THE CHALLENGE

The Foundation for Health Care Quality (FHCQ), a non-profit organization headquartered in Seattle, Washington, spearheads numerous programs aimed at enhancing quality and safety in patient care. However, achieving these goals hinges on access to comprehensive and insightful data. Without such data, many organizations struggle to evaluate their performance effectively or compare it against industry peers and benchmarks.

THE SOLUTION

FHCQ uses ARMUS by Health Catalyst for Societies to obtain the crucial data and insights required for improvement. It utilizes ARMUS to create a detailed OB clinical registry, encompassing risk factors, social determinants of health, performance metrics, benchmarks, and comprehensive reports for births exceeding 20 weeks gestation. A level 3 hospital in Washington State, which is a member of the Obstetrical Care Outcomes Assessment Program (OB COAP), has contributed over 54,000 records to this registry.

Using its registry data, the hospital identified an opportunity to improve umbilical cord gas testing rates, critically important for identifying neonates at risk of hypoxic-ischemic encephalopathy (HIE)—a form of brain injury. Delving into performance analysis, it pinpointed unwarranted clinical variation, including variances in individual practitioner performance. The hospital implemented the best practices recommended by OB COAP to enhance the collection of cord gases, actively involving providers in boosting the testing rate and increasing the identification of neonates who would benefit from hypothermia therapy to minimize potential disabilities associated with HIE.

THE RESULT

By harnessing registry data and analytics, FHCQ and the hospital gained meaningful insights and substantially improved neonatal safety. The hospital increased the adoption of umbilical cord case testing, which is key to the early identification and management of neonatal hypoxia.

• 26 percent relative increase in cord gases drawn, a 17 percent greater improvement than in comparable facilities.
• 69 percent relative increase in cord gases for vaginal deliveries with shoulder dystocia and a 42 percent relative increase in cord gases for deliveries with chorioamnionitis.
• 39 percent relative increase in cord gases for cesarean deliveries with fetal distress and a 38 percent relative increase in cord gases for neonates with Apgar scores less than seven.

“ARMUS by Health Catalyst has increased our ability to drive improvement
initiatives powered by insightful data and analytics.”

Angela Chien, MD, Medical Director, OB COAP

ADDITIONAL READING

• Electronic Data Abstraction Improves Efficiency and Registry Submission Accuracy
• Data-Informed Improvements Decrease Post-PCI Bleeding Events
• Driving Value: Boosting Clinical Registry Value Using ARMUS Solutions
• How Clinicians Derive Better Insights with Quality Data Registries
• Health Catalyst Acquires ARMUS; Bolsters Clinical Quality Offering and Outsourced Services

IMPROVED ANALYTICS COST-EFFECTIVENESS

Technological advancements, demographic shifts, and emerging medical discoveries continuously reshape the healthcare landscape. Global events such as pandemics and economic fluctuations introduce additional layers of complexity, further underscoring the industry’s need for data, analytics, agility, and adaptability. To sustain profitability and ensure high-quality patient care, health systems must navigate their financial well-being by optimizing their analytics cost-effectiveness.

APPLYING ANALYTICS TO CONTINUOUS PROCESS IMPROVEMENT

UnityPoint Health recognized the need to improve decision-making processes, enabling the organization to make faster, data-informed decisions. This includes identifying, investing in, and deploying solutions to enhance quality, access, and patient outcomes while reducing costs.

The organization had strong C-level support for analytics, setting the stage to improve analytics acumen, establish the right data and analytics infrastructure, decrease unwarranted variation in operational workflows, and develop the skill sets of its analysts and analytic consumers.

DEDICATED ANALYTICS RESOURCES BENEFIT THE ENTIRE ORGANIZATION

UnityPoint Health adopted the Health Catalyst Data Operating System (DOS) platform, initiating a multi-year analytics journey. The organization established an enterprise analytics team, which serves as a problem-solving partner, focusing on delivering the most viable solution. The team prioritizes their work to high-impact areas:

• Identifying areas of opportunity to improve clinical/patient outcomes, organizational effectiveness, and financial performance.
• Embedding analytics into the strategic planning process.
• Enabling clinicians and business leaders to use data to make decisions.
• Developing solutions to predict population health and financial trends.

The organization developed a strategic analytics charter outlining the best practice management to enable improved outcomes and long-term sustainability. The charter includes best practices for continual process improvement, effective operational leadership, strategic data management, and strategic analytics and insights development.

