Actionable Anesthesia Intelligence
White Paper Actionable Anesthesia Intelligence Smart hospitals are mining their anesthesia information management systems for data to optimize performance. From streamlining billing and operations to improving efficiency, compliance and decision support, a high-performing AIMS can provide the actionable intelligence needed to better compete in today’s demanding healthcare environment. With factual information in hand, users can stop speculating and defend decisions with confidence and real numbers. Getting More From Your Anesthesia Information Management System Your anesthesia information management system (AIMS) can be utilized to do much more than chart a patient’s progress throughout the entire surgical encounter. As an offshoot of its day-to-day functionality, an AIMS collects volumes of rich data that can be used by anesthesia management and team members, business managers and hospital administrators to drive process improvements and transform high-acuity care. Through a combination of operational reporting, business intelligence and data extraction tools, an advanced AIMS can deliver actionable insights across the perioperative environment. For example: • Analytics let clinicians and business users drill down to see what’s going on behind the numbers. • Best-practice report libraries can inform on personnel performance, case times, anesthesia milestones and physiologic data. optum.com Page 1 White Paper Actionable Anesthesia Intelligence • Data can easily be extracted and optimized for reporting to registries. • Key information can be organized and presented in a graphical dashboard. With these tools in hand, you can easily: • Track perioperative quality indicators • Investigate relationships within physiologic data • Analyze productivity and supervision of anesthesia providers • Evaluate anesthesia case throughput • Benchmark business performance • Identify good practices This paper will examine and illustrate how AIMS data can be leveraged to help clinicians improve performance, utilization, compliance, billing and safety. Performing at a Higher Level An automated anesthesia system provides a host of features that have a direct impact on the efficiency of hospital staff and processes. Most AIMS deliver flexible and robust workflow management tools that streamline work processes and improve operating room efficiency. In addition, they automate anesthesia documentation, record data directly from medical devices and integrate with other systems so that items such as allergies and medications automatically flow into the chart. With the automatic recording of physiologic data, clinicians can devote more time to the patient. “Our AIMS gives us the ability to simultaneously document complete multiple data inputs such as continuous cardiac output, systemic vascular resistance, entropy values and cerebral oximetry values,” says John MacCarthy, MD, co-director of Surgical Services at St. Jude Medical Center in Fullerton, California. “We spend time analyzing and acting on the data gathered rather than wasting time recording it.” The result: more accurate, complete and legible documentation. Beyond this core functionality, data analytics and reporting can be used to further improve performance and efficiency. Dynamic drilling and filtering help users understand productivity differences and identify areas of potential improvement. Let’s look at three examples. Identifying best practices: Analytics offers anesthesia chiefs the ability to evaluate peer performance and care quality. “We look at milestones that our Optum Anesthesia system tracks, such as average anesthesia case time, preparation time and emergence time,” says Gary Friedman, MD, vice president of Nashua Anesthesia Partners. He then delves deeper and analyzes those numbers by type of surgery, type of medication or inhalation agents, and anesthesia staff member. Perception or Reality Instead of relying on anecdotal evidence, quantitative data from an AIMS can dispel myths and provide the hard evidence needed to make data-driven decisions. With factual information in hand, users can stop speculating and defend decisions with confidence and real numbers. For example, the perception among a group of surgeons at a community hospital in the Northeast was that it was taking patients who were in the prone (headdown) position during lower back surgery as much as half an hour longer to wake up from anesthesia than patients who received a general anesthetic while supine. The anesthesia department ran a report that compared average emergence time for neurospine surgeons versus all general anesthesia cases. It revealed that there were no substantial differences between the emergence times of prone or supine patients. Quantitative information from an AIMS can also help determine if the existing OR resources can accommodate more cases or whether alternatives such as expansion need to be explored. By analyzing room utilization by day and hour, you can determine if you have the capacity to handle add-on cases and emergency surgeries or if the operating suite is at or near capacity. Consider the case of a hospital where a surgeon was having trouble scheduling surgeries in the middle of the day and was pressing for the construction of additional ORs. The utilization report showed that the capacity problem was confined to the three days of the week when he was performing surgery; on the other two days, midday ORs were available. The problem was resolved by reshuffling the surgeon’s block assignment rather than a costly construction project. “We look at our best providers and glean valuable information about what they’re doing that may be of benefit to the entire group,” says Dr. Friedman. “This allows us to adopt things practice-wide that our most efficient providers are doing.” optum.com Page 2 Actionable Anesthesia Intelligence Improving staff efficiency: Using reports such as “number of cases by the time of day” can help better staff the OR. Reports like these provide a snapshot of OR case activity around the clock for each day of the week. St. Jude Medical Center in Fullerton, California, uses data from its Optum Anesthesia system to adjust staffing requirements based on actual use, which reduces expensive overstaffing or justifies increased manpower if utilization levels are high. Reducing unnecessary labs: Some AIMS have algorithms built into the system that help clinicians determine which labs are necessary for each patient based on comorbidities, type of surgery, expected blood loss and other criteria. This added intelligence ensures that anesthesiologists are not ordering labs on patients simply because they fit into a certain patient type or age category or other more general categories. Eliminating unnecessary labs lowers costs and improves patient satisfaction. Maximizing Operating Room Utilization The creative use of AIMS data can help improve OR utilization and turnover times. By looking beneath the