1 Virginia Chamber 3rd Annual Health Care Conference June 6, 2013 Sheldon M. Retchin, MD, MSPH CEO, VCU Health System
Mar 31, 2015
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Virginia Chamber 3rd Annual Health Care Conference
June 6, 2013
Sheldon M. Retchin, MD, MSPH
CEO, VCU Health System
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Innovation is a vital competency for successful health care organizations
Value is the evolving currency in health care today
Value rests at the nexus of quality and cost, and is fleeting given a dynamic and competitive market
Two VCU programs represent innovations creating value
• Electronic Early Warning System (quality & safety)• Management of complex care patients (quality &
cost)
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Early Warning System –EWS
Quickly identify changes in critically ill patients
Pulls data from the patient’s electronic record to alert providers to potential changes in the patient’s condition
Empowers the medical center’s rapid response team (RRT) to effectively triage and visit the most critically ill patients before their conditions deteriorate
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Early Warning SystemWhere is the patient?
Who is the patient?
Who is caring for this patient?
What is their resuscitation status?
What is their EWS Score?
How are they trending?
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Population Health Management…Programs targeted to a defined population
that use a variety of individual,organizational, and societal interventions
to improve health outcomes…
Felt-Lisk, S. and Higgins, T., Exploring the Promise of Population Health Management Programs to Improve Health, Mathematica Policy Research, August 2011
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VCUHS “80/20” Scenario
• $960 million Total Costs
• 164,000 Unique Patients
*Understanding High-Cost Patients, IMS Institute for Healthcare Informatics, www.theimsinstitute.org/healthspending. Accessed April 2013.
*
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VCUHS Population Health Management Patient Stratification Process
5% of Patient Population
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Virginia Coordinated Care (VCC) ProgramComplex Care Program
VCC program established in 2000 to coordinate care for uninsured patients
Provides “medical homes” through partnerships with 50 community-based physicians
• Care coordinators and outreach workers assist patients with case management and navigation support
Approximately 27,000 patients enrolled in FY12 Published studies demonstrated the merits of
managing care for uninsured patients Launched the VCUHS Complex Care Clinic
program in November 2011• Medical home for patients with multiple chronic
conditions
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SocialWorker
Engagement with Care Team
Interdisciplinary Care
Coordination of Care
Nurse Care Manager
Physician
ClinicalNurse
Behavioral Health Provider
Pharmacist
Patient Experience With the Complex Care Clinic
Improved Health
Patient
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Complex Care Clinic Pre- and Post-Utilization Study
■ Evaluated patients with at least one clinic visit between Nov. 2011 and Oct. 2012
■ Cost of care for the population was reduced by approximately 49%
■ Inpatient utilization dropped 44%
■ Emergency Department use fell 38%
Pre-Clinic Post-Clinic $-
$1.0
$2.0
$3.0
$4.0
$5.0
$6.0
$7.0
$8.0
$8.0
$4.1
VCC Patient Costs*Pre- and Post-Complex Care
Clinic Enrollment (n=365)
Mill
ions
*Includes Hospital inpatient, outpatient and ED costs
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Find out more: www.vcuhealth.org/annualreport