Analytics Inc. All Rights Reserved. 22©Truven Health Analytics Inc. All Rights Reserved. 22 Malnutrition in Adult Patient Population Surveillance
  23. 23. ©Truven Health Analytics Inc. All Rights Reserved. 23 Malnutrition in Adult Patient Population • Adult malnutrition is a common problem, affecting as many as 60 percent of hospitalized patients in the U.S. • A major contributor to poor patient outcomes, longer hospital stays, and higher healthcare costs. • Malnutrition is often present on hospital admission, • Early Identification of malnourished patients, or those at risk of being malnourished can be treated appropriately, leading to better outcomes
  24. 24. ©Truven Health Analytics Inc. All Rights Reserved. 24 This is a Problem in Singapore too… 1 in 3 elderly Singaporeans not eating right 1 in 3 elderly Singaporeans not eating right Thursday, 14 l 07 l 2011 Source: The Straits Times By: Feng Zengkun Lack of proper diet can put senior citizens at high risk of malnutrition WHETHER out of a diminished enjoyment of food or the fact that they live alone, one in three elderly people is not taking in enough calcium, carbohydrates and fibre. The upshot of their poor food choices? They are at high risk of malnutrition, a condition caused by a diet of too much or too few nutrients such as zinc or iron. The findings were published recently in two separate studies by Tan Tock Seng Hospital and health-care company Abbott Nutrition. Together, the studies surveyed about 700 elderly people in Singapore aged 50 and older. The Abbott study also found that the elderly living in one- and two-room flats have a higher risk of malnutrition. Experts The Straits Times spoke to said the poor attention many elderly people paid to their diet could lead to more frequent falls, slower recovery from injuries and a host of diet-related complications such as fragile bones. At a nutrition seminar in Singapore yesterday, Professor Jean-Pierre Michel, 51, head of the geriatric ward at the Geneva Medical School and University Hospitals, called the findings “serious”. He said the lack of a proper diet was linked to a condition called sarcopenia, which causes people to lose muscle mass and strength. This could lead to the elderly becoming weaker and more prone to falls, he added, noting that about 20 per cent of people who suffer hip fractures die within a year of the injury. “Half of them never regain their former mobility,” he said. Experts The Straits Times spoke to said reasons for the elderly’s poor diet ranged from a lack of interest in food to their living environment. Dietitian Teo Soo Lay at the Singapore General Hospital said elderly people who live alone have no motivation to cook for themselves. “Most of the time, they will just eat biscuits or plain bread for their main meals, which is very poor nutrition,” she added. Others said natural consequences of ageing, such as problems with chewing and swallowing, also put the elderly off their food. Mr Kavin Seow, director of Touch Home Care, which delivers meals to the elderly, said it makes sure the food comes in small pieces to aid digestion. “We don’t serve hard and deep-fried food either,” he added. …….. http://www.healthxchange.com.sg/News/Pages/Elderly-Singaporeans-not-eating-right.aspx
  25. 25. ©Truven Health Analytics Inc. All Rights Reserved. 25 Freeman Health System • 517 beds, 3 hospital system • Serves an area of 450,000 people from Missouri, Arkansas, Kansas, and Oklahoma • U.S. News & World Report recently ranked Freeman as the #1 hospital in Southwest Missouri and #4 hospital in the state of Missouri.
  26. 26. ©Truven Health Analytics Inc. All Rights Reserved. 26 Problem of tracking Malnourished Patients at Freeman  Coders spent significant time each day manually reviewing patient records to identify patients with signs of malnutrition  Once identified in the hospital, a nutrition support pharmacist would ensure intervention  Charts were reviewed once more for coding accuracy to check for reimbursement.  Process was time-consuming, inefficient, and challenging to identify malnourished patients early enough to avoid complications, as well as prior to hospital discharge
  27. 27. ©Truven Health Analytics Inc. All Rights Reserved. 27 Using Healthcare Analytics to track Malnourished Patients  Implement a real-time, enterprise-wide clinical surveillance technology solution  CDS profile identifies patients who have early warning signs of malnutrition.  Real-time surveillance of structured and unstructured patient data  Alerts to Clinicians on Patients identified  Leverage built-in evidence-based guidelines to address the warning signs and avoid complications  Easy to use tools to document the clinical intervention
  28. 28. ©Truven Health Analytics Inc. All Rights Reserved. 28 Malnutrition Surveillance Profile Created a clinical profile within Micromedex 360 Care Insights to identify malnourished patients during hospitalization
  29. 29. ©Truven Health Analytics Inc. All Rights Reserved. 29 Results of Malnutrition Interventions  Improved Patient Care  Identification and treatment of malnutrition in the hospital results in improved patient outcomes and decreased lengths of stay  Time Savings  Healthcare Analytics solution automated the extensive clinical data review required to accurately identify patients  After building the Malnutrition profile, their pharmacist ran a list every morning, which takes 3 minutes.  Cost Savings  Between August 2013 - January 2014, Freeman’s Malnutrition profile has resulted in 13 interventions, for a total dollar revenue of $30,600.  Average increased reimbursement of $2300 per identified case  Estimate over $115,000 per year in increased reimbursement
  30. 30. ©Truven Health Analytics Inc. All Rights Reserved. 30©Truven Health Analytics Inc. All Rights Reserved. 30 Ebola Virus Disease (EVD) Surveillance
  31. 31. ©Truven Health Analytics Inc. All Rights Reserved. 31 CDC Case Definition for Ebola Virus Disease (EVD) • Suspected Case  Illness in a person who has both consistent symptoms and risk factors as follows: o Clinical criteria, which includes fever of greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit, and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage; AND o AND - Epidemiologic risk factors within the past 3 weeks before the onset of symptoms, such as contact with blood or other body fluids of a patient known to have or suspected to have EVD; residence in—or travel to—an area where EVD transmission is active; or direct handling of bats, rodents, or primates from disease-endemic areas.  Malaria diagnostics should also be a part of initial testing because it is a common cause of febrile illness in persons with a travel history to the affected countries. • Confirmed Case  A suspected case with laboratory-confirmed diagnostic evidence of ebola virus infection. 31 Source: Centers for Disease Control, Health Alert Network, August 1, 2014, HAN 00364 at: http://emergency.cdc.gov/han/han00364.asp
  32. 32. ©Truven Health Analytics Inc. All Rights Reserved. 32 Ebola Surveillance Profile
  33. 33. ©Truven Health Analytics Inc. All Rights Reserved. 33 Final Thoughts….  The world’s population is not only growing but living longer  Expectations from Healthcare Service Providers have changed dramatically  Clinicians need tools and resources at the point of care to provide the best possible care tailored to the unique needs for their patients  There is an increased risk for communicable disease and infection due to crowding and antibiotic over-utilization resulting in less efficacy  We have to leverage Technology in the form of Healthcare Analytics to Improve Clinical and Operational Outcomes  ….Don’t forget we are All Future Patients!
  34. 34. ©Truven Health Analytics Inc. All Rights Reserved. 34©Truven Health Analytics Inc. All Rights Reserved. 34 Thank You Questions and Comments sandeep.makhijani@truvenhealth.com Cell: +65-96863797

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