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© 2014 Health Catalystwww.healthcatalyst.com
Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics © 2014 Health Catalyst
www.healthcatalyst.comProprietary and Confidential
Eric Just, VP Technology
Kathy Merkley, RN, VP Clinical Engagement
April 9, 2014
The Path to Shared Savings With Population Health Management Applications
© 2014 Health Catalystwww.healthcatalyst.com
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Accountable Care Organizations & Shared Savings
• Healthcare provider organizations responsible for providing coordinated care for their patients
• Contract with payers through some form of shared risk payment model
• Most payment models include downside risk to the healthcare providers
• Payment models reward high-quality, low-cost care with shared savings
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Population Health Management (PHM)The Key to Shared Savings
Provider Network
1
Population
2
Cost Outcomes
4
Quality Outcomes
3
Four Building Blocks of Population Health Management
developing
the asset
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PHM and Accountable Care (AC)
Accountable Care Financing and
Administration
Population Health Management developing
the asset
packaging and
marketing the asset
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What Does Health Catalyst Do?
● Enterprise Data Warehouse “single source of truth”
● Library of data acquisition adapters
● Metadata repository
● Auditing and access control
● Supports a variety of analytic applications‒ Health Catalyst
‒ Client developedPlatform
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What Does Health Catalyst Do?
● Reports & Dashboards
● Ad-hoc query
● Registries
● Quality measures
● Population health
● Data mining
● Clinical improvement
● Workflow analysis
● Modeling and predictive analytics
Applications
Platform
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What Does Health Catalyst Do?
Installation● Configuration
● Data Architecture
Improvement● Project Management
● Clinical Improvement
● “Lean” Process Improvement
Applications
Services
Platform
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Application Families
Foundational Applications
Discovery Applications Advanced Applications
Provide deep insights into evidence-based metrics that drive improvement in quality and cost reduction through managing populations, workflows, and patient injury prevention.
Encourage broad use of the data warehouse by presenting dashboards, reports, and basic registries across clinical and departmental areas.
Allow users to discover patterns and trends within the data that inform prioritization, inspire new hypotheses, and define populations for management.
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Demos
Discovery ApplicationsFoundational Applications Advanced Applications`
Population Suitese.g., Ischemic Heart Disease
Workflow / Operational Suitese.g., Acute Medical
Patient Injury Prevention Suites e.g., Infection Prevention
Patient Injury Prevention Modules
e.g., CAUTI, CLABSI, SSI
Workflow/Operational Modulese.g., ICU, MedSurg, Emergency
Population Modulese.g., CABG, Stent, AMI
Labor Management Explorer
Rev Cycle Explorer
Patient Satisfaction Explorer
General Ledger Explorer
Readmission Explorer
Population Explorer
Patient Flow Explorer
Practice Management Explorer Suite
Financial Management Explorer
CAFE—Comparative Analytics Framework and Exchange—across Healthcare Systems and National Benchmarks
EDIT—Executive Dashboard Integration Tool (Key Performance Indicator editable collage from all app categories)
Key Process Analysis (KPA)
Cohort Builder
Comorbidity Analyzer
Payment Model Analyzer
Readmission Predictor
Patient Flight Plan Predictor
ACO Explorer Suite
Metric Correlation Analyzer
Regulatory Explorer
Attribution Modeler
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Demo 1: Key Process Analysis (KPA). Identify areas of greatest opportunity for quality improvement and savings
Demo 2: Population Explorer. Identify potential risk by understanding relative size of disease populations and risk profiles
Demo 3: Heart Failure. Achieving quality improvement and cost reductions by directing targeted interventions to high-risk patients
Demo 4: Community Care. Monitoring high-risk patients in primary care to prevent expensive acute treatment
Demos: How Analytics Drive Shared Savings
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Heart Rhythm
Disorders
VascularDisorders
Ischemic Heart
Disease
HeartFailure
CARDIOVASCULAR
Care Process Families
ClinicalProgram
CABGPCIAMIACSCare Processes
KPA: Clinical Hierarchy
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Dr. J.15 Cases$15,000 Avg. Cost Per Case
Mean Cost per Case = $10,000
$5,000 x 15 cases = $75,000 opportunity
Total Opportunity = $75,000Total Opportunity = $175,000
$4,000 x 25 cases = $100,000 opportunity
Total Opportunity = $500,000Total Opportunity = $1,200,000
Cost Per Case, Vascular Procedures
KPA: Measuring OpportunityUsing provider variation to calculate the potential financial impact of improving and standardizing care processes
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Demo 1: Key Process Analysis (KPA). Identify areas of greatest opportunity for quality improvement and savings
Demo 2: Population Explorer. Identify potential risk by understanding relative size of disease populations and risk profiles
Demo 3: Heart Failure. Achieving quality improvement and cost reductions by directing targeted interventions to high-risk patients
Demo 4: Community Care. Monitoring high-risk patients in primary care to prevent expensive acute treatment
Demos: How Analytics Drive Shared Savings
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Heart Failure StatisticsHeart failure (HF) is one of the most rapidly increasing cardiovascular disorders.
