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Data Mining Reaps Rewards
April 30, 2008
Preventing hospital-acquired infections not only saves lives and shortens hospital stays; it saves big money. In just two years, 14 hospitals in New Jersey have saved a total of about $6.4 million by preventing these infections, according to Horizon Blue Cross and Blue Shield of New Jersey, which subsidized the project. The hospitals used data mining software to identify infection patterns and take preventive steps.
In addition to Newark-based Horizon, Blues plans in Alabama, New York, Pennsylvania and Texas have launched infection control programs using MedMined software from Cardinal Health, Dublin, Ohio. In addition, Blue Shield of California recently announced it will spend $5.75 million to expand its efforts from a nine-hospital pilot project to 100 hospitals statewide.
“Most community hospitals have one or two people devoted to infection control,” notes Rajan Grover, a senior manager at Affiliated Computer Services Inc., a Dearborn, Mich.-based consulting firm. “If they can spend much less time on data collection and more time on process improvement, they’ll see infection rates decline.”
Many hospitals are taking a closer look at their infection prevention programs in light of Medicare’s decision to stop paying for treatment of many hospital-acquired infections, effective in October. “Reimbursement often drives process changes,” notes Sharron Finlay, regional manager at Beacon Partners Inc., a Weymouth, