Automated, Standardized Reporting of Patient Safety and Quality Measures to
Enable Faster Action and Time to Improvement
August 2 nd, 2012
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Today’s Presenters‣ Ryan Hayden
Healthcare Principal
315-380-0672
‣ Neil Ravitz
Chief Operating Officer (COO)
for the Chief Medical Officer (CMO)
► University of Pennsylvania Health System (UPHS) Overview
► Edgewater Corporate Overview
► Objectives for Patient Safety and Quality Dashboard Project
► Case in Point –
– Project Overview– Brief Technical Description– Primary Business Benefits
► Dashboard and Report Live Demonstration
► Ongoing Learning and Development
► Appendix: Technical Description of Solution & Architecture
Agenda
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Consulting firm that brings a blend of advisory services and product-based technology solutions to assist our clients with improving profitability, driving performance improvements, and accelerating growth
► Founded in 1992► Focus on upper-middle and global 2000 markets► 420+ employees► 800+ clients► 3,100+ projects completed to date► 95% client retention rate► Large North American footprint
– New UK presence
► Publicly traded (NASDAQ: EDGW)– Public in 2002
► Co-founders still with the Company
Edgewater Corporate Overview
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Summary of Edgewater’s Healthcare Practice
Sample Clients• EDW/BI Strategies & Roadmaps
• Data Quality, Architecture
• Data Governance
• Tool Evaluation & Selection
• Data Marts/EDW Implementation
• Reporting, Dashboards, & Analytics Implementation and Planning
• Quality of Care, Patient Safety
• Surgical Analytics
• Service Line Analytics
• Utilization & Cost
• Patient Panel and Physician Relationships
• CRM in Healthcare
• Finance Budgeting, and Strategic Planning
BI & Technology Experience
Functional Experience
► Perelman School of Medicine and The University of Pennsylvania Health System
► Comprised of three hospitals with more than 1,700 beds► More than 78,000 admissions per year► More than 2 million outpatient visits► More than 2,200 physicians and more than 21,000 employees► HUP – USNWR Honor roll hospital ► Located in the heart of Philadelphia!
Penn Medicine Overview
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Patient Safety and QualityIntegrated Data Solution
� Penn Medicine �Blueprint for Quality and Patient Safety
Penn Medicine will eliminate preventable deaths and preventable 30-day readmissions by July 1, 2014
Imperatives Priority Actions
Accountability For Perfect Care
� “Always” events - strive to provide perfect care
� Implement clear lines of accountability that span inpatient and ambulatory environments
Patient and Family-Centered Care
� Provide consistent and thorough communication with families & patient regarding plan of care
� Increase patient and family involvement in UPHS forums that address issues relevant to quality, safety and service excellence
� Enhance patient-provider partnership through better exchange of information
Transitions In Care /Coordination Of Care
� Ensure all UBCLs implement redesign care processes related to:
– Risk stratification
– Interdisciplinary rounding
– Discharge hand-off to outpatient care
Reducing Unnecessary Variations In Care
� Eliminate variations in care processes where evidence exists
� Balance conformity in practice with needs for personalized care
� Set goals that are positive and proactive
Provider Engagement, Leadership, And Advocacy
� Strengthen organizational capacity and capability for continuous improvement
� Increase involvement of house staff in quality, safety and service excellence efforts
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Three-Way Partnership is Penn’s “Swiss Army Knife” for Managing Quality on the Hospital Units
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Three-Way Partnership on the Hospital Units
This isn’t a project, it’s a way of doing things. You can bolt different strategies onto it.
“
—UPHS CFO”
We needed a multi-purpose solution on the units to handle almost any Quality problem.
We call these trios “UBCLs,” for “Unit Based Clinical Leadership.”
Vision: Advanced Analytics for Quality Data
ExecutiveUser
Functional User
Power User
Highly Aggregated/C-Level
Analyst/Informaticist
• Alignment with Quality Blue Print objects
• Improve resource utilization; patient satisfaction
• Align quality improvement / PI with industry reform
• Reduce costs by automating report development
• Improve compliance with regulatory mandates
• Targeted education for units / clinicians underperforming
• Analytic & reporting tools
• Report development and distribution
• Monitor data quality; standardize vocab.
