Automated, Standardized Reporting of Patient Safety and Quality Measures to

Enable Faster Action and Time to Improvement

August 2 nd, 2012

2

Today’s Presenters‣ Ryan Hayden

Healthcare Principal

315-380-0672

rhayden@edgewater.com

‣ Neil Ravitz

Chief Operating Officer (COO)

for the Chief Medical Officer (CMO)

Neil.ravitz@uphs.upenn.edu

► University of Pennsylvania Health System (UPHS) Overview

► Edgewater Corporate Overview

► Objectives for Patient Safety and Quality Dashboard Project

► Case in Point –

– Project Overview– Brief Technical Description– Primary Business Benefits

► Dashboard and Report Live Demonstration

► Ongoing Learning and Development

► Appendix: Technical Description of Solution & Architecture

Agenda

3

Consulting firm that brings a blend of advisory services and product-based technology solutions to assist our clients with improving profitability, driving performance improvements, and accelerating growth

► Founded in 1992► Focus on upper-middle and global 2000 markets► 420+ employees► 800+ clients► 3,100+ projects completed to date► 95% client retention rate► Large North American footprint

– New UK presence

► Publicly traded (NASDAQ: EDGW)– Public in 2002

► Co-founders still with the Company

Edgewater Corporate Overview

4

5

Summary of Edgewater’s Healthcare Practice

Sample Clients• EDW/BI Strategies & Roadmaps

• Data Quality, Architecture

• Data Governance

• Tool Evaluation & Selection

• Data Marts/EDW Implementation

• Reporting, Dashboards, & Analytics Implementation and Planning

• Quality of Care, Patient Safety

• Surgical Analytics

• Service Line Analytics

• Utilization & Cost

• Patient Panel and Physician Relationships

• CRM in Healthcare

• Finance Budgeting, and Strategic Planning

BI & Technology Experience

Functional Experience

► Perelman School of Medicine and The University of Pennsylvania Health System

► Comprised of three hospitals with more than 1,700 beds► More than 78,000 admissions per year► More than 2 million outpatient visits► More than 2,200 physicians and more than 21,000 employees► HUP – USNWR Honor roll hospital ► Located in the heart of Philadelphia!

Penn Medicine Overview

6

Patient Safety and QualityIntegrated Data Solution

� Penn Medicine �Blueprint for Quality and Patient Safety

Penn Medicine will eliminate preventable deaths and preventable 30-day readmissions by July 1, 2014

Imperatives Priority Actions

Accountability For Perfect Care

� “Always” events - strive to provide perfect care

� Implement clear lines of accountability that span inpatient and ambulatory environments

Patient and Family-Centered Care

� Provide consistent and thorough communication with families & patient regarding plan of care

� Increase patient and family involvement in UPHS forums that address issues relevant to quality, safety and service excellence

� Enhance patient-provider partnership through better exchange of information

Transitions In Care /Coordination Of Care

� Ensure all UBCLs implement redesign care processes related to:

– Risk stratification

– Interdisciplinary rounding

– Discharge hand-off to outpatient care

Reducing Unnecessary Variations In Care

� Eliminate variations in care processes where evidence exists

� Balance conformity in practice with needs for personalized care

� Set goals that are positive and proactive

Provider Engagement, Leadership, And Advocacy

� Strengthen organizational capacity and capability for continuous improvement

� Increase involvement of house staff in quality, safety and service excellence efforts

8

Three-Way Partnership is Penn’s “Swiss Army Knife” for Managing Quality on the Hospital Units

9

Three-Way Partnership on the Hospital Units

This isn’t a project, it’s a way of doing things. You can bolt different strategies onto it.

“

—UPHS CFO”

We needed a multi-purpose solution on the units to handle almost any Quality problem.

We call these trios “UBCLs,” for “Unit Based Clinical Leadership.”

Vision: Advanced Analytics for Quality Data

ExecutiveUser

Functional User

Power User

Highly Aggregated/C-Level

Analyst/Informaticist

• Alignment with Quality Blue Print objects

• Improve resource utilization; patient satisfaction

• Align quality improvement / PI with industry reform

• Reduce costs by automating report development

• Improve compliance with regulatory mandates

• Targeted education for units / clinicians underperforming

• Analytic & reporting tools

• Report development and distribution

• Monitor data quality; standardize vocab.

