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Implementation Network Webinar. April 25, 2014. Welcome! This is our first "Implementation Network Webinar". Objectives for today Present why we believe in Outcomes Measurement Share our perspective on the "Implementation Journey"

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Implementation network webinar

Implementation Network Webinar

April 25, 2014


Welcome this is our first implementation network webinar

Welcome!This is our first "Implementation Network Webinar"

  • Objectives for today

    • Present why we believe in Outcomes Measurement

    • Share our perspective on the "Implementation Journey"

    • Present support offered by ICHOM: the "Implementation Network"

Free

For organizations actively implementing our Standard Sets


Who is presenting today

Who is presenting today

Dr. Jens Deerberg

Mrs. Lisa van Maasakkers

Mr. Jean Stoefs

  • President of ICHOM

  • Faculty Member of Harvard Business School

  • Background

    • Medical Doctor

    • COO of a large private hospitals chain in Europe

  • Project Leader at ICHOM

  • Background

    • Expert in Outcomes Measurement

    • Head of Quality of a leading European Hospitals chain

  • ICHOM Vice-President of Implementation

  • Background

    • Master in Business

    • Consultant specialized in Value-Based Health Care


Many participants from all over the world today 228 participants from 28 countries

Many participants from all over the world today!228 participants from 28 countries

This Webinar is recorded for the ones

in less convenient time zones


Agenda

Agenda

The case for outcomes measurement: 20 minutes

(Jens Deerberg-Wittram, President, ICHOM)

What the implementation journey looks like: 30 minutes

(Lisa van Maasakkers, Project Leader, ICHOM)

How to join the Implementation Network: 10 minutes

(Jean Stoefs, VP Implementation, ICHOM)

Questions and answers


Variation in health outcomes is an international problem

Variation in health outcomes is an international problem

variation in 30-day mortality rate from heart attack in US

variation in bypass surgery mortality in the UK

variation in complication rates from radical prostatectomies in the Netherlands

variation in reoperation rates after hip surgery in Germany

variation in mortality after colon cancer surgery in Sweden

variation in capsule complications after cataract surgery in Sweden

2x

4x

9x

18x

20x

36x

Variations in health outcomes can be found in care teams, within institutions, nationally, internationally…


Localized prostate cancer what is the right therapy

Localized prostate cancer – what is the right therapy?


Mortality rates alone are not the answer

Mortality rates alone are not the answer

Death from prostate cancer

Death probably or definitely due to prostate cancer or prostate cancer treatment

Source: Wilt et al., N Engl J Med 367;3 2012


Florence nightingale one of the first women studying mathematics and statistics

Florence Nightingale – one of the first women studying mathematics and statistics


Implementation network webinar

“If the function of a hospital were to kill the sick, statistical comparisons of this nature would be admissible..”Florence Nightingale, 1863


Outcomes are the real world experience of patients example prostate cancer

Outcomes are the 'real world' experience of patients Example prostate cancer

Patient

initial

conditions

Protocols/

guidelines

Structure

Processes

Patient experience/

engagement

e.g., Staff certification, facilities standards

PSA

Gleason Score

Surgical margin

(…)

Indicators

Survival

Complications

Quality of life

Continence

Erectile function

Anxiety

(Health) outcomes


Patient reported outcomes one year after prostatectomy average german and swedish hospitals

Patient-reported outcomes one year after prostatectomy - average German and Swedish hospitals*

Ø

80,0 %

Ø

75,5 %

Ø

56,7 %

Ø

50,0 %

Ø

10,0 %

Ø

4,5 %

*Swedishdataroughestimatesfromgraphs

Source: National quality report for the year of diagnosis 2012 from the National Prostate Cancer Register (NPCR) Sweden, BARMER GEK Report Krankenhaus 2012, Patient-reported outcomes (EORTC-PSM), 1 year after treatment, 2010


Martini klinik nine consultants focusing on outcome improvement in prostate cancer

Martini Klinik, nine consultants focusing on outcome improvement in prostate cancer


Implementation network webinar

Martini Klinik Hamburg is openly discussing detailed outcome data in regular quality reviews and achieve excellent results

Martini

Klinik

93,5 %

Ø

80,0 %

Ø

75,5 %

Ø

56,7 %

Ø

50,0 %

Martini

Klinik

34,7 %

Ø

10,0 %

Ø

4,5 %

Martini

Klinik

0,4 %

Swedishdataroughestimatesfromgraphs

Source: National quality report for the year of diagnosis 2012 from the National Prostate Cancer Register (NPCR) Sweden, Martini Klinik, BARMER GEK Report Krankenhaus 2012, Patient-reported outcomes (EORTC-PSM), 1 year after treatment, 2010


Aravind clinic created web portal for physicians to review their just in time outcome data

Aravind Clinic created web portal for physicians to review their just in time outcome data

Web portal evolved from Excel-based reports, as physicians required more user-friendly tools

Source: Aravind Eye Care Hospitals Cataract Surgery Outcome Monitoring training document illustrative report view


Memorial sloan kettering cancer center is running a surgeons performance feedback system

Memorial Sloan Kettering Cancer Center is running a surgeons' performance feedback system

  • Screen shot from the Memorial Sloane Kettering Cancer Center surgeon performance feedback system:

  • The proportion of a surgeon’s patients who are recurrence free at two years on the x axis is graphed against the proportion of patients both potent and continent at two years (y axis). Both estimates are adjusted for case mix.

