1. The Science of Measuring Mission
NHCL Keynote
November 14, 2017

2. Who Would You Choose?
Option A
Option B

3. 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

4. What Matters?

5. The Overhead Myth

6. 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..”

7. 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

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

9. 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

10. 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.

11. Issue 3: Incentives

12. 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

13. 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

14. Remember This?