Clinical and Operational Accountability in a Large IDN

Transcription

1 Clinical and Operational Accountability in a Large IDN Session 188, March 7, 2018 Matt Eversole, System VP, IT COO 1

2 Conflict of Interest Matt Eversole Has no real or apparent conflicts of interest to report 2

3 Agenda Clinical Operations Performance Report (COPR) COPR Roles & Process KPI Accountability & Collaboration BI Standardization & KPI Drilldowns Challenges / Success Factors / Recommendations 3

4 Learning Objectives Appraise best practices of creating, producing, and distributing an enterprise performance scorecard that spans clinical, operational, and strategic domains in a Value-Based Care environment Evaluate data visualization techniques that enable self-service analysis of key performance indicators, permitting accountable leaders to focus constructive attention on lower performing facilities / practices / providers / support services Create a culture of "performance transparency" which is a prerequisite to enterprise deployment of self-service analysis of key performance indicators 4

5 Learning Objectives Apply knowledge management theory and collaboration technology to enable efficient Q&A and sharing of best (and worst) practices related to key performance indicators Evaluate data warehousing and business intelligence strategies that best enable a flexible and reliable enterprise scorecard infrastructure 5

6 6 22 hospitals 450 points of care 34K employees 2,400 provider CIN 7 markets One ministry. One calling. Zero AMCs 6

7 COPR Overview Development Leadership heavily involved in developing and setting performance targets for KPIs Many KPIs also have self-service drilldowns provided Each KPI is assigned a clinical and operational owner in each market, as well as a system leader and data analyst Deployment Reported at the system and (7) market levels Distributed to 700 Directors (and above) and 2,400 CIN providers on a monthly basis Each KPI has a dedicated SharePoint intranet site to encourage sharing of best practices and other collaboration 7 7

8 2018 COPR KPIs Strategic Initiative KPIs Net Revenue Growth Reducing Avoidable Readmissions Patient Safety Primary Care Access Disease Prevention (Primary Care 6) Reducing Opioid Dependency COPR KPIs Inpatient & ED Patient Experience 7 Day Follow Up (High Readmission Risk ACO) Medical Practice Patient Experience Profit/Loss per MCARE Patient by Condition Hospital Salaries & Supplies/WEIPA Domestic Admissions to Improve Quality CIN PCPs as a % of all PCPs in the Market Ambulatory Care Sensitive Condition Admissions RN Voluntary Turnover Reduce Epic Documentation Time 8

9 COPR Roles (Per KPI) System Leader Overall lead for the KPI, convenes regional Dyad Owners to share best practices System Data Analyst Responsible for data quality, answering data questions 14 (7 x 2) regional Dyad Owners held accountable for KPI performance Clinical Business 9

10 Actionability & Accountability Dyad Owners (and ultimately Regional CEO) held accountable for KPI performance Expectations set related to collaboration with other markets Dyad Owners KPI drilldowns provided where most beneficial Culture of performance transparency E.g. provider level performance is not blinded 10

11 KPI: MyChart Response Timeliness Links to KPI-dedicated site on intranet which includes: -Drilldown Analytics -Discussion Forum -KPI Profile Document -Dyad Owner Roster -Collaboration Documents links to Dyad Owners for this Market 11

12 COPR KPI Intranet Site

13 3 Key Takeaways from COO/CCO Each Month 13

14 More Than Charts Market Execs contribute text for Executive Summary which includes: Clinical KPI progress Operational KPI progress Strategic KPI progress Patient Story Clinician Story 14

15 Flip Builder for Online Presentation 15

16 COPR Miners A lot of data shoveling is involved in producing the COPR Not realistic that all the data for all the KPIs is sitting in a data warehouse Tough choices on what to fully automate vs. monthly flat file transfer Centralized EDW (COPR Mine) and BI team (COPR Miners) for COPR production and some of the KPI drilldowns De-centralized analyst teams for drilldowns where more appropriate Cognos for COPR, Tableau (mostly) for KPI drilldowns 16

17 Finding a Balance with Standardization Standardized look, production, process. Putting the K in KPI Important measures, but juice-not-worththe-squeeze for standardization 17

18 Practice Operations Performance Report (POPR) 18

19 Drilldown Example: Cost Per Case 19

20 Drilldown Example: Opioid Metrics 20

21 A Few Thoughts on Predictive Models & Advanced Analytics Review of abstract for this session: Discussions have moved on to data analytics and AI/predictive analytics on these KPIs, rather than building scorecards and dashboards themselves Predictive analytics, e.g. patients at high risk Not here on your for readmission, belong Enterprise Scorecard. here on the Key Driver Your board is not interested Diagram in a predicted readmission rate, they are interested in the outcome of a lower readmission rate 21

22 Challenges Opportunity cost of all the development effort KPI du jour sometimes means the hot new KPI this year drops off COPR next year E.g. MyChart message responsiveness Finding the balance between the perfect KPI and data oblivion Frustration with lack of progress on the most-difficultto-improve KPIs, e.g.: E.g. Acute care utilization rates E.g. Patient satisfaction 22

23 KPI: Inpatient & ED Patient Experience Top Quartile targets, but not top quartile performance Response: Added a new KPI for 2018 focused on reducing documentation time in Epic 23

24 COPR Key Success Factors Teaming of Execs, BI, and marketing results in a report that is actually fun to read BI team bandwidth dedicated to COPR production each month Collaboration sites + responsible parties being told to use them Exec bonuses tied to common Strategic Initiative KPIs 24

25 Recommendations Are your Execs onboard with driving the strategy, and willing to assign accountability for KPI outcomes? If not, stop, do not pass GO Formalize roles-per-kpi and assign the right people to them Figure out the communications / collaboration strategy that works for your organization Figure out the right balance of Business Intelligence standardization that works for your organization Right size total enterprise scorecard level of effort for your organization 25

26 Questions Matt Eversole, System VP, IT COO 26