The Science of Measuring Mission NHCL Keynote November 14, 2017

Who Would You Choose? Option A Option B

Still? Option A Option B Just completed capital campaign Utilization: 100% Client Satisfaction: 95% Economic impact: $50M Outcomes: 90% children have shorter length of stay/heal faster Only 4 months’ operating reserve Utilization: 40% Client Satisfaction: 30% Economic impact: $2M Outcomes: 15% children have shorter length of stay/heal faster

What Matters?

The Overhead Myth

Quality Myth? “Each hospital analyzed in the 12 data-driven rankings received an overall score from 0 to 100 based on four elements: survival, patient safety, care-related factors such as the intensity of nurse staffing and the breadth of patient services, and expert opinion obtained through the physician survey..”

Why No Outcomes? “We’ve allowed “quality” to be defined as compliance with evidence-based practice guidelines rather than as improvement in outcomes.” - Michael Porter Of the 1,958 quality indicators in the National Quality Measures Clearinghouse, only 139 (7%) are actual outcomes and only 32 (<2%) are patient-reported outcomes

Cracking the Code The Impact Genome® Standardizes Data Across 132 Common Outcomes To Identify What Works

Issue 1: Standardization Standardizing Outcomes, Not Metrics Patient-desired, Not Top-Down High-Level Program Classification Specific Program Typology Program Type Index Standardized Outcome Classification Standardized Sub Outcome Classification Standardized Beneficiary Classification Outcomes Indexed By Program Types Education Early Childhood Education B03.02 Improve academic achievement General/other Pre-kindergarten B03.02 – 007a Improve school quality School curriculum B03.02 – 009d Teacher effectiveness B03.02 – 009e Increase access to education B03.02 – 010a

Issue 2: Precision v. Accuracy No Value Ideal Today Impossible Accuracy is how close a measured value is to a standard or known value. Precision is how close the measured values are to each other.

Issue 3: Incentives

Outcome Coding “The only outcome there is, is the final diagnosis…” Current Coding Classifications for Patients in Healthcare ICD – 9/10 Diagnoses and Procedures “The only outcome there is, is the final diagnosis…” - AHIMA data entry staffer Outpatient – CPT Codes Current Procedural Terminology Patient Health Outcomes

Call To Action Start Coding Charts (Outcomes Inventory) Create A Standardized Taxonomy of Health Outcomes Create Demand (Payors) Standardize Reporting Create Cost-per-Outcome Benchmarks

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