● Leading cause of hospitalization in individuals over 65 years of age.¹
● Third leading cause of hospitalization in the U.S. in all age groups.²
1Krumholz HM, Chen YT, Wang Y et al. Am Heart J. 2000;139(1 Pt 1):72–7..
2Heart Disease and Stroke Statistics—2012 Update. Circulation. 2012;125:e2-220.3Jencks SF, Williams MV, Coleman EA. N Engl J Med. 2009;360:1418-28.
4Gheorghiade M, Vaduganathan M, Fonarow GC et al. J Am Coll Cardiol. 2013;61:391-403.
HF is the most common cause of readmission.3
Rates approach 30% within 60-90 days of discharge.4
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CMS and Medicare Readmission Penalties
Nearly 25% of all patients hospitalized for heart failureare readmitted within 30 days.
CMS has labeled HF as an area of excessive readmission.
CMS penalties will ensue to reduce readmission rates
http://www.ama-assn.org/amednews/2012/08/27/gvsb0827.htm. American Medical Association. Accessed online 12/28/2012.
9596979899
100101
FY 2012 FY 2013 FY 2014 FY 2015
Perc
ent o
f Pay
men
ts
Rece
ived
Penalties Will Reduce Medicare Payments
1% Loss
2% Loss
3% Loss
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Improvement Methodology
• A goal is a desired result the workgroup envisions, plans and commits to achieve an organizational desired end-point by a specified deadline.
• AIM statements are written, measurable, and time-sensitive objectives that move the team toward achieving the goal .
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CV Heart Failure
Goal: Decrease 30 day readmission rates of heart failure patients
Establish a baseline of all cause 30 day readmission rates for HF patients, create and validate 30 day and 90 day readmission rates for all HF patients.
AIM #1
AIM #2
AIM #3
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CV Heart Failure
Goal: Decrease 30 day readmission rates of heart failure patients
Identify high risk heart failure patients and extend the identification of these patients to a Risk Stratification Model to predict the likelihood of all cause 30-day readmission rates.
AIM #1
AIM #2
AIM #3
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CV Heart Failure
Goal: Decrease 30 day readmission rates of heart failure patients
Schedule a follow-up appointment for all HF patients within 24 hours of discharge with a focus on high risk patients being seen within 48-72 hours after discharge.
AIM #1
AIM #2
AIM #3
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CV Heart Failure
Goal: Decrease 30 day readmission rates of heart failure patients
AIM #1
AIM #2
AIM #4
AIM #3
Establish a medication reconciliation baseline and track compliance in order to achieve 75% compliance by X date.
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CV Heart Failure
Goal: Decrease 30 day readmission rates of heart failure patients
AIM #2
AIM #3
AIM #5
AIM #4
A follow-up phone call from a nurse post-discharge to assess whether the patient has obtained his/her medication and has no barriers to making their follow-up appointment.