Source: Vickers et al.,Eur Urol. 2012 February ; 61(2): 284–289


Implementation network webinar

ICHOM is dedicated to accelerating the development and impact of outcomes measurement at a Global level

Our mission

How we achieve it

We develop Standard Sets of Outcomes

We enable organizations to implement them and measure outcomes

We facilitate Global Comparisons (as of 2015)

1

Our Mission

We are transforming health care by empowering clinicians worldwide to measure and compare their patients’ outcomes and to learn from each other how to improve.

Value =

Patient health outcomes achieved

Cost of delivering those outcomes

2

2


Agenda1

Agenda

The case for outcomes measurement: 20 minutes

(Jens Deerberg-Wittram, President, ICHOM)

What the implementation journey looks like: 30 minutes

(Lisa van Maasakkers, Project Leader, ICHOM)

How to join the Implementation Network: 10 minutes

(Jean Stoefs, VP Implementation, ICHOM)

Questions and answers


Implementation network webinar

There are four key stages in the implementation journeyHow to transform a Standard Set in a tool to drive change

Convince and create buy-in

Get ready

Measure

Drive change

Convince your board/management

Obtain support from your staff

Identify "Evangelists"

Set up governance and project team

Assess your starting point

Assess the business case for outcomes measurement in your organization

Use tools to capture data

Ensure quality of data

Analyze data

Report data

Learn from your data to identify and disseminate best practices

ICHOM can assist you in every stage of the journey


Measuring outcomes requires the buy in of both the top management and the teams on the field

Measuring outcomes requires the buy-in of both the top management and the teams on the field

Convince and

create buy-in

Get ready

Measure

Drive change

What will resonate with them

  • Increasing quality typically reduces costs

  • Proving superior outcomes attracts more patients

  • Measuring outcomes allows to actively manage staff

  • Introducing new pricing models

  • Be proud of your results

  • Care even better your patients

  • Identify what to improve

  • Measure impact of decisions and improvements

  • How ICHOM can help you

    • Ready-to-use documents to present the initiative to your Board/Management and to your team

    • Success stories and proof of impact

QUALITY MANAGEMENT


Set up governance and project structure

Set up governance and project structure

Convince and

create buy-in

Get ready

Measure

Drive change

The "ideal team" you need...

... ready for a one-year journey

  • A Steering Committee

    • Physician leader

    • Nurse leader

    • Senior administrator

    • Senior representative from IT

  • A team on the field to drive effort

    • One Junior doctor, passionate

    • One nurse

    • One admin staff

    • Analyst (preferably from IT)

    • Support from a central team (e.g. quality team)

They will dedicate a few hours a week to drive Outcomes Measurement

  • How ICHOM can help you

    • Ready-to-use Project Charter

    • Detailed role descriptions

    • Ready-to-use Project Timeline

It's key to have people from the field involved


Assess your starting point gap analysis will inform the effort

Assess your starting pointGap analysis will inform the effort

Convince and

create buy-in

Get ready

Measure

Drive change

What is already measured?

How to measure what's missing?

Outcomes domains

(e.g. for Localized Prostate Cancer)

  • How ICHOM can help you

    • Ready-to-use Excel tool to assess your starting point

    • Overview of existing solutions to help choose the right technical tool to capture outcomes

Measured

Paper-based questionnaires

Major surgical complications

Major Radiation complications

Urinary incontinence

Urinary frequency/urgency/ irritation

Bowel irritation

Sexual dysfunction

Vitality

Biochemical recurrence

Metastasis

Cause-specific survival

Overall survival

Patient baseline (age, co-morbidities,...)

Other definition

Other definition

Other definition

Standalone IT solutions

Solutions integrated with your EMR/EHR

What is the effort to measure ICHOM

recommended Standard Set?


Build the business case how much does it cost

Build the business case: how much does it cost ?

Convince and

create buy-in

Get ready

Measure

Drive change

Key sources of costs

  • Financial resources: investments in an IT tool, in equipment (e.g. scanner,...),...

