Midas+ Live: Strategic Performance Management Justin Lanning Vice President Business Development, Midas+ 1
Increasing Demands 2
Original Midas+ Strategy Original Strategy Enhance CPMS and DataVision with new type of Focus study to capture data and compute e-measures Certify CPMS and DataVision as a Meaningful Use Clinical Quality Module Clients ready for Stage 1 MU in 2011 need to migrate to Midas Version 2011 no later than July 1, 2011 Anticipated that less than 25 hospitals would be ready for MU Stage 1 in 2011 Reasons for New Commitment Clinical integration is labor intensive and costly Hospitals just don t have all the data necessary to completely automate e- measure compilation and there are a LOT more data elements to collect Over 100 Midas+ hospitals ready for MU Stage 1 in 2011 could not complete full clinical integration and migrate them to V2011 in time Value based purchasing program starting July 2011 and Midas+ clients want to make quantum improvements in performance Needed a more intuitive tool to support concurrent data collection closer to the point of care 3
Strategic Performance Management MONITOR MEASURE MANAGE EMR 4
Strategic Performance Management Live EMR Care Management Seeker 5
Increasing Demands How Do You Keep Up? 6
Midas+ Live Solution Midas+ Intelligence Engine Midas+ Mapping Engine Interface Engine Midas+ Live (Web Application) Hospital Systems Reporting and Analytics Patient Access Rx Lab Clinical Radiology 7
Return To Care Who? 8
Core Measures Solution Suite Hospital Systems EMR / Admit / Labs / Rx / Clinical Doc / ER Core Measures Module Midas+ Live REAL-TIME CORE MEASURES SURVEY Patient 1 - User / Auto / User / Auto / Auto / User / Auto / Auto / Patient 2 - User / Auto / User / Auto / Auto / User / Auto / Auto / Patient 3 - User / Auto / User / Auto / Auto / User / Auto / Auto / Patient 4 - User / Auto / User / Auto / Auto / User / Auto / Auto / Patient 5 - User / Auto / User / Auto / Auto / User / Auto / Auto / Patient 6 - User / Auto / User / Auto / Auto / User / Auto / Auto / Patient 7 - User / Auto / User / Auto / Auto / User / Auto / Auto / Patient 8 - User / Auto / User / Auto / Auto / User / Auto / Auto / FINALIZE & SCORE Measure Set 1 S1 / S2 / Measure Set 2 S1 / S2 / Measure Set 3 S1 / S2 / Measure Set 4 S1 / S2 / Measure Set 5 S1 / S2 / Measure Set 6 S1 / S2 /... Measure Set 15 S1 / S2 / DataVision/CPMS User user-populated Auto pre-populated, user override allowed EXTRACT CMS / TJC 9
Meaningful Use Clinical Quality Measures (CQM) CQM Module DISCRETE DATA SURVEY Patient 1 - Auto / Auto / User / Auto / User / User / Auto / Auto / Patient 2 - Auto / Auto / User / Auto / User / User / Auto / Auto / Patient 3 - Auto / Auto / User / Auto / User / User / Auto / Auto / Patient 4 - Auto / Auto / User / Auto / User / User / Auto / Auto / Patient 5 - Auto / Auto / User / Auto / User / User / Auto / Auto / Patient 6 - Auto / Auto / User / Auto / User / User / Auto / Auto / Patient 7 - Auto / Auto / User / Auto / User / User / Auto / Auto / Patient 8 - Auto / Auto / User / Auto / User / User / Auto / Auto / Hospital Systems EMR / Admit / Labs / Rx / Clinical Doc / ER Midas+ Live Midas+ Live Midas+ Live DERIVED DATA Patient 1 - Calc1 / Calc2 / Calc3 / Patient 2 - Calc1 / Calc2 / Calc3 / Patient 3 - Calc1 / Calc2 / Calc3 / Patient 4 - Calc1 / Calc2 / Calc3 / Patient 5 - Calc1 / Calc2 / Calc3 / Patient 6 - Calc1 / Calc2 / Calc3 / Patient 7 - Calc1 / Calc2 / Calc3 / Patient 8 - Calc1 / Calc2 / Calc3 / SCORING Measure Set 1 S1 / S2 / Measure Set 2 S1 / S2 / Measure Set 3 S1 / S2 / Measure Set 4 S1 / S2 / Measure Set 5 S1 / S2 / Measure Set 6 S1 / S2 / Measure Set 15 S1 / S2 / User user-populated Auto pre-populated, no user override allowed CMS EXTRACT 10
Midas+: Interface Outline STK CQM VTE CQM ED CQM ADT 32% 28% 80% Lab (ORU) 5% 5% 0% Imaging 0% 0% 0% MedAdmin (RAS) 10% 18% 0% Vitals (ORU) 0% 0% 0% Disch Inst (ORU) 20% 15% 0% Clin Doc (ORU) 34% 33% 20% Surgery 0% 0% 0% PN Core Measure AMI Core Measure HF Core Measure SCIP Core Measure STK Core Measure VTE Core Measure ADT 52% 43% 64% 37% 45% 50% Lab (ORU) 6% 5% 0% 4% 4% 4% Imaging 2% 3% 3% 0% 0% 0% MedAdmin (RAS) 15% 7% 0% 18% 13% 19% Vitals (ORU) 0% 0% 0% 2% 0% 0% Disch Inst (ORU) 0% 11% 21% 0% 14% 9% Clin Doc (ORU) 25% 31% 12% 21% 25% 13% Surgery 0% 0% 0% 19% 0% 6% **Please note 35-50% of the data might be contained in Text/PDF which can be provided for ease of abstraction 11
Stage 1 Data Flow: What we know today Electronic Medical Record Midas+ Live Lab Results Medication administration Meaningful Use Clinical Quality e-measures Attestation to CMS Clinical documentation Discharge Instructions Concurrent Legacy Core Measures Midas+ CPMS DataVision Radiology Emerging Complications Derived Data Audited and Harvested Submit to CMS & The Joint Commission Comparative Benchmark Reports 12
