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The recent presentation by TMP of Quality, Cost leadership, Methodology and Technology
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1
SWO-HFMA : Lunch and Learn
Quality of Care
Cost Leadership, Methodology and Technology
October 30, 2009
Presenters: Sunil Rao, MD, MBA, Chief Medical Officer, TMP
Jeff Burke, MBA, Managing Partner, TMP
2www.T-M-Partners.net
3
You will Learn
1. The importance of Quality to national healthcare reform
2. The financial impact Quality can have on every part of your hospital
3. The connection between “Meaningful Use”, the ARRA and EHR use; and the reporting of CMS Quality Core Measures
4. How to move from "just reporting" quality measures to a Quality Management Program for Improved Patient Outcomes based on methods and technology
5. The importance of real time data and process improvement methodologies to the critical issue of improving quality of care processes in healthcare
6. The critical part that (IT) information technology plays in the sustaining platform for continuous improvement
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4
Agenda
• What is Quality in Healthcare?• Why is Quality so Important?• Finance and Executive Buy-in• Methodologies• Technologies• Q&A
www.T-M-Partners.net
5
Thoughts for Today
• Consider these issues:• Is Quality Improvement a “Burning Platform”?• In the long run, everything is focused on improving Quality• CMS says, Quality will improve their financial health• CMS may not care about your bottom line• CMS will pay the winners and penalize the others• ARRA will pay to accelerate IT adoption, but only based on Quality• Methods and Technologies can help• You need a Quality Improvement Roadmap and CEO Backing
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Agenda
• What is Quality in Healthcare?• Why is Quality so Important?• Finance and Executive Buy-in• Methodologies• Technologies• Q&A
www.T-M-Partners.net
Healthcare IndustryKey Quality Drivers
• Patient-Centered Quality Care• Quality is a Board Level issue• Compliance is Required• CMS Pays for Performance
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Cost of Compliance
Net Profit
QualityPatient
Care
If Quality Outcomes had been improved by 2% in 2004, the national savings would have been:
• 5,700 avoidable death• 1 million hospital days• $1.4 billion
Better patient care costs hospitals less and improves patient outcomes
8
Elimin
ate
Under
use B
A
The Industry Today
The Goal
Talking About Quality June 2009
Health Care Today | Misuse
Definition of Misuse
Committee on Quality of Health Care in America, Institute of Medicine. To Err is Human: Building a Safer Health System. Washington: National Academies Press, 1999.
“Misuse” of care is another way of describing medical errors, which can be defined as either the failure to properly carry out appropriate treatment plans or the use of inappropriate plans.
Talking About Quality June 2009
Deaths Due to Preventable Errors
Committee on Quality of Health Care in America, Institute of Medicine. To Err is Human: Building a Safer Health System. Washington: National Academies Press, 1999.
Health Care Today | Misuse
Talking About Quality June 2009
Deaths Due to Health Care-Associated Infections
Klevens RM, Edwards JR, Richards CL, Jr., et al. "Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002." Public Health Reports, 122: 160-166, 2002.
Health Care Today | Misuse
Talking About Quality June 2009
Health Care Today | Overuse
Definition of Overuse
When treatments are given without medical justification, such as antibiotics for simple infections, or when an equally effective option could have been followed that would have cost less or caused fewer side effects.
Talking About Quality June 2009
Unnecessary—and Possibly Harmful—Services
Fisher ES, Goodman DC, Chandra A. Disparities in Health and Health Care among Medicare Beneficiaries: A Brief Report of the Dartmouth Atlas Project. Princeton, NJ: Robert Wood Johnson Foundation, 2008.
Health Care Today | Overuse
Talking About Quality June 2009
Health Care Today | Underuse
Definition of Underuse
When patients do not receive medically necessary care, or when proven health care practices are not followed, e.g., when people who have heart attacks are not given beta-blocking drugs.
Talking About Quality June 2009
Health Care Today | Underuse
Recommended Care
McGlynn EA, Asch SM, Adams J, et al. "The Quality of Health Care Delivered to Adults in the United States." The New England Journal of Medicine, 348: 2635-2645 (26): 1, 2003.
