The Agency for Healthcare Research and Quality https://www.ahrq.gov has developed case studies to help health system CEOs and other C-suite leaders better understand the concept of a Learning Health System (LHS) where internal data and experience is integrated with external evidence and then puts the knowledge into practice.
Denver Health, a comprehensive health system serves more than 25% of the city’s population annually. It operates under the Denver Health and Hospital Authority and is a vertically integrated safety net health system.
The health system includes a 525 bed hospital, 17 school-based health clinics, 9 family health centers, and the city’s 911 emergency response and poison centers. The system treats more than 210,000 patients each year and has a patient mix that is 25% private pay and 75% Medicaid, Medicare, dual eligible, or uninsured.
Denver Health is making significant investments in data infrastructure and is in the process of consolidating their data operations. The health system has been using a single EHR system since 2016 and has invested heavily in using data that can be tracked and analyzed in real time.
The EHR system allows primary care clinics to incorporate reminders for certain cancer screening tests with the clinic’s daily appointment schedule. This enables the staff to know which patients are due or overdue for screening tests.
As for patient safety, the health system has looked at various performance metrics and the current science to find opportunities to improve. They have also developed a set of internal quality indicators to track progress and any variances in care.
Data transparency at the individual provider level allows the system to track and share more than 30 metrics on clinical outcomes, productivity, and financial returns. This level of transparency enables individual providers to identify where they can improve and allows system leaders to look across individual reports to identify opportunities to put the system-wide quality improvement processes in place.
Initially, Denver Health assumed there was a correlation between repeat ER visits and long stays. However, after close examination of their data, they discovered there was little overlap between patients with high emergency room utilization rates and lengthy stays.
Denver Health was able to use data effectively to review surgical site infections. They noticed the health system’s rates were higher than expected so they studied their patient populations. They discovered that many of their patients were living in circumstances without a way to follow a set of preoperative instructions. As a result, the health system changed their preoperative procedures to take these patient limitations into account, and as a result, surgical infection rates dropped.
Go to https://ahrq.gov/sites/default/files/wysiwyg/lhs_case_studies_denver_health.pdf for the case study “Denver Health: How a Safety Net System Maximizes Its Value”.