Implementing American Heart Association Practice Standards for Inpatient ECG ...Allina Health
Implementing American Heart Association Practice Standards for Inpatient ECG Monitoring: An Interventional Study at Abbott Northwestern Hospital presented by Kristin Sandau, PhD, RN
Revolutionizing Renal Care With Predictive Analytics for CKDViewics
Chronic Kidney Disease (CKD) is a common and growing condition, affecting about half of the Medicare population and of diabetics. In the United States, the lifetime risk of CKD for 30-year-olds is now greater than half, and the prevalence of CKD is projected to rise significantly over the next 15 years.
Current methods of predicting which CKD patients will progress to renal failure and require dialysis or transplant have low accuracy rates, causing great anxiety and suboptimal care. Without accurate risk prediction, many patients are over-treated, effectively wasting limited resources and negatively impacting outcomes. Conversely, other patients may receive inadequate treatment, restricting options to only the most costly and least desirable interventions.
Watch this on-demand webinar with Dr. Navdeep Tangri, developer of the Kidney Failure Risk Equation, which revolutionizes the way CKD patients are managed by leveraging laboratory data to accurately predict the risk of kidney failure in patients with CKD.
You’ll learn:
• How CKD is burdening our healthcare system, and the need for better care management tools
• How the Kidney Failure Risk Equation was researched, developed, and validated
• How Viewics is implementing CKD predictive analytics to automatically deliver risk information to clinicians and issue customized, educational reports to patients and clinicians
Advanced Lab Analytics for Patient Blood Management ProgramsViewics
Reports indicate that 30 – 70% of blood transfusions are inappropriate. Inappropriate blood transfusions put patients at increased risk of post-surgical infections, multi-system organ failure, longer hospital stays, and higher mortality rates. The transfusion guidelines most clinicians learned in their training are now outdated. As such, blood transfusion practices vary widely, and overutilization remains a major quality and cost problem.
Patient Blood Management (PBM) programs are designed to optimize the use of transfusions through a team-based approach, evidence-based guidelines, and algorithms that together guide decisions regarding specifically which patients and clinical procedures warrant blood products, and how much to transfuse. PBM programs have been quite successful in improving patient morbidity and mortality outcomes and generating millions of dollars in savings for hospitals.
Laboratory analytics can be an effective means of instituting restrictive transfusion programs, and advanced lab analytics can be critical in implementing PBM programs, as lab testing and tracking blood usage is central to decision making, changing behavior, and improving performance.
Watch a presentation by Dr. Eleanor Herriman, Chief Medical Informatics Officer at Viewics. She unveils a new suite of advanced analytics tools that support PBS and other restrictive blood management programs, enabling health systems to better leverage their valuable lab medicine assets and fully integrate this key service line into these programs.
You’ll learn:
• How inappropriate blood transfusions are burdening our healthcare system, and the need for better utilization management tools
• New guidelines restricting red blood cell transfusions
• The role of advanced lab analytics in PBM programs
• How Viewics is leveraging advanced lab analytics to help health systems more easily and cost-effectively implement PBM programs
Opening Keynote"From Patient to Population: Providing Optimal Care - The Role for Technology"
Ronald Paulus, MD, MBA
President & CEO
Mission Health System
Implementing American Heart Association Practice Standards for Inpatient ECG ...Allina Health
Implementing American Heart Association Practice Standards for Inpatient ECG Monitoring: An Interventional Study at Abbott Northwestern Hospital presented by Kristin Sandau, PhD, RN
Revolutionizing Renal Care With Predictive Analytics for CKDViewics
Chronic Kidney Disease (CKD) is a common and growing condition, affecting about half of the Medicare population and of diabetics. In the United States, the lifetime risk of CKD for 30-year-olds is now greater than half, and the prevalence of CKD is projected to rise significantly over the next 15 years.
Current methods of predicting which CKD patients will progress to renal failure and require dialysis or transplant have low accuracy rates, causing great anxiety and suboptimal care. Without accurate risk prediction, many patients are over-treated, effectively wasting limited resources and negatively impacting outcomes. Conversely, other patients may receive inadequate treatment, restricting options to only the most costly and least desirable interventions.
Watch this on-demand webinar with Dr. Navdeep Tangri, developer of the Kidney Failure Risk Equation, which revolutionizes the way CKD patients are managed by leveraging laboratory data to accurately predict the risk of kidney failure in patients with CKD.
