HFHS Analytics Journey: A Path to Transformation

May 23, 2018

• 8 hospitals, 200 care sites, DME, Home Care, Pharmacy, 30,000 employee’s serving > 1M lives in Michigan

• EPIC EMR with advanced EDW platform, 2017 Davies Award winner

• Comprehensive physician organization:➢ Henry Ford Medical Group: 1300

physicians & scientists, 26 medical centers

➢ Henry Ford Physician Network: 2000+ employed and independent physicians

➢ Henry Ford (Next Gen) ACO: 1400+ physicians on HF instance of EPIC

• Provider-owned health plan (HAP), 650,000 members

• Diversified, comprehensive retail services

• 3.2 million digital encounters, including MyChart portal, e-visits, and mobile telehealth visits

Henry Ford Health System Snapshot

Birth of a new Department - 1974

Stan NelsonCEO, Henry Ford Hospital1974

Vin SahneyProfessor, WSU, Department of Industrial Engineering1974

Problem: Chair of Surgery was very upset because elective cases were being cancelled due to lack of beds.

1) Vin’s analysis found • there was no system for

bed projections and • beds were given on first

come first basis without considering surgical cases that had been booked

2) Developed a bed assignment system based on forecasting number of discharges by each day of the week and incorporating other factors like the number of expected emergency patient arrivals.

3) Project was a success!

4) The Operations Analysis department was established, and initially staffed by students from Wayne State and the University of Michigan

Improvement in Action and over time

Used broadly in our leadership system . . . .

Customer

Needs &

Engagement

Plan

DoCheck

Actd

Employee

Engagement

d = Debrief and evaluate effectiveness of improvement methods and tools

Continuous

Improvement

& Innovation

From designing new worksystems

▪ HF West Bloomfield Hospital

▪ Patient-Centered Medical Home

To kaizen events . . . To front-line daily improvement

1990s 2000s 2009-2010 2011-2012 2013 And Beyond

Q101, LAFCI, Local FocusRapid Cycle/ Lean work shop

Quality Expo for sharing

Leadership oversight of improvement Metrics CommitteeConsistent Definitions Comparative DB alignment

Helios ReportingAnalytics Delivery/ Pub. ReportingEDW StrategyIncentives to Improve

EDW StrategyAligned DashboardsPredictive AnalyticsStandardize and Spread

Analytics Journey Over time at HFHS

Overall Analytics Strategy

Specific Goals to Achieve the Strategic Initiative• Provide a composite source of truth for strategic and management analytics

• Create a standardized, integrated data “environment”, including a foundation for common, consistent metrics across the enterprise

• Enable appropriate and convenient access to metrics at all levels in all locations

• Provide advanced analytical capabilities for research and population health management

• Provide analytic capabilities to realize improved processes and resulting outcomes

7

Enhance and improve our enterprise information management and analytic capabilities to use information to improve performance and accelerate the identification and spread of best practices.

Overall Principles• Maintain on-site resource at hospitals and in functional areas. Ensure key contacts

for subject areas.

• Avoid silos with common process for assigning work and integration across teams and developing systematic approaches to solution architecture and strategic selection of tools

• Ensure joint ownership of reports, dashboards, data, measures with operations.

• Continue data stewardship to refine source system build, work flow, definitions, etc.

• Ongoing benchmarking with peer organizations

• Leverage Microsoft and Cogito Star for EDW and add other tools as needed.

• Adherence• Specialty Management• PBM & Rebate Management

• Talent Acquisition & Retention• Organizational Design• Training & Development

• IT & Telecom• Real Estate & Facilities• Sourcing & Procurement

Analytics are everywhere! Driving value across the enterprise….

• Product Design & Performance• Network Design & Performance• Pricing• Risk & Portfolio Management• Bid Development

• Brand & Identity• Marketing Mix• Campaign Effectiveness

• Channel Management• Sales Effectiveness• Broker Performance Management• Client Reporting & Analytics

• Customer Segmentation & LTV• Member 360• Cost Transparency• Customer Satisfaction & Retention • Experience Personalization

• Risk Identification & Stratification• Care Management• Health & Wellness• Program ROI/Effectiveness

• Cost of Care Analytics• Network Contracting & Negotiation• Provider Performance Management• Provider Data Management

• Competitive Landscape• Market Expansion• Innovation• Mergers and Acquisitions

• Accounting & FP&A• Reserving, Trend & MLR• Cost Accounting & Decision Support

System (DSS)• Risk Adjustment & Revenue

• Filings• HEDIS/Quality• STARS• Fraud, Waste & Abuse

• Operational Performance• Process Automation• Staff Optimization

• Attribution & Population Health• Incentive & Shared Risk/Savings• Episodes & Bundled Payments• Care Alignment• Clinical Pathways

