Becker's Hospital Review

10 Sign up for the COMPLIMENTARY Becker's Hospital Review CEO Report & CFO Report E-Weeklies at www.BeckersHospitalReview.com or call (800) 417-2035 the drivers of the disruptive innovations at Intermountain Healthcare. "The thing that's different this time around than in the early '90s when we bent the cost curve is a better data system," Dr. Savitz says. "We're looking at taking the data system to the next level and employing it to our work moving forward." Data plays a key role in patient activation, as it helps analyze an individual patient's data and puts it in the context of risks for additional health problems and options for reducing risks. In the hot spotting project, data enables Intermountain Healthcare to identify and address patterns of care. Today, ThedaCare continues to employ disruptive innovation as a strategy for improving care. One example is its redesign of primary care, which began in 2007. In the redesign, providers at ThedaCare's primary care offices changed their workflow to provide lab results for patients at the point of care. A medical assistant does the lab draw on site and the results are processed within 15 minutes, which allows the provider and patient to discuss the patient's results and plan of care in one visit. Prior to this redesign, patients would have to come in for separate appointments to have a lab draw and discuss the results. ThedaCare "It's a revised flow that really concentrates on the patient experience," says Jenny RedmanSchell, COO for physician services at ThedaCare. "We're making sure that we're identifying any waste within the process of the primary care office visit and trying to remove those wastes." ThedaCare was one of the first healthcare organizations to adopt Lean management as a method for process improvement, which is an example of disruptive innovation because it takes a new approach to improving care. Lean principles of process mapping, eliminating non-value-added steps and simplifying practices are based on the Toyota Production System and methods used in the manufacturing industry. By adapting this approach to healthcare, ThedaCare was able to make significant improvements in quality of care and cost. In addition, the primary care office staff schedule the patient's subsequent appointments during the same visit instead of leaving the responsibility of coordinating that care to the patient. The new process not only makes the provider visit more convenient for the patient, but it also The Rise of Big Data in Hospitals: Opportunities Behind the Phenomenon (continued from page 1) The rise of big data According to Joel Dudley, MD, director of biomedical informatics for The Mount Sinai Medical Center in New York City, healthcare organizations are realizing that all of their data can be captured and leveraged as a strategic asset. "Big data is not just about storing huge amounts of data. It's the ability to mine and integrate data, extracting new knowledge from it to inform and change the way providers, even patients, think about healthcare," says Dr. Dudley. Anil Jain, MD, CMIO of Explorys, a healthcare analytics company, and former senior executive director of information technology at Cleveland Clinic, calls the abundance of data in healthcare a "perfect storm." His description is fitting as a variety of factors have converged in the past few years, increasing the amount of digitized healthcare information: • he federal push for electronic health records has increased the numT ber of hospitals and providers who use them, subsequently increasing the amount of electronic data generated. • ewer reimbursement models and accountable care organizations N need large amounts of information to be analyzed in order to more accurately understand what occurs with patients. • ew technology in general, including devices, implants and mobile N applications on smartphones and tablets, has increased the amount of data available to providers. In addition, there is a lot of pressure to become evidence-based and predictive with healthcare services — to leverage historical data and to create predictive models, says Mr. Dudley. increases the likelihood that the patient will follow through with his or her plan of care. The key changes in the primary care redesign were adding on-site lab tests and processing within 15 minutes as well as ensuring patients leave with a plan of care. To implement the on-site labs, ThedaCare collected data on the most common labs at each office and acquired technology to perform those labs. "The lab work is something that we have not seen across the country at all, so for us to be able to draw the lab and process it within 15 minutes to get it to the provider is pretty transformational," Ms. Redman-Schell says. Disruptive innovation — why it works CHI, Intermountain Healthcare and ThedaCare's disruptive innovations uproot existing systems in favor of new approaches that simplify processes and reach new markets. These organizations recognized the need for a complete overhaul of healthcare delivery models instead of tweaks to the current system due to the rising cost of care, making them models of what can be accomplished through disruptive innovation. n Dr. Jain agrees, saying that without movement to aggregate, manage and analyze big data, the healthcare industry would be in information overload. For this reason, many hospitals and health systems have begun big data initiatives in their information technology and informatics departments. "[At Mount Sinai], we have a mandate to work together to leverage informatics to leverage the future of our healthcare services. We are invested in [big data]," says Dr. Dudley. "We are putting power behind informatics, big data and predictive modeling because it will be a big part of healthcare going forward. [The administration] is enabling us to start the dialogue and sit down with clinicians." Mount Sinai is not alone in this sense. Providers, patients and the entire healthcare industry may realize a variety of beneficial implications from the use and analysis of big data. 1. Better point-of-care decisions. Big data will change how physicians take care of patients at an individual level, fostering more personalized support right at a patient's bedside, says Dr. Jain. "The analysis to deal with big data can produce valid and relevant data that is more current, which gives physicians the means and motivation to make the right decisions at the right time," says Michael Corcoran, senior vice president and chief marketing officer of Information Builders, a business intelligence and software solutions company. For instance, NorthShore University Health System in Evanston, Ill., has seen the impact at the point-of-care through predictive modeling. As a result of its large data sets, the health system has developed models to identify which patients are likely carriers of a dangerous microorganism, Methicillin-Resistant Staphylococcus Aureus. By implementing the results of that modeling into its EMR, providers within the health system will receive alerts when a patient is admitted who meets the characteristics of being a high-risk carrier of MSRA, as determined by the predictive model.

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