1) There is significant unexplained variation in Medicare costs per enrollee between different geographic markets, with costs in some markets nearly 300% higher than others.
2) UnitedHealthGroup reviews various programs aimed at influencing clinical behavior through the use of performance data, including organ transplant networks, cardiac data sharing initiatives, and gainsharing programs between providers and hospitals.
3) The organ transplant Centers of Excellence program designates certain medical centers as specialized transplant providers based on meeting quality criteria and economic criteria. This program has led to a 22% reduction in hospital length of stay and a 21% reduction in unnecessary transplants.
Martin Bardsley & Adam Steventon: Stemming demand: how best to track the impa...Nuffield Trust
The document discusses approaches for evaluating interventions aimed at reducing demand for emergency healthcare services using routine data. It summarizes challenges with traditional evaluation methods and proposes using existing data sets to continuously monitor outcomes over time for broad groups of users, developing accurate comparison groups, and exploiting linked data sets. Key approaches discussed are a randomized controlled trial of a telecare intervention and using case controls derived from routine data to account for issues like regression to the mean.
This document is an expression of interest form for the ACFE ementor project 2010. It collects information from organizations about their interest and experience with e-learning and technology-enabled learning. It asks for contact details of participating staff, whether e-learning is part of the organization's strategic plan, and what opportunities and experiences they have with various e-learning tools. The benefits of participation are seen as valuable experience for participants, opportunities for the organization, and improved learning for communities.
Ed Wagner: Integrated care: what are the key factors for successNuffield Trust
Integrated care systems that coordinate care through a shared electronic medical record, common guidelines and formularies, and co-located primary and specialty care can help prevent fragmented care. However, these systems still struggle with communication failures between primary care and specialists. Truly integrated care requires personal relationships and accountability to ensure patients receive necessary services from a collaborating care team.
Anna Dixon on health policy under the coalition governmentThe King's Fund
Anna Dixon, Director of Policy at The King's Fund, looks at the key health policies introduced by the coalition government and at whether they are likely to be effective in future.
This document summarizes a presentation on meaningful use of electronic health records (EHRs) given by Dr. Carl Dirks. It provides background on the national goal of universal EHR adoption by 2015 and the HITECH Act which provided $19 billion in incentives. It outlines the 3 stages of meaningful use, including core and menu objectives for stage 1, and discusses certification of EHR systems, incentive payment timelines, and other requirements to qualify for incentives. The conceptual approach to meaningful use focuses on improving quality, safety, efficiency, care coordination and population health.
CTA is empowering Pacific communities through knowledge by focusing its efforts on partnerships, knowledge sharing, and capacity building. Its goals are to advance food and nutrition security, facilitate policy dialogues, and strengthen agricultural institutions in the Pacific region. Activities include research collaborations, technology transfers, public-private partnerships, and improving information systems. The document provides contact details for the senior programme coordinator.
1) Evidence-based management involves making decisions based on validated facts and data rather than individual expertise, anecdotes, or untested beliefs.
2) Common misleading approaches include casual benchmarking, relying on past practices without reevaluation, and following entrenched beliefs that may be unsupported.
3) Evidence-based management collects facts, validates evidence, and uses results to drive strategic decisions, creating advantages over competitors.
The document discusses the Dental Planning Information System (DPIS), a tool developed by the American Dental Association to help plan for dental workforce needs. DPIS uses statistical analysis of productivity and utilization data from dental offices to project the future supply and demand for dental services. Key factors in the model include the number of dentists and their productivity based on staffing levels and experience, as well as patient utilization rates based on demographics. While not a perfect system, DPIS aims to provide a more evidence-based approach to dental workforce planning than prior methods.
Martin Bardsley & Adam Steventon: Stemming demand: how best to track the impa...Nuffield Trust
The document discusses approaches for evaluating interventions aimed at reducing demand for emergency healthcare services using routine data. It summarizes challenges with traditional evaluation methods and proposes using existing data sets to continuously monitor outcomes over time for broad groups of users, developing accurate comparison groups, and exploiting linked data sets. Key approaches discussed are a randomized controlled trial of a telecare intervention and using case controls derived from routine data to account for issues like regression to the mean.
This document is an expression of interest form for the ACFE ementor project 2010. It collects information from organizations about their interest and experience with e-learning and technology-enabled learning. It asks for contact details of participating staff, whether e-learning is part of the organization's strategic plan, and what opportunities and experiences they have with various e-learning tools. The benefits of participation are seen as valuable experience for participants, opportunities for the organization, and improved learning for communities.
Ed Wagner: Integrated care: what are the key factors for successNuffield Trust
Integrated care systems that coordinate care through a shared electronic medical record, common guidelines and formularies, and co-located primary and specialty care can help prevent fragmented care. However, these systems still struggle with communication failures between primary care and specialists. Truly integrated care requires personal relationships and accountability to ensure patients receive necessary services from a collaborating care team.
Anna Dixon on health policy under the coalition governmentThe King's Fund
Anna Dixon, Director of Policy at The King's Fund, looks at the key health policies introduced by the coalition government and at whether they are likely to be effective in future.
