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© 2014 Health Catalystwww.healthcatalyst.com

Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics © 2014 Health Catalyst

www.healthcatalyst.comProprietary and Confidential

Eric Just, VP Technology

Kathy Merkley, RN, VP Clinical Engagement

April 9, 2014

The Path to Shared Savings With Population Health Management Applications


Proprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics

Accountable Care Organizations & Shared Savings

• Healthcare provider organizations responsible for providing coordinated care for their patients

• Contract with payers through some form of shared risk payment model

• Most payment models include downside risk to the healthcare providers

• Payment models reward high-quality, low-cost care with shared savings



Population Health Management (PHM)The Key to Shared Savings

Provider Network

1

Population

2

Cost Outcomes

4

Quality Outcomes

3

Four Building Blocks of Population Health Management

developing

the asset



PHM and Accountable Care (AC)

Accountable Care Financing and

Administration

Population Health Management developing

the asset

packaging and

marketing the asset


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What Does Health Catalyst Do?

● Enterprise Data Warehouse “single source of truth”

● Library of data acquisition adapters

● Metadata repository

● Auditing and access control

● Supports a variety of analytic applications‒ Health Catalyst

‒ Client developedPlatform




● Reports & Dashboards

● Ad-hoc query

● Registries

● Quality measures

● Population health

● Data mining

● Clinical improvement

● Workflow analysis

● Modeling and predictive analytics

Applications

Platform




Installation● Configuration

● Data Architecture

Improvement● Project Management

● Clinical Improvement

● “Lean” Process Improvement

Applications

Services

Platform



Application Families

Foundational Applications

Discovery Applications Advanced Applications

Provide deep insights into evidence-based metrics that drive improvement in quality and cost reduction through managing populations, workflows, and patient injury prevention.

Encourage broad use of the data warehouse by presenting dashboards, reports, and basic registries across clinical and departmental areas.

Allow users to discover patterns and trends within the data that inform prioritization, inspire new hypotheses, and define populations for management.



Demos

Discovery ApplicationsFoundational Applications Advanced Applications`

Population Suitese.g., Ischemic Heart Disease

Workflow / Operational Suitese.g., Acute Medical

Patient Injury Prevention Suites e.g., Infection Prevention

Patient Injury Prevention Modules

e.g., CAUTI, CLABSI, SSI

Workflow/Operational Modulese.g., ICU, MedSurg, Emergency

Population Modulese.g., CABG, Stent, AMI

Labor Management Explorer

Rev Cycle Explorer

Patient Satisfaction Explorer

General Ledger Explorer

Readmission Explorer

Population Explorer

Patient Flow Explorer

Practice Management Explorer Suite

Financial Management Explorer

CAFE—Comparative Analytics Framework and Exchange—across Healthcare Systems and National Benchmarks

EDIT—Executive Dashboard Integration Tool (Key Performance Indicator editable collage from all app categories)

Key Process Analysis (KPA)

Cohort Builder

Comorbidity Analyzer

Payment Model Analyzer

Readmission Predictor

Patient Flight Plan Predictor

ACO Explorer Suite

Metric Correlation Analyzer

Regulatory Explorer

Attribution Modeler



Demo 1: Key Process Analysis (KPA). Identify areas of greatest opportunity for quality improvement and savings

Demo 2: Population Explorer. Identify potential risk by understanding relative size of disease populations and risk profiles

Demo 3: Heart Failure. Achieving quality improvement and cost reductions by directing targeted interventions to high-risk patients

Demo 4: Community Care. Monitoring high-risk patients in primary care to prevent expensive acute treatment

Demos: How Analytics Drive Shared Savings



Heart Rhythm

Disorders

VascularDisorders

Ischemic Heart

Disease

HeartFailure

CARDIOVASCULAR

Care Process Families

ClinicalProgram

CABGPCIAMIACSCare Processes

KPA: Clinical Hierarchy



Dr. J.15 Cases$15,000 Avg. Cost Per Case

Mean Cost per Case = $10,000

$5,000 x 15 cases = $75,000 opportunity

Total Opportunity = $75,000Total Opportunity = $175,000

$4,000 x 25 cases = $100,000 opportunity

Total Opportunity = $500,000Total Opportunity = $1,200,000

Cost Per Case, Vascular Procedures

KPA: Measuring OpportunityUsing provider variation to calculate the potential financial impact of improving and standardizing care processes



Heart Failure StatisticsHeart failure (HF) is one of the most rapidly increasing cardiovascular disorders.

● Leading cause of hospitalization in individuals over 65 years of age.¹

● Third leading cause of hospitalization in the U.S. in all age groups.²

1Krumholz HM, Chen YT, Wang Y et al. Am Heart J. 2000;139(1 Pt 1):72–7..

2Heart Disease and Stroke Statistics—2012 Update. Circulation. 2012;125:e2-220.3Jencks SF, Williams MV, Coleman EA. N Engl J Med. 2009;360:1418-28.

4Gheorghiade M, Vaduganathan M, Fonarow GC et al. J Am Coll Cardiol. 2013;61:391-403.

HF is the most common cause of readmission.3

Rates approach 30% within 60-90 days of discharge.4



CMS and Medicare Readmission Penalties

Nearly 25% of all patients hospitalized for heart failureare readmitted within 30 days.