Talking About Quality June 2009
Deaths Due to Improper Care
Essential Guide to Health Care Quality. Washington: National Committee for Quality Assurance, 2007. (No authors given.)
Health Care Today | Underuse
17
Agenda
• What is Quality in Healthcare?• Why is Quality so Important?• Finance and Executive Buy-in• Methodologies• Technologies• Q&A
www.T-M-Partners.net
News about Quality Every Day
CMS chief says Medicare should consider cost to determine coverageCMS Director Dr. Barry Straube is expected to play a critical role in ensuring that health care spending is closely linked with the quality of care as White House officials and lawmakers scramble to pass a health care reform bill. Straube says cost should be considered in deciding which treatments should be covered by Medicare in order to address rising health care costs.
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The Wall Street Journal (10/27/09)
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The HFMA believes that achieving the nation’s health goals requires effective reform of the payment system
“Payment reform will strengthen, if not codify, the relationship between payment and quality, with a significant amount of revenue at risk if quality goals are not achieved.”
Catherine Jacobson, FHFMA, CPA, Chair HFMA
Breaking Barriers
Why is Quality so Important?
• In the long run, everything is focused on improving Quality• CMS says, Quality will improve their financial health• Meaningful Use = CMS Quality Core Measures (Plus other items)
• CMS• Pay for Reporting• Pay for Performance• Value Based Purchasing
• ARRA• Certified EHR• Meaningful Use
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CMS has been pursuing this since
before 2005
ARRA raises the ante and pays for
faster action
Quality is worth
it.
What is your Plan?
What Does VBP Mean to CMS?
Transforming Medicare from a passive payer to an active purchaser of higher quality, more efficient health care
Tools and initiatives for promoting better quality, while avoiding unnecessary costs
Tools: measurement, payment incentives, public reporting, conditions of participation, coverage policy, QIO program
Initiatives: pay for reporting, pay for performance, gainsharing, competitive bidding, bundled payment, coverage decisions, direct provider support
Premier Hospital Quality Incentive Demonstration
CMS/Premier HQID Project Participants Composite Quality Score: Trend of Quarterly Median (5th Decile) by Clinical Focus Area
October 1, 2003 - September 30, 2006 (Year 1 and Year 2 Final Data, and Yr 3 Preliminary)
89.6
2%
85.1
4%
70.0
0%
63.9
6%
85.1
3%
89.9
5%
85.9
2%
73.0
6%
68.1
1%
86.6
9%
91.5
0%
89.4
5%
78.0
7%
73.0
5%
88.6
8%92.5
5%
90.5
7%
80.0
0%
76.1
4%
90.9
3%93.5
0%
93.7
0%
82.4
9%
78.2
2%
91.6
3%
93.3
6%
94.8
9%
82.7
2%
81.5
7%
93.4
0%
95.0
8%
96.1
6%
84.8
1%
82.9
8%
95.2
0%
95.7
7%
97.0
1%
86.3
0%
84.3
8%
95.9
2%
95.9
8%
96.7
7%
88.5
4%
96.1
4% 98.2
8%
89.2
8%
88.7
9%
96.8
9%
96.8
4%
98.4
4%
90.0
9%
90.0
0%
97.5
0%
96.7
644%
98.3
777%
91.4
013%
89.9
371%
97.7
264%
86.7
3%
96.0
5%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
AMI CABG Pneumonia Heart Failure Hip and Knee
Clinical Focus Area
Co
mp
os
ite
Qu
ali
ty S
co
re
4Q03 1Q04 2Q04 3Q04 4Q04 1Q05 2Q05 3Q05 4Q05 1Q06 2Q06 3Q06
Talking About Quality June 2009
Health Care Today | Variations in Care
Overall Improvement is Slowing
National Healthcare Quality Report. Rockville, MD: Agency for Healthcare Research and Quality, 2008. (No authors given.)