This document summarizes a presentation on meaningful use of electronic health records (EHRs) given by Dr. Carl Dirks. It provides background on the national goal of universal EHR adoption by 2015 and the HITECH Act which provided $19 billion in incentives. It outlines the 3 stages of meaningful use, including core and menu objectives for stage 1, and discusses certification of EHR systems, incentive payment timelines, and other requirements to qualify for incentives. The conceptual approach to meaningful use focuses on improving quality, safety, efficiency, care coordination and population health.
CTA is empowering Pacific communities through knowledge by focusing its efforts on partnerships, knowledge sharing, and capacity building. Its goals are to advance food and nutrition security, facilitate policy dialogues, and strengthen agricultural institutions in the Pacific region. Activities include research collaborations, technology transfers, public-private partnerships, and improving information systems. The document provides contact details for the senior programme coordinator.
1) Evidence-based management involves making decisions based on validated facts and data rather than individual expertise, anecdotes, or untested beliefs.
2) Common misleading approaches include casual benchmarking, relying on past practices without reevaluation, and following entrenched beliefs that may be unsupported.
3) Evidence-based management collects facts, validates evidence, and uses results to drive strategic decisions, creating advantages over competitors.
The document discusses the Dental Planning Information System (DPIS), a tool developed by the American Dental Association to help plan for dental workforce needs. DPIS uses statistical analysis of productivity and utilization data from dental offices to project the future supply and demand for dental services. Key factors in the model include the number of dentists and their productivity based on staffing levels and experience, as well as patient utilization rates based on demographics. While not a perfect system, DPIS aims to provide a more evidence-based approach to dental workforce planning than prior methods.
How readers-discover-content-in-scholarly-journals-summary-editionAamir Jadoon
1) The document summarizes a survey of over 19,000 journal readers about how they discover journal content between 2005-2012 and the impact on publisher websites.
2) Key findings include that search engines and the library/library website are the most popular starting points for discovering content, followed by publisher websites.
3) Reader demographics like region, sector, job role, and subject area were collected to allow for detailed analysis of discovery preferences within groups.
Delivered by Craig Brammer at CITIH 2011. Focus on discussion of regional and national initiatives and opportunities for regional partners to leverage them for driving healthcare improvements, public health and research.
This session will provide a broad perspective on the many initiatives related to HIT. Experts from the regional and national level will discuss data models, privacy concerns and adoption strategies from their different perspectives. Also addressed will be planning for NHIN direct adoption as a complimentary strategic to full HIEs.
- Help the Aged, a UK charity, recruited pledgers (potential future legators) to secure long-term funding through legacies. However, asking for legacies is difficult. They aimed to identify the best prospects to receive a legacy ask through data analysis.
- The analysis included profiling supporter data to find predictive variables, then building models like CHAID and logistic regression to score supporters on their pledge likelihood. This would help target legacy marketing cost-effectively.
- While tailored targeting has costs, average legacy values justify it. Measuring long-term return is difficult due to pledge-to-legacy time lags, so pledge data was used to test and inform legacy marketing.
Accountable Care + Patient Experience = Accountable ExperienceTinaMinnick
See page six in the attached Pennsylvania MGMA Matters publication. Capitation with gain-sharing—
Improving outcomes
and increasing value—Revisiting
integrated delivery tactics
among primary care physicians,
specialists, and hospitals—
Bending the health care
cost curve for managed populations—
Whatever your definition
(in whole or in part) may
be, Accountable Care Organizations
(ACOs) pose a strategic
opportunity for hospitals and
large physician practices alike.
If ACOs can overcome concerns
from a Stark and anti-trust
perspective and are successfully
implemented, patients and
ACO market leaders will see
stronger physician alignment,
improved quality, cost reduction,
and an improved patient
experience.
Two Layer k-means based Consensus Clustering for Rural Health Information SystemIRJET Journal
This document describes a two-layer k-means based consensus clustering algorithm for rural health information systems. The algorithm helps partition heterogeneous data and form sub-clusters within main clusters to enable efficient decision-making. It was tested on an MCTS dataset and found to be highly efficient and robust even with incomplete data, outperforming traditional k-means. The algorithm involves applying k-means clustering twice - first to generate main clusters, then to each main cluster to form sub-clusters - in order to better handle outliers and variations within clusters.
This document discusses the development and deployment of the Regional Cancer Program Formulary Software (RECAP-FS). It was created to automate the process of updating, editing, exporting, archiving, and printing chemotherapy regimen information in an efficient manner. An interim survey and web statistics showed positive results from its use. The document analyzes how characteristics of the innovation, number of users, communication structure, culture, and promotion efforts impacted adoption rates. It assesses the importance of "agents of change" in spreading the software beyond tipping point. Lessons learned from creating RECAP-FS are shared.
Just the Most Compelling Facts: What Communicators & PR Practitioners Want from Research.
Article for Vue - the magazine for the market research and intelligence organization.
