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Leveraging Automated Data Flows, AI, and Analytics for Chart Abstraction
The document outlines solutions by Health Catalyst to enhance registry participation through technology, specifically focusing on cost reduction and value increase via automated data flows, AI, and analytics. Key offerings include the Armus suite for streamlined chart abstraction, CRSTAR for cancer registries, and Technology-Enabled Managed Services (TEMS) to manage data abstraction responsibilities. Case studies presented demonstrate significant improvements in clinical outcomes and operational efficiencies achieved through these innovations.
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Leveraging Automated Data Flows, AI, and Analytics for Chart Abstraction
- 1. © 2024 HealthCatalyst Inc. All Rights Reserved. Reducing the Cost and Increasing the Value of Registry Participation Automated Data Flows, AI, and Analytics for Chart Abstraction Allie Coronis, Sheila Fairless, and Melanie Rogan
- 2. Agenda © 2024 HealthCatalyst Inc. All Rights Reserved. Reducing the Cost, Increasing the Value of Registry Participation ARMUS: AI Chart Abstraction Tool and Analytics CRStar: Automated Data Integrations, NLP, Accreditation Management, and Analytics TEMS: Bundled Service Offering to Reduce Costs Insights to Impact – A Case Study
- 3. © 2024 HealthCatalyst Inc. All Rights Reserved. Two Types of Value in Registries Regulatory, Accreditation, and Reputation Insights, Improvement, and Better Performance
- 4. © 2024 HealthCatalyst Inc. All Rights Reserved. Reducing the Cost, Increasing the Value ARMUS for Hospitals Suite • CV, GI, OB, and spine registries • Streamlined data abstraction • Analytics to provide insights CRStar • Cancer registries • More efficient case finding and abstraction • Analytics to provide insights Data and Analytics Platform • Data integration and automation • Tools to support efficiency and process improvements TEMS (Technology- Enabled Managed Services) Health Catalyst takes on the responsibility for your data abstractors, trains them in process improvement, and provides them tools to gain efficiency
- 5. © 2024 HealthCatalyst Inc. All Rights Reserved. ARMUS for Hospitals Suite
- 6. © 2024 HealthCatalyst Inc. All Rights Reserved. ARMUS by Health Catalyst Technology and services combined into one clinical registry solution to increase the value of clinical registry participation for healthcare institutions
- 7. © 2024 HealthCatalyst Inc. All Rights Reserved. Poll Question #1 1. What is the average time to abstract an STS Adult Cardiac CAB Only record manually (roughly 500 fields)? o 60 minutes o 90 minutes o 120 minutes o 240 minutes
- 8. © 2024 HealthCatalyst Inc. All Rights Reserved. ARMUS Automation Technologies 1. ADT Interface: Templated data extract to automatically import admission, discharge, and transfer data from Hl7 messages 2. Clinical Data Importer: Custom data extract from EMR to prepopulate fields for abstraction cases (e.g., demographics and discreate clinical data points.). The number of fields that can be prepopulated varies based on data availability in the EMR. Ideal for importing discrete data that can be directly populated. 3. Abstraction AI: Suggests an answer for each registry field based on patient note data. Ideal for populating fields that are not discretely documented in the electronic medical record (EMR). Basic Automation • ADT Interface Advanced Automation • ADT Interface • Clinical Data Importer • Abstraction AI
- 9. © 2024 HealthCatalyst Inc. All Rights Reserved. AI Chart Abstraction Tool Completed STS Registry Data PATIENT NOTES Fine-tuned Generative AI chart abstraction model* + New Patient Admission ^LLM-based search: for relevant notes or note segments related to a registry question PATIENT NOTES Suggested Answer with Supporting evidence *Fine-tuned on ~6% of available data, retraining on full data set Faster abstraction with higher quality ^LLM- Large Language Model
- 10. © 2024 HealthCatalyst Inc. All Rights Reserved. ARMUS Chart Abstraction Tool with AI The-AI Suggested Answer is intended to supplement your review of all relevant records related to the episode. Definitions & Suggestions - Definitions: o Keyboard Shortcuts o Registry Definitions o Coding Instructions - AI Suggestions: o Suggested Answers to supplement abstractors chart review Validations - Warnings for missing or out of range data - Illegal for critical missing or out of range data
- 11. © 2024 HealthCatalyst Inc. All Rights Reserved. ARMUS Chart Abstraction Tool with AI RF-Hypertension Missing The-AI Suggested Answer is intended to supplement your review of all relevant records related to the episode.