FY 2010–FY 2011 FY 2012 and Beyond
Efficiency measuresOutcomes measuresEmergency care measuresCare coordination measuresPatient safety measuresStructural measures
Performance areas to address measure gapsExpect need for new measure development
Additional Measure Topics for FY 2010 and Beyond
HACs Selected During IPPS FY 2008 Rulemaking
• Foreign object retained after surgery• Air embolism• Blood incompatibility• Catheter-associated urinary tract
infection• Vascular catheter-associated infection• Surgical site infection – mediastinitis
after CABG• Pressure ulcers• Falls – specific trauma codes
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HAC, POA
• “Since 2008, hospitals that cannot document certain conditions as POA have faced Medicare payment reductions. Medicare has also stopped paying for … Never Events. Next on the radar screen; Preventable Readmissions.
• “Financial leaders should engage with clinicians to work toward avoiding preventable complecations – something both groups want. And we need to develop costing capabilities so we know what these events are costing us.
• “It isn’t about the lost revenue anymore; it’s about preventing the complications and the associated costs in the first place.”
• Catherine Jacobson, FHFMA, CPA, Chair HFMA• Letter from the Chair, HFM Magazine, October 2009
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ARRA – Hospital HITMedicare Funding Is Provided to Encourage the Adoption of HIT
ARRA Provisions
• Hospitals Using Certified EHR During A Reporting Year Are Eligible.
• Payment for Qualified Facilities Is Based on the “Medicare Share.”
• Payments Are Phased Over Four Years Beginning in 2010.
• Non-Adopting Hospitals Face Reduction to Three-Quarters of Their Medicare Market Basket Update, Starting in 2015
Base payment is $2M plus $200 per discharge for additional discharges from 1,150 to 23,000th
Reduced using a ratio based on Medicare utilization adjusted for charity care.
• Early adopters will receive payments from Medicare during the implementation corridor, 2010 to 2015.
• Laggards will see reductions in Medicare payments beginning 2015.
• Monitor the Office of the National Coordinator for HIT to stay abreast of standards, specifications and certification criteria.
• Instead of bolting EHR on top of existing processes, facilities should re-engineer patient care and billing workflows to increase efficiency and quality.
Implications for Hospitals
ARRA – Hospital HIT
0%
25%
50%
75%
100%
Year 1 Year 2 Year 3 Year 4
“Meaningful” users of HIT will receive additional payments from Medicare…
Percentage of HIT Medicare Share Payments Received Based on When Eligible
…while non-adopters will have their Medicare market basket update reduced
75%
50%
25%
0%
25%
50%
75%
100%
Percentage of Market Basket Update Received by Non-Adopters
2010 - 2013
2014 2015 2016Eligible in:
2015 2016 2017
Meaningful Use
• “CMS is expected to publish a formal definition of meaningful use, for the purposes of receiving the Medicare and Medicaid incentive payments, by December 31, 2009.”
• “Meaningful use of EHRs, we anticipate, will also enable providers to reduce the amount of time spent on duplicative paperwork and gain more time to spend with their patients throughout the day.
• “Meaningful use, in the long-term, is when EHRs are used by health
care providers to improve patient care, safety, and quality.