You’ll learn:
• How CKD is burdening our healthcare system, and the need for better care management tools
• How the Kidney Failure Risk Equation was researched, developed, and validated
• How Viewics is implementing CKD predictive analytics to automatically deliver risk information to clinicians and issue customized, educational reports to patients and clinicians
Advanced Lab Analytics for Patient Blood Management ProgramsViewics
Reports indicate that 30 – 70% of blood transfusions are inappropriate. Inappropriate blood transfusions put patients at increased risk of post-surgical infections, multi-system organ failure, longer hospital stays, and higher mortality rates. The transfusion guidelines most clinicians learned in their training are now outdated. As such, blood transfusion practices vary widely, and overutilization remains a major quality and cost problem.
Patient Blood Management (PBM) programs are designed to optimize the use of transfusions through a team-based approach, evidence-based guidelines, and algorithms that together guide decisions regarding specifically which patients and clinical procedures warrant blood products, and how much to transfuse. PBM programs have been quite successful in improving patient morbidity and mortality outcomes and generating millions of dollars in savings for hospitals.
Laboratory analytics can be an effective means of instituting restrictive transfusion programs, and advanced lab analytics can be critical in implementing PBM programs, as lab testing and tracking blood usage is central to decision making, changing behavior, and improving performance.
Watch a presentation by Dr. Eleanor Herriman, Chief Medical Informatics Officer at Viewics. She unveils a new suite of advanced analytics tools that support PBS and other restrictive blood management programs, enabling health systems to better leverage their valuable lab medicine assets and fully integrate this key service line into these programs.
You’ll learn:
• How inappropriate blood transfusions are burdening our healthcare system, and the need for better utilization management tools
• New guidelines restricting red blood cell transfusions
• The role of advanced lab analytics in PBM programs
• How Viewics is leveraging advanced lab analytics to help health systems more easily and cost-effectively implement PBM programs
Opening Keynote"From Patient to Population: Providing Optimal Care - The Role for Technology"
Ronald Paulus, MD, MBA
President & CEO
Mission Health System
Anti-cancer therapy is big business. In Australia alone between 2000 and 2009, cancer-related pharmaceutical expenditure has risen over 200% to over half a billion dollars per annum.
General principal is that all patients with good functional capacity should proceed to surgery and coronary assessment should only be performed if the results would change management•For patients with recent MI, 2014 AHA/ACC guidelines recommend 3 month delay before stopping DAPT although anticipated updates may require only 1 month for newer DES•Several risk scores have been studied for risk MICA
Dr Sinead Clarke, Macmillan GP Advisor, Clinical Director for Performance, IT, Finance, Cancer and End of Life, South Cheshire and Vale Royal CCGs, Medical Lead for Cheshire end of Life Partnership
Dr Jackie Dominey, GP and Macmillan GP Advisor, Clinical Lead End of Life, Solihull CCG
The Top 5 Ancillary Services For Urology PracticesClark Love
Reduction in Medicare contract payments and decreased physician reimbursement from insurers are causing decreased physician salaries, medical profits and general revenue. This is driving the desire for urology practices to add ancillary services - and this is a good thing for patients.
Geriatric Oncology
1. Relationship between aging and cancer
2. Constructs of frailty and multimorbidity
3. Evidence for geriatric assessment in older adults living with cancer
Major incidents - what can we learn from them?scanFOAM
A talk by Sabina Fattah at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Presentation for UP MSHI HI201 Health Informatics class under Dr. Iris Tan and Dr. Mike Muin. Check out my blog - http://jdonsoriano.wordpress.com/2014/10/09/fitting-the-pi…making-it-work/
Anti-cancer therapy is big business. In Australia alone between 2000 and 2009, cancer-related pharmaceutical expenditure has risen over 200% to over half a billion dollars per annum.
General principal is that all patients with good functional capacity should proceed to surgery and coronary assessment should only be performed if the results would change management•For patients with recent MI, 2014 AHA/ACC guidelines recommend 3 month delay before stopping DAPT although anticipated updates may require only 1 month for newer DES•Several risk scores have been studied for risk MICA
Dr Sinead Clarke, Macmillan GP Advisor, Clinical Director for Performance, IT, Finance, Cancer and End of Life, South Cheshire and Vale Royal CCGs, Medical Lead for Cheshire end of Life Partnership
Dr Jackie Dominey, GP and Macmillan GP Advisor, Clinical Lead End of Life, Solihull CCG
The Top 5 Ancillary Services For Urology PracticesClark Love
Reduction in Medicare contract payments and decreased physician reimbursement from insurers are causing decreased physician salaries, medical profits and general revenue. This is driving the desire for urology practices to add ancillary services - and this is a good thing for patients.
