Analytics and the Future of Hospice Quality Reporting

Deborah Leyva, RN, BSN Solutions Intelligence Consultant Suncoast Solutions, Inc. May 30, 2012 The inspiration for hospice care arose during World War II, when Dame Saunders witnessed a great deal of suffering and pain and believed that people needed relief from physical pain and troublesome symptoms, they needed to preserve their dignity, and they needed help with the psychological and spiritual pain at death.i Todays Hospice agencies remain true to these inspirational ideals with teams of clinicians, chaplains, social workers, physicians, therapists, and community volunteers each dedicated to providing the highest quality of care for patients nearing end-of-life and their families. Although Hospice goals and ideals have not significantly changed in the past 60 years, the Hospice landscape is changing with new regulations requiring mandatory quality reporting being driven by The Centers for Medicare and Medicaid Services (CMS). These new rules (not inclusive) require Hospice agencies to collect patient data in compliance with the National Quality Foundations (NQF) #0209 Pain Measure for the period October 1, 2012 through December 31, 2012, reporting no later than April 1, 2013. In addition to other items of regulatory importance, this first year of mandatory quality reporting for Hospice includes documentation of participation in a Quality Assurance and Performance Improvement (QAPI) program that includes at least 3 quality indicators related to patient care, with data submission to CMS due January 31, 2013. In addition, it appears that CMS seeks to establish common definitions for many of the end-of-life quality care measurementsand quality reporting doesnt stop there. CMS is planning a pilot test in Spring, 2012 of standardized data collection and reporting capabilities similar to OASIS for Home Health. This pilot may indicate additional reporting requirements on the horizon.ii According to Pricewaterhouse Coopers Health Research Institutes survey on Clinical Informatics, knowledge gained from use of informatics-based patient care delivery provides insights to improve healthcare delivery, better understand stakeholder requirements, and measure and compare performance over time.iii It is probably no surprise that agencies who maintain their clinical records in electronic form (rather than paper-based records) will have administrative and efficiency advantages in quality reporting over agencies who have not yet converted to electronic health records. Users of Suncoast Solutions have additional benefits with a new and improved 2012 update to the Initial and Comprehensive Patient Data Assessment forms that will enable ease of data capture for required quality reporting; including the new NQF #0209 Comfortable Dying Measure. Other domains of patient care measures arise from items associated with the provision of care according to patient and family desires, effective and timely symptom management, care coordination among the patients interdisciplinary team and patient safety.iv The Patient Protection and Affordable Care Act (PPACA), Section 3004 requires implementation of quality reporting measures for long-term care hospitals, inpatient rehabilitation facilities and hospice programs.v It is anticipated that with this 1

new legislation, other measures will be forthcoming in subsequent calendar-year hospice quality reporting cycles that will influence hospice reimbursements.vi Suncoast Solutions provides two other important enablers of this changing regulatory landscape with the ability for clients to customize forms and reporting capabilities within the system. Suncoast Solutions does not require you to change your workflow; it adapts to the way care is delivered in your agency. Additionally, Suncoast Solutions provides significant value with its embedded hospice and home health care business intelligence tool called Solutions Intelligence (SI). SI enables you to monitor quality components such as OBQI and QAPI requirements with daily updates to client and administrative data, performance measures, census, staffing, administrative and accounting information. SI gives you the ability to analyze data to optimize your business and clinical processes. Analytics coupled with the wealth of patient data available in organizations can assist intradepartmental clinical professionals to compare and analyze patient data and outcomes.vii A key difference between reporting and analytics can be described as follows. DSS systems and predictive analytics transform data and information into dynamic insights that can be acted upon. Traditional reporting generally relates to a plan, target or static reporting period.viii Quality reporting, done well, can prompt users to ask questions that may be answered with an analytics tool like Solutions Intelligence. In closing, the pace of change is accelerating across all areas of healthcare with new and innovative technologies, mobile computing devices, potential changes from fee for service to bundled pay-forperformance reimbursements, changes to care delivery with Accountable Care Organizations, and other potential regulatory changes in the very near future. Look for new technologies that support higher quality delivery of patient care with predictive analytics that provides the ability to predict and act, not just sense and respond.ix Clinical informatics, as delivered in Solutions Intelligence, provides innovative methods to combine technology, patient care, staffing and financial reporting in a clinically intuitive manner.
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The History of Hospice, accessed 5/1/2012 at http://www.nationalhospicefoundation.org/i4a/pages/index.cfm?pageid=218 Hospice Quality Reporting, Person, J. L. MPH, VP Compliance and regulatory leadership for NHPCO accessed 4/14/2012 at http://mnhpc.org/wp-content/uploads/2011/03/MN-Quality-Reporting.pdf iii PwC Health Research Institute Clinical Informatics Survey, 2012 iv Hospice Quality Reporting, Person, J. L. MPH, VP Compliance and regulatory leadership for NHPCO accessed 4/14/2012 at http://mnhpc.org/wp-content/uploads/2011/03/MN-Quality-Reporting.pdf v Ibid vi New Data Quality Reporting Programs for Hospices, Long-Term Care, Goedert, J. Health Data Management, Sept, 2011 vii Analysis and the Future of Healthcare, Jan 2012, Healthcare IT News, Horner, P., Basu, Atanu. Accessed Feb 2012 at www.healthcareitnews.com/print/40946 viii Analytics Versus Reporting: The Salient Differences, MedeAnalytics, n.d. ix IBM, Capitalizing on Complexity: Insights from the Global chief Executive Officer Study, 2010, pg. 47.
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