IN THIS ISSUE: Healthcare leaders see a future that challenges their physicians, staff and the bottom line — increased access, an aging
population, declining reimbursement, a worsening payer mix and a shift to greater consumer responsibility. Faced with new payment
models based on accountable care, such as bundled payments, organizations need analytics to attain an integrated view of their clinical and financial performance. This issue provides perspectives from experts and peers on how to prepare for value-based reimbursement.
Preparing for the Future: The Value of Integrating Physician Practice Data
By Chad Brisendine, VP/CIO
St. Luke's Hospital & Health Network
Lehigh Valley, Pa.
By Amanda Mazza, Director,
Decision Support
St. Luke’s Hospital & Health Network
Lehigh Valley, Pa.
At St. Luke’s Hospital & Health Network in Lehigh Valley, Pa., we’re quite proud of our data management. Recognizing the role information technology (IT) plays in delivering quality clinical care, we’ve deliberately stayed ahead of the electronic curve. So as the rapidly changing healthcare landscape began raising new challenges, we looked to data to help us navigate – and even lead – the industry’s inevitable transformation.
Expanding Our Vision
As a fast-growing, integrated health network serving southeastern Pennsylvania and western .New Jersey – with five hospitals and growing quickly – we’ve amassed a huge repository of clinical and financial data. For years, we’ve put that data to work optimizing performance and operations via sophisticated enterprise intelligence tools.
Looking ahead, we saw that the flourishing St. Luke’s of the future would have significant data visibility beyond our hospital walls. We could see analytics’ integral and foundational role in: performance improvement, increased quality and performance reporting to regulatory agencies, physician practice acquisitions, value-based purchasing and monitoring increased outpatient delivery. Our organization saw that this called for a shift in strategy: away from a hospital-centric perspective and toward a population management model.
To propel our evolution, we needed data-driven decision support from across the entire care continuum. And therein was the problem: a glaring lack of data from our employed physician practices. On the one hand, our hospital data management was leading edge; on the other, we lacked a means to integrate data from our physician practices.
Integrating Physician Data for Comprehensive Analysis
We reviewed our situation: we owned 80 physician practice sites and employed 300+ physicians, using several different data management systems and tools. While we had recently centralized some physician practice reporting to establish a strong foundation for population management, we still needed to do some heavy electronic lifting. Given our complex needs, our goal was to centralize and integrate physician practice data (clinical and operational) with our well-established, comprehensive, acute-care reporting framework.
But the goal wasn’t limited to data. On the people side, we aimed to increase user understanding and use of that data, while strengthening resources surrounding its management. As a long-time customer, we enlisted McKesson’s expertise to help us reach our goal of centralizing and integrating data.
Creating Data Integrity
To effectively manage operations in the wake of healthcare reform, hospitals must have access to current, accurate data from across the care continuum. Accordingly, Phase I of our project involved replacing scattered and duplicative physician practice reports with a consolidated, drillable scorecard that they could easily share. Milestones included:
Ensuring data accuracy from all sources Assigning master patient identifiers across all sources to enable cross-continuum tracking Standardizing the definition of “patient visit” across practices Improving structures to support cost accounting
Once we confirmed data integrity, we pulled practice performance analysis into a centralized system that also included data from our enterprise patient visibility solution and hospital data warehouse. The resulting scorecard includes these categories:
With a drillable scorecard firmly in hand, it was time to put it to work.
Turning Data to Radar
To thrive under healthcare reform, hospitals must be able to knit clinical and financial data together to reveal the true potential of their business. Now in process, Phase II focuses on physician practice performance in terms of volume, revenues and referrals.
Insight into how individual practices affect patient flow through the system – from acute-care, to physician offices, to home health, to the business office – will provide clarity on population management. And not only will we be capable of employing near real-time data analysis across care settings, new predictive modeling tools will help us understand the impact of potential future initiatives such as those focused on population management and using data to align costs with procedures.
Pioneering the Future
Once the project is complete, we expect to have achieved both our data management and performance measurement goals. We’ll have fortified our data foundation, made it visible and useful to users, enhanced collaboration with physicians and set the stage for healthy organizational growth. So when the future arrives – in whatever form it might ultimately take – St. Luke’s will be ready.
Chad Brisendine is Vice President and Chief Information Officer of St. Luke's Hospital & Health Network in Lehigh Valley, Pa.
Amanda Mazza is the director of Decision Support at St. Luke’s Hospital & Health Network
Lehigh Valley, Pa.
Cowherd Family Medical
Center used its EHR to
improve the population health
of its patients. The practice
received a top score from
CMS and $75K in P4P funds.
Sky Lakes Medical Center
implemented a variety
of strategies to increase
revenue and reduce costs —
and ultimately improve the
bottom line.
HFMA’s CEO Richard Clarke
advises providers to view value
in healthcare from the eyes of
the purchaser. When care
costs outpace gains in care
quality, there is a value gap.
Analytics provides a pathway to
success in preparing for
value-based reimbursement
via process improvement that
integrates clinical and financial
metrics across the enterprise.
Ensuring data accuracy from all sources
population, declining reimbursement, a worsening payer mix and a shift to greater consumer responsibility. Faced with new payment
models based on accountable care, such as bundled payments, organizations need analytics to attain an integrated view of their clinical and financial performance. This issue provides perspectives from experts and peers on how to prepare for value-based reimbursement.