What does a successful AI and analytics program look like?
Table stakes. That’s what the ability for hospitals to leverage analytics today has become, according to Chris DeRienzo, chief quality officer at Asheville, North Carolina-based Mission Health. But actually using the insights gained from those analytics projects, putting them to work driving enterprise-wide improvements in quality and efficiency takes quite a bit more doing.
Mission has enabled a 58 percent increase in sepsis detection, a 32 percent reduction in severe sepsis mortality rates, a 20 percent increase in on-time surgery starts and more. It's accomplished all this while all while reducing the staff hours needed to wrangle data and prepare reports.
DeRienzo pointed to three case studies from the health system – one focused on the development and diffusion of its care process models, one on driving improvements in ED throughout and one focused on AI and machine learning – to show "how we built the process and then used our tools to drive to an outcome," he said.
"Analytics is a wonderful tool, but you've got to then have the processes in place to be able to leverage it to its maximum potential," said DeRienzo.
Toward that end, there are some key ingredients necessary to create what he calls a culture of continuous improvement. Most of them, perhaps unsurprisingly, have to do with people, not technology.
First, "you've got to have reliable data," he said. "Either in an enterprise data warehouse, with an analytics environment served on top of it or some kind of a more real-time analytics platform that's crawling across the various databases. There are different ways that folks approach it."
Next, he said, "you've got to have a strong clinical program leadership." From Mission Health's point of view, that means "a physician, nurse and administrative partnership. Because without that core group, who understand the business and clinical practice, it's difficult to articulate the value proposition of analytics and then deliver on it.
"You've also got to have a cadre of Lean engineers and trusted advisors who are able to surround that clinical program leadership team," DeRienzo added. "In our organization that means a quality improvement advisor, and folks who have either a clinical or a manufacturing background, as well as Lean and Six Sigma training."
Beyond that, effective quality improvement "means having someone on the BI side who can take what those folks want to see and translate it into an actual visualization that follows human factors," he said. "And an informatics team, to build the adaptive workflows into the EHR in a way that you can actually use."
Clinician buy-in is also a must-have. "We have a significant number of integrated physician leaders across the organization," said DeRienzo, who himself is a neonatologist. When senior physicians, especially those whose specialty will be most impacted by the new care process model, are committed to its success, that's a sure recipe for getting others on board.
"When you surround that person with a team that can develop that model, and with unimpeachable and real-time data that gets down to the physician and the patient level, you then begin to access physicians in a place that got us all through medical school," he said.
By that, he means that physicians usually respond well to competition. When physicians are confronted with the facts – "DeRienzo, you're only using the care process model 30 percent of the time on your patients with early-onset sepsis and your outcomes are 40 percent worse than your partner over here, who uses in 90 percent of the time; what are you doing?" – they tend to listen and react.
"Then you get past, 'Oh, the data is wrong,' or 'My patients are sicker' and you get to the, 'What do you mean I'm below average? I can't be below average!' and all of a sudden you see traction in a different way," he said. "That is incredibly powerful stuff."
Chris DeRienzo will be speaking in the session, “How Analytics Can Create a Culture of Continuous Improvement,” is at 4 p.m. March 8 in the Venetian, Palazzo D.
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