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Healthcare Transformation: The Journey of High-Value Healthcare

The document outlines the challenges and opportunities in American healthcare, emphasizing the need for transformation to enhance safety, quality, and cost efficiency. It highlights the importance of data-driven decision-making and process improvement for achieving better health outcomes. The document showcases various case studies demonstrating successful implementations of health data solutions leading to significant improvements in patient care.

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Healthcare Transformation: A Guide to Success in the Journey to High-Value Healthcare John L. Haughom, MD October 2013 1 © 2012 Health Catalyst | www.healthcatalyst.com
Some Important Points • Most American hospitals and caregivers provide safe and effective care for the vast majority of patients, the vast majority of the time • The vast majority of caregivers are well trained and conscientious • Western  medicine’s  ability  to  save  and  extend   life, and to improve the quality of life for the ill and injured is nothing short of miraculous © 2012 Health Catalyst | www.healthcatalyst.com
…but  that  does  not  change  a  harsh  reality… …care is far too unsafe…   …quality is too inconsistent… …and costs are too high… © 2012 Health Catalyst | www.healthcatalyst.com
American healthcare "gets it right” 54.9% of the time. McGlynn EA, Asch SM, Adams J, et al. The quality of healthcare delivered to adults in the United States. N Engl J Med; 2003;2635-2645 © 2012 Health Catalyst | www.healthcatalyst.com
$60 $45.6 trillion Medicare ~$30 trillion U.S. Net worth ~$48 trillion U.S. Comptroller General David Walker, 2006 © 2012 Health Catalyst | www.healthcatalyst.com
30% to 50% waste (Anderson C, 1991, and James B, et al 2006) © 2012 Health Catalyst | www.healthcatalyst.com
Feeling vulnerable? © 2012 Health Catalyst | www.healthcatalyst.com
Deming  101… Quality improvement is the science of process management (healthcare delivery is a system made up of thousands of interlinked processes) © 2012 Health Catalyst | www.healthcatalyst.com
Deming  101… If  you  cannot  measure  it… …you  cannot  improve  it… © 2012 Health Catalyst | www.healthcatalyst.com
Deming  101… “In  God  we  trust…   …all  others  must  bring  data.” W. Edward Deming © 2012 Health Catalyst | www.healthcatalyst.com
Brent  James,  MD,  101… “Managed  care” means “managing  processes  of  care”  ... …not managing physicians and nurses. (clinicians are the ones who manage the process of care) © 2012 Health Catalyst | www.healthcatalyst.com
Deming  101… …the right data …in  the  right  format …at  the  right  time (and place) …in  the  right  hands (the clinicians who operate the process) © 2012 Health Catalyst | www.healthcatalyst.com 12
Deming  101… …engaging  the  “smart  cogs”   of healthcare…   © 2012 Health Catalyst | www.healthcatalyst.com
“…historically encumbered and demoralized…”   © 2012 Health Catalyst | www.healthcatalyst.com
Are Physicians Willing to Change? Yes…   Physician Willingness to Change 16% Unwilling 84% Willing Source: McKinsey Physician Survey, 2011 © 2012 Health Catalyst | www.healthcatalyst.com
“…historically encumbered and demoralized…” ...inform, engage and inspire… …ENLIGHTENMENT… © 2012 Health Catalyst | www.healthcatalyst.com
Innovation Roger’s Diffusion of Innovation Model Tipping point at 1520% adoption Innovations do not spread equally over 2º different society segments (social groups) but Many studies have looked at how these groups differ: through 5 stages • Innovators are highly cosmopolite and open to new things. with particular • Early adopters tend to be opinion leaders. profile of • Early majority provide “legitimization” of the innovation. reaction • Late majority are skeptical. • Laggards put trust in the status quo. © 2012 Health Catalyst | www.healthcatalyst.com
You can buy the piano (EHR, EDW), but you will have to learn to use it effectively to produce great music (greater safety, improved outcomes, lower costs,  etc.)…   Who is responsible for producing great music in healthcare? 18 © 2012 Health Catalyst | www.healthcatalyst.com
Unlock Your data will be integrated, cataloged, and secured in the Catalyst platform Metadata: EDW Atlas Security and Auditing Common, Linkable Vocabulary Financial Sources (e.g., EPSi, Peoplesoft, Lawson) Financial Source Marts Departmental Sources (e.g., Apollo) Departmental Source Marts Cardiovascular Valves Administrative Sources (e.g., API Time Tracking) Administrative Source Marts Surgery Patient Source Marts KPA Cohort Finder EMR Source Marts HR Source Mart EMR Source Human Resources (e.g., PeopleSoft) (e.g., Epic, Cerner) More Transformation Patient Satisfaction Sources (e.g., NRC Picker, Press Ganey) Less Transformation Source:  Catalyst’s  Adaptive  Model Proprietary and Confidential © 2013 Health Catalyst www.healthcatalyst.com
