ALU_CHUG_May2010_UPMC_Building an Ecosystem for

Steven Boochever
Building
anViceEcosystem
Executive
President
International & Commercial Services Division
For
Connected
Medicine
May 20, 2010
Agenda
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UPMC Background
Connected Medicine Mission and Priorities
Looking Forward
Partners
Center for Connected Medicine
2
UPMC Background
3
UPMC Today: Snapshot
• $8 billion in assets, $7.7 billion in revenue
• 20 hospitals operating over 4,200 beds, 187,000
admissions per year; 2 International Hospitals
• 1.4 Million UPMC Health Plan members
• More than 400 service locations
• 50,000 employees, 2,700 employed physicians, 900 IT
Professionals
• 44,500 desktop devices supported, 167,500 network data
ports
• 1.1 pedabyte of data storage, 2,600 server instances,
2,000 databases
• 4 UPMC Hospitals at HIMSS Stage 6, 1 at Stage 7
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UPMC Today: Organizational
Structure
Hospital and
Community
Services
Physician
Services
Provider Services
Not-For-Profit
Insurance
Services
International and
Commercial Services
Combination ForProfit & Not-forProfit
Enterprise Services
Information Services, Human Resources, Marketing,
Advertising & Public Relations, Legal Services, Finance, etc.
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ICSD Mission
To create a global healthcare organization
focused on providing economically
sustainable excellent patient-centered
medical care, biomedical research,
information technology and commercial
products in an environment of continuous
improvement of outcomes.
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Why go Global?
Fuel growth to support
the core mission
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UPMC International Locations
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Connected Medicine
Mission and Priorities
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Connected Medicine Mission
Connecting patients and
providers and payers with the
right information at the right
time for the right care.
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Connected Medicine Priorities
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What’s Connected?
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Why this is so Important?
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It is all about the Patient….
Of All Patients
Is the number of outpatients seeking follow-up care on
any given day and these patients are at the greatest
risk for high incidence of missing data from their
clinician’s system
67
Clinicians
Is the average number of clinicians who touch a
patients’ record during a 3-day hospital stay
300+ Documents
Is the quantity of documents some patients have across
all of their visits as a result of aggregated data
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…but the systems are everywhere…
6
million Messages
Are sent every day as part of HL7 traffic for registrations,
orders, scheduling, results, etc.
1.25
Errors
million
Were discovered in a 10-year backlog of existing patient
data that has been aggregated
1-300 Encounters
Is the range of encounters for patients seeking
treatment for complex conditions
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…and there is still an Information Gap!
1/3
Primary care physicians
only have hospital care summaries when they first
see recently discharged patients
3
Physicians
weeks Spend per year simply interacting with health plans
for a total national cost of $31 billion annually
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Years
It takes to achieve widespread adoption of a new
evidence based practice in health
55% Adults
Receive recommended care
Source: Markle Foundation
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Strategy for Connected Medicine
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UPMC’s best-in-class patient care strategy
starts with a solid technology infrastructure.
Information and Communications Technology Project
-Partnership with Alcatel-Lucent established in November 2006
-The converged UPMC network enabled re-engineering of all aspects of
voice, video and data networks including organization, processes and
software
-This transformation created the infrastructure for efficient and effective
utilization of resources and enabling real-time communication both within
UPMC and key stakeholders.
Infrastructure
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UPMC
Technology Infrastructure
Information Technology Transformation Project
-Partnership with IBM established in April 2005
-Built a World-Class IT Operation
-Server/Storage/Operating System Consolidation and Virtualization
-3 year cycle for Technology refresh
-Information Technology Infrastructure Library (ITIL) Based Re-engineering
of Technology Management Processes
-Enhanced Disaster Recovery Capability
-Engaged International Data Corporation’s Health Industry Insights (IDCHII) to examine the progress and performance of the program, as well as
compare results versus other “high-performance” organizations within and
outside of healthcare
Infrastructure
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Enterprise Technology
Transformation Conclusion
•
IDC concluded that UPMC has avoided approximately $80.1 million at the conclusion
of year 3.
•
Server consolidation is returned more than 1600 square feet of existing space in the
primary UPMC data center.
“It remains IDC’s opinion that this
landmark joint venture between UPMC
and IBM has established UPMC as a
leader in the strategic use of IT, not only
amongst healthcare organizations, but
also across all industry sectors.”
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UPMC Financial and Administrative
Systems
-Hospital Revenue Cycle (since 2003) has reduced FTE’s by 24% while
increasing revenue by 43% and increasing cash processed per FTE by 88%
-Physician Services Revenue Cycle (since 2005) has reduced FTE’s by
18% while increasing revenue by 65% and increasing cash processed per
FTE by 102%
Financials /
Administrative
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UPMC Financial and Administrative
Systems
-UPMC was the first nonprofit health system to fully adopt Sarbanes-Oxley.
Financials /
Administrative
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UPMC Electronic Health Records
Clinical
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UPMC Advanced Clinical Systems
Inpatient
Outpatient
Clinical
Information
Systems
(Surgery, ED, Lab, Radiology)
Other Providers
The Provider Portal
Consumer
The Patient Portal
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UPMC Interface Capabilities
Clinical
-UPMC home grown Message Router processes over 7 million transactions
every day with more than 1,024 interfaces
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Interoperability at UPMC
Clinical
.