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Organizational TeamsIt’s not just about technology
Cardiovascular Clinical Program Guidance Team
Heart FailureMD LeadRN SME
Knowledge Manager
DataArchitect
Application Administrator
RN, Clin Ops Director
Guidance Team MD lead(e.g., Heart Failure MD Lead)
= Subject Matter Expert= Data Capture
= Data Provisioning & Visualization
= Data Analysis
IschemicMD LeadRN SME
VascularMD LeadRN SME
• Permanent Teams• Integrated Clinical and Technical members• Supports Multiple Care Process Families
Heart RhythmMD LeadRN SME
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Demo 1: Key Process Analysis (KPA). Identify areas of greatest opportunity for quality improvement and savings
Demo 2: Population Explorer. Identify potential risk by understanding relative size of disease populations and risk profiles
Demo 3: Heart Failure. Achieving quality improvement and cost reductions by directing targeted interventions to high-risk patients
Demo 4: Community Care. Monitoring high-risk patients in primary care to prevent expensive acute treatment
Demos: How Analytics Drive Shared Savings
© 2014 Health Catalystwww.healthcatalyst.com
Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics © 2014 Health Catalyst
www.healthcatalyst.comProprietary and Confidential
Appendix
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Advanced ApplicationsPediatricsAppendectomyAsthma AcuteAsthma Chronic*
CardiovascularAtrial fibrillation*Conduction disorders*Ischemic Heart Disease*Heart Failure
Community CareDiabetes*Asthma*Primary care
General MedicineDiabetes*DKA (diabetic ketoacidosis)Deep vein thrombosis*Peripheral vascular disease*
PulmonaryPneumonia Community acquiredPulmonary embolism*
Infectious DiseasesCellulitis*Urinary Tract Infection*Meningitis*Sepsis
GastrointestinalAnal/rectal disorders*AppendectomyInflammatory diseases*Lower GI procedures*Obstruction*
NeurosciencesStroke* - Hemorrhagic* - Vascular* - Transient ischemic attack*
OncologyBreastGastrointestinalThoracic
OrthopedicsFractures - Hip/pelvis* - Lower extremity* - Upper extremity*SpineTotal hip*Total knee*
Surgery - VascularAortic aneurism*Other venous disorders*Varicose veins*
Women and NewbornsAntenatal SteroidC-section DeliveryElective InductionsNTSV cesareanNewborn
DepartmentalEC (Emergency Care)*Laboratory*OR Workflow*Radiology*Nursing*
OtherCoordinated CareLabor & ProductivityMedication ManagementOPPE (Ongoing Professional Practice Evaluation)Physician CredentialingPrimary CareProfessional BillingACO
Patient Injury PreventionVT/PE prevention*CAUTICLABSIControlled substance diversion prevention
* In Development
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Data Marts and Applications
Common Definitions and StandardizationPopulation Definitions, Comorbidities, Attribution,
Patients, Labs, Encounters, Diagnoses, Medications
Source Marts
EMR
EMR Financial Patient Sat. HR Administrative Claims
Financial Patient Sat. HR Administrative Claims
e.g. Epic, Cerner e.g. EPSi, Peoplesoft,
Lawson
e.g. Press Ganey,NRC Picker
e.g. Lawson,Peoplesoft,
Ultipro
e.g. API TimeTracking
e.g. Medicare
Architecture Overview
© 2014 Health Catalystwww.healthcatalyst.com
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c
27
Demo 1: Key Process Analysis. Identify areas of greatest opportunity for quality improvement and savings
Demo 2: Population Explorer. Identify potential risk by understanding relative size of disease populations and risk profiles
Demo 3: Heart Failure. Achieving quality improvement and cost reductions by directing targeted interventions to high-risk patients
Demo 4: Community Care. Monitoring high-risk patients in primary care to prevent expensive acute treatment
© 2014 Health Catalystwww.healthcatalyst.com
Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics
c
28
Demo 1: Key Process Analysis. Identify areas of greatest opportunity for savings and quality improvement
Demo 2: Population Explorer. Identify potential risk by understanding relative size of disease populations and risk profiles
Demo 3: Heart Failure. Achieving quality improvement and cost reductions by directing targeted interventions to high-risk patients
Demo 4: Community Care. Monitoring high-risk patients in primary care to prevent expensive acute treatment
© 2014 Health Catalystwww.healthcatalyst.com
Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics
c
29
Demo 1: Key Process Analysis. Identify areas of greatest opportunity for savings and quality improvement
Demo 2: Population Explorer. Identify potential risk by understanding relative size of disease populations and risk profiles
Demo 3: Heart Failure. Achieving quality improvement and cost reductions by directing targeted interventions to high-risk patients
Demo 4: Community Care. Monitoring high-risk patients in primary care to prevent expensive acute treatment
© 2014 Health Catalystwww.healthcatalyst.com
Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics
c
30
Demo 1: Key Process Analysis. Identify areas of greatest opportunity for savings and quality improvement
Demo 2: Population Explorer. Identify potential risk by understanding relative size of disease populations and risk profiles
Demo 3: Heart Failure. Achieving quality improvement and cost reductions by directing targeted interventions to high-risk patients
Demo 4: Community Care. Monitoring high-risk patients in primary care to prevent expensive acute treatment
© 2014 Health Catalystwww.healthcatalyst.com
Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics
Thank You
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Register at http://healthcatalyst.com/
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