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Reporting and Analytics: Evolution of Information Needs Enabling system change by transforming data to insight. May 2013. Faculty/Presenter Disclosure. Presenters: Shez Daya and Alvin Cheng Relationships with commercial interests: Grants/Research Support: nothing to disclose

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slide1
Reporting and Analytics: Evolution of Information Needs

Enabling system change by transforming data to insight

May 2013

faculty presenter disclosure
Faculty/Presenter Disclosure
  • Presenters: Shez Daya and Alvin Cheng
  • Relationships with commercial interests:
    • Grants/Research Support: nothing to disclose
    • Speakers Bureau/Honoraria: nothing to disclose
    • Consulting Fees: nothing to disclose
    • Other: nothing to disclose
introduction
Introduction
  • How can we improve ALC rates?
  • How can we improve the quality of patient care?
  • There are numerous challenges in health care, that need to be solved
  • Technology can support health care providers to begin to tackle these problems but this is only the one step
  • We propose that the next step is through the utilization of information:

“Currently, healthcare providers are underutilizing 90 percent of [health care] information”

McKinsey Global Institute

  • How can we reduce avoidable readmissions?
  • What % of referrals are denied and for what reason?
  • Are providers meeting target response timeframes?
slide5

What is RM&R?

A shared electronic tool that enables matching of patients to appropriate clinical programs/services and transmission of electronic referrals between 86 acute, rehabilitation, complex continuing care, home care, long-term care and community support health service providers (HSPs) in the Toronto Central LHIN

rm r project highlights
RM&R Project Highlights

RM&R is one of the fastest-moving and most coordinated regional implementations in Ontario

  • Who currently uses RM&R?
  • 86 Health Service Providers
    • 7 Acute Hospitals (Med/Surg units and 7 EDs)
    • 1 Mental Health Facility
    • 8 Rehab/CCC Hospitals
    • Toronto Central CCAC
    • 34 Community Support Services Agencies
    • 37 Long Term Care (LTC) homes
    • (including 3 Convalescent)
  • RM&R by the numbers
  • Clients can be matched to:
  • 25 Community Support Services
  • 60 Rehab/CCC programs & services
  • 5,897 LTC beds
  • 27, 587active registered users
  • 80, 581 logins on average per month
  • 109,995 unique clients referred (Feb/08 – Mar/13)
slide7

RM&R Program Objectives and Components

Resource Matching and Referral - Program Objectives

Provide equitable access to care

Enhance the quality of care and improve patient safety

Streamline the referral process

Allow for real-time access to timely, legible, complete and a comprehensive inventory of programs/services

Have a single source of system-wide referral data for planning purposes

Provide information on health system utilization and potential service gaps

Information Standards

Technology

  • Determining the common data set and business processes

Reporting and Analytics

  • Technology that is integrated, secure and intelligent
  • Capability to use the data to support decision making
reporting and analytics the evolution
Reporting and Analytics: The Evolution

2008

Reports to Demonstrate Benefits of System Use

“Tipping Point”

GAPS

GAPS

GAPS

reporting and analytics the evolution1
Reporting and Analytics: The Evolution

2010

Reports to Understand Patient Transitions

“Tipping Point”

GAPS

GAPS

GAPS

reporting and analytics the evolution2
Reporting and Analytics: The Evolution

2012

Reports to Align Data with System Level Goals and build Accountability

“Tipping Point”

GAPS

GAPS

GAPS

reporting and analytics the gaps
Reporting and Analytics: The Gaps
  • “One-size” doesn’t‘ fit all
  • Limited understanding of what the information means
  • Not all the right players were at the table
  • Low awareness, low engagement

“Tipping Point”

GAPS

GAPS

GAPS

reporting analytics what s the formula
Reporting & Analytics: What’s the Formula?