top-line numbers, you can identify the root cause of delays and cancellations and take appropriate steps to improve OR throughput. Starting the day off right: Breakfast may be optional, but delays at the start of the OR schedule are not. If the day’s first cases are not on time, it creates a domino effect that can delay all subsequent surgeries. The costs are obvious both in terms of dollars and physician and patient satisfaction. The combination of “delayed cases” reports and system analytics can help provide the intelligence needed to make operational decisions to alleviate any problems. For example, you can answer questions such as: White Paper “When we implemented Optum Anesthesia at Southern New Hampshire Medical Center, we dramatically improved our revenue capture since the billing information was now accurate, legible and current, and included all the required data elements, both for anesthesia professional services and for the anesthesia technical component that the hospital bills.” Gary Friedman, MD, Vice president of Nashua Anesthesia Partners. Results – Southern New Hampshire Medical Center • OR revenue increased by 16%. • PACU revenue increased by 13%. • Is the surgeon getting there on time? • Endoscopy revenue increased by 15%. • Is there a relationship between the type of surgery and the delay? • Anesthesia technical component increased by 73%. • Does the surgery require a radiologic procedure that is not being completed on time to meet the anesthesia and surgical schedule? After the problem or pattern is understood, adjustments can be made to correct the situation and ensure that it’s a good morning—and afternoon—for everyone. Preventing unnecessary case cancellations: OR case cancellations represent a very large cost to a facility. Although all cancellations or delays are not preventable, many are. An analysis of AIMS data can identify the most common reasons for case cancellations. For example, the patient didn’t follow instructions to refrain from eating or drinking before surgery, or in other cases, labs, EKGs, X-rays or other preoperative evaluations weren’t completed. After a trend is revealed, you can drill down further to see if there are any other patterns. Are a significant number of the patients from a single surgery group or a single surgeon? Once a pattern is identified you can take steps—such as working with a surgeon or surgical group—to help prevent delays or cancellations in the future. Results – University Hospitals of Cleveland • A 27% increase in billable charges • Improved revenue capture • Shortened professional billing submission time • Reduced billing staff headcount Compliance Made Easy AIMS data and reports are instrumental in efficiently meeting hospital- and physicianrequired quality initiatives such as SCIP, PQRI, Medicare and AQI. Data collected as part of current documentation practices can be mapped to quality measures, eliminating the burdensome and labor-intensive collection and aggregation of anesthesia and perioperative data. optum.com Page 3 White Paper Actionable Anesthesia Intelligence Encouraging perioperative antibiotics documentation: According to Dr. Friedman of Nashua Anesthesia Partners, his AIMS system helps in compliance with perioperative antibiotic administration. “Antibiotics must be administered in a timely fashion before the incision in an operative procedure,” says Dr. Friedman. “Our Optum AIMS helps ensure our clinicians meet this requirement and then properly document it for reporting to SCIP and other outside agencies. This has a direct impact on anesthesiologists who are trying to receive incentive bonuses from CMS for reporting this information, or, in the future, to avoid a negative penalty adjustment.” Dr. Friedman points out that the AIMS is also important for collecting and publically reporting required site infection data. “It allows us to easily report on normothermia, beta blockers, central line infections and perioperative antibiotic administration. And the system is flexible enough to track and report on new criteria as requirements change.” Fulfilling condition of participation (COP) requirements: For every Medicare patient who receives anesthesia services, discharge notes and a postanesthesia evaluation must be completed no later than 48 hours after surgery. University Hospitals in Cleveland finds that their Optum AIMS system helps meet this critical requirement. “The system’s reporting capabilities allow us to remind clinicians to do 48-hour post-op checks and makes it easier to do the appropriate documentation,” says James R. Rowbottom, M.D., medical director, Operating Room, University Hospital Case Medical Center. Optum Anesthesia Optum Anesthesia is a completely integrated anesthesia information management system that helps anesthesia care providers chart a surgical patient’s progress from preop through PACU. Optum Anesthesia also supports administrative needs such as utilization, service-line analysis, compliance and quality reporting, and billing. Optum Anesthesia capabilities include: • Preoperative patient management • Medical device connectivity • Advanced patient/case tracking • Configurable documentation templates • Automated notifications Billing Capabilities Accelerate ROI An AIMS automatically abstracts and transmits billing information directly from the anesthesia record to the billing system or outside service. This is a powerful tool both for professional billing for the anesthesia practice group and for the hospital’s portion of the bill. When you bill directly from the electronic anesthesia record, all information needed by the billing service, insurance companies, and Medicare and Medicaid should be correct and complete. “You can get a positive return on investment from an AIMS just in the improvement in recovering professional fees,” says Dr. Friedman. • PACU documentation • Automation of supply and professional fee billing • Business intelligence and analytics • Quality reporting • Integration with EMR and financial systems Conclusion An AIMS is much more than an automated anesthesia recordkeeping system. Data collected by the system can be used to optimize performance throughout the perioperative environment. By taking full advantage of the system’s reporting capabilities, business intelligence tools, clinical notifications and other advanced features, hospitals and anesthesia groups have the timely information needed to improve efficiency, increase revenues, and maximize patient and physician satisfaction. optum.com 11000 Optum Circle, Eden Prairie, MN 55344 Optum™ and its respective marks are trademarks of Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners. Because we are continuously improving our products and services, Optum reserves the right to change specifications without prior notice. Optum is an equal opportunity employer. © 2014 Optum, Inc. All rights reserved. COL Actionable Anesthesia Intelligence White Paper Clinical 12012014 1 OPTPRJ7500 11/14 Page 4
© Copyright 2024