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
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 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
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?
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
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
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!
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