Monday, March 2, 2015

Cost Reduction & Clinical Quality Improvement: Where Do You Get Started?

Below is a diagram with real data from a real healthcare system in the US, that shows the top clinical processes in terms of cost. The results are almost identical, across Health Catalyst clients. The notion with this data is, if you are trying to organize yourselves around a cost reduction and clinical improvement strategy, it’s probably a good idea to choose the top 3 or 4 of these to get started in the first year, then simply work your way through the list after that. It’s the same basic problem solving framework that the FAA uses in the United States for steadily improving airline safety and reliability.

The unique aspect of this data is that it combines inpatient and outpatient data into one perspective. In the past at Intermountain, we looked at inpatient and outpatient care processes as separate processes, and we called them Clinical Programs. Also, we didn’t have an effective algorithm for grouping these inpatient and outpatient data sets into a single view of the patient care process. That approach was definitely effective, but this new perspective is based on the availability of new data, mashed together with new grouping algorithms, plus the evolution of our awareness about how best to optimize the delivery of care, with the goal of extending inpatient/outpatient concepts into true population health in the community— that is, the outpatient experience will eventually include the socio-economic data environment of the patient.

This diagram is a reflection of work at Health Catalyst over the last three years. Dr. David Burton, who hired and partnered with Dr. Brent James on Intermountain's Clinical Programs, is the brainpower behind these new inpatient/outpatient grouping algorithms.

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