The Right Information. To the Right People. At the Right Time.
CEQI, Quality Department
- Coordination of Care- ALOS- Quality Compliance
- Core Measures- HCAHPS- HAI’s- QI / PI
- SCIP, PN, AMI- Falls- Satisfaction- Events, Errors
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Enterprise Objective: Work Smarter
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Collect Data
Collect Data Collect Data
Analyze
Information
Analyze
Information
Analyze
Information
Decision Making &
ActionDecision Making &
Action
Basic / Classic Reporting
% T
ime
Spe
nt
Collect Data
Collect Data Collect Data
Analyze
Information
Analyze
Information
Analyze
Information
Decision Making &
ActionDecision Making &
Action
BI & Analytic Tools
Less Mature More Mature
% T
ime
Spe
nt
WhereWe
WERE
Where We’re
GOING
Clinical Care
Patient Safety & QualityAnalysts
Organizational Deployment: Communication & Execution
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Entities AnalystsPI Champions
UBCL
Surgeons Nursing
Physicians
Process Change
Change Mgmt
Project Mgmt
Standard Reports
Alerts &Dashboards
Safety & QualityData Collection
Establish / UpdatePriorities
Provide Support &Analysis
Data Mart
PS&Q AnalyticsData Mart
Steering Committee
Local Responseto Q&S Metrics
Capture &Analyze
Implement &Improve
IT / EDW Support
PI
Identify
Implement
PilotDesign
Justify
PI
Identify
Implement
PilotDesign
Justify
PI
Identify
Implement
PilotDesign
Justify
Health System Dashboard
Health System Dashboard is where Penn Medicine Team Goals are highlighted on the front
page and performance against those goals are depicted in Green / Yellow / Red
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Dashboard Tabs
Patient level detail availableWith more timely data, metrics will
update throughout the month
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Spark Line View of Data
Spark Line: presents users with a more advanced view of metrics in a condensed space.
This view provides the Start Point, Low Point, High Point, and directional arrow based on a three
month average. It is an efficient way to view and compare trends of several metrics at one time.
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Reporting Template
Reports allow the user to select measures by Entity, Unit,
Department and Service according to a desired date range
Patient level detail available
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Built In Graphing Capability
Trending graphs default to Statistical Process Control (SPC) charts to help promote the
process improvement techniques that are being taught throughout the organization
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► Requirements gathering and build approximately 6 months
Project Statistics
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► 136 Quality Metrics from various existing sources:– Mortality (8)– Transitions / Readmissions (8)– Patient Safety Indicators (18)– Healthcare Acquired Infections (8)– Core Measures (57)– HCAHPS Patient Satisfaction (31)– VTE/DVT/PE (6)
► Two (2) dashboards and nine (9) reports
► More than 350 users across the Health System
► Benchmarking data (in process)
Next Frontier
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► ICU specific measures (in process)
► Outpatient data mart (start Q3 2012)
► Merging data from different BusinessObjects universes (2013)– Finance and Quality– Inpatient to Outpatient– Executive View
Discussion
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Questions?
Thank You!
APPENDIX
Technical Description of Solution & Architecture
Technical Description
► The Database and Platform– Oracle 11g running on Linux– Three separate instances: Development, QA, and Production
► The ETL (Extract, Transform, Load) tools– IBM InfoSphere (an integrated solution)
• IBM Data Stage, Quality Stage, Information Analyzer, and FastTrack– Two separate instances: Development and Production
► Business Intelligence Solution– BusinessObjects and Xcelsius – Three separate instances: Development, QA, and Production
► Issue Tracking solution– Microsoft SharePoint custom developed issue tracking site
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ETLETL
Data Flow & Architecture
HDM PMC
Cerner Lab
MedView
ClinTrac
EPIC
Surgery
Cardiac
Surgery
Sunrise
TheraDoc
Ganey
Press
Ganey
AHRQ
UHC
Penn
Data
Store
HDM HUP
Source
Systems
Enterprise
Clinical
Repository
Quality
Data Mart
Transformation
Layer
Additional Sources not part of
the PDS architecture
ET
LETL
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