We at Healthcare Informatics were once again delighted by the exceptional quality of the submissions we received from innovating teams from across the country, this year. Below, please find descriptions of the initiatives of the eight teams whom we have awarded semifinalist status in this year’s program.
Also, to learn more, leaders of these teams, along with leaders of the four finalist teams, will be recognized at the Healthcare Informatics Innovator Awards Reception, to be held in Las Vegas on March 1 at the annual HIMSS conference.
Allina Health: Intensive clinical and operational gains
As an organization participating in the federal Pioneer Accountable Care Organization program, Allina Health, based in Minneapolis, has a natural incentive to improve clinical performance. Even so, the decision on the part of senior leaders at the 13-hospital, 90-clinic, 26,000-employee Allina to commit to achieving exceptional outcomes—senior executives strove to be in the top decile of performance on every meaningful, measurable quality metric—was ambitious.
Specifically, Allina team members aggregated clinical, financial, operational, patient satisfaction, and other data into its enterprise-wide data warehouse (EDW), to create consistent views of the data. They then decided to use analytics to identify the clinical programs in greatest need of optimization and waste reduction, focusing initially on congestive heart failure (CHF) readmissions, spine care, length of stay, and venous thromboembolism (VTE) care. They chose to drill down particularly intensively on reducing CHF-related 30-day readmissions.
In the readmissions arena, Allina clinicians and care managers have achieved a 17-percent 30-day CHF readmissions rate reduction in 10 of the 11 hospitals doing cardiac care, along with a 30-percent increase in patient participation in the system’s heart failure program, a 36-percent reduction in CHF patient ED visits, and a 20-percent reduction in length of stay for CHF patients. In the spine care arena, the health system has been involved in a full initiative to deliver care that supports the Triple Aim in the treatment of spine disorders and lower back pain. Among other achievements, Allina has implemented a collaborative spine care coordination program; achieved a 16-pecent reduction in length of stay for spine care procedures; achieved a 36-percent reduction in post-operative complications; and achieved a projected $2.7 million in savings through supply standardization.
Allina leaders continue to work forward across the CHF, spine care, and VTE clinical areas, and continue to show ongoing significant clinical and financial outcomes progress.
Unity Point-Meriter: Transforming bundled payment-driven joint replacement
In 2012, in preparation to begin participating in the bundled-payment program for joint replacement procedures under the Centers for Medicare & Medicare Services (CMS), leaders at UnityPoint Health-Meriter, a one-hospital health system in Madison, Wisconsin, performed financial analysis on the organization’s efficiency in that arena, with the goal to launch a high-quality, efficient joint replacement bundle by January 2014. A multidisciplinary project team worked to redesign care delivery, lower costs, and automate some of the administrative burden. Standardization and cost reduction began with re-negotiating implant contracts and tackling surgeon pick lists for surgical pathways and supplies in materials management.
Among other actions, Meriter leaders implemented a claims data-analysis and modeling tool to better understand claims reconciliation, and provide detailed performance data. They soon discovered high variability in post-acute care utilization. They also developed a set of clinical pathways to ensure standardized, best practice-driven care across clinicians. The results have been significant, including, between 2013 and 2015, a 12-percent reduction in length of stay; a 23-percent decrease in the use of skilled nursing facilities; and a 68-percent reduction in readmissions, even as 55 percent of all joint replacements performed at Meriter are done so under bundled payment.
Yale-New Haven: Engaging physicians intensively in performance improvement
At Yale-New Haven (Conn.) Health System, a focus on quality is at the center of the organization’s multi-year, $125 million cost savings initiative. As part of the execution of the initiative, Yale-New Haven leaders created a customized set of quality metrics called QVIs (quality variance indicators), and a sophisticated cost accounting systems, to better collaborate with clinicians on quality improvement and cost reduction. As a result, organizational leaders were able to overcome typical physician skepticism about performance data, thus opening the doors to full collaboration with the health system’s affiliated physicians.
Among numerous other examples, the organization was able to increase overall appropriate use of the drug bivalirudin (used as an anticoagulant in patients with unstable angina undergoing percutaneous transluminal coronary angioplasty) by nearly 30 percent, contributing to a reduction in direct cost per case among those patients, through sharing data related to costs associated with variations in care. Yale-New Haven senior leaders report that, because they have leveraged data and information systems, along with strategy, to fully engage physicians, both physicians and non-clinicians are now fully invested in working collaboratively, in a data-facilitated way, to look at costs across the health system.
Hackensack University Medical Center: Using IT to monitor blood loss in real time