A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology
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2009 2011 2013 2015
HIT-Enabled Health Reform
Me
an
ing
ful U
se C
rite
ria
HITECH Policies 2011 Meaningful
Use Criteria (Capture/share
data)2013 Meaningful
Use Criteria(Advanced care processes with
decision support)
2015 Meaningful Use Criteria (Improved Outcomes)
Meaningful Use is Being Defined and Will Follow an “Ascension Path” Over Time*
*Report of sub-committee of Health IT Policy Committee
Policy Committee Recommendations for the Definition of Meaningful Use
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Cost of Poor QualityGeneric Model
Direct poor-quality cost• A. Controllable poor-quality cost
(1) Prevention cost --- Work to avoid an error (2) Appraisal cost --- Work to assess error (3) No-value-added cost --- Rework, Fix it
• B. Resultant poor-quality cost (1) Internal error cost --- LOS, Denials, HAC/POA (2) External error cost --- Malpractice, UnPaid Care
Indirect poor-quality cost• A. Patient-incurred cost --- Time, Emotion, Money
B. Patient-dissatisfaction cost --- ReputationC. Lost-opportunity cost --- Time and Capacity LostD. Loss-of-reputation cost --- Repeat, Referral, Payer
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Cost of Poor QualitySpecific Direct Costs (Unpaid)
Selected HACMedicare Data
(FY 2007)CC/MCC
(ICD-9-CM Codes)
Selected Evidence‑Based Guidelines
Foreign Object Retained After Surgery
● 750 cases● $63,631/hospital stay
998.4 (CC)998.7 (CC)
NQF Serious Reportable Adverse Eventwww.ahrq.gov/qual/nqfpract.htm
Air Embolism ● 57 cases● $71,636/hospital stay
999.1 (MCC) NQF Serious Reportable Adverse Eventwww.ahrq.gov/qual/nqfpract.htm
Blood Incompatibility
● 24 cases● $50,455/hospital stay
999.6 (CC) NQF Serious Reportable Adverse Eventwww.ahrq.gov/qual/nqfpract.htm
Vascular Catheter-Associated Infection
● 29,536 cases●$103,027/hospital stay
999.31 (CC) Available at the Web site:http://www.cdc.gov/ncidod/dhqp/gl_intravascular.html
Surgical Site Infection
● 69 cases●$299,237/hospital stay
519.2 (MCC) Available at the Web site:http://www.cdc.gov/ncidod/dhqp/gl_surgicalsite.html
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Poor Quality Impacts
Patient•Medical Error, Harm, HAC, LOS, inefficiencies•www.hospitalcompare.hhs.gov
Finance•Rework, Uncompensated Care, Error, Coding•CMS Reimbursement, RAC
Staff•Quality of work, Satisfaction, Administrative burdens•Fewer resources and capacity for excellence
Strategy•No capacity for strategic projects, Growth Inhibitor•Competitive Advantage, Board of Directors
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Agenda
• What is Quality in Healthcare?• Why is Quality so Important?• Finance and Executive Buy-in• Methodologies• Technologies• Q&A
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36
SummaryTop 10 Things to do
1. Establish Executive Priority
2. Assess your current situation
3. Start Fast
4. Identify the Baseline
5. Align Incentives
6. Establish a repeatable approach (Program)
7. Data Flow
8. Work Flow
9. Cash Flow
10.Repeat
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Better patient care costs hospitals less and improves patient
outcomes.
Can you identify quality problems and fix them
promptly?
Do you have the:Methods
·6σ, Lean, Value Stream
Experienced People·External change agents
Technology·Data, Workflow, Portals
37
Quality is Worth It!
• CEOs• Quality Scores of You and Your Competition
• CFOs• Cost of Bad Quality• Cost of Compliance & Reporting
• COO, CNO• Nurse Staffing Shortages• Administrative burdens
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Net Profit
To maximize CMS Reimbursement, and your bottom line, you need to proactively identify
Quality Improvement opportunities now.
38
Establish Executive Priority
• How important are Quality of Care, Core Measure Scores, and Patient Safety to the overall executive leadership?
• How fast does the board know about the last “Never Event”?• Do you look at the public quality core measures of your competition?• In relation to the many other issues, how does this stack up?• What is the “Burning Platform” for this to take precedence?• What is it worth to improve? Budget? ROI?
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CEO & Board
Executives & Directors
Clinical & Quality Staff
Competitive AdvantagePatient Satisfaction
Budget, Cost, Compliance, Revenue, ROI
Best Practices, Improved Process Efficiencies
39
Dr. Sunil Rao
• A Physician’s View• Evidence Based Medicine = Best Practice• Learn and Improve• Benchmark Performance
• Quality Feedback • On errors in real time• A Desire to follow proper procedure
• Physician’s need for Core Measure data• In the simplest format possible • With easy accessibility • Up to date and relevant
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Talking About Quality June 2009
How We Get There | Performance Measurement and Public Reporting
Doctors and Performance Data
Audet AJ, Doyt MM, Shamasdin J, et al. Physicians' Views on Quality of Care: Findings from the Commonwealth Fund National Survey of Physicians and Quality of Care. New York: The Commonwealth Fund, 2005.
