A Network Commitment to Care Pathways: Integrating Clinical and Claims Data for Care Transformation

From the 2018 HVPAA National Conference

Matthew Miller (Lehigh Valley Health Network)

Background

Lehigh Valley Health Network made a commitment to a network goal for FY18 of implementing 20 care pathways through a defined governance and processes that standardized care for key diagnoses.  Building off of EMR build and integrating clinical and claims data, visualization tools were used to make the data impactful.

Objectives

Create a common governance structure to care pathway development.

Implement 20 care pathways in a fiscal year, ranging across 9 clinical consensus group areas of care.

Incorporate claims data from our population health entity with clinical data from our EMR to create advanced data visualization that is actionable.

Methods

Through a governance structure and multidisciplinary workgroups, the network is well on its way to achieving this goal. The team used a standardized approach to pathway development and integrated clinical data from the EMR (Epic) along with Claims data from our population health entity to create a robust visual presentation of care for our patients.

Results

We have already surpassed the target FY18 goal and are on trajectory to reach the max goal by June 30th.  We established three criteria for each of the pathways to be considered “”implemented””: 1) A Care Pathway Model is completed which includes an algorithm of the recommended pathway, 2) The Dashboard is created, and 3) The pathway is operational in the clinical setting.

Each of the 20 pathways includes both process transformation and technologic transformation in the EMR.  Order sets, documentation and other clinical decision support tools assist in guiding best practices in the EMR.

Conclusion

With a keen focus on care reliability, Lehigh Valley Health Network took on a robust network goal of implementing 20 care pathways in a fiscal year to reduce variability while improving quality and costs.

Implications for the Patient

Through the use of advanced data visualization with Tableau, the pathway dashboards clearly demonstrate the various metrics for the patient population being evaluated as well as the specific clinical metrics that will drive care.  The dashboards are accessible to colleagues across the network, while securing PHI unless needed.