- 12. © 2024 HealthCatalyst Inc. All Rights Reserved. Analytic Insights to Drive Improvement High-value analytic insights in the HYBRID Platform, including benchmarking, to identify and drive outcomes
- 13. © 2024 HealthCatalyst Inc. All Rights Reserved. CRStar for Cancer Registries
- 14. © 2024 HealthCatalyst Inc. All Rights Reserved. CRStar: Who We Serve Patient Serving Staff • Oncology Data Specialists (ODS-C) • Oncology directors • Oncology service line partners • Clinicians and Research • Administrators Hospital-based Cancer Registries • Large health systems • Academic facilities • Smaller community hospitals • Small state reporting-only facilities
- 15. © 2024 HealthCatalyst Inc. All Rights Reserved.
- 16. © 2024 HealthCatalyst Inc. All Rights Reserved. Integration and Interoperability Intelligent Abstracting and Casefinding Accreditation Tracker On-demand Education and Support Enterprise Reporting and Analytics Reporting to Support Oncology Service Line Initiatives Driving Improvement Transforming cancer data into patient experience to improve outcomes
- 17. © 2024 HealthCatalyst Inc. All Rights Reserved. Automated Data Integrations Improved Casefinding, Data Abstraction, and Follow-Up Interfaces Inbound Interfaces EMR Pathology Medical Oncology Data Warehouse Navigation Tumor Boards Precision Medicine Real time / Pre-scheduled HL7 API SFTP Outbound
- 18. © 2024 HealthCatalyst Inc. All Rights Reserved. NLP Reportability Solution Natural Language Processing (NLP) for more efficient and productive casefinding Why? • Organizations spend an average of 15% of their time on casefinding • Concurrent abstracting and reporting is needed for regulatory requirements and clinical research, so efficiency is vital What? • Uses NLP to analyze free-text pathology reports and extract information to identify a case’s reportability • Replaces manual methods • Provides queues to manage workflows and case assignment
- 19. © 2024 HealthCatalyst Inc. All Rights Reserved. Poll Question #2 How many of your Oncology Programs are accredited by or have plans to seek accreditation from: 1. Commission on Cancer (COC) 2. National Program for Breast Centers (NAPBC) 3. National Program for Rectal Cancer (NAPRC) 4. All of the above
- 20. © 2024 HealthCatalyst Inc. All Rights Reserved. Accreditation Management NAPBC • NAPBC Chart Audits • Continuum of Care Monitoring • Quality Measures • Data Analytics capabilities NAPRC • NAPRC Chart Audits • Continuum of Care Monitoring • Quality Measures • Data Analytics capabilities CoC • CoC Chart Audits • Continuum of Care Monitoring • Tumor Board Management • Clinical Trial Management • Quality Measures • Data Analytics NAPBC • NAPBC Chart Audits • Continuum of Care Monitoring • Quality Measures • Data Analytics NAPRC • NAPRC Chart Audits • Continuum of Care Monitoring • Quality Measures • Data Analytics National Accreditation Program for Breast Centers National Accreditation Program for Rectal Cancer Commission on Cancer
- 21. © 2024 HealthCatalyst Inc. All Rights Reserved. Insights to Drive Improvement Site Distribution Treatment Analysis Automated Survival Statistics Registry Management Custom Data Visualizations Data Quality Metrics Dashboard KPIs
- 22. © 2024 HealthCatalyst Inc. All Rights Reserved. Benchmarking with State and National Standards
- 23. © 2024 HealthCatalyst Inc. All Rights Reserved. Quality and Research
- 24. © 2024 HealthCatalyst Inc. All Rights Reserved. Technology-Enabled Managed Services (TEMS) A bundled services offering that further reduces the cost of registry participation
- 25. © 2024 HealthCatalyst Inc. All Rights Reserved. How TEMS Works A TEMS partnership transfers ownership and responsibility for data abstraction and registry submission to Health Catalyst. People. We “rebadge” team members to be Health Catalyst team members, assuming responsibility for pay, benefits, and training. Technology. We utilize tools to enable more efficient and accurate extraction and submission of data. Processes. Our project management, analytics, and improvement frameworks gives our team members a proven methodology as their time is freed up to focus on outcomes improvement.