DRILLING INTO THE DATA REVEALS OPPORTUNITIES

The UnityPoint Health analytics team provides three broad reporting and analytics capabilities:

• Reports, dashboards, and scorecards: Report key performance indicators and provide standard, ongoing reports that are broadly accessed and easily interpreted.
• Exploratory analysis: Highly consultative work explores various ideas and opportunities while remaining neutral and objective about the findings.
• Augmented intelligence (AI): Provides predictions at the decision-making point using advanced analytics techniques and continued expansion of the UnityPoint Health data science program.

UnityPoint Health continually identifies and prioritizes improvement opportunities, implementing standard work to improve organizational performance and patient outcomes as demonstrated in three examples of the organization’s work.

• Blood product utilization: The organization created an outcomes improvement task force to develop and implement a plan for optimizing blood management. The team developed clear and concise objectives and achievable goals to monitor success. UnityPoint Health standardized guidelines and documentation standards and improved wastage management. The organization progressed from using spreadsheets to monitor performance to dashboards; it then began using AI to help providers understand transfusion decisions across the organization, facilitating the adoption of evidence-based transfusion decisions.
• Readmissions and length of stay: UnityPoint Health leveraged a multidisciplinary approach to improve length of stay (LOS) and readmissions. Using data from the DOS platform and AI, UnityPoint Health predicts each patient’s expected LOS. The organization also risk-stratifies patients, proactively identifying those at the highest risk of readmission. Care teams intervene to help patients achieve safe discharge and intervene post-discharge to provide patients with needed support, avoiding unnecessary readmissions.
• Care management: As UnityPoint Health expanded its accountable care organization (ACO) presence, it had new opportunities to identify patients most likely to benefit from support, articulate clear success measures, celebrate high-performing facilities and providers through shared savings, and leverage common measures and tools across the ACO network. The organization created AI-enabled care management tools to provide care managers with a one-page view of utilization, each patient’s chronic conditions, and care gap data needed to identify patient needs and to intervene to close care gaps, improve primary and preventative care, and decrease unnecessary utilization.

CHOOSING THE RIGHT METRICS MOVES PROGRESS IN THE RIGHT DIRECTION

Data and analytics are integrated into UnityPoint Health’s strategic planning. The organization created an operating framework to ensure each team member focuses on powering the strategy. The organization starts with its “true-north” metrics—long-range metrics used by governance teams that inform all other metrics and mobilize teams around what matters most. “Guiding the way” metrics are leading, supporting metrics that provide additional life and context to true-north metrics and goals. Management system metrics are detailed metrics used to understand performance in real-time.

Rather than arbitrarily selecting a numerical improvement target every hospital must achieve, UnityPoint Health uses Healthcare.AI to develop meaningful targets for the system and individual facilities that demonstrate actual, achievable improvement in a transparent and reproducible way that motivates change. The organization also eases the interpretation burden for key performance indicators. It combines automated statistical process control modeling with natural language generation to create visuals and text that identify sustained or significant changes to accurately identify meaningful variation. This helps ensure that every leader can come to discussions with the same understanding about performance.

RESULTS

UnityPoint Health’s analytics journey has advanced analytics adoption and acumen, improved decision-making effectiveness, delivered cost-effective analytics and AI, and positively impacted organizational performance and patient outcomes. Results include:

• More than a 15:1 analytics benefit-cost ratio.
• More than $100M in improvements over eight years, including:
  • $41M avoided expense due to a reduction of excess LOS days.
  • $31M in average annual shared savings.
  • $32M reduction in healthcare spend in just one year, the result of a:
    • 39 percent relative reduction in emergency department visits and a 54 percent relative reduction in inpatient admissions.
• $17.4M reduction in direct costs over six years, the result of decreasing unnecessary red blood cell transfusions.

“Our commitment to leveraging data and analytics isn’t just about navigating the complexities of healthcare—it’s about shaping its future. Through our strategic embrace of data from our Health Catalyst Data Operating System platform and analytics, we’ve transformed challenges into opportunities, propelling us toward a future where every decision is grounded in insights and every action drives tangible impact.”

Rhiannon Harms, Vice President, Chief Data and Analytics Officer, UnityPoint Health

WHAT’S NEXT

UnityPoint Health will continue its analytics journey. It plans to expand its AI capabilities further and will balance short-term constraints against long-term value, continuing to push for significant improvements across clinical, operational, and financial domains.