This document provides information about an opening keynote at the World Congress Summit on Bundled Payments taking place on January 27-28, 2016 in Atlanta, Georgia. The keynote will feature several speakers discussing value-based purchasing and the transformation of healthcare, including representatives from Centura, Catholic Health Initiatives, UPMC Health Plan, Golden Living, Brooks Rehabilitation, and Cleveland Clinic. Workshops will also be held on leveraging mobile technologies to reduce readmissions and creating efficient and scalable telehealth and remote patient monitoring programs. The summit aims to help healthcare organizations develop successful strategies for episode-based payment through partnerships and physician engagement.
The document summarizes a webinar presentation on discharge follow-up appointments and care transitions. It provides an overview of the Office of the National Coordinator's i2 program which aims to spur innovation and highlight excellence. It then discusses the problem of care transitions and the opportunity to improve follow-up appointments. The document outlines elements of high-quality transitions and impacts on patients. It introduces the Critical Transitions Challenge to create a tool to improve post-discharge scheduling. It provides details on the challenge including desired tool components, pilot planning advice, and judging criteria.
This document summarizes the services and corporate structure of a stem cell company. It describes the costs and timelines for establishing a tissue bank and clinical facility for research and regenerative treatments. It also shows the company's corporate structure with divisions for cosmetics, exosome treatments, and medical treatments distributed in the US, Mexico and internationally.
Leveraging Disruptive Technologies to Succeed In Bundled PaymentsDylan Strecker
A presentation given at the Future of Healthcare in Washington Summit. An unprecedented assembly of Washington healthcare thought and action leaders for a day of executive briefing, connection and inspiration.
CISummit 2013: Bruce Landon, Clinically Integrated Networks and ACOs: Prepari...Steven Wardell
This document summarizes a presentation on clinically integrated networks and accountable care organizations (ACOs). It discusses:
1) The policy context and definitions of ACOs, which accept accountability for spending and quality for defined patient populations.
2) Similar past attempts at integrated care in the 1990s and lessons learned.
3) Infrastructure like electronic medical records that now enables more coordinated care compared to the past.
4) Early evidence that ACO-like models in Massachusetts reduced spending and improved quality for Medicare patients.
5) Major ongoing challenges for ACOs around aligning incentives, performance measurement, and investing to reorganize care delivery.
The how of a design, for health care quality improvement, made simple, would help constructing bridges for and effectively acceptable template for a better performance.
The document summarizes presentations from a health IT seminar in North Carolina. It discusses the NC strategy for health IT which aims to improve healthcare quality and outcomes through better use of technology. It also discusses using telehealth for rehabilitation and the CCNC informatics center which uses data to help manage patient populations. Finally, it discusses NCB Prepared which focuses on using analytics for early detection of biological hazards. Key themes included using data and technology to improve patient care, population health, and public health surveillance.
Lodestar Battery Metals is exploring for battery metals like lithium and silver. It has acquired claims near a lithium discovery in Snow Lake, Manitoba. The presentation provides an overview of the company's strategy to focus on battery metal assets through exploration of its properties and potential acquisitions. It highlights the Peny property in Snow Lake which covers claims near a lithium deposit and has potential to provide shareholder value.
Cidara is developing long-acting therapeutics designed to improve the standard of care for patients facing serious diseases. The Company’s portfolio is comprised of drug candidates intended to transform existing treatment and prevention paradigms. Its lead Phase 3 antifungal candidate, rezafungin, will report Phase 3 data at the end of 2021. The potential peak sales opportunity for rezafungin in the US is ~$750M. In addition, the Company is developing Drug-Fc Conjugates (DFCs) targeting viral and oncology diseases from Cidara’s proprietary Cloudbreak® platform.
AMBS is a regenerative medicine company developing new treatments for CNS disorders and regenerative medicine. It has several programs and subsidiaries developing treatments for conditions like Parkinson's disease, burns, cancer, and retinal diseases. Its lead programs include Eltoprazine for Parkinson's disease levodopa-induced dyskinesia through its subsidiary Elto Pharma, and recombinant MANF protein for retinal conditions like retinitis pigmentosa through its subsidiary MANF Therapeutics. AMBS is currently trading at very low prices but has achieved much higher values in the past, and it believes further progress in its clinical programs could increase its valuation.
This summary provides the high-level information from the document in 3 sentences:
The document discusses Direct Relief, a nonprofit organization that received the Peter F. Drucker Award for Nonprofit Innovation. Direct Relief strengthened its operations through innovative use of information technology to more efficiently distribute over $250 million in medical aid to clinics domestically and internationally. The document highlights comments from Direct Relief's CEO and the Drucker Institute praising Direct Relief's adaptation of private sector best practices and information systems to better achieve its social mission.
1) Catasys is a healthcare company that uses AI and telehealth to engage with members who avoid care through their OnTrak program, driving lasting behavior change and lowering costs.
2) Their proprietary PRE platform uses machine learning to identify high-cost members with behavioral health conditions and comorbidities who are not seeking treatment.
3) Catasys sees significant growth opportunities in expanding their OnTrak program to more health plans and states based on their track record of 54% savings per member and nearly 5:1 ROI for health plans.
How readers-discover-content-in-scholarly-journals-summary-editionAamir Jadoon
1) The document summarizes a survey of over 19,000 journal readers about how they discover journal content between 2005-2012 and the impact on publisher websites.