Geriatric Oncology
1. Relationship between aging and cancer
2. Constructs of frailty and multimorbidity
3. Evidence for geriatric assessment in older adults living with cancer
Major incidents - what can we learn from them?scanFOAM
A talk by Sabina Fattah at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Presentation for UP MSHI HI201 Health Informatics class under Dr. Iris Tan and Dr. Mike Muin. Check out my blog - http://jdonsoriano.wordpress.com/2014/10/09/fitting-the-pi…making-it-work/
Bundled Payment Changes: Learn What’s New and How to SucceedHealth Catalyst
In January, CMS announced the Bundled Payment for Care Improvement Advanced “BPCI Advanced” program, initiating renewed interest in a total cost of care payment model for specific episodes of care. Regardless of your organization’s current decision to participate, it’s important to understand how bundled payment programs have the ability to significantly decrease your internal costs, broaden your revenue opportunities, and improve patient outcomes across specific populations. The Center for Medicare and Medicaid Innovation’s newest iteration of bundled payments provides another tightly-defined program that allows organizations to scale Population Health Management. Best practice suggests that tactical interventions to assess clinical variation, implement strategic care redesign programs, and to adjust care management-facilitated patient stratification models are important to be successful with bundled payments – so knowing how to implement them is crucial. One organization’s savings is another’s income and without making overhead allocation changes, bundled payments may reduce revenue that has been critically important to maintain hospital profitability. Join this webinar to learn:
* What is new with bundled payments.
* The ramifications bundles can have across organizations.
* Leveraging data and strategic analysis to identify opportunities for bundled payment success.
* Operationalizing successful care program tactics to be successful in bundled payment contracts.
Pharmacy's Emerging Role in Accountable Care Organizations (ACO)Parata Systems
Your pharmacy is an excellent partner for accountable care organizations. ACOs are formed by doctors, hospitals and other healthcare providers to improve health outcomes and lower overall medical expenses for a targeted patient population. Reimbursements are tied to patient outcomes.
ACOs’ highest-risk and highest-cost patients are those managing chronic illnesses and taking multiple medications a day. When your pharmacy can improve and track adherence – a key driver of readmission prevention and overall health – you are a valuable partner to help ACOs prevent unnecessary medical care.
Jamie Hale serves as the Chief Pharmacy Officer for Cornerstone Health Care where he is responsible for the development and integration of pharmaceutical care services in the Accountable Care Organization. He transitioned to Cornerstone in December 2012 after a 15 year career at Wake Forest Baptist Health, where he last served as Director of Pharmacy.
Download the full audio webinar at http://bit.ly/pharmacyACO.
Top 3 Strategic Initiatives for Sustainable Results in Healthcare in Middle EastSTELIOS PIGADIOTIS
This research paper offers insights in three areas:
1. Current Challenges in GCC/Middle East Healthcare sector
2. Future Drivers for Healthcare Excellence
3. Future Strategic Initiatives for Sustainable Results
NVTC Capital Health Tech Summit: Dr. Shannon KeynoteAlexa Magdalenski
The 2017 Capital Health Tech Summit took place on June 15, 2017 at the Inova Center for Personalized Health. Dr. Richard Shannon, Executive Vice President, Health Affairs, University of Virginia provided the Summit's second keynote.
Why Clinical Quality Should Be Your Core Business StrategyHealth Catalyst
Over 100 years ago, healing professionals and healthcare itself went through a massive transformation that led us to the models of care delivery that we use today. Dr. Brent James argues that we are now, again, at a once-in-a-century inflection point to change the course of healthcare. Change takes real effort, but provides massive opportunity.
Those changes include a move away from the highly-profitable fee-for-service payment to fee-for-value. An IOM report, published in 2010, substantiated that more than a third of healthcare spending is waste. Pay-for-value aligns financial returns for those who invest in waste elimination. It also requires that clinicians move away from the craft of medicine to the science of medicine, using data and evidence to drive better clinical care.
As the vice president and chief quality officer at Intermountain Healthcare, Dr. James led much of the change that produced Intermountain’s recognized operational and clinical excellence. In this webinar Dr. James educates and inspires all of us to do great work by sharing practical stories of how data has become the critical tool to help healthcare shift from revenue enhancement to clinical quality, which produces the most affordable care.