- 26. © 2024 HealthCatalyst Inc. All Rights Reserved. Insights to Impact Community Health Network participates in the National Cardiovascular Data Registry. Quality metrics from the registry revealed an area for improvement: reducing the risk of bleeding after coronary intervention. Analytics and chart abstractors from Health Catalyst brought insights on how to improve. Insights and improvement Impact Implemented standard order sets to meet and document key requirements for PCI patients, with peer-to-peer education provided by physician champions Clarified the patient inclusion standards and engaged with the registry to clearly define the criteria for bleeding events 42.3% Relative increase in PCIs using a radial approach for lower bleeding risk $1.8 million Cost savings as a result of these improvements 58% Relative reduction in bleeding complications over 3 years and 18% reduction in LOS over 24 months Formed an interdisciplinary work group that used registry data insights to identify and resolve key care gaps, including time capture issues for point-of-care testing
- 27. Questions? © 2024 HealthCatalyst Inc. All Rights Reserved. Sheila Fairless | Clinical Services Director, ARMUS Melanie Rogan | Solutions Architect, CRStar Allie Coronis | SVP of Tech Enabled Managed Services Dan Samarov | VP of Data Science Solutions Alora Martin | Webinar Program Manager Hcwebinars@healthcatalyst.com
- 28. © 2024 HealthCatalyst Inc. All Rights Reserved. Thank You!
Editor's Notes
- #6 Sheila – 1 min ARMUS Technology Solutions provides clinical registry solutions, including Cardiovascular, GI, OB Spine, Vascular and other specialties. Data can be entered manually or electronically ingested into Hybrid Outcomes. In order to reduce data burden, increase abstraction efficiencies and improve data quality, ARMUS provides various interface applications, Data Quality Tools and IRR Auditing tools. Our goal is to continue to work with our partners to more efficiently and effectively get to the data results. The ARMUS Hybrid Analytics tools provide for actionable analytics with a variety of reporting tools, including pre-defined reports, dashboards and patient level ad hoc tooling. These tools help our partners drive outcomes improvement.
- #7 ARMUS – Poll Question Average time is 90 minutes
- #8 Sheila – 2 min While the average time for STS Adult Coronary Artery Bypass cases has been estimated at 90 minutes, we know that these times can vary based on the complexity of case volumes. ARMUS Automation technologies provides for Basic Automation (with ADT Interfacing for Demographics and Admit/Discharge information) and Advanced Automation (with ADT Interface, Clinical Data Importer of Clinically Discreet fields, and Abstraction AI) as noted in the slide. Of course, Automation is not required, but the efficiencies gained can be significant and can help in reducing these case times. One of our Health Catalyst Case Studies noted automation of 69 ACSD registry files, with a saving of 12-15 minutes abstraction time per record which is a 10-25% reduction in abstraction time. The addition of AI is projected to additionally increase efficiency further and time studies will be forthcoming with our Pilot projects.
- #9 Sheila – 2 min The new AI capability will further enhance abstraction opportunities and efficiencies. The AI tool utilizes the patients electronic medical records patient notes to gather data for fields in the registry and provide a recommended answer. Before I go into the next slides in order to visualize how the AI suggest tool works in the ARMUS Hybrid Outcomes User Interface, Dan would you like to add anything here?
- #10 Sheila – 2 min for slides 11-12 The slide shows the addition of the AI Suggest Chart abstraction tool in the ARMUS Hybrid Outcomes Data Entry tool. As we have worked with our Pilot sites, we have refined this based on their input. You see on the screen the Field Definitions (with Keyboard Shortcuts, Registry Definitions and Coding Instructions) and Validations panel, traditionally a part of the ARMUS Hybrid Outcomes Data Entry tool. Also you can see the new AI Suggest tool section which provides suggested answers from the patient chart in order to supplement the abstractors chart review.
- #11 Sheila – 2 min for slides 11-12 This slide shows an example of how the Chart Abstraction Tool with AI works. You can see the Missing Hypertension field, which has been selected, and then the relative chart notes. One of the chart notes is selected, which supports the AI suggestion of Yes for hypertension. The abstractor may choose to use the suggested answer or not. Over time the AI tool learns from how abstractors use the suggestions.
