Resource - Indiana Rural Health Association

Report
REDUCING PREVENTABLE READMISSIONS
THROUGH PREDICTIVE ANALYTIC MODELS
Curt Sellke - Vice President of Analytics
© 2014 Thrive HDS, Inc.
IHIE BACKGROUND
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Nation’s largest Health Information
Exchange (HIE)
Founded in February 2004
Based on the technology, knowledge,
and experience of the Regenstrief
Institute
Providing services to 96 hospitals (39
health systems), 25,000 clinicians,
and 4 payers
Serving an area with a population of
about 6.5 million people
© 2014 Thrive HDS, Inc.
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IHIE CDR DATA
IHIE operates one of the nation’s largest Clinical Data Repositories (CDR)
> 1 Network
> 96 Hospitals
> 25,000 Physicians
> 500,000 Daily Data Transactions
> 16,3000,000 Patients
> 120,000,000 Radiology Images/Reports
> 6,600,000,000 Pieces of Clinical Data (15TB)
© 2014 Thrive HDS, Inc.
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IHIE SERVICES
Health Data Sources
Value Added Services
Clinical Data Repository (INPC™)
- MPI & Record Locator Service
- Longitudinal Patient View
Hospitals
Clinical Results Delivery (D4D®)
- Web-based portal or EMR delivery
- No Cost to Physicians
Physician
Physician
Offices
Patient
Physician
Health Information
Exchange
Labs / Imaging
Centers
Data
Repository
Network
Applications
Public Health
© 2014 Thrive HDS, Inc.
Data
Governance
Rx
Public Health Integration and
Automation
- Bio-surveillance
- Communicable Disease Reporting
- Immunizations
Federal Government Services
- SSA Disability Determination
- VA’s VLER Program
Payers
Physician
ACO & Analytic Services
- ADT Alerts
- Predictive Analytics
Meaningful Use Supporting Services
- Transitions of Care
- Public Health Integration
OUTSIDE INDIANA
© 2014 Thrive HDS, Inc.
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WHY PREDICTIVE ANALYTICS?
> Lots of Rich, Disparate Data is needed to “Power”
Predictive Models; IHIE is a fantastic source for this data
> Strong Market Need, Limited Experience and Expertise
especially developing Predictive Models that use Clinical
Data versus Claims Data
> Huge Opportunities and Value if you can be
Predictive/Interventional versus Retrospective/Reactive
> We believe it is the “Right” next Step in the Evolution of a
Successful HIE (HIE 2.0)
© 2014 Thrive HDS, Inc.
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DO YOU KNOW WHERE YOUR
PATIENT IS?
> As a member of a CMS chartered ACO, a patient
can seek care anywhere in or outside the ACO.
They are not bound to a single network or
provider.
> This makes knowing where your patient is or has
been even more challenging especially when you
have clinical & financial responsibility for that
patient!
© 2014 Thrive HDS, Inc.
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ADT ALERTS
Enables Providers to:
> Track where and when care has been delivered, especially
if outside of the patient’s attributed care network
• Information comes from HL7 ADT
(Admission/Discharge/Transfer) Messages
> Examine the patient’s chief complaint
> Process the preliminary diagnosis
> Optimize care site transitions
> Identify providers in the continuum of care
© 2014 Thrive HDS, Inc.
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ADT ALERTS ARCHITECTURE TODAY
IHIE Current ADT Alerts Service
List of Patients
Including Demographics
Needed for Patient
Matching
INPC
Client
HL7 Messages
From Hospitals
ADT Alert Data
For Any Patient with ED/
Inpatient Registration over
Past 24 Hrs
IHIE CDR
© 2014 Thrive HDS, Inc.
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94 Hospitals
Connected to
INPC
ADT ALERTS CASE STUDY
ADT Alerts to Reduce ED Visits
> Results of a 6 month pilot with a
managed health care plan in Indiana:
•
53% reduction in non-urgent ED visits
•
68% increase in Primary Care office visits
•
Nearly $4 million saved
© 2014 Thrive HDS, Inc.
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MAKING ADT ALERTS MORE
PREDICTIVE, MORE VALUABLE
> We are working with Predixion Software to
develop a model to predict the probability of a
preventable readmission occurring within 30 days
of discharge
> We are “wiring” this predictive model into our
ADT Alerts system; any time an inpatient
admission happens, we will score the probability
of that patient being readmitted within 30 days of
discharge
© 2014 Thrive HDS, Inc.
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FUTURE ADT ALERTS ARCHITECTURE
(Q2 OF 2014)
IHIE ADT Alerts Service
plus Predictive Readmissions Scoring
List of Patients
Including Demographics
Needed for Patient
Matching
INPC
94 Hospitals
Connected to
INPC
Client
HL7 Messages
From Hospitals
ADT Alert Data For Any Patient with ED/
Inpatient Registration over Past 24 Hrs
PLUS
Predictive Score, Risk Stratification,
3 – 5 Risk Influencers
Clinical Data from CDR
For Predictive
Readmissions Scoring
IHIE CDR
Predictive Score,
Risk Stratification
3 – 5 Risk Influencers
© 2014 Thrive HDS, Inc.
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Predixion Software Predictive Analytics Platform
OTHER POTENTIAL USE CASES
OUTSIDE ACOS
> ADT Alert on Admission and/or Discharge to the Patient’s
PCP to enable more effective transitions of care
> Medicare is financially supporting “Transitional Care
Management Services” by encouraging PCPs to see Patients
within 7 to 14 days of discharge and providing new CPT Codes
(99495 and 99496) to provide payment for these services
> ADT Alerts coupled with a Prediction of the potential for
Readmission within 30 days can help PCPs and their staff
focus resources on those patients that have the highest
probability for readmission
© 2014 Thrive HDS, Inc.
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THANK YOU
Curt Sellke
Vice President, Analytics
> [email protected]
> Office: 317-735-4084
> Twitter: @CurtSellke
© 2014 Thrive HDS, Inc.
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