Using analytics, Gundersen Health reduced knee replacement costs by 18 percent
Gundersen Health System in La Crosse, Wisconsin, has strived to be an industry leader by delivering high-quality, affordable care for its patients.
But it was difficult to bring meaningful, critical patient outcome and cost metrics together in a straightforward manner aligned with the organization’s vision to drive change in maximizing quality and reducing costs. The health system’s surgeons and others needed the ability to compare outcomes to communicate with healthcare organization leaders to challenge current practices.
Gundersen Health turned to healthcare analytics technology vendor Avant-garde Health and the vendor’s CareMeasurement system to help Gundersen understand its true costs of care, benchmark performance, and pursue opportunities to maximize quality and profitability, via accurate and actionable insights.
Many healthcare information technology vendors offer healthcare analytics systems. These vendors include 3M Health Information Systems, Berg Analytics, Change Healthcare, Dimensional Insight, Geneia, Innovaccer, Inovalon, Medecision, Optum, Oracle, PeraHealth, SCIO Health Analytics, SPH Analytics and VigiLanz.
MEETING THE CHALLENGE
Gundersen Health’s Avant-garde data is reviewed regularly by the orthopedic leadership team and is accessible to all surgeons and leaders across the care continuum.
“The ability to compare Gundersen to other health systems in the cohort helps Gundersen determine collectively how its compares and where are the continued opportunities,” said Lisa Wied, vice president of clinical operations at Gundersen Health System. “Gundersen surgeons are able to compare their outcome and cost metrics to other surgeons within the organization.”
"The ability to compare Gundersen to other health systems in the cohort helps Gundersen determine collectively how it compares and where are the continued opportunities."
Lisa Wied, Gundersen Health System
On a quarterly basis, Gundersen surgeons come together to review the outcome metrics, reflect on their practice that impacts the results, challenge others’ practices, and determine practice change opportunities. The surgeon group establishes the direction and the orthopedic leadership team supports the surgeons to implement these changes.
“Gundersen has an orthopedic leadership committee that includes leaders from across the care continuum that meets monthly to discuss the direction established by surgeons,” Wied said. “This committee identifies the key stakeholders that need to be involved, discusses the method to operationalize the direction, determines barriers, and implements initiatives when appropriate that can aid in improving outcome and cost metrics based on the knowledge gained through the Avant-garde CareMeasurement technology.”
As a result of using the analytics, same-day physical therapy increased by 68 percent, and use of higher-cost post-acute facilities decreased by 22 percent. Cost disparities in supplies also led surgeons to switch to generic bone cement that costs 57 percent less than alternatives, without sacrificing quality. Insights ultimately helped Gundersen reduce its knee replacement costs by 18 percent in less than two years.
“We achieved savings of $1,600 per case by reducing average length of stay by 1 day, increasing physical therapy on day of surgery to 2/3 of patients, reducing usage of skilled nursing facilities by 22 percent,” Wied explained. “While cost savings – as supported by decreased length of stay, reduced post-acute care cost, reduced supply cost and reduced personnel cost – are generally the simplest to communicate and quantify, it’s important to emphasize a domino effect and additional downstream benefits.”
Accelerating physical therapy speeds up recovery time which decreases length of stay which frees up more beds which brings in more patients which increases surgical volume which drives more revenue, she explained.
ADVICE FOR OTHERS
Healthcare analytics is a critical component to drive change within an organization, Wied advised.
“Without having reliably available benchmarking data, an organization cannot adequately have a pulse on its current state and know the direction it is headed,” she said. “Find a reputable and supportive technology organization to create a partnership that can provide influential data to lead your organization in a positive direction.”