In a rapidly changing health care landscape, data is a foundational component to success. Whether implementing a data-driven strategic plan or a new technology with data at its core, knowing how to leverage data is a skill that every leader must acquire. Executives seeking to push their organizations forward are challenged with garnering the support of multiple teams and stakeholders, each with their own concerns and perspective. In every situation, data can be a powerful tool for persuasion – but not all data is created equal. Knowing how, and when, to use the right data can make all the difference.
As demands for innovation grow, many Texas hospital leaders are successfully leveraging data to have a positive impact on their organizations and communities. These initiatives are shaping the future of health care in Texas, and there are valuable lessons to be learned from those successes.
THE RIGHT DATA AT THE RIGHT TIME
Houston Methodist has taken decisive action to reduce wasteful and unnecessary cost incurred from the patient encounter. By deploying the THA Smart Ribbon, the system has been able to bypass burdensome interactions with the electronic medical record system and provide the ordering physician with the data needed to make informed choices based on the costs and risks associated with each decision.
Far from a heavy-handed approach, the Smart Ribbon preserves physician autonomy by leveraging an innate human tendency to lower the cost and risk of one’s actions. Instead of overwhelming providers with too much, or irrelevant, information, the Smart Ribbon presents only the data that is needed and in a manner that does not require extensive interaction.
Like many solutions that insert data in the clinical workflow, Houston Methodist experienced the usual skepticism from its providers who feared a loss of autonomy or more EMR interruptions. However, they quickly found that doctors embraced the information and adjusted approaches accordingly, said Nicholas Desai, M.D., chief medical information officer at Houston Methodist. After piloting the Smart Ribbon at its Sugar Land Hospital last year and experiencing savings of almost $720,000, or $105 per admission, Houston Methodist is now working to spread the endeavor systemwide.
Desai attributes Houston Methodist’s successful implementation of the Smart Ribbon to placing data in front of doctors at the right moment but doing so in a way that still grants providers the flexibility to make snap decisions.
“Doctors wanted more data; that was lesson number one for me,” Desai said. “Physicians not only had the appetite,
but they also had the tenacity and the desire to want to do more with this information. The utilization of it has just been off the charts for us, because the doctors have started to rely on it very differently.”
Houston Methodist’s experience reinforces the notion that “when” is of the essence when using data to earn buy-in from health care decisionmakers, experts note. “The timing of that information is just as important as the wisdom that comes from it,” said Fernando Martinez, chief digital officer of the Texas Hospital Association. “Information is only useful if it’s available at the time that it’s needed to make a decision. That just makes sense. If you’re going to have information that’s actionable but you receive it after the patient is no longer in front of you, then it’s too late.”
Across the state, local providers and the Texas Hospital Association have partnered to reduce cost while improving care by getting the right data into the hands of doctors and other decisionmakers. Delivering those insights at the right time – the point of care when ordering decisions are made – has led to the success of THA Smart Ribbon initiative and demonstrates the power of matching data with need and opportunity. Today, the Smart Ribbon is accessible by nearly 50 unique facilities across Texas, with reported savings of more than $19.8 million, or $109 per admission.
Pinpointing the correct type of data to impact doctors and administrators also requires knowing the warning signs of data that may not provide an adequate or complete picture. Being aware of those traps can prevent the sidelining of a project. Two common red flags are data that is “not granular or specific enough, or months old and already irrelevant,” said Mukul Mehra, M.D., chief medical officer and co-founder of Illumicare, the company who developed the Smart Ribbon technology.
Physicians want finely detailed data that provides comparative peer analyses, Mehra explained. For instance, if a doctor is told that 4 percent of the time, he or she is ordering labs with results that don’t arrive until after the patient is discharged, whereas their peers are at 2 percent, many providers will “self-adjust” in order to better meet community standards. “Very few physicians begin to argue with that kind of data,” Mehra said. “If you just said to me, ‘you spend this much per admission, period.’ What am I supposed to do with that?”