2) Key findings include that search engines and the library/library website are the most popular starting points for discovering content, followed by publisher websites.
3) Reader demographics like region, sector, job role, and subject area were collected to allow for detailed analysis of discovery preferences within groups.
Delivered by Craig Brammer at CITIH 2011. Focus on discussion of regional and national initiatives and opportunities for regional partners to leverage them for driving healthcare improvements, public health and research.
This session will provide a broad perspective on the many initiatives related to HIT. Experts from the regional and national level will discuss data models, privacy concerns and adoption strategies from their different perspectives. Also addressed will be planning for NHIN direct adoption as a complimentary strategic to full HIEs.
- Help the Aged, a UK charity, recruited pledgers (potential future legators) to secure long-term funding through legacies. However, asking for legacies is difficult. They aimed to identify the best prospects to receive a legacy ask through data analysis.
- The analysis included profiling supporter data to find predictive variables, then building models like CHAID and logistic regression to score supporters on their pledge likelihood. This would help target legacy marketing cost-effectively.
- While tailored targeting has costs, average legacy values justify it. Measuring long-term return is difficult due to pledge-to-legacy time lags, so pledge data was used to test and inform legacy marketing.
Accountable Care + Patient Experience = Accountable ExperienceTinaMinnick
See page six in the attached Pennsylvania MGMA Matters publication. Capitation with gain-sharing—
Improving outcomes
and increasing value—Revisiting
integrated delivery tactics
among primary care physicians,
specialists, and hospitals—
Bending the health care
cost curve for managed populations—
Whatever your definition
(in whole or in part) may
be, Accountable Care Organizations
(ACOs) pose a strategic
opportunity for hospitals and
large physician practices alike.
If ACOs can overcome concerns
from a Stark and anti-trust
perspective and are successfully
implemented, patients and
ACO market leaders will see
stronger physician alignment,
improved quality, cost reduction,
and an improved patient
experience.
Two Layer k-means based Consensus Clustering for Rural Health Information SystemIRJET Journal
This document describes a two-layer k-means based consensus clustering algorithm for rural health information systems. The algorithm helps partition heterogeneous data and form sub-clusters within main clusters to enable efficient decision-making. It was tested on an MCTS dataset and found to be highly efficient and robust even with incomplete data, outperforming traditional k-means. The algorithm involves applying k-means clustering twice - first to generate main clusters, then to each main cluster to form sub-clusters - in order to better handle outliers and variations within clusters.
This document discusses the development and deployment of the Regional Cancer Program Formulary Software (RECAP-FS). It was created to automate the process of updating, editing, exporting, archiving, and printing chemotherapy regimen information in an efficient manner. An interim survey and web statistics showed positive results from its use. The document analyzes how characteristics of the innovation, number of users, communication structure, culture, and promotion efforts impacted adoption rates. It assesses the importance of "agents of change" in spreading the software beyond tipping point. Lessons learned from creating RECAP-FS are shared.
Just the Most Compelling Facts: What Communicators & PR Practitioners Want from Research.
Article for Vue - the magazine for the market research and intelligence organization.
This document provides information about an opening keynote at the World Congress Summit on Bundled Payments taking place on January 27-28, 2016 in Atlanta, Georgia. The keynote will feature several speakers discussing value-based purchasing and the transformation of healthcare, including representatives from Centura, Catholic Health Initiatives, UPMC Health Plan, Golden Living, Brooks Rehabilitation, and Cleveland Clinic. Workshops will also be held on leveraging mobile technologies to reduce readmissions and creating efficient and scalable telehealth and remote patient monitoring programs. The summit aims to help healthcare organizations develop successful strategies for episode-based payment through partnerships and physician engagement.
The document summarizes a webinar presentation on discharge follow-up appointments and care transitions. It provides an overview of the Office of the National Coordinator's i2 program which aims to spur innovation and highlight excellence. It then discusses the problem of care transitions and the opportunity to improve follow-up appointments. The document outlines elements of high-quality transitions and impacts on patients. It introduces the Critical Transitions Challenge to create a tool to improve post-discharge scheduling. It provides details on the challenge including desired tool components, pilot planning advice, and judging criteria.
This document summarizes the services and corporate structure of a stem cell company. It describes the costs and timelines for establishing a tissue bank and clinical facility for research and regenerative treatments. It also shows the company's corporate structure with divisions for cosmetics, exosome treatments, and medical treatments distributed in the US, Mexico and internationally.
Leveraging Disruptive Technologies to Succeed In Bundled PaymentsDylan Strecker
A presentation given at the Future of Healthcare in Washington Summit. An unprecedented assembly of Washington healthcare thought and action leaders for a day of executive briefing, connection and inspiration.
CISummit 2013: Bruce Landon, Clinically Integrated Networks and ACOs: Prepari...Steven Wardell
This document summarizes a presentation on clinically integrated networks and accountable care organizations (ACOs). It discusses:
1) The policy context and definitions of ACOs, which accept accountability for spending and quality for defined patient populations.
2) Similar past attempts at integrated care in the 1990s and lessons learned.
3) Infrastructure like electronic medical records that now enables more coordinated care compared to the past.