ADDITIONAL READING

• Population Health Analytics and Innovative Care Delivery Generate an Average $31M in Shared Savings Every Year for More than Ten Years
• AI-Enabled Care Management Reduces Healthcare Spending by $32.2M
• Improving Percutaneous Coronary Intervention Reduces Adverse Events and Length of Stay
• $17.4M Saved Through Analytics-Driven Patient Blood Management Improvements
• Health Catalyst Names UnityPoint Health Winner of the 2024 Flywheel Award

THE CHALLENGE

WakeMed Health & Hospitals (WakeMed) was challenged to meet the needs of patients who presented to the organization for mental health care. Demand for mental health services was high, and psychiatrists were challenged to respond to consult results in a timely manner.

THE SOLUTION

WakeMed used data from the Health Catalyst Data Operating System (DOS) platform to engage the psychiatry team in understanding current consult turnaround time (TAT) and identifying and implementing changes to improve performance.

A physician leader engaged their peers in analyzing performance data, allowing the data to tell the story about consult TAT and the underlying factors contributing to delays and evaluating changes to improve performance. Led by a proactive physician leader, the team embarked on a thorough review of performance data, allowing insights to guide their actions. It quickly became apparent that many consults exceeded their desired 24-hour TAT goal. Through the strategic use of a heat map, the team pinpointed specific time periods where delays were most pronounced, particularly in the afternoon and evening. In response, they restructured their staffing models to provide enhanced coverage during these critical hours.

THE RESULT

Through the strategic application of data and analytics, WakeMed successfully engaged physicians in solutions to improve consult TAT performance, ensuring the timely delivery of mental health services to those in need.

• 80 percent relative reduction in mental health consult turnaround time.
• 16-hour improvement in the timeliness of inpatient mental health care.
• Nearly 100 percent of inpatients—more than 5,100 patients—in need of a mental health consult received needed services.

“We used data and analytics to address the critical issue of mental health consultation turnaround times (TAT), resulting in an 80 percent reduction in TATs.”

Micah Krempasky, MD, Chief Medical Officer, Mental Health & Wellbeing, WakeMed

ADDITIONAL READING

• Analytics Fuel Enhanced Recovery After Cardiac Surgery Improvements
• Analytics Accelerates Clinical Transformation, Saving $10M
• Decreasing Unnecessary Testing Improves Urgent Care Efficiency
• Improved Patient Access and Increased Demand Contribute to Additional Revenue
• WakeMed’s Clinical Transformation Earns 2024 Catalyst Award for Quality and Cost

SLOWLY EVOLVING CLINICAL PRACTICES

Translation of new knowledge into clinical practice is slow: physician researchers may take a decade or more to quantify and describe disease experience using retrospective data analysis. Often, that experience is framed by the physician’s perspective and influenced by the data collection structure.

CHALLENGES OF UNDERSTANDING A NEW DISEASE

Early in the COVID-19 pandemic, a physician at this large health system observed that patients who had recovered from acute COVID-19 infection were sharing concerns about lingering and unusual symptoms. Patients and physicians sought to understand the symptoms of COVID-19 and how long they lasted.

Faced with this new disease, physician researchers recognized a unique opportunity to use patient engagement technology to generate the knowledge clinicians needed to address long COVID faster.

CROWDSOURCING A CLINICAL TRIAL FOR NEW INSIGHTS

To learn more about patients’ experience with COVID-19, the health system is using crowdsourcing and Twistle Patient Engagement by Health Catalyst. This platform engages adult patients in journaling, in their own words, what they are experiencing.

Using secure Twistle text messages, physician researchers can rapidly recruit, consent, and enroll patients in the Institutional Review Board–approved clinical trial. Patients testing positive for COVID-19 receive an automated message from Twistle inviting them to participate in the clinical trial and become citizen scientists. Those who consent to the trial remain enrolled for one year, receiving automated text messages at defined intervals. Patients receive messages every other day for the first two weeks, once a week for the following three months, then once a month.

Twistle uses conversational English messages to ask symptom-specific questions and PRO Measurement Information System Global Health, capturing patient-reported data in these areas: physical health, physical functioning, general mental health, emotional distress, satisfaction with social activities and relationships, the ability to carry out usual social activities and roles, pain, and fatigue.

Patients submit responses to the messages via structured surveys and open-ended journal entries. Researchers then use natural language processes to analyze journal entries, creating a robust COVID-19 symptom timeline. Researchers are gaining new insights by leveraging the tool to capture crowdsourced data in real-time, and patients who participate in the clinical trial are provided the unique opportunity to contribute to the scientific process.

