TCPI Data Management Webinar Eddie Fonner, Assistant Project Director Virginia Cardiac Services Quality Initiative Support and Alignment Network 2.0 TCPI Data Management Webinar Eddie Fonner, Assistant Project Director

TCPI Goals Support 140,000+ clinicians in their practice transformation work Improve health outcomes for millions of Medicare, Medicaid, and CHIP beneficiaries and other patients Reduce unnecessary hospitalizations for 5 million patients Generate $1-4 Billion in savings for health systems Sustain efficient care delivery by reducing unnecessary testing and procedures Build the evidence-base on practice transformation so that effective solutions can be scaled … to do all this, we need DATA!

Overview: VCSQI SAN 2.0 Data Collection Quarterly Data Uploads for selected quality metrics Measure definitions and mechanisms for data capture Track programs’ performances and corresponding quality improvements & cost savings

Defining Quality Measures VCSQI has agreed to report 5 measures to CMS thus far: New Onset of Atrial Fibrillation (CABG Only) Intra- or Post-operative Blood Products Transfused (CABG Only) 30-Day Readmissions (CABG Only; but could apply to all patients) Tobacco Use Screening: Smoking Cessation Counseling & Intervention (All Patients) Hypertension Control (All Patients) Quality measures can include ANY definable metric — what QI/PI projects are you currently working on? List of QPP measures for CMS is available at: https://qpp.cms.gov/measures/quality

How to query your data Cardiac Surgery: Data can come from your quarterly STS reports or from your database vendor Cardiology: Data can come from your quarterly ACC reports or from your database vendor Other specialists and family practice: registries and EMR data will be the easiest method, but if you do not have access to these resources then we can work on other options, including claims data or online data capture

How to send your data Secure options for data transfer: Encrypted ZIP File: FTP Upload https://www.senditonthenet.com/ secure#/secure/drop/cefonner@gm ail.com To upload your files, simply enter your name and email in the form, then click the 'Add a File' button. Navigate to the folder on your computer and select the data file. If there is no PHI or other sensitive info, you can simply send via email

Estimating cost savings TCPI has compiled resources related to cost savings of quality improvement: e.g. $22,224 per unplanned hospital readmission Applies to the TCPI common metrics: Controlling high blood pressure in patients with hypertension Use of imaging studies for patients with low back pain Screening for clinical depression and follow-up plan Substance abuse screening and intervention Tobacco use and help with quitting among adolescents Documentation of a comprehensive health and life plan developed collaboratively by the patient and the health professional team Referral of at-risk patients to community-based prevention and support resources Medication management VCSQI has also published about the costs of post-operative complications following heart surgery

Additive Costs: Primary and Secondary Complications: (CABG only) 2011-2015; N=15,358 Granularity in the database allowed us to identify the most costly complications, prioritize quality improvement work and evaluate cost savings of quality initiatives Blue = baseline (no complications or mortality) Red = Primary Complication -- solely attributed to that complication Gray = Secondary Complications – separated out by statistical techniques

Estimating cost savings (continued) Example calculation: In Quarter 2 2017, Practice X had an A-Fib Rate of 25% for its 100 total cases (N = 25) In Quarter 3 2017, Practice X had an A-Fib rate of 20% for its 100 total cases (N = 20) Based on this improvement by 5 percentage points, we estimate that 5 cases of atrial fibrillation were prevented, saving the practice 5 * $6,890 = $34,450

Summary “We are what we repeatedly do. Excellence, then, is not an act, but a habit.” ~ Aristotle Pick at least one measure that aligns with your practice’s quality improvement goals Send your data securely to the VCSQI SAN 2.0 team As VCSQI provides coaching that will help improve quality of care, we will track quality improvement and cost savings for your practice Recurrence: VCSQI requests quarterly data uploads (email reminders will be sent)

Thank You! Questions / Comments? Feel free to reach out: cefonner@gmail.com 913-909-3140