MultiCare Health System, an integrated delivery system serving communities throughout Washington state, reporting achieving a 16 percent reduction in pneumonia mortality across its medical centers through the combined use of Health Catalyst’s pneumonia application and a team of clinical and analytics experts. The outcome compares well to the 1.7 percent improvement in pneumonia mortality reported by top the U.S. hospitals during the same period.
One of the largest not-for-profit health systems in the state, with five hospitals and 130 locations, MultiCare also reported a 23 percent reduction in pneumonia readmissions (compared to a two percent reduction in pneumonia readmissions for the National Top Quartile of U.S. hospitals); and a 2 percent decrease in length-of-stay for pneumonia patients.
The MultiCare initiative included setting up evidenced-based order sets, assigning a team of social workers (called personal health partners) to research and improve patient follow-up and communication, and deploying Health Catalyst’s application to provide near real-time feedback on program compliance and performance, as well as on patient-specific data such as medication and readmission histories.
Through these efforts, according to a press release, MultiCare was also able to achieve a 6.4 percent reduction in average variable cost per patient (charge ratio), largely through more appropriate imaging tests and shorter hospital stays. The reduction in mortality was attributed to patients receiving more appropriate and timely care, especially in optimum antibiotic dose and duration, while the drop in readmissions was due to reasons that included improved care and care management, appropriate follow-up, and better use of antibiotics.
According to the Centers for Disease Control and Prevention (CDC), pneumonia accounts for nearly 1.1 million patient hospitalizations annually in the United States and more than 5.7 million inpatient days each year.
MultiCare launched its own Pneumonia Workgroup, under guidance of the Medicine Collaborative, to improve care and outcomes for its pneumonia patients in February 2014. Skills represented in the Pneumonia Workgroup are diverse and varied, among both disciplines and care locations, and include emergency and other specialized physicians and nurses, inpatient and outpatient units, transitional care and nursing home providers, respiratory therapists, pharmacists, and physical therapists.
To achieve the program’s goals, MultiCare partnered with Health Catalyst in deploying the pneumonia analytics application, enabling defined patient cohorts and corresponding metrics to include all pneumonia patients over age 18 (expanding the population beyond that of publicly reported metrics by the Centers for Medicare & Medicaid Services). The resulting software solution was designed to quickly and easily display data and trends to show improvements related to specific interventions, for example, an increased order set that could be correlated to a readmissions reduction.
Health Catalyst’s pneumonia analytics application is used by MultiCare’s Pneumonia Workgroup to monitor high-level outcome measures, as well as each team’s process metrics on a monthly basis. This enables the Workgroup to quickly identify patterns and problem areas, and take appropriate corrective action. The application also allows workgroups to interact directly with the data.
Health Catalyst’s content strategy is based on developing a data warehouse that can handle the complexities specific to healthcare data, and on integrating best practice and evidence-based guidelines. The company’s analytics solution, known as the “Adaptive Data Architecture” model, is flexible and can be implemented in a matter of weeks, compared to the months, at best, that traditional approaches might require.