Chief Executive

Officer

Chief Marketing / Consumer

Officer

Chief Medical Officer

Chief Operating

Officer

MARKET‏ & FINANCIAL

CUSTOMER‏

OPERATIONAL‏CLINICAL‏

& Product‏Pricing

& Marketing‏Branding

Sales & Client‏Mgmt

Customer‏Experience

Care‏Management

Pharmacy‏Management

& Value-Based Care‏Population Health

Back Office‏Operations

& Technology‏Facilities

& Regulatory‏Compliance

& Accounting‏Financial

Strategic‏Positioning

Human‏Resources

Network‏Management

Credit to Deloitte

HIMSS Analytics Maturity

Fosway Maturity Model

Dresner Maturity Model

Before everything else, getting ready is the secret of success.

Henry Ford

Analytics and Performance Review processes should support our Priorities

Communication & Integration

Performance Measures & Targets

Action Plans – Pillars/ Business Units

Strategic Objectives & Initiatives

Performance

Review

HFHSEnterprise

Individuals

Dept.Local

Teams

Business Units

System Teams

Goals and Measures should cascade across

the Organization

How are we doing?

Governance

Direction setting is done through functional and business unit teams with coordination, prioritization and integration of global initiatives and infrastructure.

Executive Council

Strategy and Operations

Revenue Cycle Steering

HFMG Ops Council

Clinical/ Operational

Councils

Surgical Council

Value Based Care

Critical Care

Standard Definitions where appropriate• Alignment across organizations, allows for

comparisons.

• For example: Volume statistics, Readmissions, Harm, Operational Statistics

• Unique metrics and definitions are developed as needed, but we always ask if we can make consistent which supports understanding performance and sharing best practices.

• Strategic Plan

• Budget Initiatives

• Balanced Scorecard Goals

• Big organizational changes

• New Contracts

• M&A

What do we work on?How do we prioritize programs?

User Types

• 1 & 2 click Users• Reports available in Epic that allow users to click & run or make small edits.

• Click on SharePoint dashboards and drill down to see additional details.

• 3 Click Users• Use predesigned data marts to do additional analysis in Excel ect.

• 4 Click Users• Use predesigned EDW data marts to create simple queries and do data

analysis.

• 5 Click Users• Full access to the clarity database and EDW.

Action Plan Measures

Quality STEEEP

Physician Scorecards

Nursing UnitEPIC Radar Dashboards

BU STEEEPHarm,

ReadmitCore Meas.

etc

Quality Example Cascade

Critical CareCAUTI Etc.

SharePoint Nursing Reports

Clinical Councils- Surgery Example

• Surgical metrics team is a sub-committee of the Surgical Clinical Council. They work as a group to prioritize analytic needs, agree on definitions, determine application and workflow modifications needed to accurately collect data, and monitor data integrity.

• They have multiple dashboards available that they have worked on together over time.

Hospital Radar Homepage

Reporting Workbench

Clarity Report

Clarity Report

Blend External & Internal Information

High Level Tracking of Populations

Information at the point of care

Data is moved upstream to

alert providers

Dashboards & Scorecards for Programs

• Feedback loop to front line staff

• Program dashboards available to entire health system

• Staff scorecards available to program manager and employees

Own Your Numbers!

“In God we Trust, all others bring data”

– W. Edwards Deming

“All models are wrong, some are useful”

– George Box

“Its tough to make predictions, especially about the future”

– Yogi Berra

Credit to Deloitte

Advanced Analytic Applications

Operational

• Staffing

• Coding Accuracy

• Patient Assignment

Clinical

• Readmission

• Population Risk

• Disease

Consumer Segmentation

• Loyalty

• Promotion

• Cross marketing

Being Data Driven- What is it really all about?• Synthesize data to improve performance with a focus on safety,

customer experience and value.• Lead local learning systems

• Understand Current State

• Investigate relationships

• Track impact of change

• Use Reliability and PDCA boards

• Put data in context

• Comparative Data- internal and external

• Trends

• Sampling

• Explore alternate data sources

• Patients and family members

• Staff

• Pareto charts

Overall Lessons Learned

• Link together the Strategic Plan, Annual Budget, and Performance Goals

• Build it into the standard work of Leadership Teams, Board Meetings

• Partner with visionary leaders and add value to them.

• Have data and information available in a timely manner

• Use technology to share documents and results for leadership teams and programs

• Do not take on managements’ responsibilities but also help coach with analysis, problem solving, and innovative suggestions

• Teach people to fish and leave the team stronger and more self-sufficient