- #12 Sheila – 2 min Once the data is in ARMUS Hybrid, the various Hybrid Analytics tools, allow for reporting across data versions longitudinally. Displayed are some examples of Cross Registry reporting and the StarMetrix heatmap dashboard. ARMUS maintains metric definition libraries that support all reporting to provide consistency from one report display type to the other. Regardless of whether metrics are in a metric library, cross registry report or a dashboard, the definition (with their inclusion/exclusion criteria and data version identification) will be the same. These definitions are available to the user on screen as well as a downloadable format. These tools are designed with input from our partner clients with a goal of providing information for Outcomes improvement. I will now turn things over to Melanie Rogan.
- #13 Hi, I am Melanie Rogan. I am a Solution Architect with Health Catalyst, where I specialize in our oncology registry solution, CRStar. I am a certified Oncology Data Specialist, referred to as ODSs. I have been a certified ODS and have worked with the CRStar platform for over 25 years, where I have specialized in education, training and the development of the software.
- #14 Melanie – 1 min CRStar is a cancer registry software solution used by over 750 health systems nationwide and has over 35 years in this space. As I am sure you are aware, cancer is a reportable disease. Our solution is primarily used in hospital based cancer registries to collect, analyze and submit data to the CDC and the National Cancer Database. Our customers come from different hospital settings, large health systems, academic facilities, community hospitals and small facilities that are just state reporting facilities. Staff that use the solution or benefit from the data are mostly cancer registrars, clinicians, hospital administration and other departments across the oncology service line.
- #15 Melanie 1.5 One of the things we are committed to is helping our customers find solutions to their pain points. We know how much pressure is put on registries not just from increasing regulatory requirements, but also the increased cancer caseload while experiencing a shortage of CTR’s in the field. There are increased needs for more concurrent abstracting as well as requests for more current data across the service line. And we recognize the increased pain points for the cancer program itself. The need is great for interoperability with an array of data sources for cancer program initiatives to expand in the areas of research, genomics, tumor boards, survivorship[, quality, clinical trial eligibility and accrual, financial analytics and many other areas.
- #16 Melanie – 1 min Our goal is partner with our clients to be more than a data collection software and provide multiple ways for our clients to transform the data into actionable insights to improve patient care. We do this by providing integrations as we discussed to make registries more efficient. We help manage the ever important accreditation process, provide the means for enterprise data analytics. Our reputation for providing top notch education, training and support is world class. We offer an intuitive data collection tool and finally, work not just with the cancer registry, but with the entire oncology service line to improve outcomes.
- #17 Melanie 2 min As we partner with clients to improve efficiencies and increase productivity in the registry, we provide automated data integrations from an array of sources. Inbound interfaces include data from the EMR, pathology solution as well as medical and radiation oncology systems for the purpose of cancer casefinding, abstraction and outcomes data. We also automate processes to export data from CRStar to other solutions such as a data warehouse, tumor board or patient navigation software, which is a help for other oncology partners. The interfaces can be done in real-time or a pre-scheduled time, like daily or weekly feeds. We utilize the method of choice for the health system and you can see some of those methods listed here. The oncology standard setters are moving to more concurrent abstracting and this is a huge help and therefore helps with concurrent reporting
- #18 Melanie – 1 min We also provide a NLP pathology reportability solution for casefinding. Cancer registries spend an average of 15 % of their time on manually combing through pathology records looking for reportable cases and then manually entering the data in CRStar. The solution utilizes NLP technology to analyze pathology records and determines each case's reportability status and then enters those cases in to a work queue in CRStar where registry managers can manage case assignment. And of course this replaces the manual methods and increases efficiences.
- #20 Melanie – 2 Another way we provide value to the entire cancer program is to provide an accreditation management module. Most cancer registries are accredited by the Commission on Cancer, Additionally some breast and rectal centers are accredited by the National Program for Beast Centers and the National Program for Rectal Cancer. Each of these entities have multiple standards of care that have to be recorded and reported on and the cancer registry usually shepards these efforts. CRStar provides a module for tracking for each standard. We provide chart audits per standard, continuum of care monitoring, clinical trial and tumor board management, Quality metrics set by each entity and then of coarse a means to provide data analysis. This is extremely helpful vs manual means of tracking this information.