4) Early evidence that ACO-like models in Massachusetts reduced spending and improved quality for Medicare patients.
5) Major ongoing challenges for ACOs around aligning incentives, performance measurement, and investing to reorganize care delivery.
The how of a design, for health care quality improvement, made simple, would help constructing bridges for and effectively acceptable template for a better performance.
The document summarizes presentations from a health IT seminar in North Carolina. It discusses the NC strategy for health IT which aims to improve healthcare quality and outcomes through better use of technology. It also discusses using telehealth for rehabilitation and the CCNC informatics center which uses data to help manage patient populations. Finally, it discusses NCB Prepared which focuses on using analytics for early detection of biological hazards. Key themes included using data and technology to improve patient care, population health, and public health surveillance.
Lodestar Battery Metals is exploring for battery metals like lithium and silver. It has acquired claims near a lithium discovery in Snow Lake, Manitoba. The presentation provides an overview of the company's strategy to focus on battery metal assets through exploration of its properties and potential acquisitions. It highlights the Peny property in Snow Lake which covers claims near a lithium deposit and has potential to provide shareholder value.
Cidara is developing long-acting therapeutics designed to improve the standard of care for patients facing serious diseases. The Company’s portfolio is comprised of drug candidates intended to transform existing treatment and prevention paradigms. Its lead Phase 3 antifungal candidate, rezafungin, will report Phase 3 data at the end of 2021. The potential peak sales opportunity for rezafungin in the US is ~$750M. In addition, the Company is developing Drug-Fc Conjugates (DFCs) targeting viral and oncology diseases from Cidara’s proprietary Cloudbreak® platform.
AMBS is a regenerative medicine company developing new treatments for CNS disorders and regenerative medicine. It has several programs and subsidiaries developing treatments for conditions like Parkinson's disease, burns, cancer, and retinal diseases. Its lead programs include Eltoprazine for Parkinson's disease levodopa-induced dyskinesia through its subsidiary Elto Pharma, and recombinant MANF protein for retinal conditions like retinitis pigmentosa through its subsidiary MANF Therapeutics. AMBS is currently trading at very low prices but has achieved much higher values in the past, and it believes further progress in its clinical programs could increase its valuation.
This summary provides the high-level information from the document in 3 sentences:
The document discusses Direct Relief, a nonprofit organization that received the Peter F. Drucker Award for Nonprofit Innovation. Direct Relief strengthened its operations through innovative use of information technology to more efficiently distribute over $250 million in medical aid to clinics domestically and internationally. The document highlights comments from Direct Relief's CEO and the Drucker Institute praising Direct Relief's adaptation of private sector best practices and information systems to better achieve its social mission.
1) Catasys is a healthcare company that uses AI and telehealth to engage with members who avoid care through their OnTrak program, driving lasting behavior change and lowering costs.
2) Their proprietary PRE platform uses machine learning to identify high-cost members with behavioral health conditions and comorbidities who are not seeking treatment.
3) Catasys sees significant growth opportunities in expanding their OnTrak program to more health plans and states based on their track record of 54% savings per member and nearly 5:1 ROI for health plans.
Similar to Kirk Stapleton: How performance data can influence clinical behaviour (20)
This document discusses the potential impacts of automation on healthcare employment and discusses alternative views beyond job loss. It notes that automation may lead to reconfiguring of healthcare work rather than outright job loss. Examples of existing technologies that have automated tasks in healthcare like pharmacy automation and emerging technologies like decision support systems and personal health tracking are provided. The document advocates that automation could lead to a virtuous cycle in healthcare if it allows workers to focus on tasks that require human skills and judgment.
Evaluation of the Integrated Care and Support Pioneers ProgrammeNuffield Trust
This document summarizes the findings of evaluations of the Integrated Care and Support Pioneers Programme in the UK. The evaluations found that while Pioneers aspired to comprehensive system change, their activities focused more narrowly on initiatives like risk stratification and care coordination teams. Progress was difficult to measure against indicators and Pioneers faced challenges from financial pressures and competing priorities. The evaluations concluded that further integration will be challenging under increasing demands on the health system.
The document discusses lessons learned from the Southwark and Lambeth Integrated Care (SLIC) program in London. Key points:
- SLIC aimed to reduce hospital admissions and care home placements for older adults through risk stratification, holistic assessments, and care management.
- Success required agreement on the problem, dedicated teams, funding shifts to support community care, and leadership development.
- Future programs need a strong business case, co-design with citizens, and a dedicated "engine room" team to drive local transformation.
Effectiveness of the current dominant approach to integrated care in the NHSNuffield Trust
Jonathan Stokes of the Greater Manchester Primary Care Patient Safety Translational Research Centre presents a systematic review of case management in integrated care.
Providing actionable healthcare analytics at scale: Understanding improvement...Nuffield Trust
This document discusses measurement for quality improvement. It explains that measurement in improvement aims to provide a basis for action to improve processes and outcomes, rather than just estimating parameters. Improvement measures should be simple, specific, and available in real-time. Statistical process control methods are important to separate normal variation from changes resulting from interventions. Examples are provided of run charts measuring improvements in recording BMI for mental health patients and compliance with care bundles. The document advocates making the theories behind improvement efforts more explicit.
