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© 2014 Thrive HDS, Inc. REDUCING PREVENTABLE READMISSIONS THROUGH PREDICTIVE ANALYTIC MODELS Curt Sellke - Vice President of Analytics
© 2014 Thrive HDS, Inc. IHIE BACKGROUND > Nation’s largest Health Information Exchange (HIE) > Founded in February 2004 > Based on the technology, knowledge, and experience of the Regenstrief Institute > Providing services to 96 hospitals (39 health systems), 25,000 clinicians, and 4 payers > Serving an area with a population of about 6.5 million people 2
© 2014 Thrive HDS, Inc. IHIE CDR DATA IHIE operates one of the nation’s largest Clinical Data Repositories (CDR) 3 > 1 Network > 96 Hospitals > 25,000 Physicians > 500,000 Daily Data Transactions > 16,3000,000 Patients > 120,000,000 Radiology Images/Reports > 6,600,000,000 Pieces of Clinical Data (15TB)
© 2014 Thrive HDS, Inc. Patient Physician Hospitals Payers Physician Offices Labs / Imaging Centers Public Health Rx Health Information Exchange Data Repository Network Applications Data Governance Value Added Services Health Data Sources IHIE SERVICES Clinical Data Repository (INPC™) -MPI & Record Locator Service -Longitudinal Patient View Clinical Results Delivery (D4D®) -Web-based portal or EMR delivery -No Cost to Physicians ACO & Analytic Services -ADT Alerts -Predictive Analytics Public Health Integration and Automation -Bio-surveillance -Communicable Disease Reporting -Immunizations Federal Government Services -SSA Disability Determination -VA’s VLER Program Meaningful Use Supporting Services -Transitions of Care -Public Health Integration
© 2014 Thrive HDS, Inc. OUTSIDE INDIANA 5
© 2014 Thrive HDS, Inc. WHY PREDICTIVE ANALYTICS? 6 > Lots of Rich, Disparate Data is needed to “Power” Predictive Models; IHIE is a fantastic source for this data > Strong Market Need, Limited Experience and Expertise especially developing Predictive Models that use Clinical Data versus Claims Data > Huge Opportunities and Value if you can be Predictive/Interventional versus Retrospective/Reactive > We believe it is the “Right” next Step in the Evolution of a Successful HIE (HIE 2.0)
© 2014 Thrive HDS, Inc. DO YOU KNOW WHERE YOUR PATIENT IS? 7 > As a member of a CMS chartered ACO, a patient can seek care anywhere in or outside the ACO. They are not bound to a single network or provider. > This makes knowing where your patient is or has been even more challenging especially when you have clinical & financial responsibility for that patient!
© 2014 Thrive HDS, Inc. ADT ALERTS Enables Providers to: 8 >Track where and when care has been delivered, especially if outside of the patient’s attributed care network Information comes from HL7 ADT (Admission/Discharge/Transfer) Messages >Examine the patient’s chief complaint >Process the preliminary diagnosis >Optimize care site transitions >Identify providers in the continuum of care
© 2014 Thrive HDS, Inc. ADT ALERTS ARCHITECTURE TODAY 9
© 2014 Thrive HDS, Inc. ADT ALERTS CASE STUDY ADT Alerts to Reduce ED Visits 10 > Results of a 6 month pilot with a managed health care plan in Indiana: 53% reduction in non-urgent ED visits 68% increase in Primary Care office visits Nearly $4 million saved
© 2014 Thrive HDS, Inc. MAKING ADT ALERTS MORE PREDICTIVE, MORE VALUABLE 11 > We are working with Predixion Software to develop a model to predict the probability of a preventable readmission occurring within 30 days of discharge > We are “wiring” this predictive model into our ADT Alerts system; any time an inpatient admission happens, we will score the probability of that patient being readmitted within 30 days of discharge
© 2014 Thrive HDS, Inc. FUTURE ADT ALERTS ARCHITECTURE (Q2 OF 2014) 12
© 2014 Thrive HDS, Inc. OTHER POTENTIAL USE CASES OUTSIDE ACOS 13 > ADT Alert on Admission and/or Discharge to the Patient’s PCP to enable more effective transitions of care > Medicare is financially supporting “Transitional Care Management Services” by encouraging PCPs to see Patients within 7 to 14 days of discharge and providing new CPT Codes (99495 and 99496) to provide payment for these services > ADT Alerts coupled with a Prediction of the potential for Readmission within 30 days can help PCPs and their staff focus resources on those patients that have the highest probability for readmission
© 2014 Thrive HDS, Inc. THANK YOU Curt Sellke Vice President, Analytics 14 > email@example.com firstname.lastname@example.org > Office: 317-735-4084 > Twitter: @CurtSellke
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