Talking About Quality June 2009
Doctors and Process-of-Care Data
Audet AJ, Doyt MM, Shamasdin J, et al. Physicians' Views on Quality of Care: Findings from the Commonwealth Fund National Survey of Physicians and Quality of Care. New York: The Commonwealth Fund, 2005.
How We Get There | Performance Measurement and Public Reporting
Talking About Quality June 2009
Doctors and Clinical Outcomes Data
Audet AJ, Doyt MM, Shamasdin J, et al. Physicians' Views on Quality of Care: Findings from the Commonwealth Fund National Survey of Physicians and Quality of Care. New York: The Commonwealth Fund, 2005.
How We Get There | Performance Measurement and Public Reporting
Talking About Quality June 2009
Doctors and Quality Data
Audet AJ, Doyt MM, Shamasdin J, et al. Physicians' Views on Quality of Care: Findings from the Commonwealth Fund National Survey of Physicians and Quality of Care. New York: The Commonwealth Fund, 2005.
How We Get There | Performance Measurement and Public Reporting
44
Flash Poll
Is there a CEO or Board Level mandate to improve Quality?
Does this relate to Core Measure scores or your reporting process?
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Talking About Quality June 2009
How We Get There | Performance Measurement and Public Reporting
Improving Health Plan Performance with Public Reporting
• Health plans that willingly allow public reporting perform at a higher level than those that choose not to do so.
• In 2006, publicly reporting health plans outperformed non-publicly reporting plans on 37 of 40 measures.
The State of Health Care Quality 2007. Washington: National Committee for Quality Assurance, 2007. (No authors given.)
Quality Reporting
• National IT Coordinator David Blumenthal, MD, emphasized that quality measures are at the heart of his office’s strategy for using IT to transform the U.S. healthcare system
• “The key to Meaningful use is to know how to measure for performance and to be able to give feedback to providers”
• “just the act of measuring will continually cause us to improve”
• “Providing better information is the foundation for change”
A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology at a National Quality Forum
www.T-M-Partners.net 46
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47
Improving Process
• Real Time Analysis
• Real Time Alerts• Trending Reports• Rapid Changes
to process of care
• More people involved
• Access to useful real time data
• Incentives for change
Moving from Reporting to Quality Management
• How does your Quality process stack up?• Retrospective Review of Quality Data?• Concurrent Review of Core Measures?• Ability to drill down and analyze Core Data?• Process changes easily deployed?• Strategic Quality Goals being met?
