Leveraging the Power of Supply Chain to Transform Clinical Operations

Matthew Mentel Executive Director, Integrated Performance Solutions

Betty Jo Rocchio Vice President Perioperative Performance Acceleration

SMIOctober 2017

Introductions

BETTY JO ROCCHIO

RN, BSN, CRNA, MS

VICE PRESIDENTPERIOPERATIVE PERFORMANCE

ACCELERATION

MATTHEW MENTEL

CMRP, MHA, MBA

EXECUTIVE DIRECTORINTEGRATED PERFORMANCE

SOLUTIONS

3

Services & LocationsAn Overview of Mercy

June 2017

With the changing healthcare landscape, procedural areas are

being faced with the need to comprehend their total costs,

reduce expenses and optimize clinical operations while positively

impacting care. This paradigm shift sets the stage for the

collaboration and partnership of supply chain and clinical

leadership to effect sustainable change, provide high value care

and realize financial improvements.

Objective

OPERATIONAL FINANCIALCLINICAL

5

Objective

OPERATIONAL FINANCIALCLINICAL

sustainable change

high value care

realize financialimprovements

6

Vance Moore – SMI Oct 2015

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

9.8%

3.9%

1.8%

$1.2 BILLION spend in top 5

categoriesRepresenting

34.6% of Expense

Mercy Expense Breakout (Top 15) - FY14

7

FY Comparison of Perioperative Operations

$0

$20,000

FY14 FY15 FY16

$0

FY 14 FY15 FY16

$500

FY16

0

100,000

200,000

FY14 FY15 FY16

VOLUME

STATISTIC FY14 FY15 FY16 FY17

OR Cases 125,474 135,833 163,725 190,500

• Inpatient 35,935 36,822 40,276 46,873

• Outpatient 89,539 99,011 123,449 143,627

Revenue $ 2,207,931,239 $ 2,093,276,868 $ 2,226,216,263 $ 2,289,173,790

• Revenue per Case $ 17,597 $ 15,411 $ 13,597 $ 12,017

Supplies $ 257,820,021 $ 253,724,844 $ 261,011,392 $ 261,169,200

• Supplies per Case $ 2,055 $ 1,868 $ 1,594 $ 1,371

Labor $ 100,303,743 $ 97,762,727 $ 104,470,849 $ 99,658,359

• Labor per Case $ 799 $ 720 $ 638 $ 523

-

50,000

100,000

150,000

200,000

250,000

FY14 FY15 FY16 FY17

OR Cases

$-

$5,000

$10,000

$15,000

$20,000

FY14 FY15 FY16 FY17

Revenue per Case

$-

$500

$1,000

$1,500

$2,000

$2,500

FY14 FY15 FY16 FY17

Supplies per Case

$-

$200

$400

$600

$800

$1,000

FY14 FY15 FY16 FY17

Labor per Case

• Patient safety •Minimize distractions

• Cost per case

The Triple Aim

Superior Patient

Outcomes

PositiveBottom Line

GreatExperience• Reduce risk

• Comparative effectiveness

• Improve clinical workflow

• Improve clinical satisfaction

• Standardization

• Charge capture

• Expiry & recall

9

Vance Moore – SMI Oct 2015

Key Elements to Survive or Thrive

10

What is the key ingredient to survival and performance

excellence?

Data

Information

Insight

Action

The How of the Triple Aim

INVENTORY MANAGEMENT

SOLUTION

ANALYTICS

Comparative effectiveness

Standardization

Cost per case

11

Inventory Management Solutions and Analytics

12

1010110110000010011101010101000101100001011011010101010100111000100111001010110110000010011000101010101011100101011101110001011110100010001010101010100

1101010101000101100001011011010101010100111000100111001010110110000010011101010101000101101010010110111010001010101010001010110100010101010101010101101

10101101100000100111010101010001011000010110110101010101001110001001110010101101100000100101010001110101010101000011101010101

1101010101000101100001011011010101010100111000100111001010110110000010011101010101000101100101010101110110101010111011100010100010010101010100010100100

0100111000100111001010110110000010011101010101000101100001011011010101010100111000100111000101001111010100011010101010001011100010100010101010101011111

0101101100000100111010101010001011000010110110101010101001110001001110010101101100000100110010101010101101101010000011010010010100010101010101010100100

0100111000100111001010110110000010011101010101000101100001011011010101010100111000100111001010101010101101010101010101010101010111010000011101010101101

10101101100000100111010101010001011000010110110101010101001110001001110010101101100000100100101010101011010101100101000111000

10101101100000100111010101010001011000010110110101010101001110001001110010101101100000100100010101010101001010101010110101011

1101010101000101100001011011010101010100111000100111001010110110000010011101010101000101100101010101011011010101010111101101001111000100010001111010111

Vance Moore – SMI Oct 2015

…Healthcare information has converged to create a usable

“Digital Fingerprint”