What will success look like? © 2012 Health Catalyst | www.healthcatalyst.com
North Memorial Women’s  and  Newborn:  Elective  Inductions “We  wouldn’t  have  had  a  chance  to  do  some  of  the  things  we’ve  done  in  last  18  months  to  enhance   care,  reduce  waste  and  lower  costs  without  Catalyst.  It’s  amazing  how  differently  and  effectively  we   can  gather  and  use  data  now.”     -Jon  Nielsen,  MD,  Medical  Director  Women  and  Children’s  Services  at  North  Memorial  Health  Care Objective • Define existing workflows and identify improvement opportunities • Establish baseline measures • Define evidence based standards for elective inductions • Reduce rates of pre-39 week deliveries from 1.2% to 0.6% to qualify for a payer partner bonus Health Catalyst Solution Results to date • Late-bindingTM Data Warehouse Platform • Standardized workflows to improve data reliability • Cohort Finder • Key Process Analysis Application • Established elective delivery baseline measurements to track quality improvement gains • Population Advanced Application Module, Early Induction Application • Reduced early-term deliveries from 1.2% to 0.3% • Installation Services • Payer partner bonus payment • Clinical Improvement Services Proprietary and Confidential 21 © 2013 Health Catalyst www.healthcatalyst.com
HF Readmissions Large Medical Center Objective • Define Congestive Heart Failure (CHF) baseline measures for 30 and 90day readmissions rates • Implement evidencebased practice interventions to drive CHF readmission rate reductions • Establish balance metrics including ED visits, observation days and patient satisfaction • Develop sustaining processes for evaluating readmission rates to ensure continuous process improvement Health Catalyst Solution • Late-bindingTM data warehouse that enables faster time-to-value • Integration of clinical, patient satisfaction and financial data to establish baseline, ongoing and balance measures • Discovery, Foundational and Advanced HF applications including cohort finder, registry and evidence- based clinical content • Healthcare analytic visualization including gauges and trend lines for at-a-glance view Proprietary and Confidential Results to date • Seasonally adjusted rate reduction of 21% in 30-day and 14% in 90-day CHF readmissions • 2X increase in the number of phone calls made to patients within 48 hours of discharge • Average of 63 % increase in physician medication reconciliation within 48 hours of discharge • Follow-up appointment intervention baseline and balance measures established 22 © 2013 Health Catalyst www.healthcatalyst.com
Winner CHIME-AHA Transformational Leadership Award! Improving Outcomes and Reducing Waste in Asthma Healthcare: The Impact of Data “It’s  one  thing  to  establish  an  order  set  and  another to actually drive its adoption. Seeing how well this process works—how well and how quickly our clinical improvement teams and evidence-based care experts are able to encourage clinicians across our organization to standardize processes—is  very  gratifying..”   - Dr. Charles Macias, TCH Attending Physician and Director, Evidence Based Outcome Center. Objective • Improve clinical outcome for asthma patients across the care continue • Better manage populations in a new Valued Based Purchasing environment • Measure and ensure sustained clinical quality improvements Health Catalyst Solution Results to date • Late-Binding™  Data   Warehouse • Decreased average LOS by 11 hours • Key Process Analysis (KPA) Application • Achieved and sustained a 49% decrease in unnecessary Chest X-rays over 16 months • Population Analytics Advanced ApplicationAsthma Module • Installation Services • 80% order set utilization …67%  sustained  increase   over 8 months • Clinical Improvement Services • 90% usage of asthma action plan by providers Proprietary and Confidential © 2013 Health Catalyst www.healthcatalyst.com
Adversity …is  hard… …and  an  opportunity… …lean into it! © 2012 Health Catalyst | www.healthcatalyst.com
“It  is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” Theodore Roosevelt, 1910 © 2012 Health Catalyst | www.healthcatalyst.com
“To have lived through a revolution, to have seen a new birth of science, a new dispensation of health, reorganized medical schools, remodeled hospitals, a new outlook for humanity, is an opportunity not given to every  generation.” Sir William Osler (1849-1919) © 2012 Health Catalyst | www.healthcatalyst.com
Healthcare Transformation An Opportunity Not Often Given Participating in the Creation of a New Era in Healthcare By John L. Haughom, MD 2013 FREE Book! Available online January, 2014 © 2012 Health Catalyst | www.healthcatalyst.com
Questions, discussion, comments…   Placeholder, enter your own text here For Information Contact: John.Haughom@healthcatalyst.com © 2012 Health Catalyst | www.healthcatalyst.com