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Message: Iameter "white paper" January 2009
I read this an have to say, I'm still a believer !
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C
LINICAL
Q
UALITY
I
MPROVEMENT
™
S
OLUTIONS
O
VERVIEW
Actionable Information for Clinicians
and the Healthcare Community
J
ANUARY
2009
F
OR
M
ORE
I
NFORMATION
,
P
LEASE CONTACT
:
R
OBIN
L
EVENTHAL
RLEVENTHAL
@
CROSSFLO
.
COM
303‐717‐1322
888.583.0333
2
I
AMETER
C
LINICAL
Q
UALITY
I
MPROVEMENT
S
OLUTION
O
VERVIEW
Iameter’s Clinical Quality Improvement (CQI) solution suite provides clinical decision
support analysis and insight tools for physicians, hospitals and the broad healthcare
community in support of a value‐based healthcare delivery system that rewards
hospitals and their medical staffs on the basis of high quality and cost efficient medical
care.
Over the past two decades, Iameter has developed its experience‐based, clinical process
improvement solution that enhances the quality and cost efficiency outcomes of
physicians’ practice patterns and hospitals’ service lines. Iameter Clinical Quality
Improvement is a software and services suite that provides actionable, objective clinical
information to physicians, along with physician‐led techniques, for practice
modifications that improve the hospital's clinical quality and cost efficiencies. The suite
also satisfies the information needs of multiple stakeholders, including consumers,
purchasers, providers, health plans and policy makers, by providing benchmark
reporting tools that objectively identify the physicians and hospitals that provide the
highest quality and most cost effective care.
How Does Iameter Work?
The common language with which physicians communicate is clinical data. Iameter
provides physicians their own risk‐adjusted clinical data. Physician are willing to
construct clinical pathways around superior outcomes when they are presented with
their own risk‐adjusted clinical outcomes data and given tools to identify which of their
processes yield the best outcomes for mortality, morbidity, lower length‐of‐stay, and
reduced resource consumption.
Iameter’s Sherlock Decision Support Tool Report
Experience has shown that physicians do not mind making improvements on their own
processes, but they are reluctant to make changes based on other hospitals’ data. Every
doctor reads the medical literature to determine superior “evidence‐based” ways of
treating patients. But those evidence‐based processes allow for tremendous variations
in practice patterns from hospital to hospital. Using their own data seems to make all
the difference to physicians’ perceptions of how they should approach process and
quality improvement.
Iameter’s physicians capitalize on this phenomenon as they interact with the hospital’s
doctors using severity‐adjusted, clinical information in conjunction with non‐threatening
educational techniques. This combination of education and clinical information produces
experience‐based, clinical process improvement at the physician and hospital service
levels. The hospital’s physician leaders incorporate these techniques into their quality
improvement activities to achieve quantifiable and sustained quality and efficiency
enhancements.
Bottom line: although many hospitals have attempted clinical pathways, the Iameter
approach achieves physician acceptancebecause:
•
The clinical pathways are based on each physician’s own best‐demonstrated
practices, not on an externally generated set of “cook‐book recipes”. Using their
own data seems to make all the difference to physicians’ perceptions of how they
should approach process and quality improvement.
•
Experience‐based clinical process improvement concentrates on improving
processes rather than on punitive “good doctor vs. bad doctor” approaches.
•
Iameter physicians work with the hospitals’ medical leaders to apply these processes
and facilitate physician‐to‐physician communications in clinical services.
•
Iameter can supply chart‐level data gathering templates that optimize the hospital’s
Clinical Improvement Process.
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The Iameter Solution Suite is comprised of these components
:
•
AIM™ ‐ Severity Risk‐Adjustment Tool for hospital data
•
Sherlock™ ‐ Decision Support Tool for hospital data
•
IQI™ ‐ Index of Quality Improvement Reporting Tool
•
Professional Services ‐ Iameter physicians and technical experts
•
Accreditation Support ‐ Approved to transmit data for ORYX® Hospital Core
Measure Sets
Iameter Solution Features:
• AIM™ is an accepted severity of illness methodology which risk adjusts hospital medical
records to enable meaningful, measurable and reliable severity‐adjusted profiles of
length of stay, resource utilization and mortality using more or more years of
retrospective inpatient data. (Other accepted risk‐adjusted methodologies can be used.)