Learn how to:
- Use data to find variations in both cost and quality of care.
- Standardize care without demotivating underperforming outliers.
- Build a culture of data-driven care providers.
- Develop an improvement strategy that you can start today.
Sought the world over, Dr. James is a recognized expert in this outcomes improvements area. He has championed the standardization of clinical care through data collection and analysis on a wide variety of treatment protocols and complex care processes for more than 20 years.
Prof. Martin Gaynorin esitys VATT-päivässä 1.11.2016
Gaynor on professori Carnegie Mellon yliopistossa, tutkija Britannian johtavassa, julkisen sektorin reformeihin keskittyvässä tutkimuslaitoksessa (Bristolin yliopiston Centre for Market and Public Organisation) ja jäsenenä NHS:n kilpailuasioita käsittelevässä asiantuntijapaneelissa.
Gaynor on tehnyt vaikutusvaltaisia tutkimuksia ja kirjoittanut laajasti terveydenhuoltomarkkinoiden toiminnasta, kilpailusta, kilpailua rajoittavista tekijöistä, tuottajien saamista korvauksista sekä Yhdysvalloissa että Briteissä.
The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The changing landscape of health care in the US -- drivers and outcomesGregory Travis
The United States has the worst health care outcomes among its OECD peers. It also has the highest health care costs within the OECD. What are the reasons for this and what changes can we anticipate going forward?
Presentation delivered by John Kurvink, VP, Corporate Services, Chief Financial Officer, Georgian Bay General Hospital at the marcus evans National Healthcare CFO Summit Spring 2017 held in Orlando, FL May 15-17.
Adding Value to the EMR: A Clinical PerspectiveHealth Catalyst
Known for leading large-scale healthcare improvement using data and analytics to drive positive change, Dr. Charles Macias speaks to creating greater value in the EMR through analytics. This approach has done more to increase value than many other cost-reduction efforts.
In this webinar you will 1) Explore each component of the value equation, 2) learn how TCH has increased the value of its healthcare using data to drive quality an ever more important need of those facing capitated or value–based care reimbursements and 3) consider a new ROI equation for systems who have invested heavily in their EMRs
Enhancing Mental Health Care Transitions: A Recovery-Based ModelAllina Health
Enhancing Mental Health Care Transitions: A Recovery-Based Model - Mental Health Care Navigators and Inpatient Psychiatry presented by Christina Schwartz, BA Psychology, MHP, Mental Health Navigator and Heather Sievers, RN, MSN, MA Counseling Psychology, PI Advisor
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Leveraging Data And Strong Partnerships To Thrive In The Land Between Volume And Value
1. Leveraging Data And Strong Partnerships To Thrive In
The Land Between Volume And Value
Pam Rush, RN, MS
Dr. William Katsiyiannis
2. Objectives
• To describe the collaborative partnership between the hospital, health system,
and cardiology group.
• To explain the value and rationale for investing in an enterprise data warehouse
(EDW).
• To highlight the development of the Minneapolis Heart Institute (MHI) Center
for Healthcare Delivery Innovation as a framework to transition from volume to
value.
• To demonstrate, through specific case examples, the value of strong
partnerships and an EDW in driving meaningful change in cardiovascular (CV)
quality and outcomes.
2
3. Key Points
• Healthcare market forces are driving an increased need for complex data
analytics to improve value.
• Allina Health, in collaboration with Health Catalyst, has developed an Enterprise
Data Warehouse (EDW) that provides nation leading data analytic capabilities.
• A relentless focus on improving quality drives lower costs.
• Success requires 3 components:
Physician Leadership
Strong care team collaboration (MDs, RNs, Administrators)
An EDW with access to accurate data analytic resources
3
4. Allina:
Region’s Largest Health Care Organization
Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of
individuals, families and communities throughout Minnesota and western Wisconsin.
Allina Health
• 13 Hospitals
• 82 Clinic sites
• 3 Ambulatory care centers
• Pharmacy, hospice, home care,
medical equipment
• 26,000 employees
• 5,000 physicians
• 2.8 million+ clinic visits
• 110,000+ inpatient hospital
admissions
• 1,658 staffed beds
• 3.4B in revenue
• 32% Twin Cities market share
5. Land Between Volume and Value
The mixed world is here to stay.