ID Predicting Value Based Purchasing Results For Midas+ Clients How Do Midas+ Clients Compare to a CMS Baseline Scores to their Performance Period in 2010? Clinical Processes of Care Domain: Measure Name CMS Attainment Score (National Median) CMS Benchmark Score (Mean of Top 10th) 2010 Midas+ Attainment Score (Midas+ Median) 2010 Midas+ Benchmark Score (Midas+ Mean Top 10th) AMI-7a Fibrinolysis therapy received within 30 minutes arrival 65.48% 91.91% 66.67% 100.00% AMI-8a Primary PCI within 90 minutes arrival 91.86% 100.00% 93.55% 100.00% HF-1 All Discharge Instructions 90.77% 100.00% 93.62% 100.00% PN-3b Blood culture in ED prior to initial antibiotic 96.43% 100.00% 97.47% 100.00% PN-6 Antibiotic selection for ICU/non-ICU patients 92.77% 99.58% 94.29% 100.00% SCIP-Inf-1 Antibiotic within 1hr of incision - Overall 97.35% 99.98% 98.07% 100.00% SCIP-Inf-2 Antibiotic selection - Overall 97.66% 100.00% 98.15% 100.00% SCIP-Inf-3 Antibiotic disc. Within 24 hrs- Overall 95.07% 99.68% 96.55% 100.00% SCIP-Inf-4 Cardiac patients 6am postop serum glucose 94.28% 99.63% 95.28% 100.00% SCIP-CARD-2 Beta blocker prior to admission and periop 93.99% 100.00% 95.00% 100.00% SCIP-VTE-1 VTE prophylaxis ordered 95.00% 100.00% 96.18% 100.00% SCIP-VTE-2 VTE prophylaxis timing 93.07% 99.85% 94.16% 100.00% The CMS Attainment and Benchmark scores were taken from the values posted in the final rule on Hospital Inpatient Value Based Purchasing Program published in April 2011. When we compare performance of Midas+ Clients during the year following the baseline period (2010), Midas+ Clients clearly meet and exceed the national baseline values in both the attainment and benchmark thresholds and are more likely to secure higher VBP scores and reimbursements based on performance trends. 13
Anticipating Trouble in Real Time Patient Admitted Increased Severity Patient Discharged 14
Anticipating Trouble in Real Time Acting on a few clues from the large volume of clinical data early on Patient Admitted Increased Severity Patient Discharged 15
Anticipating Trouble in Real Time Acting on a few clues from the large volume of clinical data early on Will prevent avoidable complications and their costs Patient Admitted Increased Severity Patient Discharged 16
Anticipating Trouble in Real Time Acting on a few clues from the large volume of clinical data early on Will prevent avoidable complications and their costs Patient Admitted Emerging Complication Messaging Increased Severity Patient Discharged 17
Stage 1 Integration: Midas+ Live and Care Management Hospital Information Systems Lab Results Medication administration Midas+ Live Meaningful Use Clinical Quality e-measures Attestation to CMS Clinical documentation Vital Signs Radiology Procedures Customizable Clinical Views Emerging Complications Midas+ Care Management Hospital Case Management Communication with Payers Clinical Documentatio n Improvement 18
Anticipating Trouble in Real Time 19
Anticipating Trouble in Real Time Acting on a few clues from the large volume of clinical data early on 20
Anticipating Trouble in Real Time Acting on a few clues from the large volume of clinical data early on Will prevent avoidable complications and their costs 21
Anticipating Trouble in Real Time Acting on a few clues from the large volume of clinical data early on Will prevent avoidable complications and their costs 22
Surviving Sepsis 65 YO Female Admitted with Missed Pneumonia Clinical Changes 10 hours Post admission Sepsis Recognized ICD-9 995.90 Sepsis Protocol Initiated Responding to a Crisis HR 85 BP 118/80 Resp 18 Bpm Temp 100.5 WBC 8,000 HR 102 BP 85/50 Resp 34 Bpm Temp 102.5 WBC 14,000 $$$$$$ Central Venous O2 Line sensor Ventilator Start new medications Draw a series of labs Longer LOS $$$$$$ 23
Surviving Sepsis 65 YO Female Admitted with Pneumonia 10 hours Post admission Sepsis Recognized ICD-9 995.90 Sepsis Protocol Initiated Delayed Recognition of Clinical Changes Delayed Response to Crisis HR 85 BP 118/80 Resp 18 Bpm Temp 100.5 WBC 8,000 HR 122 BP 85/50 Resp 34 Bpm Temp 102.5 WBC 14,000 $$$$$$ Transfer to ICU Draw a series of labs Pulmonary Artery Catheterization Intubation/ placed on Ventilator Initiation of sepsis medications Increased Mortality Longer LOS $$$$$$ 24
Return To Care 25
Focused on Meaningful Impact 26
Midas+ Live: The New Midas+ Commitment The Benefits of Midas+ Live Software as a service web-based platform Simplifies clinical integration project for clients EMR agnostic Implement in 4-6 weeks and ready to start now Independent of Midas+ Versions No additional hardware Train in minutes not days Supports manual data capture for data elements not in EMR Flexibility to control who sees what Reduces data collection burden Real-time clinical surveillance Quantum leap in performance Faster case management reviews Cost competitive solution Certified by ONC as a Meaningful Use Clinical Quality Module 27
Contact Information Justin W. Lanning VP Business Development and Marketing justin.lanning@credencehealth.md o. 615-712-2212 c. 615-414-3867 28