ReportingManual
Meet MinimumLate
Staff Limited
EfficientBetter Data
Real Time AccessWorkflow
Notifications
ConcurrentAnalysis:
• Timeliness of Data• Usefulness of Data• Extend to include
• More Core Measures• More Reports
• Include more people
FinancialImpact
• Patient Satisfaction
• Core Measure Scores
• Efficient Reporting
• Pay for Performance
• CompetitiveAdvantage
Level 4
Level 5
Level 3
Level 2
Level 1
48
Return On Investment
• Cost of Compliance = $500K+• FTEs for growing requirements• Cost of training and change• Buying EHR/IT
• Risk = $ Millions• 4% of Annual Payment (P4R + P4P)• Cost of Uncompensated Care, Poor Quality• Risk of being Slow or Late to Move
• Quality Benefits = Priceless• ARRA/MU Incentive, CMS Bonus• Real-Time Visibility of Quality Measures• Competitive Advantage (Hospital Compare)• Patient And Employee Satisfaction
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ROI = 5x Data Flow + Work Flow= Cash Flow
49
Sample ROI Model
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Your Hospita l's Fina ncia lOve rvie w of S a vings Num be rs Im pa ct S ca le Authority
A nnual Net P atient Revenues $527,284,629 FY 2007 from A HD.comA nnual M edicare P aym ent $263,275,743 $5,265,515 2% Fines or poss ible B onusA nnual Inpatient Claim s 38,000 7,600 20% Num ber of I/P Reports per yearA nnual Outpatient Claim s 402,000 80,400 20% Num ber of O /P Reports per yearA pprox im ate Num ber of P atient Claim s per Y ear 440,000 88,000 20% Tota l Num be r of Re ports pe r ye a r to CM S
Am ount a t RIS K w ith CM S Qua lity Da ta 4.00% $10,531,030 2% Fines for non-com pliance Reporting P rocess 2% B onus for P erform ance
Cost of Q I Nurse S a la ry 68,000$ 300 Days per year
Curre nt 18 Reports per day per Q I nurseReports per Day I/P 25 $95,704 1.4 Required FTE sReports per Day O /P (and others pending) 268 $1,012,444 14.9 Required FTE s
P ropose d 50 Reports per day per Q I nurseReports per Day I/P 25 $34,453 0.51 Required FTE sReports per Day O /P (and others pending) 268 $364,480 5.36 Required FTE s
Ne t Im pa ct on S ta ffing a nd P roductivity $709,215 Im prove d Re ports / Da y/ Q I Nurse
Additiona l Im prove m e nts Im provem ents listed as a % of NPR (Notes below)Quality M easures in Real-Tim e 0.07% $369,099 Fas ter correc tion of Quality Issues (2)Im proved Com petit ive A vantage from Quality 0.05% $263,642 B etter "Hospital Com pare" pos it ion (3)A bility to secure P 4P B onus 0.03% $158,185 B onus based on bes t in c lass reporting and quality (4)A bility to rapidly change processes in support 0.03% $158,185 P rocess Changes rapidly deployed to s taff (5)
Tota l Additiona l Be ne fit from Autom a tion $949,112
Total V alue of Cash F low at Risk $12,189,357 as a percentage of Net P atient Revenues 2.31%
50
Agenda
• What is Quality in Healthcare?• Why is Quality so Important?• Executive Buy-in• Methodologies• Technologies• Q&A
www.T-M-Partners.net
51
How do you move forward?Some things you will need
• Methodologies for solving problems• Executive Workout, Assessments• Six Sigma, Lean, Continuous Improvement• Requirements Definition, Program/Project Leadership
• Additional Resources• Add Capacity to deliver multiple projects• Dedicated and Experienced Team
• Standard Technology Platforms• Complementary to existing and planned platforms• Any Real Time Data, Any Hospital Process or Measure
www.T-M-Partners.net
People
Technology
Methods Your
Success
52
Assess your current situation
• How well are you reporting CMS Core Measures?
• Are the scores as high as possible? • How do you plan to improve them?• Do you have real time quality measures for
action?• What other quality measure or process is
more important right now?• Executive Quality Dashboards in need?
www.T-M-Partners.net
It is up to every hospital to
Analyze their specific
measures, Improve the
quality of care processes that
these measures represent and
Control the processes
onward so as to ensure quality of
care.