Likely to move to value dominant systems:
Medicare
Advantage | Fee-For-Service
Medicaid Less Certain
Fully Insured Commercial
Least Certain
Self-Insured Commercial
6. Power of Partnership:
Minneapolis Heart Institute (MHI) and Allina
Common
vision.
Aligned
interests.
Supportive
infrastructure.
Platform to
allow ongoing
investment.
Trust.
7. Power of Partnership: MHI and Allina
• Support of three types of innovation.
– New Treatments and Therapies
• Structural Heart Program.
– 500 transcatheter aortic valve replacement (TAVR).
– 30% increase in open heart volume.
– First in human mitral valve.
– New Care models to enhance experience.
– Cardiology curbside.
– Metro hubs.
– Heart Failure Care Coordination
– Increase value through demonstrating better outcomes at a lower cost.
– MHI Center for Healthcare Delivery Innovation.
8. US Healthcare Spending
U.S. Health spending—larger than the gross domestic product
(GDP) of most nations
• If all of that activity was separated into
its own sovereign nation, it would
constitute the fifth largest economy in
the world, behind only the United
States, China, Japan, and Germany.
$2.7 TRILLION
U.S. HEALTH SPENDING in 2011
9. Return on Investment
Source: OECD Data 2011
Life expectancy in the U.S. does not compare favorably to other
countries which spend less per capita.
0
1000
2000
3000
4000
5000
6000
7000
8000
70
72
74
76
78
80
82
84
PerCapitaSpending
AverageLifeExpectancy
Life Expectancy Per Capita Spending (International Dollars)
10. Healthcare Spending in Minnesota
Total healthcare spending in Minnesota
was $40 billion in 2012; expected to
grow 6.5% per year.
11. Forecasting the Future of CV Disease
Source: Heidenreich, P. A., Trogdon, J. G., Khavjou, O. A., Butler, J., Dracup, K. … Woo, Y. J. (2011). Forecasting
the future of cardiovascular disease in the United States: A policy statement from the American Heart
Association. Circulation, 123, 933-944.
A policy statement from the American Heart Association
CV Costs
Reach
$ 818 Billion
in 2030
13. Payment Reform Pressures
Target percentage of Medicare fee-for-service (FFS) payments linked to
quality and alternative payment models in 2016 and 2018.
All Medicare FFS (Categories 1-4)
2016
All Medicare FFS
30%
85%
FFS linked to quality (Categories 2-4) Alternative payment models (Categories 3-4)
2018
All Medicare FFS
50%
90%
14. CMS Proposes Mandatory Cardiac Bundles
14
1. New mandatory CMS bundles apply to acute MI and
CABG patients.
2. Bundles require hospital accountability for cost and
quality during inpatient stay and 90 days after
discharge.
3. Hospitals chosen from 98 randomly selected
metropolitan statistical areas.
4. Bundles would begin July 1, 2017.
5. CMS will pay quality adjusted target payments for
each episode of care.
15. Opportunities For Collaboration
• Relentless pursuit of:
– High quality outcomes.
– Optimized publicly reported measures.
– Reduced cost.
– Increased revenue.
– Improved patient experience.
– Increased affordability.
– Growth.
– Improved health of the community.
16. Quality of Care Focus
16
“Quality improvement is the most powerful
driver of cost containment.”
~ Michael Porter, PhD Harvard Business School
17. Need for CV Care Innovation
• The development of the MHI Center for Healthcare Delivery
Innovation places Allina Health as a national leader in driving
necessary change in our healthcare delivery system.
• Focused on reducing variation through:
• Standardized cardiovascular care protocols.
• Advanced risk-stratification tools.
• Real time decision support at the point of care.
• Innovative strategies for care delivery.
The Center leverages the existing infrastructure of Allina’s EDW and
cardiology participation in national registries to achieve the Triple Aim
goals of improving population health, reducing per capita costs, and
improving the patient experience.
18. Primary Care
•Healthy lifestyle.
•Weight management.
•Smoking cessation.
•Exercise.
•Lipid management.
•Routine treatment
protocols.
•Referral protocols.
Outpatient
Cardiology
•Timely access to
specialists.
•Guideline driven testing
and treatment.
•Comprehensive
diagnostic testing.
Sub-Specialty
Cardiology
• Complex patients
requiring further
evaluation and
treatment.
• Cardiac surgery.
• Arrhythmias.
• Structural heart
disease.
• Prevention.
Inpatient and
Emergency Services
• Level I program.