• Sherlock ™ is Iameter’s “point‐and‐click” data analysis and reporting tool. Your severity‐
adjusted outcomes information will be integrated into Sherlock™, providing you with
easy access to your information and the ability to generate standard and complex
reports profiling hospital, physician or patient‐level performance. Sherlock™ enhances
the reporting and analysis process by eliminating or limiting the need for spreadsheet
manipulation of the data.
• IQI™ provides Benchmark Reports and Ratings of data that are transparent, meaningful
and comprehensible to all stakeholders – clinicians and non‐clinicians alike ‐ including
hospitals, physicians, patients, payers, and businesses. It provides Value‐based Quality
ratings that are meaningful and comprehensible to all stakeholders.
• Professional Services offer Iameter physicians and technical experts who work with the
hospitals’ medical leaders and staff to apply the quality improvement processes and
data to facilitate physician‐to‐physician communications and improvements in clinical
services. Our subject‐matter experts are comprised of physicians and professionals with
over 20 years experience in clinical quality improvement data, methods and technology
support tools.
• Accreditation Support. Iameter has met the criteria for inclusion in the accreditation
process and is included on The Joint Commission's list of acceptable systems. Iameter
has successfully met the technical requirements and is approved to transmit data for the
following ORYX® Hospital Core Measure Sets: Acute Myocardial Infarction (AMI), Heart
Failure (HF), Pneumonia (PN), Pregnancy & Related Conditions (PR), and Surgical Care
Improvement Project (SCIP). Additionally, Iameter has met the technical requirements
and is approved to transmit data for the Hospital Based Inpatient Psychiatric Services
(HBIPS) and Children's Asthma Care (CAC) Test Sets.
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Why Does Iameter Clinical Quality Improvement Work?
The Iameter model is based solely on the principle that good physicians, given good
clinical data on their own practice behavior, will make good clinical decisions to improve
quality and cost efficiencies. When physicians are presented with their own, risk‐
adjusted clinical outcomes that demonstrate significant outcomes variations in their
own best‐demonstrated practices, and are also given the tools to identify which or their
processes yielded the best outcomes or mortality, morbidity, lower Length Of Stay and
fewer resources, they are willing to construct better clinical pathways around those
superior outcomes.
Each clinical service’s outcomes data are fed back to the doctors quarterly to
demonstrate where outcomes are improving and where they need further
improvement. It is a continuous clinical process improvement cycle that requires
collaboration and commitment on the part of both the hospital and physicians. Iameter
also provides physician‐led training to enhance this collaboration so necessary for
success.
What are the benefits to Hospitals and Physicians?
•
Improve Hospital Medicare Reimbursements by Improving Quality
•
Improve Hospital Profitability for Medicare & Medicaid Patients by conserving
resource consumption through reduction in variation
•
Provide Data to Negotiate Higher Reimbursements for MDs & Hospital
•
Create sufficient savings to finance Physicians’ EHRs and IT Integration
•
Address documentation and quality of care issues for RACs
•
Improve CMS and public quality ratings
•
Defend Each Physician’s Quality Outcomes
•
Appropriate resource consumption is defined by the physicians, NOT third
parties
What kind of Outcomes Do I Get?
–
Clinical Outcomes Improvement (Mortality, Morbidity)
–
Increased Cost Efficiency
–
Reduction In Variation (RIV)
–
Improved documentation
–
Morbidity Trending
–
IQI Assessment
–
Quality Measures (including National Hospital Quality Measures)
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Why Iameter?
Physician‐developed, Physician‐led, Physician Driven Clinical Quality Improvement
The Iameter Clinical Quality Improvement Solution is a unique clinical decision support
system that engages physicians in participating because it's physician‐driven, physician‐
led, and physician‐developed.
