Leveraging Analytics To Standardize Clinical Care And .
Leveraging Analytics to StandardizeClinical Care and Reduce Cost of CareSeptember 24th, 2019
Agenda Baptist Health Overview Overview of BHSF Analytics EBCC Role of Dimensional Insight in Supporting EBCC EBCC Accomplishments Future Dimensional Insight Analytics at BHSF Open Discussion
Baptist Health Statistics
Baptist Health Statistics Admissions 109,922 Patient Days . . 671,871 Births . 15,007 ED Visits . . 493,039 Urgent Care Visits . 331,457 Total Surgical Cases . 103,869 International Patients 11,853 Licensed Beds .2,251 Physician Office Visits . 334,856 Medical Staff .4,000 Employees . . 23,000 Charity Care and uncompensated services 339,000,000
Centers of Excellence
Mission & VisionOur mission is to improve the health & well-beingof individuals in the communities we serve.We are committed to maintaining the highest standardsof clinical and service excellence,rooted in utmost integrity and moral practiceOur vision is to become the preeminent healthcare provider in thecommunities we serve, the organization that peopleinstinctively turn to for their healthcare needs.Baptist Health will be a national & international leaderin healthcare innovation.
Baptist Health Strategic ImperativesAffordability Price competitiveness for payers and patients Identify and eliminate non value-added expenses Sustainability: change the way we do businessSystemness Enterprise-wide view: current and future services Highest and best use of our assets Provide right service, right setting, right priceClinicalStandardizationVolume Physician-led Collaborative Leadership Aligned Incentives Clinical programs with real-time data analytics New Business ModelsIncreased RiskImportance of Physician AlignmentSmart Growth
BHSF Analytics
BHSF Data Analytics Maturity ModelDATAGOVERNANCEBHSF BHSF BHSF BHSFEnterpriseDataWarehouseBHSF ReportingAdvancedAnalyticsBig DataBusinessPerformanceManagement Dashboards Scorecards Hadoop Predictive Analytics Machine Learning Natural LanguageProcessing (NLP) Real-Time Information SelfService Artificial Intelligence(AI)
BHSF Data Analytics InfrastructureDATASOURCES85Existing SourcesEmerging Sources(EMR, Ancillary Systems, Devices)Cerner SoarianAriaXper(Sensor Streaming, Social Media,Telemedicine, Unstructured)PremierEDW,Big DataOracleBig DataMapREnterprise Data WarehouseData Marts137 ANALYTICSAPPLICATIONSDATA SYSTEMSExternalMCIEBCCReporting and Analytics Dimensional Insight DiverSAP BOEIBM CognosIBM Watson ContentAnalytics MS SQL Reporting ServicesMCVIBHMGRev 3PharmacySurgeryMOSMIData Visualization &DashboardsResearch & StatisticalAnalysis Tableau Xcelsius SPSS Stata MCSSPASS SAS TreeageRData PlotInstataM PlusRehabNeuroAdvanced Analytics Predictive Analytics Machine Learning NLP (Natural LanguageProcessing)Green are compatiblewith big data
BHSF EDW Data Sources: 85Aria3M HDMAgilityAHRQ (Diver)Allscripts EPSiAllScripts Home CareAMS Medical OncologyAMS Oncology EMRANSOS One-StaffAvMed ACO FilesCareAwareCentralLogicCentricityCerner Invision PA and PMCerner Millennium, ProdCerner Millennium, TestCerner Soarian ClinicalCerner Soarian FinancialChartlinksClairvia Clinical Acuity SystemCommon Vocabulary Engine fromCerner EAD/LCReCareManagerEchoED Call TrackerEDMeICU Replicated DBEPremisERSEssentrisFL Blue ACO FilesgGastroGMED (Globus Medical)GMED (Globus Medical)Great MindsHCLL Blood BankHL7 ADT from OpenLinkHome HealthHorizonLabImageNowIntranet Physician DirectoryJDA ParathonKronosLabVantageLawsonMagView Breast ImagingMCI DoseEdgeMCI Patient TrackerMedical ReconciliationMedSeekMidasNeodata Reporting applicationNextGenNuance CDMPOmnicellOnCore Clinical ResearchOpenLink and Informatica B2BOPTIFLEXPandora PharmacyPatient SchedulingPeopleSoft FINPRDPeopleSoft OBIPhysician On CallPlatoPowerPathPremierProgenyProliance ConstructionProVation MedicalPyramis EKGQuantumQuadraMedRapidComm Siemens Blood GasRedCapRightPatient BiometricSDESiemens PharmacySoarian DSSSovera HIMSyngo RadiologyTeletrackingT-SystemXper Cardiovascular
Evidence Based Clinical Care(EBCC)
EBCC Mission & VisionTo provide the structure and guidance for our organization in thedesign, adoption and implementation of relevant and up-to-datesynthesized research based clinical pathways and protocols thatcan be measured real time across the entire episode of care; inorder to eliminate clinical variation, improve patient safety andreduce cost.Our vision is to ensure BHSF healthcare providers deliver care that isdeliberate and coordinated across all services. EBCC is a systemcommittee charged with reducing unnecessary variation in the careof patients with certain diagnoses. Develop and enforce systemwide policies that are necessary to support the clinical care.