• ST-segment elevation
myocardial infarction
(STEMI).
• Critical limb ischemia.
• Aortic dissection.
• Abdominal aortic
aneurysm.
• Specialized inpatient CV
care.
Advanced Therapies
•Extracorporeal
membrane oxygenation
(ECMO.)
•Left ventricular assist
device (LVAD).
•Heart transplant.
•Trans-catheter aortic
valve replacement
(TAVR).
•MitraClip
•Percutaneous mitral
valve repair (MVR).
Developing The Healthcare Delivery Innovation Center
Optimize Care Across the CV Continuum
20. POPULATION HEALTH
MANAGEMENT
• Quantify the
population needs and
measure adherence
to clinical guidelines.
• Develop strategies
and tools to improve
care access and
efficiency.
REDUCE CLINICAL
VARIATION
• Reduce unnecessary
variation in clinical
care.
• Standardize care
pathways and
protocols.
• Increase value.
TEST NEW PROCESSES
OF CARE & PAYMENT
MODELS
• Build on existing best
practice programs and
protocols to improve
quality and efficiency
in care delivery.
• Develop and test new
payment models.
LEVERAGE CUTTING
EDGE TECHNOLOGY
• Cardiomems
Monitoring.
• TAVR, MitraClip.
• Linq.
Improve health of the
population through
adherence to clinical
guidelines across the
continuum.
Transform care delivery
through the reduction of
clinical variation.
Transform care delivery
by piloting new and
creative processes and
payment models.
Explore new ways to
efficiently care for
patients.
MHI-HDI Foundational Pillars
21. Clinical Intelligence Tools
What happened? What happening? What may happen?
Retrospective Real time Predictive
GeneralSpecific
Potentially Preventable
Readmissions (PPR) Dashboard
22. 2012: Limited Tracking of
Performance Enhancement $
•Acute myocardial infarction (AMI) optimal
care.
•Heart failure (HF) optimal care.
•Coronary artery bypass (CAB) surgical care
improvement project (SCIP) optimal care.
•Bivalirudin or radial access increased from
25% to 55% in high risk bleeding patients.
•Revised and standardized HF, AMI and
percutaneous coronary intervention (PCI)
patient education documents.
•United HF readmissions reduced from
19.25% to 14.9%.
•Society of thoracic surgeon (STS)
dashboard developed.
•100% of cardiologist trained on the clinical
documentation improvement project
(clinical documentation).
•Length of stay (LOS) savings $73,000.
•$1.3M in supply cost savings.
2013 Performance
Enhancement: $12,074,221
•Bivalirudin use in high risk PCI pts: 69.0%
at Abbott Northwestern Hospital (ANW),
68.8% at Mercy Hospital, and 75.0% at
United Hospital.
•72% (124/173) patients seen in pre-op
clinic.
•Blood utilization.
•Goal: $461,641.
•Actual: $396,000.
•RBC: 2.14 1.98 u/case
•FFP: 1.43 .94 u/case
•Platelets: .72 .59 u/case
•HF dashboard developed.
•Cardiovascular (CV) LOS:
•104% baseline.
•102.6% Actual.
•Savings: $640,221.
•Supply chain savings: $2,670,600.
•Clinical documentation: $8,367,400.
•Willingness to recommend: 94%.
2014 Performance
Enhancement: $13,645,000
•160 more PCI patients at high risk for
bleeding had a closure device used.
•114 intensive care unit (ICU) days were
avoided for low risk ST segment elevation
myocardial infarction (STEMI) and
transcatheter aortic valve replacement
(TAVR) patients.
•481 more HF patients had care coordinated
by a HF care coordinator.
•13 more HF patients appropriately evaluated
by Advanced HF referrals for ventricular assist
device (VAD)/transplant.
•400 days saved through HF LOS efforts.
•886 fewer units of blood given to CV surgery
patients.
•22% more patients who developed Afib post
CV surgery were treated using the Afib
protocol.
•28,029 fewer unnecessary creatine, kinase,
muscle, and brain (CKMB) lab test completed.
•$2.9M: over utilization and LOS
improvements (8 improvements noted
above).
•$7.2M: clinical documentation.
•$3.5M: decreased variation in supply chain
contract.
Track Record of Success
2015 Performance
Enhancement: $6,374,690
•STEMI LOS $120,600.
•Advanced HF referrals $1,432,000.
•TAVR ICU days $153,500.
