April 24 2018 BY: Sarah Chen, MD

Healthcare Association Deploys Advanced Analytics to Reduce Pneumonia Readmissions and Mortality


Quality improvement in healthcare begins with data. But data in and of itself is insufficient if you cannot engage clinicians. Clinicians can’t be expected to take steps toward change without trustworthy data that’s delivered in the right format at the right time. Surprisingly, not all clinicians have access to their data. And when they do, one of the main complaints is that the data is just not timely enough. Timely in the sense that the data is too delayed to be actionable. Timely in the sense that they cannot get their follow-on questions answered quickly enough by their analysts to inform their decisions.

Fortunately, sophisticated analytics exist today to help providers turn massive silos of data into actionable insights for improving the cost and quality of the care they provide. These tools reduce analyst burden, automating the collection and interrogation of data to identify patterns, and predict outcomes. Real-time tracking provides visibility into whether changes are occurring and allows for course correction along the way. And for hospital associations or large care networks, the availability of customized benchmarking and comparisons increases sharing of best practices among members.

To see what how this plays out in practice, let’s look at an example from a Clarify customer, North Carolina Healthcare Association (NCHA).

In March 2017, NCHA rolled out a statewide initiative called the Pneumonia Knockout Campaign to significantly reduce pneumonia (PNE) mortality and readmissions. North Carolina is ranked 49 out of 50 states for its pneumonia mortality rate, with 73% of hospitals falling below the CMS national benchmark. On top of that, more than half of all North Carolina hospitals are above the national benchmark for 30-day pneumonia readmission rates (meaning their readmission rate is higher than average). The healthcare association had two goals:

• Save 1,000 lives by reducing PNE mortality rate by 7.5% to the national average of 16.3%
• Save $8.8M by reducing PNE readmissions by 5.4% to target the top 25% quartile of the nation

NCHA found themselves presented with a common problem: they were data rich but insights poor. With access to Medicare quality rankings and inpatient claims from member hospitals, they had a lens into what was happening within the four walls of the hospital. However, they lacked critical insights on what happened to their patients after they left the hospital as well as the ability to case mix adjust their analyses.

NCHA selected Clarify Health as their partner in this campaign. Through Clarify’s analytics solution, Care Prism, NCHA has visibility across a patient’s history of care – 30, 60 and 90 days after they leave the hospital. NCHA can now more easily identify patterns of readmissions and analyze their data at regional, district, affiliated care partner, individual physician, and hospital levels. They are able to assess the performance of their member hospitals, giving them actionable insights and the ability to enact change in real-time. Clarify’s Care Prism analytics allows NCHA to:

• Benchmark case mix-adjusted performance
• Quickly identify and prioritize specific improvement opportunities
• Engage physicians and hospital leadership with trusted data
• Rapidly scale across all facilities delivering initial insights within 2 weeks

The NCHA now serves rich information to over 90 hospitals at a fraction of the time previously required to produce analytics. Leaders from a mid-sized North Carolina hospital in the Piedmont region identified that patients with asthma were at increased risk of dying from pneumonia. This information will help care teams identify at-risk patients and intervene sooner, thereby reducing the risk of costly readmission or death.

“We are excited to see how the Clarify platform is shaping new opportunities to improve patient care, especially during transitions between hospitals and skilled nursing facilities. In one innovative pilot, care teams are using Clarify data to better understand the patient experience outside the walls of the hospital. By bridging those gaps, our members and partners can better identify patients at risk of adverse events and care for them in the most appropriate setting.”

– Karen Southard, RN Vice President Quality & Clinical Performance Improvement

Change is possible. With the right tools, predictive analytics and advanced data models are surfacing areas of change out of a seemingly insurmountable amount of data. Hospitals and healthcare associations like NCHA have tangible, trustworthy insights to use to drive improvements in patient outcomes and financial returns.

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