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Service Line Strategy and Data
Today and Beyond: The Journey
Becker’s Healthcare Conference
Presenters:
Shashi Vangala, MS
Vice President, Enterprise Data Services, Baylor Scott and White Health
Nancy Vish, PhD, RN, NEA-BC
President and CNO, Baylor Heart and Vascular Hospital Dallas Texas
Administrative lead for Baylor Scott and White Cardiovascular Service Line
Saturday, April 30, 2016
11:15 - 12:00 pm
Circle of Care
Key Points
• Purpose of a Cardiovascular Data Warehouse
• Goals for Cardiovascular Data Warehouse
• Data Strategy
• Approach
• Results (Screenshots)
• Governance
What’s the BIG Deal?
• Why have a CV Data Warehouse?
• Who is this for anyway?
• Why all the effort?
CV Data warehouse - Context
• Build an integrated data warehouse that delivers immediate access to Clinical and Financial data which would enable the business units to monitor, measure and improve all aspects of the cardiovascular service line.
PURPOSE
• Build a centralized repository to integrate data from all cardiovascular systems in use at Baylor Scott & White northern region.
• Integrate CV data with data from select non-cardiovascular systems. For e.g. EMR, Patient Accounting, Clinical Cost Accounting, Coding, Financial, and Supply chain systems etc.
• Transform, standardize, aggregate and organize the integrated data for Business Intelligence reporting and analytics.
• Present the data in easy to use formats – Dashboards, Scorecards, Reports and Cubes to Executives, Clinical Staff and Analysts across the organization.
BUSINESS GOALS OF THE PROJECT
CV Data warehouse– use cases
Financial: Monitor length of stay, revenue trends , cost of care by
diagnosis and treatment procedures , case mix for each service line by
facility, payors band, and physician. Drill down to supporting encounter
level detail.
Clinical Procedures: Monitor internal operations to improve throughput &
outcomes for patient care.
Registry Statistics: Use the data that is collected and submitted to
national registries to gain a better understanding of facility performance.
Quality – Core Measures: Improve patient care outcomes and safety by
tracking core measures applicable to the cardiovascular service line.
Patient Satisfaction & Brand Awareness: Track patient satisfaction
scores & perform market share analysis by service line for all facilities.
CV Data Warehouse Strategy
BHCS CVIS
CATH EP NI National Registries
Transplant Other
CV
Cath
Echo
NI
STS
MUSE
Follow-up Data
BSWH EDW
DIS
COV
ER
INTE
GR
ATE
O
RG
AN
IZE
MA
NA
GE
AN
ALY
ZE
EHR Medhost CVIS
SoftLab EMPI/PMF LIS/RIS
Lawson
OR-CPM
PATCOM TRENDSTAR
MIDAS HEWITT-HR
Survey PRESSGANEY
NRC
HL7
ADT SoftMed(3M)
3rd Party THCIC-PUDF
Death Master
Data Sources
Batch
Real-time Change Capture
Data Integration
Universal Data Connectivity
Any Latency
Any Delivery Mechanism
Data Marts
Enterprise Data Warehouse
Unified Data Model Data warehouse Appliance
PR
ESEN
T
Business Intelligence Platform
Reports Dashboards Cubes Predictive Analytics Actuarial Modeling Da
ta G
ov
ern
an
ce
Financial Analysts Data Scientists Researchers Clinicians
Da
ta Q
ua
lity
Me
tad
ata
Man
ag
em
en
t M
as
ter D
ata
Ma
nag
em
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t
BSWH EBI Architecture
Information Delivery
9
10
Apr 15, 2015
•CV WOW Factor Dashboard
Aug 24, 2015
•CV DW Demo at •Governance meeting
Completed Projects
CV Data Warehouse Milestones
Jul, 2014 Project Kick-off
CV All day Retreat
Apr 15, 2015 CV Service Line
Dashboard
Jun 1, 2015 CV Phase 1 (Finance &
Patient Satisfaction
Oct 16, 2015 Lumedx Registry
NTX Data
Nov 15, 2015 HOCM Clinic
Patient Tracker
Dec 31, 2015 CVIS Non Invasive BHV Echo/Holter/PVD Data
Mar 26, 2016 Lumedx Registry
CTX Data
Apr 30, 2016 Physician Performance
Dashboard
Jun 30, 2016 CVIS Cath BHV
Data Integration
FY 2017 Consolidated
Analytics Suite
FY 2017 Integrate External
Data Sources
Upcoming Milestones
Centers of Excellence: Valve Surgery
• Literature in NEJM suggests that centers with high
surgical volumes result in lower patient mortality.