Information Insight… Change Makers… Pursuit of Action…

information insight translating data into information to create understanding
Information Insight: Translating Data into Information to Create Understanding
  • Information Insight:
  • What: the questions needing to be answered
  • How: how information is presented and interpreted

Right questions for the problem, dynamic information

Broad, untargeted questions, static data

information insight gaps and approach
Information Insight: Gaps and Approach

Gaps

  • One-size” doesn’t‘ fit all - Reports were not meeting all stakeholder groups needs
  • Limited understanding of what the information means - Quality over quantity

Approach

  • 17 Site Visits
  • Clinical and Data Experts
  • Elicit feedback about reports
  • Elicit information needs of varying stakeholder groups
information insight goals by audience interactive visual reports
Information Insight: Goals by Audience + Interactive Visual Reports

Outcomes

  • Identified 3 broad groups of stakeholders with different information needs
  • Revised report structure to match stakeholder needs
  • Modified delivery and presentation of reports
change makers gaps and approach
Change Makers: Gaps and Approach

Gaps

  • Reports were often only going to decision support experts; many clinical leaders were not reviewing reports

Approach

  • Review of stakeholders:
    • distribution lists for regular reporting
    • committee memberships
    • Identification of forums and existing networks
  • Ensured site visits included engagement of both clinical and decision support experts from each organization
change makers leaders planners decision support stakeholders
Change Makers: Leaders, Planners, Decision Support Stakeholders

Outcomes

  • Individual health system planners, organizational leaders and decision support stakeholders are comprised in the following segments that utilize RM&R data:
pursuit of action gaps and approach
Pursuit of Action: Gaps and Approach

Gaps

  • Low awareness, low engagement - engagement to date had been passive with little call for action

Approach

  • Leverage momentum from site visits to engage in dialogue around information
  • We sought invitations to different groups and forums to discuss meaning of RM&R data
  • Leverage existing governance and forums
  • Use technology (i.e. webinars) to reach a broader audience
pursuit of action active dialogue
Pursuit of Action: Active Dialogue

This is the “do something” part.

Dialogue stimulates a plan of action

Action begets action.

Outcomes

Action Cycle:

  • Actively approaching Existing Networks and forums outside of RM&R to initiate dialog
  •  Support organizations to establish mechanisms to review and action information
  •  Process established within RM&R governance to review and action information
stimulating system change1
Stimulating System Change

2013

4th Gen. Reports to Improve Understanding

“Tipping Point”

stimulating system change the signs
Stimulating System Change: The Signs
  • Web traffic is significantly greater than anecdotal use of previous reports
  • Many organizations have extended invitations to the program to present and discuss data
  • Analytics proposals have generated interest from stakeholders
  • RM&R information currently being used within organizational and system planning processes
rm r system level reports
RM&R System Level reports
  • Hospital
  • Hospital
  • Hospital
  • Hospital
  • Hospital
  • Hospital
  • MH&A
  • The RM&R Program supports many of the LHINs strategic priorities
  • Initiated to support the ER/ALC imperative but now supports the work of the LHIN Quality Table as well
  • RM&R is a key data-source for some of the big and small-dot indicators
  • MH&A
  • MH&A
  • MH&A
  • MH&A
  • MH&A
  • LTC

Big-Dot Indicators

  • LTC
  • LTC
  • LTC
  • LTC
  • LTC

Big-Dot Indicators

Big-Dot Indicators

Big-Dot Indicators

Big-Dot Indicators

Big-Dot Indicators

  • CSS
  • CSS
  • CSS
  • CSS
  • CSS
  • CSS
  • CCAC
  • CCAC
  • CCAC
  • CCAC
  • CCAC
  • CCAC
  • CHC
  • CHC
  • CHC
  • CHC
  • CHC
  • CHC
sample report referral decision rendered within 2 days
Sample Report – Referral Decision Rendered within 2 days

Hospitals

Finding:82% of TC LHIN referrals have a decision rendered within 2 days. Considerable variation in decision time among receiving facilities – ranging from 64% to 96%.

slide34

Sample Report – Denial Reasons for Rehab/CCC

Finding:26% of referrals from acute to rehab/ccc hospitals were denied in Q3 2012/13. “Medical needs cannot be accommodated: Other” and “Not rehab ready: inconsistent participation/tolerance” were the most common reasons for a denied referral.

moving forward
Moving Forward
  • LHIN perspective is one example of how RM&R data has begun to stimulate change
  • Each organization has their own goals – the work completed to date has aligned RM&R to help drive progress against those goals
  • The “tipping point” is a place to start – infinite potential to continually improve and tailor the information to needs of organizations
  • Will pursue further enhancements
    • Business Intelligence solutions
    • Ability to link data from across organizations to understand the patient journey
thank you
RM&R Program

Alvin Cheng - Alvin.cheng@uhn.on.ca

TC LHIN

Shez Daya - Shez.daya@lhins.on.ca

Thank you