CMS has labeled HF as an area of excessive readmission.

CMS penalties will ensue to reduce readmission rates

http://www.ama-assn.org/amednews/2012/08/27/gvsb0827.htm. American Medical Association. Accessed online 12/28/2012.

9596979899

100101

FY 2012 FY 2013 FY 2014 FY 2015

Perc

ent o

f Pay

men

ts

Rece

ived

Penalties Will Reduce Medicare Payments

1% Loss

2% Loss

3% Loss



Improvement Methodology

• A goal is a desired result the workgroup envisions, plans and commits to achieve an organizational desired end-point by a specified deadline.

• AIM statements are written, measurable, and time-sensitive objectives that move the team toward achieving the goal .



CV Heart Failure

Goal: Decrease 30 day readmission rates of heart failure patients

Establish a baseline of all cause 30 day readmission rates for HF patients, create and validate 30 day and 90 day readmission rates for all HF patients.

AIM #1

AIM #2

AIM #3



CV Heart Failure


Identify high risk heart failure patients and extend the identification of these patients to a Risk Stratification Model to predict the likelihood of all cause 30-day readmission rates.

AIM #1

AIM #2

AIM #3



CV Heart Failure


Schedule a follow-up appointment for all HF patients within 24 hours of discharge with a focus on high risk patients being seen within 48-72 hours after discharge.

AIM #1

AIM #2

AIM #3



CV Heart Failure


AIM #1

AIM #2

AIM #4

AIM #3

Establish a medication reconciliation baseline and track compliance in order to achieve 75% compliance by X date.



CV Heart Failure


AIM #2

AIM #3

AIM #5

AIM #4

A follow-up phone call from a nurse post-discharge to assess whether the patient has obtained his/her medication and has no barriers to making their follow-up appointment.



Organizational TeamsIt’s not just about technology

Cardiovascular Clinical Program Guidance Team

Heart FailureMD LeadRN SME

Knowledge Manager

DataArchitect

Application Administrator

RN, Clin Ops Director

Guidance Team MD lead(e.g., Heart Failure MD Lead)

= Subject Matter Expert= Data Capture

= Data Provisioning & Visualization

= Data Analysis

IschemicMD LeadRN SME

VascularMD LeadRN SME

• Permanent Teams• Integrated Clinical and Technical members• Supports Multiple Care Process Families

Heart RhythmMD LeadRN SME


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www.healthcatalyst.comProprietary and Confidential

Appendix



Advanced ApplicationsPediatricsAppendectomyAsthma AcuteAsthma Chronic*

CardiovascularAtrial fibrillation*Conduction disorders*Ischemic Heart Disease*Heart Failure

Community CareDiabetes*Asthma*Primary care

General MedicineDiabetes*DKA (diabetic ketoacidosis)Deep vein thrombosis*Peripheral vascular disease*

PulmonaryPneumonia Community acquiredPulmonary embolism*

Infectious DiseasesCellulitis*Urinary Tract Infection*Meningitis*Sepsis

GastrointestinalAnal/rectal disorders*AppendectomyInflammatory diseases*Lower GI procedures*Obstruction*

NeurosciencesStroke* - Hemorrhagic* - Vascular* - Transient ischemic attack*

OncologyBreastGastrointestinalThoracic

OrthopedicsFractures - Hip/pelvis* - Lower extremity* - Upper extremity*SpineTotal hip*Total knee*

Surgery - VascularAortic aneurism*Other venous disorders*Varicose veins*

Women and NewbornsAntenatal SteroidC-section DeliveryElective InductionsNTSV cesareanNewborn

DepartmentalEC (Emergency Care)*Laboratory*OR Workflow*Radiology*Nursing*

OtherCoordinated CareLabor & ProductivityMedication ManagementOPPE (Ongoing Professional Practice Evaluation)Physician CredentialingPrimary CareProfessional BillingACO

Patient Injury PreventionVT/PE prevention*CAUTICLABSIControlled substance diversion prevention

* In Development



Data Marts and Applications

Common Definitions and StandardizationPopulation Definitions, Comorbidities, Attribution,

Patients, Labs, Encounters, Diagnoses, Medications

Source Marts

EMR

EMR Financial Patient Sat. HR Administrative Claims

Financial Patient Sat. HR Administrative Claims

e.g. Epic, Cerner e.g. EPSi, Peoplesoft,

Lawson

e.g. Press Ganey,NRC Picker

e.g. Lawson,Peoplesoft,

Ultipro

e.g. API TimeTracking

e.g. Medicare

Architecture Overview



c

27

Demo 1: Key Process Analysis. Identify areas of greatest opportunity for quality improvement and savings






c

28

Demo 1: Key Process Analysis. Identify areas of greatest opportunity for savings and quality improvement






c

29







c

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Thank You

Next Educational Webinar

By Failing to Prepare, You Are Preparing to FailLaying the Foundation for Sustainable Change and SuccessDate: Wednesday, April 16thTime: 1:00-2:00 PM ETPresenter: John Haughom, MD, Senior Advisor, Health Catalyst

Register at http://healthcatalyst.com/

http://pages.healthcatalyst.com/20140402-12PointReviewWebinar-Website.html

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