Banner Health
William Holland, MD
VP, Chief Medical Informatics Officer
• Integrated governing process• Single Board of Directors
• Centralized management structure
• Centralized corporate functions
• Designed to achieve results• Enhance clinical quality
• Affordable cost model
• Patient/member experience
• Alignment from strategy through initiatives• Drives common strategy from senior leaders down through entire organization
• Allows IT leaders to tightly align technology strategies with Banner strategy
• Aligns IT sub-strategies and tactics across IT operations
The Banner Operating Model
Banner’s
Operating
Model
CRITICAL
CARE
Michael Simon
Gary Foster
WOMENS
HEALTH
Michael Urig
Cathy
Townsend
CV SURGERY
Michael
Maxwell
Marianne
LaFleur
PEDIATRICS
Bill Schneider
Sandra Marken
BEHAVIORAL
HEALTH
Gagan Singh
Nancy Sylvester
PHARMACY &
THERA-
PEUTICS
Joe Lozon
Nathan
Spence
CARE MANAGEMENT COUNCIL
ED
David Cohen
Dan Lingle
CARDIOLOGY
Paul Hurst
Lynn De
Guzman
ANESTHESIA
Josh
Bloomstone
Susan Eubanks
HOSPITAL
MEDICINE
Cheryl O’Malley
Julie Reister
NEURO-
SCIENCES
Maninder Kahlon
Al Wildman
MEDICAL
IMAGING
Kevin Hirsch
Erica Dorward
PRIMARY
CARE
Mary Ellen
Dirlam
Judy Reddin
INFECTIOUS
DISEASE
Edwin Yu
Joan Ivaska
ORTHO
David
Jacofsky
Young An
NEPHROLOGY
Dharminder
Marwah
Debbie Kohm
ONCOLOGY
Daniel
Chamberlain
Kathy Altergott
LONG TERM
CARE
Natalya
Faynboym
Kelly Johnson
SURGERY
Jon King
Nancy
Adamson
PULMONARY
Rajeev Saggar
Chuck Ramirez
NICU/Newborn
Greg Martin
Kathleen
Walker
Evidence Based Practices• Medical Imaging for Dx Community Acquired Pneumonia
• Chlorhexidine Alcohol for Surgical Skin Preparation
• Seprafilm Use in Cesarean Sections
• Knee High SCDs and TEDs
• Early Sepsis Identification
• Acute Respiratory Distress Syndrome (ARDS)
• Delirium
• Newborn Hypoglycemia Screening & Mgmt
• Medical Imaging for Peds Appendicitis
• Large/Small Bowel Surgical Care
• Diagnosis of Diarrheal Disease
• Pooling of Bronchoscopy respiratory specimens
• Diagnosis of Coccidioidomycosis by Serological Means
• Diagnosis of Clostridium difficile Associated Diarrhea
• Elective Deliveries Prior to 39 Weeks
• Behavioral Health Medical Clearance
• Ventilated Patient Management (oral care, sedation)
• CT Scan in ED for Atraumatic Headache
• Dysphagia Management for peds patients
• Subcutaneous Insulin
• Syncope
• ED Ischemic Stroke tPA
• Scorpion Envenomations
• ED to Critical Care Admissions
• Intra Op Goal Directed Therapy
• PET Scan
• Admin Intravenous Contrast Media
• Vertebroplasty
• Pre-Term Labor
• Ambulatory Lower Back Pain
• Insulin Drip Transition Post Cardiac Surgery
• Palliative Sedation
• Readmission Risk Assessment and Management
• Pediatric Sepsis
• Enhancing Progression of Labor
• Indwelling Catheters in Laboring patients
• Pharmacy Drug Level/Lab Monitoring Service
• Appropriate Use of PPI’s (Proton Pump Inhibitors)
• DKA Hyperglycemic Crisis
• Moderate-Severe EtOH-Substance Withdrawal
• Pediatric Bronchiolitis
• Pediatric Fevers
• Adult Implantable Automatic Cardio-Defibrillators (ICD’s)
• Epoetin-Adult
• Orthopedic Care for Total Knees, CPMs, Cold Therapy
• Anesthesia Administration
• Post Partum Hemorrhage
• Early Warning System for Adult Patients
• ED Pulmonary Embolism Rule-Out Criteria (PERC)
• ED Discharge Transition
• ED Acute paint management
• Midline Sternotomy – Post Operative Management-Adult
• Point of Care Chest Ultrasonography
• Chorioamnionitis Management
• Developmental Screening for Peds
• Acute Blood Loss
• ED Chronic Pain