…Clinical, Operational, & Financial

Immediate

Traceable

Explorable

Unique

13

14

Variability Along the Continuum of Care

Physician Office Visit

Pre-Procedure

ProcedurePost

ProcedureFU-30

dayFU-60

dayFU-90

daySchedule

Our Vision: To enhance the Patient experience while optimizing the clinical workflow and provide transparency through the entire episode of care

Point of Use

Managing the Continuum of Care

ERP/EMR

Analytics

15

Physician Office Visit

Pre-Procedure

ProcedurePost

ProcedureFU-30

dayFU-60

dayFU-90

daySchedule

16

Solutions: Systems Segmentation

• Provides nudges or forced actions• Real-time capabilities• Multi-delivery methods (text, pop-ups)

• Descriptive & Predictive Analytics• Status sources• Interesting but limited action

• Data generation sources• Most organizations have hundreds of these• Often claims to be more than reality

Systems of Record

Systems of Action

Systems of Display

Why Start with Point of Consumption

Patient Level Product Scanning

Inventory Management

Automated Charging

Major Process

• Scanning product barcode to patient

• Capture of UDI (lot / serial / exp)

• Capture cost per case

• Patient Safety

Major Process

• Automated charge capture

• Lost charge reporting

Major Process

• Tracking of shelf level inventory

• Tracking of lot / serial / exp date of product

• Automated inventory replenishment

• Comparative Effectiveness

• Post Market Surveillance

• Standardization

• Real-time Information at Point of Care

Major Outcome

People Process Solutions

17

Goal:

Tie the patient, physician, product and financials together:

• EMR • Clinical Documentation• Patient charging

• POU • Product consumption• Inventory replenishment• UDI capture• Expiry & recall notification

• ERP• Complete cost accounting

Clinically Led – Operational Driven Solution

18

People Process Solutions

Vance Moore – SMI Oct 201519

Integrated Continuum of Care

Vance Moore – SMI Oct 2015

Source: Aberdeen Group, June 2014

Top Performers Rely on Analytics

20

21

Variability Along the Continuum

Controlling variation is the key to realizing operational efficiencies

• Standardization• Cost per Case• Leveraging UDI• Comparative Effectiveness• Post Market Surveillance

Physician Office Visit

SchedulePre-

ProcedureProcedure

Post Procedure

FU-30 day

FU-60 day

FU-90 day

Descriptive Analytics –From Schedule to PACUPredictive Analytics –

From Physician to PACU

Prescriptive Analytics –From Physician to Post 90 days – the entire Episode of Care

Data Analytics

Analytic Nirvana

► We will be successful by:

▪ Understanding and providing the best care possible

▪ Using the least amount of resources

► This work will be enabled by:

– Focus on measurement highlighting variation as an opportunity for improvement

– Understand of the key clinical, service, cultural, community and financial drivers

– Performance information that is relevant and timely to decisions being made

– Business ownership of the measures and their usefulness

– Commitment to grow and develop our data science resources

► The gains will be assured by:

– Business engagement and ownership

– Commitment to continually improving measures

– Frequent review and discussion by leaders & teams

– Action leading to results

22

Performance Measurement

Vance Moore – SMI Oct 2015

The Triple Aim in Results

QUALITY SERVICE FINANCIAL

Comparative Effectiveness

Linking quality outcomes to how we use the product

Clinical

Operational

Financial

Operationalization

Partnership and support of product use, sharing

ownership

Comprehensive

Value Not just cost of the product, but also the application and

use

23

• Patient safety • Minimize distractions

• Cost per case

The Triple Aim in Results

Superior Patient

Outcomes

PositiveBottom Line

GreatExperience• Reduce risk

• Comparative effectiveness

• Improve clinical workflow

• Improve clinical satisfaction

• Standardization

• Charge capture

• Expiry & recall

24

Improvement in frequency preference card optimization

284%25

• Real-time patient safety alerts (expiry, recall)

• Automated tissue tracking

• Regulatory compliance

• Comparative Effectiveness

The Triple Aim Performance Measurement

Reduction in serious reportable events

71%

Improvement in clinical coworker satisfaction

37%

Reduction

in OR turnover time

12%26

• Single scan to EMR and EHR

• Enabled preference card optimization and sustainability

• Enhanced Clinical Workflow

• Improved Physician, Patient and Coworker Satisfaction

The Triple Aim Performance Measurement

27

Automation

of replenishment

10%

Reduction

in cycle counts

18%

Optimally manage

owned vs. consigned

Inventory

Realizing unrecognized inventory assets

$2.4M

Improving

inventory utilization

$4.7M

Optimizing

charge capture

$13M

Improving

preference card accuracy

$459K

The Triple Aim Performance Measurement

True Impact to Cost Visibility

28.4% Change*

This equates to an 7.9% improvement in Gross Supply Dollars Captured ($215 increase per case)

Go Live

28

Questions

Right patient, right procedure, right supplies, right

time….every time.

OPERATIONAL FINANCIALCLINICAL

29