• CV Leadership at BSWH asked EBI team if similar
trend is seen across BSWH Hospitals for mitral valve
cases.
• Data showed high volume centers within BSWH indeed
have lower mortality.
• CV Leadership is assessing lower volume centers.
Business Development - New
Service Offering: Adult
Congenital Disease
• Adult Congenital disease is a very
specialized field.
• These patients are often managed by
regular cardiologists. Each
cardiologist typically has a handful of
these patients in their practice.
• When an Adult Congenital Disease
Specialist joined BSWH, they reached
out to the EBI team to assist in
location of patients.
• EBI identified 1,509 patients spread
out over 65 practices providing a
road map to the new specialist.
.
Clinical Care Path:
Surgical Site Infection
after EP Implants
• EP physicians wanted to
understand if certain
comorbidities lead to higher
infection rates in patients.
• EBI analysis showed that
patients with comorbidities of
CHF, kidney disease and diabetes
have nearly double the infection
rates.
• Physicians are contemplating
prophylactic use of antibiotics
and other options on this high
risk group of patients to reduce
infection rates.
Cases Infection #
Infection% Cohort # Cohort %
Totals
Any Dx
All CHFs
All Diab
All CKD
All Three
CHF+Diab
CHF+CKD
CKD+Diab
Only CHF
Only CKD
Only Diab
Research: Cohort
Selection
• Lead Investigator wanted to
study extent of Mitral Valve
Disease in Heart Failure
Patients
• Defined Criteria: Identify all
patients in last 3 years who are
admitted with Heart Failure
diagnosis and have LV Ejection
Fraction <50%
• Requested data (5368 Records)
provided to researchers in 24
hours
CV Data Warehouse User Base View
• Experts in the data
• Technical Developers
• Requires DB Level Access Data Analysts
• Analytic SME
• Ability to drive requirements
• Create self-service content for others
Super Users
• General population of users
• Business and clinical decision makers
Dashboard Consumers
Technical involvement
14
CV Data Warehouse Governance Structure
16
CV Executive
Leadership Strategic Vision
Project Sponsorship
CV Project Steering Team
Project Scope & Prioritization
Monitor & Communicate Project Status
Escalation Point for Issue Resolution
IS Governance
IS Strategy Alignment
IS Capacity Planning
IS Project Prioritization
CV Information
Stewards
Data Standards
Information Access
Content Expertise
Assess Level of Effort
Design, Develop & Implement Requests
Provide status to CV Project Steering
Team
Clinical
Registry Team
CVIS
Team EBI Team
CV Solution Team
CV Analytics/Reporting Requests-Workflow
17
Submit Request
CV Project Steering Team
• Status • Prioritize • Schedule • Develop
* CV Requestor – Clinicians, Administrators, Researchers
and other staff who use or need to use data from CVIS (Lumedx) and/or the CV Data Warehouse.
CV Requestor*
Routine
Complex
• Support
2 day Turnaround
Fulfilled Request
CV Data & Analytics
CV Support Phone/Email
Critical Success Factors
• Our Philosophy:
– Think BIG
– Start Small
– Move Fast
• Securing organizational buy-in from key stakeholders.
• Network with peers; do your own research and develop a process that works for your organization. Didn’t find too many vendors with a track record in this space
• You may not get it right first time. Be willing to learn and be prepared to tweak as necessary.
• Realize that it is a journey, not a destination.
• Look for change agents who can diffuse these data governance concepts into business rapidly.
Key Summary Points
• Key Summary Points
– Answering WIIFM questions from physicians.
– Impact of data on operational focus areas and
strategy.
– Providing data to increase quality and decrease cost.
– Providing data service for analysis and clinical
inquiry.
Partners in Care
• We, as the interdisciplinary care team, are the
critical link to process improvement and
transformation of patient care.
• Without data and the power of information, we
cannot impact care.
So, who are we really working for?
Our patients. Your mother. Your father. Your
Spouse. Your Friends. Your brothers and sisters.
Our children. We have the power to bridge care
through data, analysis, and information.
THAT IS THE WHY. THAT IS THE WHAT.
THAT IS THE WHO.
Contacts:
214-820-4270
214-793-3619
Our patient care outcomes are the product of the partnerships between multiple specialties who work as
partners with a common vision of patient care excellence.