RESULTS

Using Twistle, physician researchers are capturing prospective and longitudinal patient-reported outcomes and generating new knowledge about patients’ experience with long COVID. The data provides a new understanding of how long COVID presents and helps improve the identification and care of these affected patients. By publishing previously unknown physical, mental, and social challenges and impairments, researchers are changing and improving clinical practices in a responsive way. Results include:

• Using Twistle, physician researchers are capturing prospective and longitudinal PROs and generating new knowledge about COVID-19.
• 19.2K people consented for the study, with more than 138K journal entries from nearly 18K patients.
• $750K costs avoided, the result of automating patient recruitment.

“Using Twistle, we can quickly engage patients in prospective, participatory research. In just a few months, we’ve gathered data and uncovered insights that typically require years to obtain, enabling us to gain a new understanding of patient-reported outcomes and disease progression.”

Physician Researcher

WHAT’S NEXT

The organization continues to collect data from patients newly diagnosed with COVID-19. It is using Twistle in numerous ways, including presurgical patient education, patient-reported outcomes data for orthopedic and spinal surgeries, and medication education and adherence.

ADDITIONAL READING

• Digital Patient Engagement Supports Patients with End-Stage Heart Failure
• Personalized Patient Engagement Improves Outcomes and Decreases Costs for Patients Undergoing Orthopedic Surgery
• Digital Patient Engagement Decreases Cancellations for Children and Adolescents Undergoing Procedures with Anesthesia
• Digital Patient Engagement Technology Addresses Gap for Pediatric Patients and Caregivers
• Digital Care Technology Enables COVID-19 Care at Scale

THE CHALLENGE

The University of Kansas Health System acknowledged the pivotal role of precise patient registration in ensuring patients’ access to necessary care, understanding of care coverage, and accurate coding and billing procedures, which significantly impact financial outcomes. The organization had heavily invested heavily in auditing registration accuracy to maintain accuracy. Exponential growth and dependence on manual auditing led to a continuous need for additional resources to sustain and enhance performance. Faced with these challenges, the organization recognized the urgency of finding a new and innovative solution.

THE SOLUTION

Using the Health Catalyst^® data platform, The University of Kansas Health System automated registration audits. The organization can conduct comprehensive registration accuracy audits for each registration representative and every patient served, supporting timeline changes for full registration at scheduling and the Centers for Medicare & Medicaid Services No Surprises Act for good faith estimates. The quality assurance supports the organization in getting registration right the first time, improving overall financial experience for patients and the health system’s accounts receivable aging. Utilizing an intuitive registration audit web tool, patient registration staff and leaders can swiftly identify errors, resolve issues, track performance trends, pinpoint improvement opportunities, and commend outstanding performers. This streamlined approach ensures immediate and efficient error resolution, empowering the team to enhance accuracy and efficiency.

THE RESULT

Leveraging the data platform and registration audit tool, The University of Kansas Health System has streamlined its auditing procedures, enabling it to scale auditing processes to every patient encounter. This comprehensive approach identifies process inefficiencies and knowledge gaps, allowing timely interventions to enhance performance. The organization can support patients in understanding care coverage, and ensure accurate and timely billing and coding, leading to improved revenue cycle effectiveness and financial performance.

• More than 6.8K hours of manual audit hours were eliminated annually.
• Established the infrastructure to audit the performance of more than 1K patient registration representatives without adding any additional costs.
• Automated audits for more than 38K patient visits.

“Every revenue cycle leader must prioritize enhancing registration quality. This solution enables us to consistently improve performance without incurring extra staffing expenses.”

Jaime Murphy-Zufelt, MHL, System Director of Revenue Cycle Operational Effectiveness, The University of Kansas Health System

ADDITIONAL READING

• Adaptive Problem-Solving and Analytics Improves Quality and Saves $4.7M
• Analytics Drive Lean Processes to Lower Healthcare-associated Infections
• Clinical and Financial Partnership Reduces Denials and Write-Offs by More than $3 Million
• Machine Learning, Predictive Analytics, and Process Redesign Reduces Readmission Rates by 50 Percent
• Effective Healthcare Data Governance: How One Hospital System is Managing its Data Assets to Improve Outcomes

THE NEED FOR IMPROVED ANALYTICS CAPABILITIES

Many health systems continue to operate with weak margins, requiring organizations to look for new opportunities to streamline operations, improve efficiency, and decrease costs. This often involves employing new strategies and implementing innovative technologies to optimize operational efficiency and enhance patient care while managing expenses to strengthen financial stability.

TRANSFORMING THE USE OF DATA AND ANALYTICS

Carle Health chose to streamline its processes to support organizational decisions and improve patient outcomes. The organization was transforming; it was changing how it used data and analytics. Organizational demand for robust data and analytics increased, but with this increased demand came escalating costs, and the business intelligence team couldn’t effectively meet demand.

