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Bringing data and tools to clinical care 
Health Information Technology
The Game
Healthcare Technology 
BSOs
Healthcare Technology 
BSOs
Healthcare Technology 
Not BSOs 
•80% people 
•15% process 
•5% technology
UCLA vsYale
UCLA vsYale
Customer 
Customer 
Customer 
Customer 
CRDR 
De-Identified 
Identified 
Discovery 
PBI 
TSI 
Premier 
On 
Core 
VIPER 
Epic 
HCAPS 
UHC 
Press 
Gainey
Customer 
Customer 
Customer 
Customer 
Customer Service 
Tools & Tech 
CRDR 
De-Identified 
Identified 
Discovery 
PBI 
TSI 
Premier 
On 
Core 
VIPER 
Epic 
HCAPS 
UHC 
Press 
Gainey
Customer 
Customer 
Customer 
Customer 
Customer Service 
Tools & Tech 
CRDR 
De-Identified 
Identified 
Discovery 
PBI 
TSI 
Premier 
On 
Core 
VIPER 
Epic 
HCAPS 
UHC 
Press 
Gainey
Bridgeport Hospital QVI Registry FY2013Total Spend = $18.2m/977 cases
Visualizing PatientData
A Single Patient’sExperience 
5-day default patient view 
Full hospitalization view 
Multiple hospitalizations view 
1 
4 
3 
2
Palliative and End of Life Care 
“I was rounding in 11 NP and noted a patient whose rothman indexwas in the red that was in a decline(47.5 to 28.7). I spoke with the RN who shared with me the patient has had a change in MS. I further evaluated the patient and found him to be tachypneic, tachycardic and hypoxic. The patient was being taken off the floor for a cardiac echo. I stopped the transfer. The patient's skin color was ashen and he was unable to speak based upon his shortness of breath. I suggested to the PA that we obtain an ABG : 7.51/24/57/18.2/91.2. The wife decided (pt was 56 with end stage cancer) not to intubate and place him on a ventilator. He was made comfort measures. 
This could have had a different outcome if the patient had coded and was intubated with an admission to the ICU. This would have been traumatic not only to the patient but the family as well.” 
YNHH SWAT Nurse e-mail , Mon 6/4/2012 9:59 AM
Better PatientCare Leads toReduced Variation in Cost 
Case Type 
Oncology patients with at least one overnight stay transferred to ICU and expired in ICU 
Cost Savings 
Intervention 
RRT Nurse consults RI prior to transfer, immediate intervention, patient not transferred, receives Palliative Care measures in Oncology Unit and expires on Oncology Unit 
Non Intervention Cases 
95 patients, at least one overnight stay on the Oncology Unit, then transferred to and expired on ICU (7/11/11 –5/31/13) 
Cost and Goal Metrics 
•Patients transferred to ICU and expired: Total cost per case $30,965 
•Patients not transferred to ICU and expired: Total cost per case $5,590 
•Cost difference per case:Difference: $25,375 
•GOAL: 50% of transferred patients receive palliative care 
$1.27M
Healthcare Technology 
•80% people 
•15% process 
•5% technology

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Health IT Summit New York 2014 - Presentation with Daniel Barchi, SVP & CIO, Yale-New Haven Health System

  • 1. Bringing data and tools to clinical care Health Information Technology
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  • 9. Healthcare Technology Not BSOs •80% people •15% process •5% technology
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  • 18. Customer Customer Customer Customer CRDR De-Identified Identified Discovery PBI TSI Premier On Core VIPER Epic HCAPS UHC Press Gainey
  • 19. Customer Customer Customer Customer Customer Service Tools & Tech CRDR De-Identified Identified Discovery PBI TSI Premier On Core VIPER Epic HCAPS UHC Press Gainey
  • 20. Customer Customer Customer Customer Customer Service Tools & Tech CRDR De-Identified Identified Discovery PBI TSI Premier On Core VIPER Epic HCAPS UHC Press Gainey
  • 21. Bridgeport Hospital QVI Registry FY2013Total Spend = $18.2m/977 cases
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  • 24. A Single Patient’sExperience 5-day default patient view Full hospitalization view Multiple hospitalizations view 1 4 3 2
  • 25. Palliative and End of Life Care “I was rounding in 11 NP and noted a patient whose rothman indexwas in the red that was in a decline(47.5 to 28.7). I spoke with the RN who shared with me the patient has had a change in MS. I further evaluated the patient and found him to be tachypneic, tachycardic and hypoxic. The patient was being taken off the floor for a cardiac echo. I stopped the transfer. The patient's skin color was ashen and he was unable to speak based upon his shortness of breath. I suggested to the PA that we obtain an ABG : 7.51/24/57/18.2/91.2. The wife decided (pt was 56 with end stage cancer) not to intubate and place him on a ventilator. He was made comfort measures. This could have had a different outcome if the patient had coded and was intubated with an admission to the ICU. This would have been traumatic not only to the patient but the family as well.” YNHH SWAT Nurse e-mail , Mon 6/4/2012 9:59 AM
  • 26. Better PatientCare Leads toReduced Variation in Cost Case Type Oncology patients with at least one overnight stay transferred to ICU and expired in ICU Cost Savings Intervention RRT Nurse consults RI prior to transfer, immediate intervention, patient not transferred, receives Palliative Care measures in Oncology Unit and expires on Oncology Unit Non Intervention Cases 95 patients, at least one overnight stay on the Oncology Unit, then transferred to and expired on ICU (7/11/11 –5/31/13) Cost and Goal Metrics •Patients transferred to ICU and expired: Total cost per case $30,965 •Patients not transferred to ICU and expired: Total cost per case $5,590 •Cost difference per case:Difference: $25,375 •GOAL: 50% of transferred patients receive palliative care $1.27M
  • 27. Healthcare Technology •80% people •15% process •5% technology