Edgewater and UPenn presented on "Moving from Volume to Value Based Care" at The World Congress 10th Annual Healthcare Quality Congress, August 2-3, 2012.
1. Automated, Standardized Reporting of
Patient Safety and Quality Measures to
Enable Faster Action and Time to
Improvement
August 2nd, 2012
2. Today’s Presenters
‣ Ryan Hayden
Healthcare Principal
315-380-0672
rhayden@edgewater.com
‣ Neil Ravitz
Chief Operating Officer (COO)
for the Chief Medical Officer (CMO)
Neil.ravitz@uphs.upenn.edu
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3. Agenda
â–ş University of Pennsylvania Health System (UPHS) Overview
â–ş Edgewater Corporate Overview
â–ş Objectives for Patient Safety and Quality Dashboard Project
► Case in Point –
– Project Overview
– Brief Technical Description
– Primary Business Benefits
â–ş Dashboard and Report Live Demonstration
â–ş Ongoing Learning and Development
â–ş Appendix: Technical Description of Solution & Architecture
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4. Edgewater Corporate Overview
Consulting firm that brings a blend of advisory services and product-based
technology solutions to assist our clients with improving profitability, driving
performance improvements, and accelerating growth
â–ş Founded in 1992
â–ş Focus on upper-middle and global 2000 markets
â–ş 420+ employees
â–ş 800+ clients
â–ş 3,100+ projects completed to date
â–ş 95% client retention rate
â–ş Large North American footprint
– New UK presence
â–ş Publicly traded (NASDAQ: EDGW)
– Public in 2002
â–ş Co-founders still with the Company
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5. Summary of Edgewater’s Healthcare Practice
BI & Technology Experience
• EDW/BI Strategies & Roadmaps
Sample Clients • Data Quality, Architecture
• Data Governance
• Tool Evaluation & Selection
• Data Marts/EDW Implementation
• Reporting, Dashboards, & Analytics
Implementation and Planning
Functional Experience
• Quality of Care, Patient Safety
• Surgical Analytics
• Service Line Analytics
• Utilization & Cost
• Patient Panel and Physician Relationships
• CRM in Healthcare
• Finance Budgeting, and Strategic Planning
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6. Penn Medicine Overview
â–ş Perelman School of Medicine and The University of Pennsylvania
Health System
â–ş Comprised of three hospitals with more than 1,700 beds
â–ş More than 78,000 admissions per year
â–ş More than 2 million outpatient visits
â–ş More than 2,200 physicians and more than 21,000 employees
► HUP – USNWR Honor roll hospital
â–ş Located in the heart of Philadelphia!
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8. Penn Medicine
Blueprint for Quality and Patient Safety
Penn Medicine will eliminate preventable deaths and preventable 30-day readmissions by
July 1, 2014
Imperatives Priority Actions
“Always” events - strive to provide perfect care
Accountability For Perfect
Implement clear lines of accountability that span inpatient and
Care
ambulatory environments
Provide consistent and thorough communication with families & patient
regarding plan of care
Increase patient and family involvement in UPHS forums that address
Patient and
issues relevant to quality, safety and service excellence
Family-Centered Care
Enhance patient-provider partnership through better exchange of
information
Ensure all UBCLs implement redesign care processes related to:
Transitions In Care / – Risk stratification
Coordination Of Care – Interdisciplinary rounding
– Discharge hand-off to outpatient care
Eliminate variations in care processes where evidence exists
Balance conformity in practice with needs for personalized care
Reducing Unnecessary
Variations In Care Set goals that are positive and proactive
Strengthen organizational capacity and capability for continuous
Provider Engagement, improvement
Leadership, And Advocacy Increase involvement of house staff in quality, safety and service
excellence efforts
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9. Three-Way Partnership is Penn’s “Swiss Army
Knife” for Managing Quality on the Hospital Units
Three-Way Partnership We needed a
on the Hospital Units multi-purpose
solution on the
units to handle
almost any Quality
problem.
“ This isn’t a project, it’s a
way of doing things. You
can bolt different
strategies onto it.
We call these trios
“UBCLs,” for “Unit Based —UPHS CFO
”
Clinical Leadership.”