EBCC Physician EducationRollout Council Deliverables EBCC website now live on intranetpage (external hyperlink being created“goebcc.baptisthealth.net”) Exclusive email MD DG-group created“ DG-BHSF EBCC” CME education will be available withevery MS-DRG or pathway as it rollsout Power plan usage reports by MS-DRGand provider Entity specific educational needsassessment to target the specificprovider groups for the MS-DRGs Entity specific operational assessmentto identify operational gaps
EBCC At-A-GlanceEvidence-Based ClinicalCare At-A-Glance9-July
Role of Analytics in Supporting EBCC Operational reports for day to day operations Integrate data from multiple data sources real time Generate actionable insights using quality, financial, andclinical metrics to monitor performance Monitor physician compliance of Order Sets
EBCC Data SourcesSoarianFinancialsPremierBenchmarkingEPSI ClinicalCost AcctgCernerMillenniumEnterprise DataWarehouseDimensional InsightSpectre CBase ModelsDiveport PortalPeopleSoftSupply ChainCMS ClaimsDataTableauData Visualization
EBCC Core Functionality Executive Dashboard Monthly Trends Quality Data withNational Benchmarks Profitability Cost and UtilizationDetail Clinical Variability (KPIs) Physician PerformanceScorecard Order Sets Compliance Consultant Utilization Training & Education HIM Coding Validation Severity of Illness (SOI)Detail
Finding Variation and Cost OpportunityEBCC and Analytics Integrity Committee members review MS-DRGsgroupings for cost opportunity based on volumes, ALOS, and variablecost per casePremier benchmark levels at the 50th & 75th percentile variablecost opportunities are used to further validate the data (2standard deviation exclusion)EBCC DivePort 7.0 portal reporting is updated as MS-DRGwaves are defined for tracking outcomes
WAVE – EBCC Group – DRG Mapping
WAVE – EBCC Group – DRG Mapping
DivePort - EBCC Main
Provider Detail Analysis
Account Details
Patient Profile
Monthly Trends
Executive Dashboard
Key Performance Indicators
Key Performance Indicators (continued)
Key Performance Indicators (continued)
Key Performance Indicators (continued)
Trends
Order Sets – Cerner PowerPlans
Physician Education Rollout Council
Discharge Medications
What has EBCC Accomplished?
What has EBCC Accomplished?(FY 2018 – 2019 YTD)77,335Patients thatqualified for an EBCCPowerPlan/Pathway1,058Providers educated181MS-DRGs redesignedRedesigned 43 clinicalpathways and 59 algorithmsCreated 20 CMEs taken byDeveloped and deployedover 854 Providers129 PowerPlans187,074 EBCC PowerPlansused with an overallcompliance rate of 82.8%Created/updated 32 policies,and 40 eWINKs.
What has EBCC Accomplished?(FY 2018 – 2019 YTD)73%reduction in bloodproduct utilization in CJRpatients from 2017 to 2019Minor severity cellulitisadmissions decreased by40.5% from 2018 to 2019More than 38%improvement in dischargingDVT patients home ratherthan admitting from 2017 to2019Variable cost per case reductionfrom prior year on 50% of theMSDRGs, at the severity level, inwaves 1-5
Volume Adjusted EBCC 1:1 Match SOIMSDRGs RealizationOct 17-May 18 and Oct 18-May 19Excludes volume 10 Cases and adjusted for outliers (2STD)
Next Steps Move our Daily EBCC process from Weekly loads to daily loads Continue to develop clinical KPIs for each of the clinical areasidentified with highest potential to decrease LOS, Cost andVariability of Care Implementing Measure Factory and Dimensional InsightAmbulatory Operations (Phase I) Physician Augmentation (Phase II) Implement real time data capture from our Cerner EMR. Develop real time alerts for clinical metrics
The “Ask”
Alicia M. d’EmpaireChief Data OfficerBaptist Health South Floridaaliciad@baptisthealth.net(786) 662-7659Nora LissyDirector of Healthcare InformationDimensional Insightnlissy@dimins.com(781) 229-9111
ANSOS One-Staff AvMed ACO Files CareAware CentralLogic Centricity Cerner Invision PA and PM Cerner Millennium, Prod Cerner Millennium, Test Cerner Soarian Clinical Cerner Soarian Financial Chartlinks Clairvia Clinical Acuity System Common Vocabulary Engine
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