  • How ICHOM can help you

    • Ready-to-use framework to assess costs/resources

    • Impact stories

  • People: How many people will you need to set-up and run outcomes measurement?

  • IT resources: dedicated software, data warehouse,...

  • Time investments from key staff: Physicians, nurses and admin staff to collect outcomes and analyze them


When you go live the journey is not over storage and quality of data must remain two key concerns

When you go-live, the journey is not over... storage and quality of data must remain two key concerns

Convince and

create buy-in

Get ready

Measure

Drive change

Capture data

Define your data capture plan

Store them in a database

Several options depending on context

Local database

(e.g. MS Access)

Electronic Medical Records

Hospital

Data warehouse

  • How ICHOM can help you

    • Template of data capture process

    • Ready-to-use questionnaires

    • Ready-to-use MS Access database

Ensure Quality

  • Results can be quickly disqualified if teams are not convinced by the quality of data

    • Regular touch point with key staff (physicians, nurses) to validate findings

    • Continuous improvement process in place to fix "bugs"


Learn from your data to drive change and unlock the power of value based health care

Learn from your data to drive change and unlock the power of value-based health care

Convince and

create buy-in

Get ready

Measure

Drive change

  • How ICHOM can help you

    • Examples of reporting

    • Change management best practices

    • Guides to organize "Improvement workshops" with your clinicians

Transparent outcomes data

reporting

  • Discuss data at different levels

    • Between physicians

    • Between sites/hospitals

  • Take actions

Continuous feedback&learning

Increased health care value

+

Drive adoption of changes

Improved Outcomes

Reduced Variation

Reduced Medical Cost


Agenda2

Agenda

The case for outcomes measurement: 20 minutes

(Jens Deerberg-Wittram, President, ICHOM)

What the implementation journey looks like: 30 minutes

(Lisa van Maasakkers, Project Leader, ICHOM)

How to join the Implementation Network: 10 minutes

(Jean Stoefs, VP Implementation, ICHOM)

Questions and answers


Implementation network webinar

Implementing Outcomes Measurement is not straightforwardICHOM can assist you with 3 different levels of support

Download our

"Reference Guides"

Join the

Implementation Network

Get on-site support

Clear and unambiguous definitions to implement our Standard Sets

Resources to help you get started

Community to connect with your peers and ask questions

Regular Webinars to share content and discuss your issues

Official recognition of your efforts

  • Our ICHOM team provides on-site support to select partners

    • E.g. 4-weeks diagnostic, seminars,...

  • This is only offered to selected ICHOM Sponsors

Free on our website

$500 per Medical Condition

(launch price)

Contact us


Implementation network webinar

We will host regular Webinars to accompany you through your implementation journey - one year to measure outcomes!

Our objective:

Whatever your starting point, you will be able to measure our full Standard Set within a year

We will accompany you in this journey!

Key topics for the call

Date1

Convince &

Create Buy-in

  • Objectives of the Implementation Network, calls agenda and your expectations

  • What is the case for outcomes measurement?

  • What the Implementation journey will look like

Today

  • Typical call (1:30)

    • Milestones of the month

    • Success story of one of our members

    • Content discussion (with an expert or a guest who will share his experience)

    • Presentation of useful material available on the Implementation Network

    • Key milestones for the next month(s)

  • How to assess the resources I will need? (financials, team,...)

  • What is the best strategy to get started? (small vs. big)

Early June

Get Ready

  • What are the legal requirements I should consider (patient consent, data collection,...) ? What are my obligations?

August '14

  • What are the tools available to help me measuring outcomes?

  • Should I outsource parts of the process?

September '14

  • How to store the data collected? What are the best practices?

  • How to risk adjust? How to ensure validity and accuracy?

November '14

  • How to analyze my data and make sense of it?

  • How to report data in an appealing way? What does a typical report look like?

January '15

Measure

&

Drive Change

  • How to report it back to the clinicians?

  • What does the typical feedback process look like? (data validation,...)

February '15

All resources will be available online on our Implementation Network website so that you can progress at your own pace

  • How to learn from our findings and drive change that lasts?

March '15

  • Wrap-up

April '15

Dates and exact agenda will be refined and confirmed to the Implementation Network members. Agenda might evolve based on Participants needs


How to join us

How to join us?

www.ICHOM.org


Agenda3

Agenda

The case for outcomes measurement: 20 minutes

(Jens Deerberg-Wittram, President, ICHOM)

What the implementation journey looks like: 30 minutes

(Lisa van Maasakkers, Project Leader, ICHOM)

How to join the Implementation Network: 10 minutes

(Jean Stoefs, VP Implementation, ICHOM)

Questions and answers


Any questions

Any questions?

  • Thanks for joining today!

  • Send your remarks or questions to

  • [email protected]


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