Ehealth Success Story LUMEDXApollo Case Study

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Presentation Summary

• LUMEDX Overview
• Inova Heart Center Background
• Business Problem
• LUMEDX Solution
• Approach
• Results
• Summary
• QA

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LUMEDX Overview

• More than 10 years of experience in cardiology
  data management systems
• More than 280 medical centers worldwide
• Client base reflects one-third of the top 40
  cardiovascular centers in the U.S.
• Massachusetts General Hospital
• New England Medical Center
• Baylor University Medical Center
• Stanford University Hospital
• Washington Hospital

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LUMEDX Overview Continued

• Depth and breadth of Apollo Advance?
• A modular suite of clinical-data repository
  products focused on cardiovascular medical
  specialties and subspecialties
• Serves cardiology and cardio thoracic surgery
  through traditional client-server models,
  Web-based models, and ASP solutions
• Offers physicians and administrators desktop
  access
• Rich longitudinal patient data
• Aggregated clinical and cost outcomes

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LUMEDX Overview Continued

• Offers 47 modules (from cardiovascular surgery to
  inventory)
• Supports 17 interfaces
• Offers national and state registry compliance
• STS and ACC national data registries
• New Jersey and Washington state registries
• Anthem registry (covering Midwestern U.S.)

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LUMEDX Strategic Relationships
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Inova Heart Center Background

• Part of Inova Fairfax hospital and Inova Health
  System
• In 1999, rated Inova Fairfax Hospital among the
  nations best in 5 specialties
• Cardiology/cardiac surgery
• Neurology and neurosurgery
• Respiratory disorders (pulmonology)
• Digestive tract (gastroenterology)
• Urology
• One of 25 heart programs in the US, providing
  heart services for both adults and children

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Inova Heart Center Background

• 656-bed regional medical center and teaching
  hospital, serving the Washington, D.C.,
  metropolitan area
• Affiliations with medical schools
• Georgetown University
• George Washington University
• Medical College of Virginia
• and the Medical College of Virginia
• Affiliations with nursing schools
• George Mason University
• Marymount University
• Northern Virginia Community College

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Business Problem

• Disparate cardiology information systems
• Large managed care patient population
• Volume of data from disparate cardiac legacy
  systems
• Nearly 7,000 catheterization procedures and 2,000
  cardiac surgeries per year
• Inefficient or lack of outcomes and cost
  reporting
• Unable to connect cardiac and cost data to SPSS
  via ODBC
• Unable to collect quality indicators for Clinical
  Value Compass

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Business Problem Continued

• Managed care organization RFP and contract
  negotiations
• Unable to provide patient level data for outcomes
  or aggregate patient information
• Unable to gain contracts and potential revenue
  without valuable patient outcomes information for
  MCO contracts
• National Cardiovascular Database RegistryTM needs
  
• American College of Cardiology
• Society of Thoracic Surgeons

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LUMEDX Solution

• Apollo32 implementation
• Cardiology data integration
• Clinical data repository reporting capabilities
• National Registry participation
• Apollo32 components installed
• SQL Server 7.0
• Catheterization Module
• Surgery Module
• HL7-ADT Interface to HIS
• Q-Cath QCX Interface
• TCP/IP Receive Client

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Approach

• Integrating cardiology data at Inova Heart Center
• Providing open architecture, integrating with
  desktop Office? products
• Providing ODBC--a common language--for Windows
  applications to access databases on a network
• Applying intermediate databases for complex
  queries and pivot tables, connected with other
  statistical databases

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Approach Continued

• Integrating cardiology data at Inova Heart Center
  continued
• Allowing easy connection with statistical
  software (SPSS and SAS) without exporting or
  converting data
• Providing comprehensive and complete record as
  soon as patient exits the cath lab

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Apollo32 Cardiology Integration
hospital information system ADT, Lab, Pharmacy
patient reports
EnConcert
clinical outcomes
Tracemaster
existing interfaces

• Quinton Qcath
• Marquette MUSE
• Seimens Cathcor
• Zymed Holter

cost outcomes
Example Apollo32 Configuration
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Approach Continued

• Creating reporting capabilities with Apollo32
• Scalable repository large volume of transactions
• Ease-of-use has enabled clinical practice
  specialists to run reports or queries whenever
  they wish
• Apollo database to write queries and spreadsheet
  pivot tables
• Generating comprehensive and accurate
  clinical-outcomes reports
• Running physician profiles that are compared with
  predetermined benchmark

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Approach Continued

• Clinical pathways reporting for monitoring and
  continuous process improvement
• Clinical pathways program for catheterization and
  cardiac surgery
• The goal is to provide quality patient care,
  improve efficiency and cost effectiveness
• Analyze and monitor existing pathways
• Determine why patients fall-off some pathways
• Understand factors that may affect compliance by
  patient or physician
• Understand why patients are able to sustain a
  particular pathway

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Approach Continued

• Outcomes management reporting for Clinical Value
  Compass
• Collects and allows the monitoring of performance
  with cost and clinical outcomes metrics on a
  monthly, quarterly, and annual basis
• Measures the value of care for similar patient
  populations, analyze the internal delivery
  process, and determine if these changes lead to
  better outcomes and lower costs
• Uses Apollo reporting to collect quality
  indicators

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Inova Apollo32 Connectivity
Clinical Value Compass
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Approach Continued

• Physician profiling and benchmarking
• Using SPSS Error Bar graphs and reports to modify
  physician practice patterns
• Generating coded physician profiles that define
  performance levels for each physician
• Compares physicians with those of their
  individual colleagues or surgical group
• Profiles compared to predetermined, in-house
  benchmarks

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Inova Physician Profiling Report
Tails Represent 95 Confidence Interval
Each Box Represents the Individual Physician or
Group Performance
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Approach Continued

• MCO RFP and contract negotiations
• Quantify the cost data to accurately respond with
  an accurate per member/per month (PM/PM) for
  capitation
• Leverage opportunities to preserve income through
  better management of services delivered
• Link the cost of care to their practice patterns,
  thus better understanding how to manage care
  efficiently

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Approach Continued

• National registries solution
• Apollo registry modules for ACC and STS, allowing
  Inova to participate in national registries
• Apollo registries provide ability to add fields
  and incorporate custom tables to capture other
  specific that are not included in the national
  registries

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Results

• Affect physician practice patterns in a
  non-threatening way
• Improves physician compliance with clinical
  pathways and outcomes
• Provides comparative physician profiling reports
  that allows physicians to modify their practice
  patterns
• Contributes to the individualized patient care

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Results Continued

• Inovas application of Apollo32 delivers more
  accurate outcomes and cost reports
• Preserves income through better management of
  services for MCO contracts
• A cornerstone for Inova Heart Centers clinical
  pathways program for catheterization and cardiac
  surgery

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Summary

• The LUMEDX solution
• A turnkey solution for Inova Heart Centers
  Cardiology/cardiac surgery needs
• Apollo yields versatile outcomes data that drives
  quality improvement frameworks
• Kaplan and Nortons Balanced Scorecard
• Dartmouths Clinical Value Compass
• Executive Dashboard
• ACC and STC participation

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Questions