Ramani Moonesinghe, Associate National Clinical Director for Elective Care at NHS England, discusses the use of data for monitoring care quality at various levels within the system.
This document discusses using statistical process control (CUSUM) charts to monitor mortality rates at the level of individual general practitioners and health authorities. It describes how CUSUM charts could potentially have detected Harold Shipman, a GP who murdered over 200 patients, by spotting outliers in the routine mortality data. The document also discusses challenges in risk adjusting outcomes to account for differences in patient characteristics and casemix between providers. Accurately adjusting for factors like age, comorbidities, and emergency status is important for fair comparisons but difficult using only administrative data.
Martin Utley, Director of the Clinical Operational Research Unit at University College London, reflects upon his involvement in the launch of specific tools to monitor care quality for paediatric cardiac surgery.
Evaluating new models of care: Improvement Analytics UnitNuffield Trust
Martin Caunt, Improvement Analytics Unit Project Director and NHS England and Adam Steventon, Director of Data Analytics at The Health Foundation share insights into how they have approached evaluating new models of care.
Lisa Annaly, Head of Provider Analytics at the Care Quality Commission, discusses lessons learned from the CQC as they have worked to monitor care quality over time.
- Real-time monitoring of healthcare services requires defining both a reporting window and data window to accurately capture demand, activity, and wait times.
- Using only a reporting window (e.g. a single month) to request data can result in invalid or misleading performance metrics, as it does not account for patients with long wait times.
- Defining a larger data window that includes all patients requested before the end of the reporting window and reported after the start avoids this problem, but requires a counterintuitive data request.
- Without properly defining both windows, real-time monitoring can provide an inaccurate picture of service performance and falsely suggest the need for more resources.
Monitoring quality of care: making the most of dataNuffield Trust
Chris Sherlaw-Johnson, Senior Research Analyst at the Nuffield Trust, introduced the Monitoring quality of care conference and gives an overview of some of the approaches that we've been using at the Trust to identify where care quality has been improving, especially for frail and older people.
Providing actionable healthcare analytics at scale: Insights from the Nationa...Nuffield Trust
Christopher Boulton, Falls and Fragility Fracture Audit Programme Manager at the Royal College of Physicians and Rob Wakeman, Clinical Lead for Orthopaedic Surgery at the National Hip Fracture Database talk about what they have learned by analysing the national hip fracture database.
Providing actionable healthcare analytics at scale: A perspective from stroke...Nuffield Trust
Benjamin Bray, Research Director and the Sentinel Stroke National Audit Programme, presents at the Monitoring quality of care conference about stroke care analytics.
New Models of General Practice: Practical and policy lessonsNuffield Trust
Nuffield Trust policy researchers Rebecca Rosen and Stephanie Kumpunen present findings from our upcoming report on large scale general practice models.
low birth weight presentation. Low birth weight (LBW) infant is defined as the one whose birth weight is less than 2500g irrespective of their gestational age. Premature birth and low birth weight(LBW) is still a serious problem in newborn. Causing high morbidity and mortality rate worldwide. The nursing care provide to low birth weight babies is crucial in promoting their overall health and development. Through careful assessment, diagnosis,, planning, and evaluation plays a vital role in ensuring these vulnerable infants receive the specialize care they need. In India every third of the infant weight less than 2500g.
Birth period, socioeconomical status, nutritional and intrauterine environment are the factors influencing low birth weight
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
Kirk Stapleton: How performance data can influence clinical behaviour
1. How Performance Data Can
Influence Clinical Behavior
Kirk Stapleton- SVP United HealthGroup
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
2. Unexplained Market Variation in Cost and Quality
2
Medicare Per Enrollee Annual Cost Growth Rates Nearly 300% Variation in Last 2 Years of
+3.7% to 7.7% Life by Market
Miami $81,175 per Person
Minneapolis $33,325
Honolulu $27,655 per year
Health Expenditure Data, Health Expenditures by State of Residence, Centers for Medicare and Medicaid Services, Office of the
Actuary, National Health Statistics Group, released September 2007; available www.cms.hhs.gov/NationalHealthExpendData/“
Kaiser Foundation, http://www.statehealthfacts.org/profileind.jsp?ind=332&cat=6&rgn=25
