Cleansing and Categorizing Data to
Improve Supply Utilization
Adventures in Orthopedic
Data Management
October 15, 2015
Kurt MacDonald
Topics
•
Overview of Trinity Health
•
Supply Chain Strategic Plateaus
•
Informatics Infrastructure
•
Data Classification
•
Metrics/Key Performance Indicators
•
Tools: Reports and Dashboards
Trinity Health
Supply Chain Strategic Focus
Achieve the lowest cost for the highest quality Products and
Services across our Ministries through engagement with
Ministry Leadership; alignment with Physicians, Clinicians,
and others who are driven by outcomes and data with a
focus on supporting the vision of stewardship and care
excellence across Trinity Health.
•
Achieved by excellence in:
•
Logistics – (Supply Chain Operations)
•
Pricing (Sourcing)
•
Value Analysis (Infrastructure/utilization management)
Objective: Clinically Driven Supply Chain
•
To support the goal of a Clinically Driven and Integrated
Supply Chain Trinity Health:
•
Recognized the need to provide usable data to identify cost and
utilization patterns
•
Acknowledged supply cost per case is elusive
•
Defined requirement to capture Orthopedic Joint and Spinal
Hardware Implants by line item costs and identify waste at the
patient case level
Supply Chain
Inventory Management
Inventory Management
Technology
Technology
Analytics
Analytics
Utilization
Utilization
Expense Management
Expense Management
Need:
Integrated
Reporting
System
Clinical
Practice
Patient
Care
How to Achieve a Clinically Driven Supply Chain
•
Design systems to support identification of implants and
tie their utilization to metrics
Utilize systems of data already available
Create capture tools
Develop reporting systems
Producing Information
Presentation Layer – Executes report logic
Provides summary level data with ability to drill to detail
Data Mart Layer - Performs Complex Joins
• Collects and processes the Transactional Level data
Data can be used in ad-hoc queries
Transactional Level - Input
• Detail on product supplies
• Several hundred tables of data
Information Keys
•
Rely on ability to Classify Data
•
Data must be collected or transformed into a common
classification for aggregate and comparison analysis
• Access specific standard created by third party
•
Ortho/Spine Implants use Mendenhall and Associates (ONN)
• Generic Implant Code (GIC)
•
Must be available on a timely basis
•
Provide summary level data with ability to drill into detail
•
Produce monthly reports and post to Analytics Portal
•
Have to show benchmarks
•
Provides metrics on utilization and KPI’s
•
Utilize Traffic Lighting (red/yellow/green)
•
Graphic and tabular formats
Importance of Data Classification
•
Creates the ability to compare data with confidence
•
Clinicians and Physicians trust the information
•
Opportunities are more easily identifiable as variances
stand out
•
Creative sourcing strategies can be positioned
Classifying Data at Entry Point
The process of
classifying starts
HERE:
We input our case
data as part of our
replenishment
process (e.g.
Consignment – Bill
and Replace or Bill
Classifying Data at Entry Point
This begins the
“punch out” to
ONN for case
entry and data
This also completes the Requisition
No duplication of
data entry
Procedure
Input Case
Database
Metrics
Replenishment
Importance of Metrics
•
Generates scorecards with meaningful measurements
•
Allows for benchmarking of utilization
•
Provides standard language for comparison
•
Sourcing strategies can be positioned
•
Provides a platform for engaging with Physicians /
Surgeons
Strategic Sourcing Implant Database (SSID)
•
The Database was developed to give the System and its
hospitals access to detail of implant spend and utilization
by providing:
•
Visibility to type of implant used, accessories, and up-charges
•
Implant information by Patient and Physician
•
Benchmark pricing and volume utilization across hospitals
•
Ability to send data to external databases
•
Electronic Implant Log to meet regulatory requirements
Strategic Sourcing Implant Database (SSID)
•
Database Statistics:
•
Began data collection of Orthopedic Joint cases July 2007
•
Began data collection of Spine cases June 2009
•
175 trained associates who actively input case data
•
Supports:
•
Strategic Sourcing of Orthopedic Joints, Spine, Orthobiologics
•
Sending supply and cost data to Clinical and Revenue Systems
•
Identification of variation in cost and product utilization per case
Database represents:
183,000+ in patient cases
Strategic Sourcing Implant Database (SSID)
•
Key Performance Indicators:
•
Volumes, Cost, Revision Cases, Reimbursement, Waste, LOS
• Hardware costs - Implanted items
• Total Costs – Inclusive of Hardware AND significant per patient items
used to implant product (e.g. Cement or items used to supplement
implant such as orthobiologics)
•
Real Time Selections Available:
•
By Hospital(s), Procedure, Construct, DRG, ICD, Physician,
Vendor
•
Time Periods – All years of data, Month, Quarter, Fiscal Year
Comparisons
•
Added information for physician report:
•
KPI’s include: Case Volume, Cost, Waste, Revisions, and
Reimbursement
•
Becomes the mechanism to monitor cost, volume trends,
and establish benchmarks across the health system
•
Available through the web via Trinity Health Analytics
Portal
SSID & The Implant Executive Dashboard
SSID and the Clinical Data Warehouse
•
Implant Data is exported to Clinical Data Warehouse
•
Used to review with physicians opportunities for improvement in
cost and utilization
•
Information is available by hospital and drillable to patient
case and physician level
Spinal Fusion Clinical Cost Metrics
SSID and the Clinical Data Warehouse
•
Spinal fusion cases needed additional data elements to
produce more meaningful information
New Dashboard – Bone Cement
Results:
• Created
guidelines for
number of
units used per
procedure
• Created clinical
protocol for
type of cement
utilized
Snapshot of Results
Orthopedic Joints – Fiscal Year End
Key Performance Indicators Trending in Positive Direction
•
Orthopedic Joints – Fiscal Year End
Snapshot of Results
Orthopedic Joints – Fiscal Year End
Key Performance Indicators Trending in Positive Direction
