Harnessing Your Organization's Big Data to Improve Outcomes, Reduce Costs, Improve Service June 16, 2014 RWJF supports several grants testing health care payment reforms, which are managed by AcademyHealth
Overview Today s webinar will review the University of Utah Health Sciences Center s model for leveraging data to: Underst the costs of care; Identify tackle inefficiencies in care processes; Empower providers,, consumers. For more information on the other two webinars our ing Health Care Payment Delivery Systems series, visit AcademyHealth s website. 2
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Speaker Vivian Lee, Senior Vice President, University of Utah Health Sciences, CEO, University of Utah Health Care, Dean, University of Utah School of Medicine 7
Creating a Value- Driven Organization @vivianleemd vivian.lee@utah.edu Vivian Lee 2014 Vivian S. Lee, M.D., Ph.D., M.B.A. Senior Vice President, University of Utah Health Sciences CEO, University of Utah Health Care Dean, University of Utah School of Medicine
University of Utah Health Sciences Who we are
4 HOSPITALS 10 COMMUNITY CLINICS 1,200 PHYSICIANS COLLEGES School of Medicine College of Nursing College of Pharmacy School of Dentistry College of Health $230.3m FUNDED 637 RESEARCH GRANTS $2.5b ANNUAL BUDGET University Neuropsychiatric Institute Huntsman Cancer Institute John A. Moran Eye Center Primary Children s Hospital (IMC) University of Utah Hospital University Orthopaedic Center Clinical Neurosciences Center South Jordan Health Center
Who We Serve The Academic Medical Center for 10% + of the continental United States
The Sweet Spot Best Health Most Affordable United Health Foundation, 2013; Total Health Cost Kaiser Family Foundation, 2009
University of Utah Health Sciences Rankings 2013 - Top Ten 4 Years Running!
The Cost Curve McKinsey, Accounting for the cost of U.S. Health Care 2011
A Value-Driven Organization The Value Equation
HOW DO WE TRANSFORM SYSTEM? AN ALGORITHM FOR
establish METRICS
CASE STUDY: PATIENT SATISFACTION TESTING OUR ALGORITHM
Identify Communicate SOLVABLE PROBLEMS establish METRICS
Team COLLABORATION establish METRICS Tom Miller, M.D. Chief Medical Officer Brian Gresh Senior Director of Interactive Marketing Web Chrissy Daniels Director of Strategic Initiatives
How We MEASURE SATISFACTION ESTABLISH METRICS
How We DEFINE METRICS ESTABLISH METRICS @vivianleemd Vivian S. Lee, 2014
How We Engage Faculty by SHARING DATA establish METRICS
Feedback Recognition REINFORCE MENT & establish METRICS @vivianleemd Vivian S. Lee, 2014
How We SHARE DATA WITH CONSUMERS establish METRICS
How We SHARE DATA WITH CONSUMERS establish METRICS Scaife
How We SHARE DATA WITH CONSUMERS establish METRICS Scaife
How We SHARE DATA WITH CONSUMERS establish METRICS Scaife
How We SHARE DATA WITH CONSUMERS establish METRICS Scaife Every medical system in the country should embrace online reviews.
Improving PATIENT SATISFACTION 100 Online Reviews go- live December 1, 2012 establish METRICS 80 83 87 88 88 60 63 72 40 45 20 FY11 FY12 Q1FY13 Q2FY13 Q3FY13 Q4FY13 Q1FY14 Data collection: Press Ganey Medical Practice Survey, UHC Compare Group
% of total providers How Do We Percentile of Providers 90 TH %ILE OR ABOVE 50% 40% 1 out of 2 are in the top 10% nationally 46% establish METRICS 30% 20% 22% 27% 10% 4% 9% 0% 2009 2010 2011 2012 2013 Medical Practice Survey providers must have n=30 returned in calendar year National Rank compared against the Press Ganey National Database: 128,705
% of total providers How Do We Percentile of Providers 99 TH %ILE OR ABOVE establish METRICS 30% 25% 20% 15% 1 out of 4 is in the top 1% nationally 13% 17% 25% 10% 5% 0% 1% 3% 2009 2010 2011 2012 2013 Medical Practice Survey providers must have n=30 returned in calendar year National Rank compared against the Press Ganey National Database: 128,705
establish METRICS
CASE STUDY: VALUE DRIVEN establish METRICS OUTCOMES TACKLING HEALTH CARE CRISIS
October 2013 establish METRICS
establish METRICS October 2013 For a field in which high cost is an overarching problem, the absence of accurate cost information in health care is nothing short of astounding. - Robert S. Kaplan Michael E. Porter, The Big Idea: How to Solve the Cost Crisis in Health Care, HBR, September 2011
establish METRICS October 2013 Accurate costing also unlocks a whole cascade of For opportunities, a field in which such as process high cost improvement, is an better overarching organization problem, of care, the absence new of accurate reimbursement cost information in approaches health care that is nothing will accelerate short of astounding. the pace of innovation value creation - Robert S. Kaplan Michael E. Porter, The Big Idea: How to Solve the Cost Crisis in Health Care, - Robert S. Kaplan HBR, September Michael 2011 E. Porter, The Big Idea: How to Solve the Cost Crisis in Health Care, HBR, September 2011
Can We Hle TRUTH IN HEALTH CARE? establish METRICS WE DON T KNOW OUR COSTS. WE DON T KNOW OUR OUTCOMES.