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
3. Review of Programs
3
• Organ Transplant- Hospital & Clinical Team Focus
• Cardiac Data Sharing- Office Practice Focus
• Cardiologist Gainsharing on AMI- Practice vs Hospital Gain
• Provider Designation- Patient Focus
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
4. Transplant Centers of Excellence (since 1986)
4
Goal:
•Provide payors and patients with accessible, high quality
performance with economic value and consistency for S upe rior Ou tc om e s, C linica l Ex pe rtis e a nd Exp erie nce
transplantation services le ad to Gr ea te r S av ings a nd C os t A voida nc e
C en te rs o f Ex ce ll e nc e N e t w o rk p ro g ra m s y ie ld a n a v e ra ge 2 2 %
d e c re as e in ho s p i tal le n g th o f s ta y
Specialized Transplant Care Provider Network C li n ic a l Ex p e rt is e l e a ds to a 21 % re d u c tio n o f inc i d e n c e b y
a vo id i n g u nn e ce s s a ry a n d i n a p p ro pr i ate tra n sp la n ts, thr ou g h b e tt er
•126 Multi-organ Medical Centers (623 transplant programs) d ia g no s is a n d m o re ap p ro p ria te tre atm e n t i de n tif ic a ti o n
•selected based meeting quality criteria (ie. patient and graft Tr a n s pla n t I n p a tie n t D a y s Tr a n s pl a nt In c id e nc e pe r 1 M M M e m b e r s
survival thresholds, case volumes, team attributes), and; 25
180
• economic criteria (patient episode of care contracts including 20
22%
160
21%
Txps per 1M M Memb ers
140
Avg. Txp. IP Days
15 120
MD, organ procurement, inpatient and outpatient care)- 10
100
80
•Patient episode of care contract with Medical center~ pre- 5
60
40
20
evaluation through 1 year followup 0
O pt u m He a lth CO Es M i lliim a n 20 0 5 Es ti m a te
0
O p t um He a lt h M illim a n 200 7
In ci de n c e Es t im a t e
Patient and Referring MD Decision Support S OU R CE S : 2 00 2 – 2 00 7 Op tu mH ealt h C O E tra ns pla nt da ta , M il lim an 2 00 5 + 2 00 7
13
•Patient education and MD referral support to transplant
network with dedicated case and account management and Savings via Contract Design Expertise
service
Claims Repackaging OptumHealth’s transplant cost exposure experience allows us to design
•fee for service claims assembled into patient episode and detailed terms around other cost risk areas outside of the transplant
procedure which often represent 40%+ of costs
priced consistent with contract terms- reported and measured
e.g. Fixed $ Defined Cont rol led Cost s Uncapped Cost Risk
against market and billed charge costs.
e .g. % Disc ount
Phase I Phase II Phase III Phase IV Phase V
Transplant Pre- Transplant Post- Transpl ant Post-Transplant
T o t a l R e f e r r a l s a n d T r a n s p la n t s 2 0 0 1 - 2 0 0 7 Evaluat ion Transplant Procedure 90 Days 365 Days
Dis tr ib uti on o f
1 2000
R e f e r r a ls
1 1 ,1 4 0
Tra ns p la nt
Cha rg e s 5% 10% <60% 15% 10%
10, 686
T ra n s p la n t s
976 2 ** ** Average
Average
1 0000 OH **
savings per
savings per
867 5 Contracts
T o ta l p e r Y e a r
case* ==43%
case* 43%
8000
Competitor Average
647 0 Average
Con tracts savi ngs per
5 738 savings per
6000 522 2 case* ==30%
* Sav in gs based on Milliman, In c charges (2006), which do not incl. candidacy ch arges case* 30%
** For in patient services; outpatient is % discounts a n also uncapped
d
368 8 3, 960
36 27
4000
30 68 Typical Competitor Contracts address <60% of the ec onomic risk
2 542
19 55 21 55
2000
16
0
0 1 02 03 0 4 0 5 06 0 7
20 20 20 2 0 2 0 20 2 0
Confidential property of UnitedHealth Group.Y e a r distribute or reproduce without the express permission of UnitedHealth Group.
Do not
5. Cardiac Data-Sharing Visit Program (since 2006)
5
Goal:
•decrease utilization of unnecessary high-cost diagnostic services and
procedures Results:
•redirect inpatient procedures to low-cost facilities •A paired t-test analysis showed a statistically
•reinforce society defined appropriateness criteria significant difference in the change pre/post for
Angiograms, Echo's, and Perfusion Studies per
•Activity: Office Visit for the intervention group compared to
• Study: 2 groups (visited /35 groups~351MDs vs not visited/16 the control group No difference in use of low cost
groups~200MDs ) facilities and cv rate per visit noted
•Group visits discussions included ,episode of care measurement, utilization
of diagnostic services, performance characteristics and comparison to peers, •In addition, the intervention group showed a
ACC treatment guidelines statistically significant decrease in PCI
Procedures/Office Visit
•Intervention vs control groups compared on pre/post-intervention utilization
metrics •Overall rate of use per office visit declined 16% for
Diagnostic Services/Office Visit*: Angiograms, Echocardiograms, Perfusion Studies angiograms and 6% perfusion studies for the
Procedures/Office Visit: CV Surgeries, PCIs intervention group, offset by an increase of 13% of
% of Procedures performed at a Low Cost Facility: CABG, Valves, Implants, PCIs echoes. This trend appears sustainable at 12
months..
