Bon Secours Mercy Health’s enterprise assessment experience:
Uncovering clinical data efficiencies and cost savings
Introduction
Depending on its size, a health system may spend anywhere from $2 million to more than $20 million on clinical quality data activities every year (based on an average of $500,000 to $650,000 annually for every 160 beds). Because these costs are often dispersed throughout the system and may not be line items in hospital budgets, many healthcare leaders have little understanding of how much their health system is investing in clinical quality data—or where untapped cost efficiencies may lie. Data management practices can also vary widely across facilities or service lines, opening the door for redundant or inefficient practices.
As chief quality officer of Bon Secours Mercy Health (BSMH), a 48-hospital health system with facilities in the United States and Ireland, Dr. Taryn Kennedy knew that getting a comprehensive view of BSMH’s clinical quality data activities would help her further BSMH’s ability to continually improve healthcare quality, safety, and costeffectiveness. With a deeper understanding of the health system’s clinical data management processes, BSMH leadership would be better equipped to drive efficiencies and maximize the value of their clinical data.
For this reason, Dr. Kennedy and BSMH’s leadership team chose to partner with Q-Centrix’s advisory solutions team for an enterprise assessment. Their decision—which is detailed in part one of Q-Centrix’s case study series—set BSMH on a transformative path that would pave the way for systemwide improvements and strategic growth.
This case study is the second in Q-Centrix’s series exploring an enterprise assessment journey from start to finish. It provides an overview of the enterprise assessment process, shares key opportunities the assessment highlighted for BSMH, and examines how Dr. Kennedy and the BSMH leadership team chose to act on the assessment findings.
A health system may spend anywhere from $2M-$20M+ on clinical quality data activities every year.
BSMH's goals
Before undertaking the assessment, Dr. Kennedy shared BSMH’s goals with Q-Centrix’s advisory solutions team. This helped the Q-Centrix team tailor the assessment to BSMH’s needs.
Stratify the total cost of participation in clinical registry and quality reporting
Improve efficiencies in clinical quality data management processes
Identify clinical staff utilization and realignment opportunities for future strategic growth
Over the course of 23 weeks, Q-Centrix’s advisory solutions team worked with BSMH to develop and deliver a custom assessment that aligned with the health system’s goals
The enterprise assessment process
This section provides an overview of key assessment milestones and all available components that custom assessments may involve. Each assessment is tailored to the health system’s goals and needs.
Key Milestones
Kick-off: Set expectations with executive stakeholders and hold a full stakeholder meeting to review the project and begin the assessment process.
Registry and stakeholder identification: Identify and connect all current registries, physician leaders, and administrative support teams.
Analysis and validation: Generate, collect, and validate data audit and survey results for inclusion in a final report.
Initial data review: Share current state findings with executive stakeholders and discuss outstanding areas that need validation.
Final strategy presentation: Review a final report that combines strategic growth initiatives and alignment opportunities to create a roadmap for achieving greater centralization and utilization of clinical data.
Components of an assessment
Registry and technology assessment:
Review and catalog regulatory/national inpatient registry participation and evaluate the corresponding data management support technology.
Top of license assessment:
Review the current support structure for registry participation and confirm the appropriate staff is suitably integrated into the process to maximize values.
Clinical data validation:
Clinical experts review cases previously abstracted by the health system’s team for accuracy for seven of the most commonly requested registries (Sepsis, CLABSI, CAUTI, STS-ACS, LAAO, TVT, and CathPCI) and provide improvement opportunity insights. While all inpatient registries are evaluated for quality, this deep dive into the data elements themselves provides a rich learning opportunity for administration and staff.
Oncology platform visualization and database validation:
Strategic analytics to identify key opportunities to increase the ROI of the health system’s oncology program and unlock the wealth of information in the cancer registry.
Research data analysis:
Understand the health system’s approach to mining and utilizing clinical data for research purposes.
Team efficiency assessment:
Review internal teams’ throughput and utilization to determine appropriate processes and staffing models.
Outcome data utilization analysis:
Outline the current process by which the organization interprets and uses outcomes data.
Physician perceptions:
An interview of key leadership personnel to identify their usage and perceived value of the registry data.
Value alignment:
Ensure existing and new programs align with strategic initiatives and priorities.
Total cost of registry management:
A detailed cost analysis providing insight into the health system’s overall registry participation.
Strategic growth action plan:
Uncover the steps to transform the health system’s approach to interpreting clinical data and transforming care.
Enterprise assessment findings
After analyzing the quantitative and qualitative data they gathered as part of the assessment, Q-Centrix’s advisory solutions team presented the assessment data and key findings to BSMH’s leadership team, sharing concrete numbers for BSMH’s total cost of clinical quality and registry participation, the total number of registries BSMH participated in, the hours BSMH spends on data collection and performance improvement, and much more.
Some opportunities that arose from these findings included:
Opportunities to invest in system reporting and centralize clinical data management for select registries.
