Adventures in Orthopedic Data Management

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Melinda Clark
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Supply Utilization October 15, 2015 Kurt

2 Topics Overview of Trinity Health Supply Chain Strategic Plateaus Informatics Infrastructure Data Classification Metrics/Key Performance Indicators Tools: Reports and Dashboards 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 2

Metrics/Key Performance Indicators Tools: Reports and

3 Trinity Health Our Diversified network extends across the full continuum of care 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 3

4 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 4

5 Supply Chain Strategic Focus Achieve the lowest cost for the highest quality Products and Services across our Ministries through engagement with Ministry Leadership; alignment with Physicians, Clinicians, and others who are driven by outcomes and data with a focus on supporting the vision of stewardship and care excellence across Trinity Health. Achieved by excellence in: Logistics (Supply Chain Operations) Pricing (Sourcing) Value Analysis (Infrastructure/utilization management) Business Intelligence (Data for decision making) 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 5

stewardship and care excellence across Trinity Health.

6 Supply Chain Management Strategic Plateaus 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 6

7 Objective: Clinically Driven Supply Chain To support the goal of a Clinically Driven and Integrated Supply Chain Trinity Health: Recognized the need to provide usable data to identify cost and utilization patterns Acknowledged supply cost per case is elusive Defined requirement to capture Orthopedic Joint and Spinal Hardware Implants by line item costs and identify waste at the patient case level Supply Chain Inventory Management Technology Analytics Utilization Expense Management Need: Integrated Reporting System Clinical Practice Patient Care 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 7

and Spinal Hardware Implants by line item costs and identify waste at the patient case level Supply Chain Inventory Management Technology Analytics

8 How to Achieve a Clinically Driven Supply Chain Design systems to support identification of implants and tie their utilization to metrics Utilize systems of data already available Create capture tools Develop reporting systems 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 8

systems of data already available Create capture tools Develop reporting

9 Producing Information Presentation Layer Executes report logic Provides summary level data with ability to drill to detail Data Mart Layer - Performs Complex Joins Collects and processes the Transactional Level data Data can be used in ad-hoc queries Transactional Level - Input Detail on product supplies Several hundred tables of data 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 9

Level data Data can be used in ad-hoc queries Transactional Level - Input Detail on product supplies

10 Information Keys Rely on ability to Classify Data Data must be collected or transformed into a common classification for aggregate and comparison analysis Access specific standard created by third party Ortho/Spine Implants use Mendenhall and Associates (ONN) Generic Implant Code (GIC) Must be available on a timely basis Provide summary level data with ability to drill into detail Produce monthly reports and post to Analytics Portal Have to show benchmarks Provides metrics on utilization and KPI s Utilize Traffic Lighting (red/yellow/green) Graphic and tabular formats Not blinded across Trinity Health 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 10

level data with ability to drill into detail Produce monthly reports and post to Analytics Portal Have to show benchmarks Provides metrics on utilization and KPI s Utilize

11 Importance of Data Classification Creates the ability to compare data with confidence Clinicians and Physicians trust the information Opportunities are more easily identifiable as variances stand out Creative sourcing strategies can be positioned Data becomes usable with other information systems 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 11

variances stand out Creative sourcing strategies can be positioned Data becomes usable with

12 Classifying Data at Entry Point The process of classifying starts HERE: We input our case data as part of our replenishment process (e.g. Consignment Bill and Replace or Bill Only) 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 12

13 Classifying Data at Entry Point This begins the punch out to ONN for case entry and data classification 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 13

14 Third Party Implant Classification 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 14

Replenishment Database Metrics 2014 Trinity

16 Importance of Metrics Generates scorecards with meaningful measurements Allows for benchmarking of utilization Provides standard language for comparison Sourcing strategies can be positioned Provides a platform for engaging with Physicians / Surgeons 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 16

strategies can be positioned Provides a platform for engaging with Physicians /

17 Strategic Sourcing Implant Database (SSID) The Database was developed to give the System and its hospitals access to detail of implant spend and utilization by providing: Visibility to type of implant used, accessories, and up-charges Implant information by Patient and Physician Benchmark pricing and volume utilization across hospitals Ability to send data to external databases Electronic Implant Log to meet regulatory requirements Exportable information to link with other data sources 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 17

Benchmark pricing and volume utilization across hospitals Ability to send data to external databases Electronic Implant Log to meet regulatory

18 Strategic Sourcing Implant Database (SSID) Database Statistics: Began data collection of Orthopedic Joint cases July 2007 Began data collection of Spine cases June trained associates who actively input case data Supports: Database represents: 183,000+ in patient cases $1.2+ Billion in Spend Strategic Sourcing of Orthopedic Joints, Spine, Orthobiologics Sending supply and cost data to Clinical and Revenue Systems Identification of variation in cost and product utilization per case 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 18

19 Strategic Sourcing Implant Database (SSID) Key Performance Indicators: Volumes, Cost, Revision Cases, Reimbursement, Waste, LOS Hardware costs - Implanted items Total Costs Inclusive of Hardware AND significant per patient items used to implant product (e.g. Cement or items used to supplement implant such as orthobiologics) Real Time Selections Available: By Hospital(s), Procedure, Construct, DRG, ICD, Physician, Vendor Time Periods All years of data, Month, Quarter, Fiscal Year Comparisons Added information for physician report: Patient Gender, Age, Payor Profile, Spine Approach, Spine Levels 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 19

ificant per patient items used to implant product (e.g.

20 The Deliverable: Implant Executive Dashboard KPI s include: Case Volume, Cost, Waste, Revisions, and Reimbursement Becomes the mechanism to monitor cost, volume trends, and establish benchmarks across the health system Available through the web via Trinity Health Analytics Portal 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 20

establish benchmarks across the health system Available through the web via Trinity

21 SSID & The Implant Executive Dashboard Ortho / Spine Implants Implant Executive Summary 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 21

22 SSID and the Clinical Data Warehouse Implant Data is exported to Clinical Data Warehouse Used to review with physicians opportunities for improvement in cost and utilization Orthopedic Hips and Knees Clinical Cost Metrics Information is available by hospital and drillable to patient case and physician level 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 22

23 SSID and the Clinical Data Warehouse Spinal fusion cases needed additional data elements to produce more meaningful information Spinal Fusion Clinical Cost Metrics 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 23

24 New Dashboard Bone Cement Results: Created guidelines for number of units used per procedure Created clinical protocol for type of cement utilized 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 24

25 Snapshot of Results Orthopedic Joints Fiscal Year End Orthopedic Joints Fiscal Year End Key Performance Indicators Trending in Positive Direction Several KPI s trending in the right direction 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 25

26 Snapshot of Results Spine Fusion Cases Fiscal Year End Orthopedic Joints Fiscal Year End Key Performance Indicators Trending in Positive Direction Several KPI s trending in the right direction 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 26

27 Show Me the Data - Examples Can Export to Excel to analyze details Pivot Tables, Impact Analysis, etc Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 27

28 Examples of How Data is Used Identification of PHYSICIAN benchmarks (cost per case) Identification of HOSPITAL benchmarks (cost per case) 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 28

29 Examples of How Data is Used Cost by Part Number, Construct, etc. Development of Part Number Target Prices 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 29

30 Examples of How Data is Used Vendor Strategy Physician Alignment 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 30

31 2014 Trinity 2015 Health. Trinity All Health Rights - Livonia, Reserved. MI 31

Healthcare Resource and Supply Management Opportunities and Challenges

Healthcare Resource and Supply Management Opportunities and Challenges A Subsidiary of 1 2013 Resource Supply Management Group d/b/a The Resource Group This work, including its content, may not be used,