In addition to the increased demand, the organization also faced difficulty recruiting and retaining the analytics talent it needed and didn’t have the resources to implement and maintain professional development pathways for its analytics team members. Carle Health needed a solution that would allow it to scale analytics efficiently and effectively across the entire enterprise.

PARTNERING FOR SUCCESS

Carle Health chose to strengthen its partnership with Health Catalyst, expanding to an all-access technology subscription plus Tech-Enabled Managed Services in analytics, data management, reporting, and project management.

Gaining access to analytics expertise

The organization transitioned employment of its business intelligence team members to Health Catalyst. These Tech-Enabled Managed Services team members provide expert analytics support and innovation to the entire Carle Health system. Carle Health gained broader access to analytics experts and the best practices to scale analytics across its enterprise. The team members gained access to technology, analytics and data science expertise, and development pathways that provide skills training and career growth.

Implementing new processes

Carle Health and the Tech-Enabled Managed Services team implemented new processes for opportunity identification, project prioritization, and project management. Teams use the KPA Analytics Accelerator to quantify variation within clinical care processes and assess the impact of improving care delivery. Carle Health uses the data to understand the drivers of organizational performance and prioritize improvement and analytics initiatives.

Providing self-service analytics

The provider organization, Carle Health, and the health plan, Health Alliance, use the Health Catalyst Pop Analyzer application to improve efficiency and provide self-service analytics. Previously, analytics team members were overwhelmed by high volumes of custom analytics requests and reports. Now, end users can efficiently perform ad hoc analyses using Pop Analyzer. Drag-and-drop filters within the visually oriented application make it easy for non-analyst end users to quickly ask and answer questions, freeing analysts to take on higher-level analytics projects.

Enabling data-informed decision making

Health Alliance uses the Health Catalyst Value Optimizer application to inform its value-based care strategy to achieve success in population health management. Leaders can identify the most valuable benchmarked opportunities for improvement, providing teams actionable guidance.

Carle Health uses the Healthcare.AI suite, integrating statistical and machine learning techniques into its business intelligence tools, producing higher-quality insights faster and improving the effectiveness of leadership decision-making. For example, Carle Health sought to understand length of stay (LOS) drivers. Team members had ideas about the factors contributing to prolonged LOS and were considering establishing an improvement team to address one of the root causes. Using comparative analytics, Carle Health determined that the suspected root cause was not contributing to prolonged LOS. Armed with better insights, the organization was able to focus improvement efforts on interventions that would make the most significant impact and avoided spending time and money on interventions that wouldn’t have produced the desired results.

RESULTS

The Carle Health and Health Catalyst Tech-Enabled Managed Services partnership is helping transform how Carle Health uses data and analytics to improve organizational performance and patient outcomes.

• In the first year of the Tech-Enabled Managed Services relationship, Carle Health gained economies of scale, contained escalating costs, and decreased costs by millions. The organization is efficiently scaling analytics across the enterprise, has advanced analytics adoption and acumen, and is advancing analytics maturity.
• 96 percent of team members who transitioned to Health Catalyst remain employed one year later, stabilizing daily operations. Team member engagement has increased and is greater than 70 percent of those in the Gallup database.

“Health Catalyst’s Tech-Enabled Managed Services has exceeded our expectations. The rigor, standards, and best-practice processes have meaningfully advanced analytics at Carle Health and decreased costs.”

Suzanne Sampson, MBA, PMP, FACHE, Senior Vice President, Transformation Services Division, Carle Health

WHAT’S NEXT

Carle Health will continue to use analytics to improve operational effectiveness and patient outcomes. The organization plans to use PowerCosting to gain an accurate, comprehensive view of all costs, improve the effectiveness of cost accounting, and identify actionable improvement opportunities.

ADDITIONAL READING

• Analytics Improves Population Health Operational Insight and Reduces Labor Costs
• Analytics Enables Identification of Opportunities to Improve Value and Accountable Care Organization Performance
• A Prescription for Success: Embedded Decision Support Improves Refill Timeliness and Saves $1.6M
• Automating Professional Practice Evaluation Improves Quality and Saves Thousands of Labor Hours
• Data Platform Supports Acquisition of Practices and Network Growth, Increasing Revenue

BRIDGING CARE GAPS FOR BETTER PATIENT HEALTH

Oklahoma healthcare providers face a tough challenge: the state ranks 47^th in the country for overall health.¹ Effective primary and preventive care improves health outcomes, increases equity for marginalized populations, and decreases per capita health costs.² INTEGRIS Health knew it had to find a way to bridge significant gaps in patient care to achieve long-term improvements in patient health and the health of the organization.