The Right Information. To the Right People. At the Right Time.

CEQI, Quality Department

- Coordination of Care- ALOS- Quality Compliance

- Core Measures- HCAHPS- HAI’s- QI / PI

- SCIP, PN, AMI- Falls- Satisfaction- Events, Errors

10

Enterprise Objective: Work Smarter

11

Collect Data

Collect Data Collect Data

Analyze

Information

Analyze

Information

Analyze

Information

Decision Making &

ActionDecision Making &

Action

Basic / Classic Reporting

% T

ime

Spe

nt

Collect Data

Collect Data Collect Data

Analyze

Information

Analyze

Information

Analyze

Information

Decision Making &

ActionDecision Making &

Action

BI & Analytic Tools

Less Mature More Mature

% T

ime

Spe

nt

WhereWe

WERE

Where We’re

GOING

Clinical Care

Patient Safety & QualityAnalysts

Organizational Deployment: Communication & Execution

12

Entities AnalystsPI Champions

UBCL

Surgeons Nursing

Physicians

Process Change

Change Mgmt

Project Mgmt

Standard Reports

Alerts &Dashboards

Safety & QualityData Collection

Establish / UpdatePriorities

Provide Support &Analysis

Data Mart

PS&Q AnalyticsData Mart

Steering Committee

Local Responseto Q&S Metrics

Capture &Analyze

Implement &Improve

IT / EDW Support

PI

Identify

Implement

PilotDesign

Justify

PI

Identify

Implement

PilotDesign

Justify

PI

Identify

Implement

PilotDesign

Justify

Health System Dashboard

Health System Dashboard is where Penn Medicine Team Goals are highlighted on the front

page and performance against those goals are depicted in Green / Yellow / Red

13

Dashboard Tabs

Patient level detail availableWith more timely data, metrics will

update throughout the month

14

Spark Line View of Data

Spark Line: presents users with a more advanced view of metrics in a condensed space.

This view provides the Start Point, Low Point, High Point, and directional arrow based on a three

month average. It is an efficient way to view and compare trends of several metrics at one time.

15

Reporting Template

Reports allow the user to select measures by Entity, Unit,

Department and Service according to a desired date range

Patient level detail available

16

Built In Graphing Capability

Trending graphs default to Statistical Process Control (SPC) charts to help promote the

process improvement techniques that are being taught throughout the organization

17

► Requirements gathering and build approximately 6 months

Project Statistics

18

► 136 Quality Metrics from various existing sources:– Mortality (8)– Transitions / Readmissions (8)– Patient Safety Indicators (18)– Healthcare Acquired Infections (8)– Core Measures (57)– HCAHPS Patient Satisfaction (31)– VTE/DVT/PE (6)

► Two (2) dashboards and nine (9) reports

► More than 350 users across the Health System

► Benchmarking data (in process)

Next Frontier

19

► ICU specific measures (in process)

► Outpatient data mart (start Q3 2012)

► Merging data from different BusinessObjects universes (2013)– Finance and Quality– Inpatient to Outpatient– Executive View

Discussion

20

Questions?

Thank You!

APPENDIX

Technical Description of Solution & Architecture

Technical Description

► The Database and Platform– Oracle 11g running on Linux– Three separate instances: Development, QA, and Production

► The ETL (Extract, Transform, Load) tools– IBM InfoSphere (an integrated solution)

• IBM Data Stage, Quality Stage, Information Analyzer, and FastTrack– Two separate instances: Development and Production

► Business Intelligence Solution– BusinessObjects and Xcelsius – Three separate instances: Development, QA, and Production

► Issue Tracking solution– Microsoft SharePoint custom developed issue tracking site

22

ETLETL

Data Flow & Architecture

HDM PMC

Cerner Lab

MedView

ClinTrac

EPIC

Surgery

Cardiac

Surgery

Sunrise

TheraDoc

Ganey

Press

Ganey

AHRQ

UHC

Penn

Data

Store

HDM HUP

Source

Systems

Enterprise

Clinical

Repository

Quality

Data Mart

Transformation

Layer

Additional Sources not part of

the PDS architecture

ET

LETL

23