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10. Vision: Advanced Analytics for Quality Data
- Coordination of Care
- ALOS
Highly Aggregated/ - Quality Compliance
C-Level
• Alignment with Quality Blue Print objects
• Improve resource utilization; patient satisfaction
- Core Measures
• Align quality improvement / PI with industry reform - HCAHPS
- HAI’s
- QI / PI
Executive CEQI, Quality Department
User • Reduce costs by automating report development
• Improve compliance with regulatory mandates
• Targeted education for units / clinicians underperforming
Functional User
Power User Analyst/Informaticist
• Analytic & reporting tools
- SCIP, PN, AMI
• Report development and distribution
- Falls
• Monitor data quality; standardize vocab. - Satisfaction
- Events, Errors
The Right Information. To the Right People. At the Right Time.
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11. Enterprise Objective: Work Smarter
Decision Making & &
Decision Making
Analyze Action
Action
Decision Making &
Information
Action
Where Where
We We’re
% % Time Spent
WERE GOING
Time Spent
Analyze
Analyze
Information
Information
Collect Data
Analyze
Analyze
Information
Information
Collect Data
Collect Data Collect Data
Collect Data
Basic / Classic Reporting BI & Analytic Tools
Less Mature More Mature
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12. Organizational Deployment:
Communication & Execution
Change
Mgmt Provide Support &
Process Project Mgmt Analysis
Change Steering Committee
Identify
Establish / Update Alerts &
Priorities Dashboards
Entities Analysts
Justify Implement Patient Safety & Quality
PI Champions
PI Analysts
Identify
Design Pilot
Standard
Justify Implement Reports
PI
Design Pilot Local Response
to Q&S Metrics Data Mart
PS&Q Analytics
UBCL Data Mart
Identify
IT / EDW Support
Surgeons Nursing
Justify Implement
Safety & Quality
Data Collection
PI
Design Pilot
Implement & Physicians Capture &
Improve Analyze
Clinical Care
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13. Health System Dashboard
Health System Dashboard is where Penn Medicine Team Goals are highlighted on the front
page and performance against those goals are depicted in Green / Yellow / Red
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14. Dashboard Tabs
With more timely data, metrics will
Patient level detail available update throughout the month
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15. Spark Line View of Data
Spark Line: presents users with a more advanced view of metrics in a condensed space.
This view provides the Start Point, Low Point, High Point, and directional arrow based on a three
month average. It is an efficient way to view and compare trends of several metrics at one time.
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16. Reporting Template
Patient level detail available
Reports allow the user to select measures by Entity, Unit,
Department and Service according to a desired date range
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17. Built In Graphing Capability
Trending graphs default to Statistical Process Control (SPC) charts to help promote the
process improvement techniques that are being taught throughout the organization
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18. Project Statistics
â–ş Requirements gathering and build approximately 6 months
â–ş 136 Quality Metrics from various existing sources:
– Mortality (8)
– Transitions / Readmissions (8)
– Patient Safety Indicators (18)
– Healthcare Acquired Infections (8)
– Core Measures (57)
– HCAHPS Patient Satisfaction (31)
– VTE/DVT/PE (6)
â–ş Two (2) dashboards and nine (9) reports
â–ş More than 350 users across the Health System
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19. Next Frontier
â–ş Benchmarking data (in process)
â–ş ICU specific measures (in process)
â–ş Outpatient data mart (start Q3 2012)
â–ş Merging data from different BusinessObjects universes
(2013)
– Finance and Quality
– Inpatient to Outpatient
– Executive View
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20. Discussion
Questions?
Thank You!
Download a copy of this presentation here
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22. Technical Description
â–ş The Database and Platform
– Oracle 11g running on Linux
– Three separate instances: Development, QA, and Production
â–ş The ETL (Extract, Transform, Load) tools
– IBM InfoSphere (an integrated solution)
• IBM Data Stage, Quality Stage, Information Analyzer, and FastTrack
– Two separate instances: Development and Production
â–ş Business Intelligence Solution
– BusinessObjects and Xcelsius
– Three separate instances: Development, QA, and Production
â–ş Issue Tracking solution
– Microsoft SharePoint custom developed issue tracking site
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23. Data Flow & Architecture
Source Enterprise
Additional Sources not part of
Clinical
Systems the PDS architecture
Repository
HDM HUP
Press AHRQ
HDM PMC Ganey UHC
ClinTrac
ETL
Penn
TheraDoc Transformation Quality
ETL Data ETL ETL
Store Layer Data Mart
Sunrise
EPIC
Cardiac
Surgery
MedView
Cerner Lab
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