IMPLEMENTING CHANGE REQUIRES CLEAR KNOWLEDGE

INTEGRIS Health recognized it had the opportunity to improve overall patient health, but a lack of high-quality data and analytics impeded improvement efforts. The organization couldn’t assess current performance or identify which primary and preventive care measures had the most significant room for improvement, and it could not identify, quantify, and understand variation in performance. INTEGRIS Health needed a solution to provide the data and insights that could save lives, improve overall patient health, and ensure that each patient receives comprehensive primary and preventive care.

DRILLING DOWN INTO THE NUMBERS

INTEGRIS Health leveraged the Health Catalyst^® data platform and a robust suite of analytics applications, including Care Gap Analyzer, to gain insight into primary and preventive care performance.

Using Care Gap Analyzer, INTEGRIS Health quickly and efficiently assessed performance across primary and preventive care measures, quantifying baseline performance and prioritizing care gap closure for five measures that impacted tens of thousands of patients. The organization established multiyear improvement targets and aligned performance incentives to reward the team for following established procedures.

INTEGRIS Health engaged leaders, physicians, quality teams, and frontline team members in improving processes and redesigning workflows, implementing standard work for each measure. Teams used the analytics application to identify physicians and medical clinics with high performance, enabling the organization to spread best practices rapidly.

Creating comprehensive care guides

The organization created comprehensive care guides for each measure, clearly documenting and communicating improvement targets, such as how to decrease unintended variation and close each care gap. The care guides include the requirements for each measure, required documentation, tips and tools for increasing patient engagement, common chart deficiencies resulting in failed measures, and exclusion criteria.

Physicians and care teams perform pre-visit planning, identifying the care gaps that need to be closed during each visit. Teams build trusting relationships with the patients they serve, providing patient education and following up with patients to ensure care gaps are closed.

Evaluating workflow and monitoring performance

INTEGRIS Health uses high-quality data and analytics in Care Gap Analyzer to evaluate workflow changes’ impact on outcomes and monitor performance. Leaders and teams can quickly drill into the data to identify organization, clinic, and individual physician performance and can easily access detailed data to determine the root causes of low performance, enabling the organization to implement interventions to improve performance more quickly.

INTEGRIS Health broadly shares non-blind performance data and uses patient stories to illustrate improved performance impact on patient lives. Physician-led quality committees routinely review data, recognizing and learning from top performers and providing peer-to-peer education to increase the number of care gaps closed. Data are publicly displayed in each clinic. INTEGRIS Health uses public data to teach patients about the primary and preventive care they should receive and how that care can impact overall health.

RESULTS

INTEGRIS Health’s data-informed improvement efforts have substantially improved performance, leading to better patient care and outcomes. The organization achieved a:

• $2.2M increase in revenue and 55,000 care gaps closed.
  • Two-fold relative increase in depression screening rate.
  • 8.7 percent relative increase in colorectal cancer screening rate.
  • 4.1 percent relative increase in blood pressure control.
  • 4.1 percent relative increase in glycemic control.
  • 0.3 percent relative increase in breast cancer screening rate.

INTEGRIS Health has positively impacted the long-term health of tens of thousands of patients and their families. For example, in just six months, one physician following the standard care gap closure work identified two patients with early-stage breast cancer and two patients with early-stage colon cancer who would not have otherwise been identified. Closing care gaps enabled early detection and treatment, prevented cancer progression, and provided these patients and their families more years of good health and time together.

“The Health Catalyst data platform provides us with the high-value data and analytics needed for ongoing performance improvement. We can see our measures improve each month, demonstrating the power of data transparency.”

Todd Clapp, MD, Primary Care Physician, INTEGRIS Health

WHAT’S NEXT

INTEGRIS Health plans to continually expand performance improvement activities to increase the number of patients receiving primary and preventive care. The organization plans to integrate more social determinants of health data into its analytics applications.