•HF care coordination $819,600.
•Troponin testing $29,500.
•CKMB Lab Testing $426,900.
•Closure device $395,100.
•Clinical documentation $2,094,000.
•Vascular supply chain $509,500.
•Afib protocol $393,990 (Jan14-Aug 15 at
ANW and United Hospital).
23. Examples: CV Dashboards
• PCI:
– Use of closure devices in high risk patients.
• Structural Heart Disease:
– Population management of severe symptomatic
aortic stenosis.
• Up to date on guideline recommended echo
surveillance.
• Role of primary care physician (PCP),
cardiologist, valve specialist.
• Survival curves with and without definitive
procedure.
• Cost implications.
• CV Surgery:
– Real-time physician scorecard.
– Bundled payments.
24. Example: PCI Bleeding Risk
• Area of Opportunity:
– Peri-procedural bleeding complications are
common following PCI (3-6%).
– Transfusion rates across Allina Health were
higher than national average for patients
undergoing PCI.
• Accurate Data:
– NCDR national PCI registry provides
standardized, nationally benchmarked,
abstracted data.
– EDW enables linking of multiple data sources
to evaluate the impact of novel care processes
on clinical quality and costs.
25. Impact of Closure Devices
4% 6%
23%
3%
6%
10%
0%
10%
20%
30%
Low Intermediate High
Any Complication
No Vascular Closure Device Yes Vascular closure Device
1.0% 1.7%
12.6%
0.7%
2.3%
5.9%
0%
5%
10%
15%
Low Intermediate High
RBC Transfusion
No Vascular Closure Device Yes Vascular closure Device
1% 1%
8%
0%
2%
3%
0%
5%
10%
Low Intermediate High
Bleeding with 72 Hours
No Vascular Closure Device Yes Vascular closure Device
0.3% 0.4%
6.8%
0.2% 0.1%
1.4%
0%
2%
4%
6%
8%
Low Intermediate High
Mortality
No Vascular Closure Device Yes Vascular closure Device
31. Learnings: PCI Bleeding Risk Key Steps
• Accurately calculate a pre-PCI Bleeding
Risk Score for all PCIs across the Allina
Health System.
• Apply consensus guidelines in clinically
appropriate cases.
• Effectively communicate bleeding risk
to providers managing the patient’s
care.
• Track outcomes and provide timely
feedback.
Cumulative Savings of 1.8 M
Reduction of LOS for high bleeding risk from 3.8 to 2.4 days
Reduction in complications from 23% to 18% in high bleeding risk
32. Examples: CV Dashboards
• PCI:
– Use of closure devices in high risk patients.
• Structural Heart Disease:
– Population management of severe symptomatic
aortic stenosis.
• Up to date on guideline recommended echo
surveillance.
• Role of primary care physician (PCP),
cardiologist, valve specialist.
• Survival curves with and without definitive
procedure.
• Cost implications.
• CV Surgery:
– Real-time physician scorecard.
– Bundled payments.
36. 36
Real-time Example:
90 year old patient wanted to
know what her risk of stroke was
for transcather aortic valve
replacement
Measure Name Numerator Denominator %
% with In-hospital Mortality 2 60 3.3%
% with Stroke 1 60 1.7%
% with Vascular Access Site Complication 1 60 1.7%
37. Examples: CV Dashboards
• PCI:
– Use of closure devices in high risk patients.
• Structural Heart Disease:
– Population management of severe symptomatic
aortic stenosis.
• Up to date on guideline recommended echo
surveillance.
• Role of primary care physician (PCP),
cardiologist, valve specialist.
• Survival curves with and without definitive
procedure.
• Cost implications.
• CV Surgery:
– Real-time physician scorecard.
– Bundled payments.
42. Key Points
• Healthcare market forces are driving an increased need for complex data
analytics to improve value.
• Allina Health, in collaboration with Health Catalyst, has developed an Enterprise
Data Warehouse (EDW) that provides nation leading data analytic capabilities.
• A relentless focus on improving quality drives lower costs.
• Success requires 3 components:
Physician Leadership
Strong care team collaboration (MDs, RNs, Administrators)
An EDW with access to accurate data analytic resources
42
43. Lessons Learned
43
• Strong, committed leadership is essential for success.
• A focus on innovation is required to navigate present and future
challenges.
• Collaborative teamwork is essential in order to realize the Triple Aim
• Robust analytics is a powerful tool to achieve the best quality and
cost outcomes.