How Can We Know Our Costs? START WITH SEQUESTRATION establish METRICS
VDO VALUE DRIVEN OUTCOMES $396 establish METRICS You Don t Want to Know $47
Value Driven Outcomes: Nuts Bolts IDENTIFY AND GAR DATA establish METRICS ANESSIA surgery Med icati ons E.R. Gen eral Ledg er Supplies Labor Vitals Billing EHR Outcome s @vivianleemd Vivian S. Lee, 2014
Value Driven Outcomes: Nuts Bolts EXTRACT, LOAD AND TRANSLATE DATA Supplies Labor Vitals Med icati ons establish METRICS surgery Billing 91237 - UUH ANC 22A POST ANESSIA 91243 - UUH ANC 13A PULMONARY LAB 91607 - UUH ANC 14A NONINV CARD MON 91665 - UUH IPC 24A INTERMEDIATE CARE 91236 - UUH ANC 22A OPERATING RM 91066 - UUH OPC 29A EMERGENCY RM 91277 - UUH ANC 13A BLOOD PRODUCTS 91642 - UUH IPC 21A SURG SPEC TRANSPL 91040 - UUH IPC 33A GEN ACUTE REHAB 91238 - UUH ANC 22A ANESSIOLOGY 91259 - UUH ANC 12C CT IMAGING 91275 - UUH ANC 13A CLINICAL LABS 91054 - UUH ANC 37A DISTRO INVENTORY 91239 - UUH ANC 13A RESPIRATORY THRPY @vivianleemd Vivian S. Lee, 2014
Value Driven Outcomes: Nuts Bolts CATEGORIZE AND ALLOCATE EXPENSES establish METRICS Cost Type Groupings Laboratory Supply Pharmacy Diagnostic Imaging Other Operating Room Utilization Accommodation @vivianleemd Vivian S. Lee, 2014
Facility Cost Allocations Emergency Appendectomy (47.01 Laparoscopic Appendectomy), 3.12 Clinical LOS Cost Source: 5 Depts Pathology Anesthesiology establish METRICS Surgery Neurology Radiology Cost Source: 16 Orgs 91066 - UUH OPC 29A EMERGENCY RM 91237 - UUH ANC 22A POST ANESSIA 91277 - UUH ANC 13A BLOOD PRODUCTS 91259 - UUH ANC 12C CT IMAGING 91607 - UUH ANC 14A NONINV CARD MON 91236 - UUH ANC 22A OPERATING RM 91238 - UUH ANC 22A ANESSIOLOGY 91275 - UUH ANC 13A CLINICAL LABS 91243 - UUH ANC 13A PULMONARY LAB 91031 - UUH IPC 24A SURG ICU 91665 - UUH IPC 24A INTERMEDIATE CARE 91642 - UUH IPC 21A SURG SPEC TRANSPL 91271 - UUH IPC 11C PHARMACY IP 91040 - UUH IPC 33A GEN ACUTE REHAB 91054 - UUH ANC 37A DISTRO INVENTORY 91239 - UUH ANC 13A RESPIRATORY THRPY @vivianleemd Vivian S. Lee, 2014
Use Data to SHARE PRESENT STANDARDS establish METRICS
Use Data to SHARE PRESENT STANDARDS establish METRICS
Use Data to SHARE PRESENT STANDARDS establish METRICS Filter By DRG
Use Data to SHARE PRESENT STANDARDS establish METRICS Filter By Diagnosis Group
Use Data to SHARE PRESENT STANDARDS establish METRICS Filter By ICD9
Use Data to SHARE PRESENT STANDARDS establish METRICS
Use Data to Create a LEAN PROCESS establish METRICS
Engage Your FRONT LINES establish METRICS
Engage Everyone to REDESIGN SYSTEMS & PROCESSES Mapping Current State establish METRICS @vivianleemd
Use DATA to Engage PROVIDERS TO BE PROBLEM-SOLVERS establish METRICS
Use DATA to Engage PROVIDERS TO BE PROBLEM-SOLVERS establish METRICS
Use DATA to Engage PROVIDERS TO BE PROBLEM-SOLVERS establish METRICS
Where Quality Goes Up & COST GOES DOWN establish METRICS Perfect Care Cost
Where Quality Goes Up & SAVINGS GOES UP establish METRICS
Bending COST CURVE $10,500 Total Expense per CMI-adjusted Discharge establish METRICS $10,000 $9,562 $9,859 $10,204 $9,500 $9,000 $8,500 $8,000 $8,874 $9,221 $8,947 $9,143 $9,407 FY 10 FY 11 FY 12 FY 13 FY14 April YTD $9,388 UUHC Avg. Inflation (1.4%) U.S. Health Care Inflation (3.5%) Source: Bureau of Labor Statistics CMS University of Utah Hospitals & Clinics Finance
Hard-wiring the System THROUGH PARTNERSHIPS establish METRICS TIME-DRIVEN Activity-Based Costing LEAN 101
Learn MORE establish METRICS algorithmsforinnovation.com
establish METRICS
Creating a Value- Driven Organization Thank You @vivianleemd vivian.lee@utah.edu Vivian Lee 2014 Vivian S. Lee, M.D., Ph.D., M.B.A. Senior Vice President, University of Utah Health Sciences CEO, University of Utah Health Care Dean, University of Utah School of Medicine
Q&A To submit a question: 1. Click in the Q&A box on the left side of your screen 2. Type your question into the dialog box click the Send button To register for the final webinar in this series, visit AcademyHealth s website. For additional payment reform resources, visit: RWJF s Payment Reform webpage HCFO s website 64
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