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Cleveland Clinic CEO: How We Improve Care Access and Quality, Reduce Cost for Six Million Patients

June 4, 2013
by Gabriel Perna
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When it comes to the Cleveland Clinic, a large, world renowned nonprofit multi-specialty academic medical center, every improvement—from better designed hospital gowns to predictive analytics—has played an integral role in the organization’s overall strategy of transforming care to comply with the ideals of healthcare reform.

This strategy was outlined by Cleveland Clinic’s CEO, Delos Cosgrove, M.D., in front of an audience of Health Datapalooza attendees in Washington D.C. Cosgrove spoke for approximately 20 minutes detailing the organization’s various initiatives, using health information tools to improve care quality and access, while significantly reducing the cost of care at an organization that sees six million patients.

Starting with how Cleveland Clinic has improved access to care, Cosgrove talked about the organization’s decision to make its MyChart electronic health record (EHR) app for patients opt-out. By doing this, the CEO said it’s connected 1.5 million users to their health record electronically, compared to 500,000 when it was opt-in. In addition, he mentioned the fact the app is available on handheld devices.

In addition, Cosgrove talked about how it tracks data from call centers. It looks at how fast calls are answered for people who want to make appointments. “We think it should be less than 50 seconds and monitor this on a daily, hourly basis,” he said, adding that the organization implemented a same-day appointment strategy. “Last year we had one million same day appointments.

Overall, this idea of tracking data plays into Cleveland Clinic’s overall strategy that Cosgrove spoke of during Health Datapalooza. “What we’ve learned is that if you can’t measure it, you can’t improve it,” he told the audience.

In this case, Cosgrove was referring to Cleveland Clinic’s strategy on how it has improved the quality of care. Specifically, he was talking about n Cleveland Clinic’s development of outcomes books. The books, which have been in the organization since the late 1990s, show the results of various clinical procedures for a physician audience.

The books, which Cosgrove made mandatory across the organization, allows the provider see what’s working and stay ahead of the curve on various procedures. In an example, he pointed to the use of artery grafts in cardiac care by the organization where it was ahead of the industry.

In terms of where Cleveland Clinic has used health information systems and technology to improve care quality, he mentioned the organization’s well-known relationship with Cleveland-based Explorys, a predictive analytics modeling company. Explorys had actually spun-off from Cleveland Clinic, but the two maintain a strong relationship. Through it, Cleveland Clinic has access to Explorys’ network of 200 hospitals and 100,000 providers.

Cleveland Clinic, Cosgrove mentioned, is also working with Watson, the deep question answering technology, created by the Armonk, N.Y.-based tech giant, IBM. Also, the organization has begun to do virtual home visits, he said.

During the speech, Cosgrove touched upon the work being done in the organization to improve patient satisfaction. He mentioned the hiring of Jim Merlino, Cleveland Clinic’s chief experience officer, and how the company’s Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores have gone up since various patient satisfaction surveys have gone into place. Cosgrove even spoke of how the organization redesigned hospital gowns, using fashion designer Diane Von Furstenberg.

All told, this work in access and quality has lowered Cleveland Clinic’s costs, Cosgrove said. In some cases, they’ve used health information technology to do so. To rousing applause, he mentioned that as an example, the organization controlled costs by eliminating 12,000 lab tests. Cosgrove said they did this by putting stops in the EHR to ensure a physician couldn’t order a redundant lab test.

“Obviously, you guys don’t work in labs,” Cosgrove joked with the crowd after they applauded the statistic.