53
CMS, You and Six Sigma
Define CMS P4R, VPB
Measure Core Measures, Never Events, HAC/POA
Analyze Concurrent Chart Review, Quality Analytics
Improve Process of Care, Outcomes, Evidence Based Medicine
Control Continuous Improvement, Automation, IT systems
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It is up to you to Analyze the Data,
Improve your Quality of Care Processes, and
Control IT
CMS continues to Define and Measure
54
CMS ComplianceMore important than ever before…
• CMS Core Measure Reporting Process• Approaching over 100 required reports of clinical quality• Abstraction From Many Sources• Manual Data = Error• Time & Cost of Each Report
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Cost of Compliance
“Meets minimum is not enough”
Changes and mounting requirements = Unfunded Mandates
Define
Measure
55
Its Not Just sending data
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• Data is 3 months old• Vendors don’t help with abstraction• No Reuse of Quality Data• Multiple Reports = Multiple Abstractions
Reporting Data does NOT improve Quality
The tracking and reporting of Core Measure performance is a huge amount of work which occupies multiple clinical staff members
Analyze
56
Agenda
• What is Quality in Healthcare?• Why is Quality so Important?• Executive Buy-in• Methodologies• Technologies• Q&A
www.T-M-Partners.net
57
Flash Poll
• Are you buying a large new HIS appliction to solve all your issues? (Rip & Replace)• We will not even touch on EHR Systems
• Do you have access to Real Time Quality Data?• We will address how you can get to more data and use it
• Do you want to make better use of exisiting IT applications?• We can discuss Composite Healthcare Applications• Complementary to existing application investments
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58
Applying Technology to Obtain Benefits
www.T-M-Partners.net
• Real-Time Quality Measures for Improvement
• Get Data from Any System• Populate Any Form or Dashboard• Reduce Cost of Data Abstraction
• Improving Processes• Eliminate Administrative Tasks• Reduce Task and Process Times• Notify, Escalate, Manage by Exception
• Increase Net Income• Reduce Uncompensated Care• Reduce the Cost of Compliance• Improve Quality, Satisfaction, Profits
Data Flow
Work Flow
Cash Flow
Analyze
Improve
Control
59
Quality Management Functions
• Real Time Quality Data• Abstraction• Workflow Processes• Notification and Control• Quality Dashboards• Management Platform
• Alerts, Reports, Charts, KPIs, Never Events
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Quality DBMS
(PN, AMI, SCIP, HF, OP)
60
CNO Executive Dashboard
• Board of Directors Report
• Concurrent Review
• Drill Down
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Quality Database
• Quality Reports• Charts• Benchmark Data
Abstraction & ReportingWorkflow
• Data Drop Starts Workflow
• Data is checked against Rule Sets
• Processes Launched
• Tasks Assigned• QI Staff Notified• Alerts
Quality Reporting
• CMS Quality Reports• PN• HF• AMI• SCIP• OP
• Extendable• Meaningful Use• JCAHO• HB 197• Any Report
• Easily analyze data and see trends
• Make well-informed decisions
• Create, publish, and share reports
• Provide insight into operational, clinical, and financial data with scorecards and
dashboards
BI can help simplify the integration of information from clinical and line-of-business systems, with personalized
views for caregivers, staff, and administrators.
Business Intelligence (BI) in
Portal Solutions for Health Business Intelligence provides
health professionals with the tools to:
65
Technology StrategySummary
Action Result Technology
GetData
Real Time Abstraction Interface Engines, HL7, other
Analyze Data Quality Database Business Intelligence & Analytics
DeliverData
SecurePortals Dashboards, Reporting, Benchmarking
Improve Processes Automated Workflow Forms, Tasks, Alerts, Escalate Notification
www.T-M-Partners.net
Real Time Quality Data
and other Technology can
help you improve Quality of Care at your
Hospital.
It is up to you to Analyze the
Data, Improve your Quality of Care Processes.
66
Agenda
• What is Quality in Healthcare?• Why is Quality so Important?• Executive Buy-in• Methodologies• Technologies• Q&A
www.T-M-Partners.net
67
Quality Roadmap
www.T-M-Partners.net
As Is
• COPQ• Quality Reporting
To Be• EHR and Meaningful
Use• High Quality Scores• Better Outcomes
• Patient Satisfaction
Risk
• Risk of Inaction• Investment Loss
• Too Early, Late, Slow
Drivers• CMS & ARRA Spending
• Payers will follow• Patient Demands• Board of Directors
• Mounting Requirements• More Reporting• EHR is required
Cost
• Buy an EHR, Invest in IT
• Analysis, Consulting• Training and Process
Change• ComplianceBenefits
• ARRA Payments• CMS P4P Bonus
• Better Patient Care• To 10% in Quality
• Higher Reimbursement• Net Income
• As Is• To Be
Assess