Transcript Resource - Indiana Rural Health Association
REDUCING PREVENTABLE READMISSIONS THROUGH PREDICTIVE ANALYTIC MODELS
Curt Sellke - Vice President of Analytics © 2014 Thrive HDS, Inc.
IHIE BACKGROUND
> > > > > 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 2 © 2014 Thrive HDS, Inc.
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) 3 © 2014 Thrive HDS, Inc.
IHIE SERVICES
Health Data Sources
Physician Hospitals Physician Offices Patient Physician Labs / Imaging Centers Public Health Physician Payers © 2014 Thrive HDS, Inc.
Rx
Health Information Exchange Data Repository Network Applications Data Governance Value Added Services Clinical Data Repository (INPC™)
- MPI & Record Locator Service - Longitudinal Patient View
Clinical Results Delivery (D4D®)
- Web-based portal or EMR delivery - No Cost to Physicians
ACO & Analytic Services
- ADT Alerts - Predictive Analytics
Public Health Integration and Automation
- Bio-surveillance - Communicable Disease Reporting - Immunizations
Federal Government Services
- SSA Disability Determination - VA’s VLER Program
Meaningful Use Supporting Services
- Transitions of Care - Public Health Integration
OUTSIDE INDIANA
© 2014 Thrive HDS, Inc.
5
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) 6 © 2014 Thrive HDS, Inc.
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!
7 © 2014 Thrive HDS, Inc.
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 8 © 2014 Thrive HDS, Inc.
ADT ALERTS ARCHITECTURE TODAY
IHIE Current ADT Alerts Service Client List of Patients Including Demographics Needed for Patient Matching © 2014 Thrive HDS, Inc.
ADT Alert Data For Any Patient with ED/ Inpatient Registration over Past 24 Hrs IHIE CDR 9 INPC 94 Hospitals Connected to INPC HL7 Messages From Hospitals
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 10 © 2014 Thrive HDS, Inc.
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.
11
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.
12 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 13 © 2014 Thrive HDS, Inc.
THANK YOU
Curt Sellke Vice President, Analytics > > > [email protected]
Office: 317-735-4084 Twitter: @CurtSellke © 2014 Thrive HDS, Inc.
14