By aligning the technology platforms and resources BSMH used to collect and report registry data for high-impact areas such as oncology, cardiology, core measures, and Get With the Guidelines – Stroke, BSMH could enhance transparency, access to data, and data security throughout the health system.
Opportunities to cut direct operating costs by 28 percent.
Addressing backlogs and centralizing clinical data management for select registries would enable BSMH to streamline processes while lowering costs.
Opportunities for clinical staff to work top of license more consistently.
Redefining staff roles and responsibilities would help clinical and quality staff spend less time on data curation and registry submission activities—and more time on patient care and performance improvement.
Opportunities to eliminate duplicative registries, evaluate the necessity of specific registries, and align governance of registry efforts.
A few registries BSMH participated in were duplicative or potentially unnecessary. Focusing on high-impact registries would save costs, free up staff time, and pave the way for more impactful quality and performance improvement activities.
Dr. Kennedy shared that the assessment findings were eye-opening in many ways. “When we started to get the data back, it was really interesting to see how we benchmarked against [industry] benchmarks, and where there might have been outliers,” she said. “We also unfortunately had a significant backlog in some of our registry work, which definitely was an aha moment that I really don’t think as a system we knew the extent and breadth of at the time.”
The assessment also highlighted the scope of registries in which BSMH was participating. “When we undertook this very large assessment across the health system, there were registries where I didn’t even know that people were collecting some of the data,” said Dr. Kennedy. “We had a lot of registry work going on. I don’t think I quite understood the breadth of it, and I didn’t understand how many people were spending some of their time doing this work.”
To help BSMH’s leadership team decide how to move forward, Q-Centrix provided the team with a checklist for evaluating the usefulness and impact of each registry the health system invests in. Q-Centrix also shared a guidebook featuring resources on how to plan for and enable transformative change in healthcare quality, best practices for developing and implementing a centralized clinical data management model, and how Q-Centrix can support BSMH throughout the process.
“Identifying the right strategy is a collaborative process,” said Doug McGill, Q-Centrix’s managing director of advisory solutions. “Understanding the opportunities and risks, balancing priorities and timelines, building an implementation roadmap, and measuring impact are all fundamental to ensuring that a strategy moves forward into an action plan—but most importantly, it is casting the vision of what’s possible. With BSMH, the assessment provided clear evidence for the need for change. However, for that change to be transformational, it was going to require a serious commitment to the vision and flexibility in process.”
Making a decision
Armed with these findings and resources, Dr. Kennedy and the BSMH leadership team had some important decisions to make. They began by digging more deeply into the data. “It’s a lot of data that you get back a lot,” said Dr. Kennedy. “And [it’s] interesting. You do need to sort of delve into it and ask some questions about it.”
To guide their decision-making, Dr. Kennedy and the leadership team considered what BSMH was best equipped to manage internally and what could be managed more effectively by leveraging the health system’s partnership with Q-Centrix. “We decided to divide it into a couple of different buckets,” said Dr. Kennedy. “One that made sense to address first, that we were going to definitely [partner with] Q-Centrix. There was another element that we’d already started some internal centralization, and that actually has been working pretty well as well—but we also realized we don’t want to do this for everything.”
After reviewing the data and having internal discussions, the BSMH leadership team reached a decision. As the assessment had revealed that cardiology and oncology registries were especially high-impact areas for BSMH, with significant opportunities for increasing efficiencies and cutting operating costs, BSMH leadership decided to partner with Q-Centrix to manage clinical data for these registries. By aligning duplicative technology platforms with Q-Centrix’s enterprise solution, BSMH would benefit from the enhanced transparency, access, and data security that a centralized approach offers—and more effectively manage the health system’s oncology backlog. Further, clinical and quality staff would have more time to spend on patient care and performance improvement. This approach would also ensure that clinical data was managed consistently throughout the health system, allowing for greater data integrity.
“Typically, a centralized approach is going to bring standardized processes, a common governance structure, enhanced connectivity, and collaborative shared learnings,” said Doug McGill. “Our goal with BSMH was to find the right strategy to balance a centralized governance approach with regional ownership and accountability.”
For core measures and Get With the Guidelines – Stroke, which had also been identified as high-impact areas that would benefit from centralization, BSMH leadership felt that the health system was best equipped to continue managing these internally. The assessment outlined key performance metrics and goals for how BSMH could advance this work internally, helping to inform BSMH’s internal strategy alignment and performance improvement efforts going forward.
Conclusion
BSMH’s registry value assessment provided invaluable insights into the health system’s clinical data activities. BSMH leadership had the information they needed to drive improvements throughout the health system and guide internal centralization efforts for core measures. By partnering with Q-Centrix to manage clinical data for high-impact oncology and cardiology registries, BSMH would be able to benefit from significant cost reductions, increased efficiency, and greater data integrity. But first, they would need to make the systemwide changes necessary to bring about these improvements.
The next case study in this series examines how BSMH and Q-Centrix worked together to plan for and implement these changes throughout the health system.
Part two in Q-Centrix’s enterprise assessment case study series with Bon Secours Mercy Health