Analytics & Teamwork A 5-Year Perspective Who we are. The - PowerPoint PPT Presentation

Analytics & Teamwork

A 5-Year Perspective  Who we are.  The original population health challenge.  The analytics solution:  New challenge opportunities.  Key success drivers.  Measurable benefits.  Lessons learned and next steps.

GBMC Healthcare System  Greater Baltimore Health Alliance (GBHA)  ACO in the Medicare Shared Savings Program  Private practicing physicians  Greater Baltimore Medical Associates (GBMA) (200+)  GBMC Medical Center (245 beds)  Gilchrist Hospice Care (ADC 777)  Circle of Life Award Winner (2012)  3 Inpatient Units  Towson  Howard County  Baltimore City (Joseph Richey House) December 2014  Support Our Elders Program

GBMC Healthcare Vision What do we want for our loved ones? 1. The Best Health Outcomes 2. The Best Care Experience 3. Lowest Cost ( Least Waste ) 4. With the Most Joy for those providing the care

The Challenges • Original Challenge: • Annual labor-intensive CMS reporting requirements, just for DM, the CMS documentation runs to 25 pages! • Replace manual Excel sheet-based process with automated report to be reviewed prior to annual CMS submission. • Evaluated third-party solutions, decided to leverage our newly designed internal data warehouse.

Technical Overview: Architecture The GBMC DW and its universes Ambulatory Ambulatory Non- Non- Ambulatory Ambulatory employed employed EHR EHR SAP BI 4.1 MS SQL 2008 CMS CMS BI CLAIMS CLAIMS DATA WAREHOUSE LAUNCHPAD Integrated Integrated DW DW CMS NPI CMS NPI WEBI WEBI UNIVERSE UNIVERSE STAGE STAGE ODS ODS DW DW DASH- DASH- BOAR BOAR Patient Patient D D Tracking Tracking CMS_Claims CMS_Claims CRYSTAL CRYSTAL UNIVERSE UNIVERSE ICD ICD 4.0 4.0 ICD ICD PROC PROC DRG DRG Medical Medical GROUPER GROUPER GROUPER GROUPER Staff Staff CRYSTAL CRYSTAL Hospital Hospital 2011 2011 EHR EHR 6

Technical Overview: Data Model COMMON DIMENSIONS

Technical Overview: Business Layer

New Opportunities • Analyze our entire population, not just the CMS sample and not just Medicare. • Integrate with thousands of other data points. • Distribute monthly scorecards to all providers. • Ad-hoc inquiries with fresh (daily) data.

Provider & Practice Scorecards

Key Success Drivers  Executive support for BI framework and resources shared across functional areas.  Early MIS engagement.  ACO, Physician Practice and MIS stakeholders jointly defined the scope and deliverables.  Few but skilled in-house resources with organizational knowledge.  Trust in each other.  Knowledge and feedback freely transferred across departmental lines.  No hidden agendas.

Key Success Drivers  Shared data governance and stewardship: well defined roles (who owns the data), clear metric definitions, ongoing data quality and process validation.  Physician and GBHA leadership support of standardized workflows, e.g. CARE2, falls risk  Incremental build approach, focused on strategic priorities: quick pivot to ACO focus.  Scalable model: e.g. CARE3 current meds.  Use of proxies: do not automate 100%, leverage system to point to further research.

Measurable Benefits  A once-a-year reporting process mostly automated  Expanded from a small sample population to a panel of all patients with an office visit in the last 18 months and all practices  Provided access to thousands of other data points beyond ACO-specific  Requiring on average six less people to support.  Monthly scorecards and ability to review at any point in time through the prior day.  CARE2 – Falls Risk Screening, in place since inception, has improved from 58.1% in Sep 2014 to 86.6% in Sep 2016.

Measurable Benefits 45% CARE3 – Documentation of Current Meds 44% 44.1% 43% 43.4% 42% 42.7% 42.0% 41% 41.4% 40.9% 40% 40.0% 39.8% 39.8% 39% 39.7% 39.7% 39.4% 38% 37% 36%

Lessons Learned and Next Steps  Impact of new integrated EHR.  Scalable model moot point once we switched to a new data warehouse.  18-month period split across two systems.  Skills and knowledge transferable, same technology (SQL, SAP BI).  Same data governance and definitions: e.g. 18-month panel.  Collaborative approach, teamwork and shared experiences streamlined definition and implementation of rules in new system.  On-going improvement efforts, e.g. leveraging alerts and non-IT opportunities.