Incorporating benchmarking to allow for peer-to-peer comparisons has proven crucial, experts said. Comparing a doctor to an average across the entire hospital is meaningless, with so much variation in circumstances and patients from one clinician to the next in different specialties.
“You can hold physicians hostage for an hour in a conference room and expect them to listen because they have to, and if you’re nice, maybe you feed them. Or you can give them transformative data that’s so granular that it’s easy for them to connect the dots themselves,” said Mehra.
Houston Methodist’s Desai explained that a key lesson learned is that no one can “force fit” a new data initiative; instead, be deliberate and engage clinical experts. “‘What’s in it for me?’ must be answered ahead of time,” he said. “You can’t just turn it on and leave it at that.”
“Physicians are very detail-oriented creatures. They demand precision and specificity,” said Adam Travis, M.D, head of inpatient solutions for Clarify Health, a San Francisco-based technology company that has also worked with Texas hospitals. “If the hospital gives data saying, ‘you perform at a certain level’ and doesn’t allow any ability to interrogate that or understand it more deeply, then it’s
going to be a very short conversation.”
Arlington-based Texas Health Resources has undertaken a similar data initiative aimed at making data mining and analysis available to all employees. Michael Parris, VP for enterprise data and analytics, calls it “teaching employees to fish.”
He hopes getting more assistance from the workforce will free up data analysis experts’ ability to drill
deeper into information at the DRG level and head off some of the most common reasons for physician pushback (i.e., my patients are sicker, your data are wrong, or you’re not comparing apples to apples).
Parris underlined the importance of involving clinicians when building a new data-measurement system and
communicating what’s next. “It’s good to use those partners in building the measure to actually have those clinician-to- clinician conversations,” he said. “Otherwise, information technology teams can get too technical, and it doesn’t translate well.”
DOWN TO BUSINESS
Beyond the point of care, Texas hospitals are also leveraging data to garner board and leadership team buy-in on larger change initiatives like launching new service lines, recruiting tough-to-find specialists and building new hospitals.
Pampa Regional Medical Center — a 115-bed community hospital in the Texas Panhandle — has made use of market data insights through the THA’s Compass data program. Harnessing software tools developed by Nashville-based Stratasan, the community hospital has drilled down into demographic and diagnoses data for the six surrounding counties to determine where it might be missing the mark.
Leaders found a high incidence of stroke patients in the region, fueling the hospital’s decision to become an accredited stroke center. Pampa also recently partnered with a local school district to improve treatment and counseling for children with behavioral issues, based on a care gap found in the data.
Having that specificity of information has helped Pampa Regional to minimize risk, better deploy its resources and more easily convince leaders on new strategies, said CEO Edwin Leon.
“It’s always helpful to have concrete information, rather than a hunch that this might work out,” he said. “We’re able to make a case to our leadership team that is really rock solid and that these numbers are legitimate.”
The same has proven true for physician recruitment, Leon added, helping to convince specialists who are considering moving to the community but concerned that they would not see enough patient volume.
Irving-based CHRISTUS Health has similarly used data for performance monitoring around its service lines, and to help justify the placement of assets, said Tina Barker, vice president of strategy development and management. Data demonstrated a dwindling population in the Beaumont–Port Arthur metropolitan area, which the system used to back support the closure of facilities in that region. Decisions like that are incredibly hard to make without trended demographic data to show that a hospital closure will not leave the community with a shortage of access to care.
On the flipside, market data and the urging of a local physician group led CHRISTUS to pursue a $43 million expansion project in Shreveport. The project will double the size of its emergency department, add more inpatient rooms, and both expand the cardiac catherization lab and build a dedicated entrance for such patients to capitalize on shifting demographics.
Barker urged hospital leaders to be wary of misconstrued data and seek out the right partners to navigate uncertainty.
“Data in the wrong hands without an explanation can be dangerous. It can lead you to make decisions, hire staff or even close services if you don’t know what you’re looking at,” Barker said. “So, finding a partner that will work with you and be honest and candid about its limitations is crucial.”