Major data analytics-fueled clinical and operational performance improvement has been taking place at Mercy Health, the 45-hospital, 300-clinic integrated health system that is based in the St. Louis suburb of Chesterfield, Missouri, and which serves patients and communities in four states—Missouri, Oklahoma, Arkansas, and Kansas.
Leveraging powerful data analytics tools, Mercy leaders have made dramatic progress in a number of clinical areas and services, from the large perioperative area, to cardiology, to laboratory, to pharmacy.
Among those helping to lead an organization-wide charge on operational performance improvement are Gil Hoffman, Mercy Health’s CIO, and Curtis Dudley, its vice president of integrated performance solutions.
Among other things, Hoffman and Dudley collaborated with a large, system-wide team of colleagues to develop a system-wide cost-per-case perioperative dashboard, which provided a wealth of opportunities for the organization’s clinical and administrative leaders to improve performance along a number of dimensions, through monitoring, measuring, and improving costs and clinical outcomes of a variety of surgical procedures. Indeed, using key cost and outcomes data related to surgical procedures across the entire integrated system, Mercy Health achieved $9.42 million through cost reduction, the elimination or minimization of the use of certain surgical products, reduced supply utilization variation, and best practices across perioperative departments in the system.
As Hoffman and Dudley note, Mercy Health has a very high volume of surgical procedures—about 210,000 procedures annually—with the system’s second leading driver of cost coming from surgical supplies and implants. The health system’s leaders looked at that reality and also at the opportunity to impact quality and the patient experience, and went to work, with the system’s perioperative team and technology services team partnering to create a set of custom dashboards launched through an information portal for one-stop access to high level metrics, reports and data exploration tools for immediate answers, faster decisions and more agile process improvements. The interactive dashboards leverage cutting-edge technology to provide a holistic view, consolidating large sets of diverse clinical, operational and financial data into a single platform.
Prior to 2012, determining surgical costs at Mercy was an unstructured, manual process. At the time, surgeon preference cards and product contracts (which contain supply cost) were the only methods available to determine the cost of surgical procedures. Without data as evidence, there were varying opinions as to the best practice, price and product for a given procedure. As a result, there were significant variations in the cost per surgical case across Mercy. But, through the use of dashboards, along with extensive governance development, clinician and staff training, and the leveraging of health IT (including the extensive leveraging of the HANA platform from the Charlotte-based SAP), the leaders of the initiative were able to make significant progress, with a system-wide cost savings of $9.42 million across perioperative departments for all surgical procedures as calculated through January 2016, after launching the initiative in 2013. Among other elements, Mercy’s median cost per case for total knee surgery dropped from $7,045 with an interquartile range of $1,999 in 2014, to a median cost per case of $5,527 and interquartile range of $901 in 2016. In addition, following dashboard implementation, there has been a significant drop in costs of intraoperative implants and supplies per case related total knee arthroplasty.
Recently, Hoffman and Dudley spoke with Healthcare Informatics Editor-in-Chief Mark Hagland to discuss some of the elements of their organization’s success to date with this system-wide performance initiative. Below are excerpts from that interview.
Tell me a bit about the secret of your success so far with this wide-ranging initiative?
Gil Hoffman: Part of the secret is that our team really focused on how to look at the best outcomes, and then determined what were the best practices involved, and determined how to deliver those good outcomes as efficiently as possible, by reducing costs and improving care.
Curtis Dudley: I’ve been at Mercy health for 27 years. I came from our supply chain division, and have been there for 20 years. I led our Texas warehouse system implementation, the implementation of our Lawson ERP and deployment of that system system-wide, and through that, our supply chain system that we created, which has won a number of awards. A lot of that has been enabled by analytics and data, and that is what brought me to corporate headquarters four years ago. I’ve led our OR operations, supply chain, etc.