•12-18 month group and individual MD risk adjusted claims data , grouped
into patients episodes; groups are selected based on variance between •Program expanded to over 400 groups nationwide
actual and expected episodic costs as measured in the Premium program
Cardiac Data-Sharing Preliminary Results - (Paired T-Test, Two-Tailed)
Pre/Post Visit Change
Metric Pilot Group Control Group Fav/Unfav Significance
% of Cases Performed at a "Low Cost" Facility (met efficiency) n/a n/a Not applicable T-Test not significant for both
Diagnostic Services
Angiograms / Office Visit + 11 bp n/a Favorable T-Test significant for Pilot only
Echocardiograms / Office Visit - 27 bp - 37 bp Favorable T-Test significant for both
Perfusion Studies / Office Visit + 26 bp n/a Favorable T-Test significant for Pilot only
Procedures
CV Surgeries / Office Visit n/a n/a Not applicable T-Test not significant for both
PCIs / Office Visit + 5 bp n/a Favorable T-Test significant for Pilot only
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
6. Cardiac Gainsharing Pilot- Tampa (since Jan 2009)
6
Goal:
•Improve quality and cost effectiveness of cardiac care with support of community delivery systems (cardiologist) through
sharing cost and quality performance data
•Participating groups must meet threshold of quality and demonstrate consistency of high quality
•Participating groups share in market level savings through enhanced fee for service
Establish mandatory quality thresholds for all participating cardiologists
•Must meet 80% of cardiac related Evidence Based Medicine criteria
•Must earn UHPD Premium Designation for Quality for all proceduralists
Created a mutually shared target for total cardiac cost for all members living in the geographic boundary
•Cardiac PMPM target shared by key cardiologist physician groups in the market
•Includes inpatient facility costs, all professional fees (regardless of specialty), ancillary testing, etc.
•Provide opportunity for physicians to increase revenue while helping improve overall quality and cost for members and employers
•Group of MDs & UHC are focused on reduction of Chest Pain Admissions
Gain Sharing Bonus Determination Early but Promising reductions in Cardiac Admissions
The Gain Sharing bonus will be determined by the 6 month Cardiac PMPM cost for Pinellas County Weekly Chest Pain Admissions
Pinellas county members. There is no penalty or “down-side” to the physician groups.
y = -0.0427x + 1712.2
Baseline Cardiac 20
PMPM Costs for If actual costs finish above
Market target; no bonus payment
18
Chest Pain Admissions 16
Target PMPM Costs
14
Costs below target;
12
Participating MD Groups get 50% of the
savings below the target level 10
Example: if target was $30.00 and actual costs
for the 6 month measurement period were 8
$28.00 PMPM, the bonus for physicians would
be 50% X (30.00 – 28.00) = $1.00 PMPM* 6
(~$1.4 million for pilot population)
4
2
0
*The bonus is distributed through a temporary increase in the physician’s fee schedule
9/1/2008
9/15/2008
9/29/2008
10/13/2008
10/27/2008
11/10/2008
11/24/2008
12/8/2008
12/22/2008
1/5/2009
1/19/2009
2/2/2009
2/16/2009
3/2/2009
7
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
7. Cardiac and Orthopedics Specialty Centers (Since 2004)
7
Goal:
•Differentiate hospital/MDs network for acute and frequent interventions resulting in value creation for customer and health consumer
(UHC)
•Share data with delivery system to Improve practice patterns through public designation supported with actionable information –
gain cost efficiency through reduced complications, and rework
Facilities and MDs that are measured against national When combined with Premium
performance quality standards and cost expectations: Designations for MDs who achieved quality
and efficiency and high performing cardiac
•Facility and Clinical teams measured together- scored and depicted on
and orthopedic facilities :
quality scale from 1 to 3 stars; economic scores depicted from greater
efficiency to lower efficiency Cardiologists who earn a quality designation have 42% fewer
redo procedures and 13% lower complication rates for stent
placement than other cardiologists.
•Cardiac programs (1,240 interventional, rhythm management and surgical)
nationwide that are scored against criteria utilizing, process and outcomes Cardiothoracic surgeons who earn a quality designation
have 19% fewer redo CABG (CoronaryArtery Bypass Graft)
measures ~ Society for Thoracic Surgery ( 11 NQF measures) and surgeries than other surgeons.
American College of Cardiology (7 executive summary measures) hospital
ranking to measure quality and outcomes; uses UHC claims data for risk Cardiologists who earn a quality designation have 31% fewer
redo procedures for rhythm management device implants
adjusted episode of care costs (pacemakers, implantable defibrillators, etc.) than other
cardiologists
•Spine and total joint repair programs (523) uses process of care and Orthopedic surgeons who earn a quality designation have
outcomes (complication, redo) and volume data survey data ; and UHC 45% fewer redo spine surgeries than other surgeons
claims data for risk adjusted cost
Orthopedic surgeons who earn a quality designation have
20% fewer redo arthroscopic knee procedures than other
surgeons.
•Hospitals with the highest quality ranking and lowest costs
are projected to have hospital costs that are 30% below market
average
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
8. What We Have Learned
8
• Reporting Accuracy- Patient Level Proof
• Reconsideration- If Data Is Wrong- Get it Right
• Clinical Reporting Is A Process
Introduction to Process- “What we are going to measure & Why”
Transparency of methodology- “How we are measuring and When”
Face to Face Meeting with Actionable Information “Your Report and What it Means”
• Academic and Health Policy Recognition
• Reinforcement for Sustainable Change –New Business Model Adoption
Policy and Payment
Market Share (ie More Patients)
Recognized Value (ie improved profitability or greater revenues)
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.