• T Dap Vaccine
• Use of BMP
• Nitrous Oxide
• Reducing Postoperative Pulmonary Complications
• Ambulatory Diabetes Care
• Hepatic Encephalopathy Patient Management
2012–Top 5 Health System Clinical
Quality
2010-2011 - Top 10 Health System
(Thomson Reuters)
2010 - 2011 Top 25 Connected
Facilities in US
(Health Imaging & IT Magazine)
2010 & 2011- Top 10 of the Top
100 Integrated Healthcare Systems
in the US(SDI & Modern Healthcare Magazine)
2010 - One of Arizona’s Most
Admired Companies
(Business Magazine & Best
Companies AZ)
2009 & 2010 - Top 100 best
technology innovators in US(Information Week 500)
2007 - 2010 Best Places to Work
winner
(Business Journal & Best Companies
AZ)
2011 -2012 Best Hospitals (US News/World Report)
2011 Top Leadership Team in
HealthCare(Health Leaders Media)
Truven Health Analytics
15 Top Health Systems 2013
Banner’s Vision 2020
Acute Hospital
Company
Clinical Quality
Company
Population Health
Management Company
0,0%
10,0%
20,0%
30,0%
40,0%
50,0%
60,0%
70,0%
80,0%
% CT Scans % Ultrasounds
2008 - 2015 CT Scan vs Ultrasound Use% of Peds Appendicitis Patients Who Received an Abdominal/Pelvic CT Scan or Ultrasound
63.6%
39.9%
7.4%
40.8%
9.6%
14.8% 15.5%
68.9%
54.1%
47.3%
Reporting Quarter
51.0%
36.5%34.4%
43.8%
26.3%
40.3%
Source: Josh Noble (CPA)01/04/2016Data: Quality Advisor, TSI
74%
68%71%
69%
75% 74%71%
62%
72%
68%
65%
60%
48%50%
42%
37%
51%
44%
49% 49% 48% 48%
44%
50%
54%
44%
52%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Peds Asthma Inpatient Chest X-Ray
Source: Josh Noble (CPA)1/4/2016Data: Quality Advisor, TSI
Reduce Variation in Blood UtilizationOrthopedic: Hip/Knee
16,6%
12,5%
8,4%7,8%
7,8%8,0%
6,9%6.7%
3.2%
0.9%1.6%
0,0%
2,0%
4,0%
6,0%
8,0%
10,0%
12,0%
14,0%
16,0%
18,0%
1Q 2013 2Q 2013 3Q 2013 4Q 2013 1Q 2014 2Q 2014 3Q 2014 4Q 2014 1Q 2015 2Q 2015 3Q 2015
Business Intelligence, Mature Initiatives Scorecard, Accessed 01/04/2016
65%
70%
75%
80%
85%
90%
95%
Clinical Practice:Sepsis, Delirium Identification, Prevention and Treatment
Research indicates >60% as positive
Clinical Performance Analytics, Critical Care Data Cube, Accessed 11/26/2014
Delirium and Coma Free Days
Critical Care Patients
0
20
40
60
80
100
Length of Stay in HoursIntensive Care Patients
> 20 hours Improvement
Clinical Practice:Sepsis, Delirium Identification, Prevention and Treatment
Clinical Cost Avoidance of $22 Million
Business Intelligence, Critical Care Data Cube, Accessed 05/01/2014
Banner Medical Group
Sterling, CO
Opened in January
2015. The center
offers primary care
with onsite labs
and medical
imaging
Banner Health
Center
Fernley, NV
Opened in March
2015. The center
offers primary care
and OB/Gyn with
onsite labs and
medical imaging
Banner Health
Center
Vision without execution is just hallucination
Henry Ford
How big?• Change Management
• Cultural, Workflow, Patient/Consumer
• Merging of Ambulatory and Acute• Optimization, Transitions of care
• Availability of skilled resources• Speed vs. Quality• Regulatory• Data migration• Interfaces• Growth, Acquisitions• Revenue
Projected Ambulatory Implementations
0
50
100
150
200
250
300
350
June July August September October November December
Providers (Projected)
Clinics
Specialties
Actual Ambulatory Implementations
0
50
100
150
200
250
300
350
June July August September October November December
Providers (Actual)
Providers (Projected)
Clinics
Specialties
Additional aspects of our partnership
Optimization
SMART on FHIR
Population Health
MobilityHealtheLife
Cerner Advance
PowerChartMaternity