Promise #1 The Promise of Coordinated and Patient Centered Care

1. Promise #1The Promise of Coordinated and Patient Centered Care September 25, 2008 Presented by: Stephanie Kitt RN MSN, Director Quality & Clinical Informatics David Liebovitz MD, CMIO Northwestern Memorial Hospital & Northwestern Medical Faculty Foundation Northwestern Memorial HealthCare

2. Panelists • Susan Heichert, VP Health Information & Systems Allina Hospitals & Clinics • Glenn Rodriquez MD, CMO Providence Health System • Bill Spooner Sr. VP & CIO Sharp Healthcare • Sidney Thornton PhD, Senior Medical Informaticist Intermountain Healthcare • Ronald Walters MD MBA, Associate VP Medical Operations & Informatics UTMD Anderson Cancer Center

3. Agenda • The Promises of IT • NUMC experience • Defining coordinated & patient centered care

4. The Promise

5. Promises of Healthcare IT • # 1 Coordinated, Patient Centered Care • # 2 Improved Quality and Safety • # 3 Efficient Cost Effective Care Key Drivers for Quality Care

6. Ranking Scheme for Prioritization Modified FMEA RPN = Severity Rank x Occurrence Rank x Detection Rank

7. Benefits Realization Number • Quantifies the benefits of the Clinical Information System • Based on three questions: • Is the CIS being used? • Does it make a difference in quality of care, clinician workflow, or business decision making? • Is the change related to the technology implemented? • Ranking value product of 3 numbers multiplied (highest 27) • Use 1-3 • Difference 1-3 • Sharing 1-3 Individual projects can be evaluated comparatively for benefit realization

8. Ranking Scheme – Benefits Realization BRN = Population Rank x Outcomes Rank x CIS Rank

9. The Benefits of CIS Improvements

10. The Benefits of CIS Improvements

11. What Do We Mean by Coordinated and Patient Centered • The deliberate organization of patient care activities to facilitate the appropriate delivery of health care services • Organizing care is often managed by the exchange of information among participants responsible for different aspects of care • Includes the patient Closing the quality Gap: A critical Analysis of Quality Improvement Strategies: Volume 7 – Care Coordination, AHRQ, June 2007

12. Care Coordination: The Importance • Care coordination is needed • Medicare beneficiaries see, on average, five physicians a year • Those with CHF, CAD, and DM see on average 13/year • Chronic conditions leading cause of morbidity & mortality • 75% of healthcare spending on chronically ill • Information transfer is a key feature impacting coordination** Identified by IOM as a key strategy to improve the healthcare system ** OECD, December 2007 Improved Health System Performance Through Better Care Coordination IOM: September 2006 Rewarding Provider Performance: Aligning Incentives in Medicare

13. The Promise of IT? • Improving communication • Better hand-off tools • Immediate access to current data • Improved decision making/care planning based on comprehensive and timely information • Effective interdisciplinary and inter-specialty communication • Reduction in duplicative testing • Providing patients’ access to their own health record ** Bates DW, & Gawande, AA, Improving Safety with Information Technology, NEJM 348: 2526-2534 (25), June 2003. **Formulating New Rules To Redesign and Improve Care, Crossing the Quality Chasm, pp.77, IOM, 2001

14. Where Are We?

15. On This Continual Climb!