SOLUTION PROVIDER Q&A


AI-powered Clinical Intelligence: How to Reduce the Total Cost of Surgical Care


Working with clinician leaders in any area connected to patient care, whether directly or indirectly, involves many challenges. How did the Intermountain leaders provide a framework for the development of perioperative operations optimization that helped to facilitate a good process for


Olive and Intermountain leaders? The framework is built on three key pillars. The first pillar is an analytics approach using integrated data and clinician driven cohort definitions. The cohorting approach ensured that cases were grouped in a way that was mean- ingful to surgeons, rather than relying on groups that were optimized for coding and reimbursement. The cohorting also looked across the entire episode of care versus just the cost associated with care. We found that this holistic approach pro- vided a more complete perspective that was important to clinicians. We also determined that analytics out- put by itself was not sufficient enough to engage with clinical leaders. So, the second pillar of the framework had clini- cians or operating room nurses own the analytics development and compilation. This helped to ensure that what was pre- sented was relevant to clinicians and that the change management dialogue became clinician to clinician, rather than analyst to clinician. The third pillar of the framework focused on system level thinking and engagement rather than localized discus- sions. The analytics served to spark a com- mon dialogue between surgical leaders from the 20+ Intermountain facilities. In some cases, this was the first time many of them had connected with peers from geographically separated facilities within Intermountain. That shared dialogue helped to progress the change manage- ment process and to also further inform the analytics process itself.


What were some of the key operational goals


targeted by the initiative? Intermountain Healthcare is a partially integrated health system with owner- ship of the largest private payer in Utah, SelectHealth. The very early days of the initiative began with a commitment from SelectHealth to constrain employer plan premium increases. This commitment to employers and plan members drove Intermountain to launch system-wide efforts on cost containment, while main- taining and improving outcomes. One of the identified projects was a focus on surgi- cal related costs, due to the high percentage of costs that surgery represents. An early objective was to keep surgical supply costs at or below medical inflation rates. This led to the development of strategies around both supply chain optimization and utiliza- tion management. These goals were then broken out into specialty-based objectives with cohorts becoming the leverage point for further opportunity discovery.


What were some of the most important process, analytical, and operational outcomes


gained from the initiative? Intermountain accomplished its early goals around surgical supply cost man- agement and discovered additional opportunities around outcomes and effi- ciencies. Perhaps of greater significance was the recognition that the cohorts and cohort-based approach to analysis led to substantial insights into clinical best practices. There were many examples where cohort-based variance analysis led to insights supporting methodolo- gies, techniques, and care pathways that improved outcomes while lowering costs. Better outcomes and lower cost can go hand in hand. Examples we found range from changes in technique on pediatric lap appendectomy patients to site of care volume shifts for certain procedures, such as lumbar fusions, to the impact of par- ticular anesthesia reversal agents.


Justin Schaper SVP Olive Knows


Olive


Dr. David Skarda Sr Medical Director for Value-based Surgery


Intermountain Healthcare


What have been the biggest lessons learned from this


specific initiative? A critical observation was that cost and outcomes are not trade-offs but rather a way to align on clinical and operational efficiency to drive improved performance. As the work has matured and evolved, Intermountain has been able to account for the full episode of surgical care, includ- ing activities pre-admission and post-dis- charge. The core concepts of grouping data in a way that matters to the physicians and bringing in the full detail of care unlocks depths of opportunities that ultimately lead to better care pathways for patients.


Sponsored Content


www.oliveai.com


SEPTEMBER/OCTOBER 2021 | hcinnovationgroup.com 7 SEPTEMBER/OCTOBER 2021 | hcinnovationgroup.com 7


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32