-By the end of 2006, UPMC identified dbMotion as the strategic partner of
choice based upon the technology framework and healthcare specific
vision.
-UPMC and dbMotion entered into a strategic, eight year interoperability
initiative.
-dbMotion set up U.S. headquarters at UPMC facilities in Pittsburgh that
includes clinicians, tech professionals, and other staff.
-UPMC has equity in dbMotion plus joint development of advanced
functionality applications
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The Value of Interoperating
Interoperable health IT can improve individual patient care in numerous
ways, including:
1.Complete, accurate and searchable information
– Available at the point of diagnosis and care
– Allowing for more informed decision making
– Enhancing the quality and reliability of health care delivery
2.More efficient and convenient delivery of care
– No waiting for the exchange of records or paperwork
– Without requiring unnecessary or repetitive tests or procedures
3.Earlier diagnosis and characterization of disease
– Potential to improve outcomes and reduce costs
http://healthit.hhs.gov/portal/server.pt
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The Value of Interoperating (cont’d)
4.
Reductions in adverse events
–
–
–
5.
Through improved understanding of each patient’s particular medical history
Potential for drug-drug interactions
Eventually enhanced understanding of a patient’s
• Metabolism
• Genetic profile
• Likelihood of a positive or potentially harmful response to course of treatment
Increased efficiencies
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Related to administrative tasks
More interaction with and transfer of information
• To patients
• To caregivers
• To clinical care coordinators
Monitoring of patient care
The goal is to create an uninterrupted chain of data across
7000 hospitals
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Looking Forward
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Planning for the Future
Accountable Care
A major shift to accountable
care will incent provider
organizations to decrease
cost and increase quality
Regional Network
A regional network of
hospitals, clinical care
providers, patients, and
caregivers will be required.
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Building the Broader Community
The
cornerstones
of the
exchange
are:
Security
Validity
Accuracy
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Guiding Principles to evolve Healthcare IT
• Recognize data as an asset which must be
managed with prudence.
• Use technology as an enabler to support
improved clinical outcomes through intelligent
data presentation and exchange.
• Improve enterprise-level coordination among
stakeholders and business units to support a
variety of EMR’s, integration, and decision
support systems with data.
• Connect clinicians and care givers around the
patient.
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What it takes to create a HIE
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Moving Towards Accountable Care Organizations
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Data is the Foundation
Accountable Care
Regional Network
EMR deployment and
meaningful use are prerequisites to digitizing health
care data.
Patient outcomes and quality
measure are central to this
paradigm shift.
Population management and
advanced analytics are core
components to achieving
efficiencies in chronic disease
management and promotion of
wellness.
Aggregate data must be
organized and harmonized in
order for it to be usable and
actionable.
Meaningful use of electronic
information systems is the
foundation
Regional networks will be
linked to form a national health
information network.
In all cases, exchange must be
managed in an appropriate
manner based on need to
know enacted by patient
consent.
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Future State
• Team based care
– Population management
• Predictive modeling
– Targeted interventions for high risk patients
– Removing practice variability at the provider level
• Value based care
– Performance based credentialing
– Total Transparency
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Quality is the Platform of the Future
Achieved through the blend of clinical science,
comparative effectiveness, and integrated
patient-centered data
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Partners
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Investment in Emerging Technologies
1. UPMC selectively invests in business initiatives with outside partners.
2. UPMC develops and commercializes new business from internal
software development and expertise.
3. UPMC has strategically selected partners for joint investment and
commercialization.
4. UPMC and CMU have a formed a unique partnership to utilize each
others domain expertise and innovations for mutually synergistic
commercial goals.
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R& D Strategy
• Introducing intelligence into healthcare IT
which has predominately suffered from an
abundance of data with little translation to
usable information
– Structured Data (semantic
interoperability/analytics)
– Unstructured Data (NLP)
– Image Data (advanced visualization, image
interoperability, image mining algorithms)
– Video Streaming (Smart Suite)
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Center for Connected
Medicine
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Center for Connected Medicine
empowers healthcare leaders to transform the
continuum of care, by showcasing how the
integration of medical, communications, and
information technologies and solutions are
improving patient outcomes and revolutionizing
healthcare today and in the future.
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Center for Connected Medicine Partners
Founding Partners
Strategic Partners
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700 Physicians have dbMotion via
Blackberry
Built by UPMC using
dbMotion SDK
•Pulls semantic patient
record from over 25
sources of clinical data.
•Built using a few .net
developers on secure RIM
infrastructure.
•Pushed out to all BB users
at UPMC with minimal
training
•Instant Impact - service
improvement, access to
clinical info
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Bi-directional data exchange with Google Health
Go live next quarter
Pittsburgh, Pa. March 1, 2010
Aggregated data from inpatient and
ambulatory settings is shared bidirectionally between providers and
patients through the PHR and
dbMotion.
This information is captured in the
Virtual Patient Record, and can be
used for decision support.
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Let’s not forget…
The right patient, gets the right
care, at the right time, in the right
way….
every time
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Thank You!
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