REFERENCES

1. America’s Health Rankings. United Health Foundation. (2023). Oklahoma. Retrieved from http://assets.americashealthrankings.org/app/uploads/oklahoma-ahr23.pdf
2. FitzGerald, M. et al. (2022) Primary care in high-income countries: How the United States compares. The Commonwealth Fund. Retrieved from https://www.commonwealthfund.org/publications/issue-briefs/2022/mar/primary-care-high-income-countries-how-united-states-compares

ADDITIONAL READING

• Closing Care Gaps at the Point-of-Care Yields 4X Value Realization
• Closing Gaps in Care Through Medication Refill Technology
• Population Health Analytics Enables Improved Quality Increasing Revenue by Nearly $1M
• AI-Powered Benchmarking Transforms Data into Insight, Improving Organizational Effectiveness
• Data and Analytics Platform Delivers $3M in Annual Savings and Increases Capacity for Improvement

THE CHALLENGE

AlohaCare, a community-led, non-profit health plan, is the third-largest health plan in Hawai’i and is the only health plan dedicated to serving those eligible for Hawai’i’s QUEST Integration (Medicaid) and Medicare program. The organization continually works to improve the health and wellness of its members. However, cumbersome data collection, limited analytics, and gaps in social determinants of health (SDOH) data hindered efforts to understand, quantify, and improve population health.

THE SOLUTION

AlohaCare used the Health Catalyst^® data platform and a robust suite of analytics applications, including Pop Insights, to access the data and insights required to improve population health and ensure accurate understanding and reporting of performance. The organization has access to the clinical and claims data required to drive health coordination, including member movement between islands, ensuring care teams can adjust service delivery.

AlohaCare is expanding its whole-person care approach by integrating over 10 SDOH data sources with 20 segmentation views. This integration of data empowers the organization to identify member needs effectively, facilitating proactive outreach and connection to necessary referrals and resources.

THE RESULT

By utilizing the Health Catalyst data platform, AlohaCare has fortified its analytics capabilities, enabling more effective population health management and the discovery of insights into member needs. The organization can effectively quantify and report performance and has discerned common trends impacting members’ health, including a high prevalence of chronic medical conditions, behavioral health needs, and SDOH.

• 12.5K hours of manual data collection, aggregation, and reporting saved annually.
• Prioritized improving housing, food security, and transportation access.
• Increased member referrals to the community-based organizations best suited to meet member needs.
• Refined internal data-driven planning and decision-making strategies.

“The Health Catalyst data platform has enabled us to identify and focus on the areas where our members have the greatest needs so we can close gaps, improve outcomes, and strive for health equity.”

Kealoha Fox, PhD, Social Health Integration at AlohaCare

ADDITIONAL READING

• Social Determinants of Health: Tools to Leverage Today’s Data Imperative
• Three Ways Population Health Solutions Can Transform Public Health
• Advancing Health Equity: An Analytics Framework for Measuring and Managing Disparities
• Innovative Care Management Program Avoids Nearly $16M in Costs and Transforms Lives of Super-Utilizers
• Analytics Drive Malnutrition Management Improvement, Increasing Reimbursement and Enhancing Patient Care

THE CHALLENGE

Up to fifty percent of hospitalized patients in the U.S. suffer from malnutrition, but it is often unnoticed without systematic screening. Orlando Health’s clinical nutrition department wanted to optimize hospitalized patients’ nutrition status. However, burdensome manual data review processes and poor data quality hindered the prompt identification of patients in need of screening and those at risk.

THE SOLUTION

Leveraging the Health Catalyst^® data platform, Orlando Health improved the identification of patients at risk for malnutrition. The organization can quickly identify patients’ malnutrition screening status and patients who would benefit from registered dietitian services.

Orlando Health can easily monitor documentation specificity and accuracy, and intervene to ensure clinical documentation accurately reflects patient complexity, including malnutrition diagnoses. In addition, the organization can capture the financial impact of the diagnosis as the primary driver of additional reimbursement. 

With improved access to high-quality data and analytics, Orlando Health can evaluate the impact of malnutrition on crucial outcomes like length of stay, mortality, and 30-day readmissions, as well as differences in outcomes related to social determinants of health. The organization uses outcomes data to engage frontline care teams in increasing the number of patients screened for malnutrition.

THE RESULT

Orlando Health increased the number of patients screened for malnutrition, improved the number of patients who receive registered dietitian services and interventions, optimized nutrition status and patient outcomes, and increased reimbursement.

• $1.9M reimbursement increase over 11 months, the result of improved malnutrition management and increased accuracy and specificity of clinical documentation.
• $60K annual costs avoided, the results of automating data abstraction, aggregation, and reporting.
• 73 percent adherence rate to evidence-based malnutrition screening recommendations.

“The Health Catalyst data platform has been instrumental in helping us evaluate and communicate the impact of malnutrition on patient outcomes, supporting our ongoing efforts to increase malnutrition screening and provide early medical nutrition therapy to those patients at nutritional risk.”