Iameter engages physician’s to improve their practice patterns because we provide
physicians:
•
Patient‐centric data that focuses on each diagnosis.
•
Medical data allows drill down to the patient level
•
Medical data reflects each physician’s own practices for analysis
•
Training techniques for analyzing and improving on clinical outcomes that are led
by Iameter’s physician team.
Objective, Meaningful Clinical Quality Data and Metrics
Iameter offers the most comprehensive set of quality metric measurements and reports
for clinical decision support and quality improvement, including Reduction in Variation –
the all‐industry standard metric to measure and improve quality – as well as morbidity,
mortality, resource consumption and CMS’ National Hospital Quality Measures.
•
Local, regional, state, national benchmark quality comparisons
•
Comparative Ratings and Reports to satisfy the information needs of multiple
stakeholders, including consumers, purchasers, providers, health plans and P4P
initiatives
•
Documented outcome metrics to gain higher ratings from accrediting and quality
improvement organizations and offer a competitive advantage within the
community
Significant Net Revenue improvements to the hospital’s bottom line
Iameter offers "at risk" pricing –so payments for our services are minimal unless we
achieve agreed upon quality and cost improvements.
•
As hospitals use Iameter clinical quality improvement, physician are provided the
tools to determine which processes and resources objectively produced the best
outcomes of mortality, morbidity, shorter LOS and fewer charges. As they deploy
these processes through clinical pathways, the hospital will lose fewer dollars or
even make money on each case.
Client Case Study Snapshot
One hospital in the Northwest has been an Iameter Clinical Quality Improvement client
for the past six years. The results of clinical quality improvement are evident given the
fact that the hospital’s all‐payer inflation rates have steadily declined from an inflation
rate of 15% in 2002 to an inflation rate of 2.8% in 2007.
The client’s inflation rate in 2007 was under that year’s average Total Consumer Price
Index inflation rate of 2.85%. More remarkable is the fact that the inflation rate for 2007
for the medical portion of the CPI, specifically for hospital services, was 6.6%, so this
client’s inflation rate for that year was less than half the nation’s hospital average. These
are remarkable outcomes that benefit the hospital, local businesses and patients.
In 2008, this hospital received the Quality Achievement Award, the top award of the
Mountain Pacific Quality Health Foundation, an independent organization of the
hospitals in Montana, Wyoming, Hawaii and Alaska, and working with Medicare. Not
only do they examine all aspects of patient care, but they critique the organization itself
– how it operates. In particular, they cited the hospital’s working atmosphere,
encouraging all staff to make changes benefiting patients – in short, teamwork and
communication that includes everyone.
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The Iameter Clinical Quality Improvement Solution Vision
Iameter’s Vision is a value‐based healthcare delivery system that rewards hospitals
and their medical staffs on the basis of high quality, cost efficient medical care.
When hospitals and physicians use Iameter’s objective metrics and continuous quality
improvement techniques, they not only improve the quality and financial position of the
hospital, they also have it within their power to transform their local markets from the
present price‐based system into a competitive model based on value ‐ both quality and
price. Iameter supports a value‐based system that will produce reliable medical
information for all constituents, re‐institute patients’ choice of providers based on
value, re‐establish physicians’ clinical decision‐making autonomy and assist the hospital
with its ability to provide excellent care for its community.
Iameter’s Mission is to improve healthcare delivery by providing objective outcomes
information and continuous quality improvement techniques for hospitals and medical
staffs to manage medical and financial risks, thereby optimizing the health status of
selected patient populations with medical services appropriate to their needs.
American healthcare will be transformed from a price‐based to a value‐based
healthcare delivery system when purchasers and patients have access to reliable health
information and knowledgeably select and reward providers who demonstrate superior
medical and service performance.
Iameter Index of Quality Improvement Benchmark Reporting Tool
More Information
For more information on our clinical quality improvement and other healthcare
solutions, please visit www.crossflo.com/healthcare or call us at 888‐5853‐0333.
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