Chelsea Santiago, MS, RD, LDN, CDCES, Clinical Nutrition Manager, Orlando Health

ADDITIONAL READING

• Advancing Pediatric Sepsis Care with Analytics
• Data-Driven Operations Improve ED Efficiency
• Data Accessibility and Analytics Enables Data-Driven Emergency Care
• Integrated Data Enables Single Source of Truth and Rapid Adoption
• Integrated Healthcare Data Quickly Enables Adaptive, Purpose Driven Analytics

ENHANCING PATIENT FLOW FOR BETTER CARE

Hospitals’ total costs increased 17.5 percent between 2019 and 2022, straining many health systems’ ability to continue providing care.¹ Additionally, prolonged length of stay (LOS) creates capacity constraints, impeding hospitals’ ability to meet patient demands for care and negatively impacting the patient experience. To deliver cost-effective care and remain financially viable, healthcare organizations must have coordinated processes to enhance patient flow, moving patients safely and effectively from admission to discharge.

PROLONGED LOS CAN LEAD TO WORSE OUTCOMES

Demand for services at Queen’s was high, but capacity constraints and prolonged LOS impeded the organization’s ability to meet patient needs, and patients were frequently boarded in the emergency department. The organization had discussed the need to improve patient flow, but a lack of standard processes and limited insight into performance impeded improvement. Queen’s needed new solutions to improve patient flow.

DATA-INFORMED PATIENT FLOW IMPROVEMENT

The solution for Queen’s was a patient flow improvement team and executive steering committee, supported by the Health Catalyst^® data platform and a robust suite of analytics applications, including Patient Flow Explorer, and Tech-Enabled Managed Services.

The patient flow improvement team and executive steering committee clarified roles, responsibilities, and decision-making authority, making changes in three key areas, and engaging all team members to improve patient flow.

• A capacity management plan. The capacity management plan identifies action items for each stage, including standard operations, pre-surge, and specific-surge levels. These action items include activities to increase bed capacity and plans for patient placement that address both the volume and acuity of the patients requiring admission.
• Geographical hospitalist assignment and standardized daily interdisciplinary rounds. Teams conduct daily interdisciplinary rounds and use the rounds to consistently work patients to safe discharge, ideally at the standard daily discharge time. The team addresses any outstanding patient needs, such as mobility, prompt discontinuation of lines and drains, outstanding tests and imaging, and education. The team plans for discharge, ensuring that patients have transportation, needed medications, and a post-discharge follow-up plan.
• A centralized command center. New patient flow coordinators staff the centralized command center. The team proactively engages with care teams to identify and resolve patient flow barriers. Care teams also contact the centralized command center to escalate issues. Patient flow coordinators play a pivotal role in the organization’s surge plans, implementing standard and consistent interventions to improve capacity.

Additionally, Queen’s leverages the Patient Flow Explorer analytics accelerator to:

• Understand demand and capacity.
• Identify areas where demand and capacity don’t match.
• Quantify patient flow improvement opportunities.
• Evaluate the impact of interventions on outcomes.
• Assess and quantify the value of the improvement efforts.

Health Catalyst Tech-Enabled Managed Services support ongoing clinical quality improvement, advancing analytics adoption, and facilitating improvement using a seven-step improvement model, giving Queen’s team members a proven methodology to drive improvement.

RESULTS

Queen’s data-informed improvement efforts are producing meaningful results. The organization has improved capacity management effectiveness, decreased LOS, increased the ability of the organization to serve more patients, and improved the patient experience. Results include:

• $22M cost savings. Patients were able to spend 19,000 more days at home, the result of an 8.4 percent relative reduction in average LOS in 15 months.
  • Without this work, Queen’s would have had as many as 18 more patients a day boarded in the emergency department.
• $1.9M new revenue, the result of an 8.4 percent relative increase in admissions over 11 months.

“By leveraging our data and analytics, we’ve been able to significantly
improve patient flow—reducing length of stay, decreasing costs, and
increasing revenue—all leading to enhanced healthcare delivery and an
improved patient experience.”

Matthew Ing, MD, VP of Medical Affairs & Chief Medical Officer, The Queen’s Medical Center

WHAT’S NEXT

Queen’s plans to expand its standard interventions across the health system and will continue to use data, analytics, and the proven improvement methodology to further improve patient flow, ensuring patients can access care when they need it. Queen’s is also building a centralized command center to further expand its patient flow efforts.

REFERENCES

1. Krishnamurthy, B. (2023). Margin misconceptions: What do break-even hospital margins mean for patient care? American Hospital Association. Retrieved from https://www.aha.org/news/blog/2023-08-01-margin-misconceptions-what-do-break-even-hospital-margins-mean-patient-care

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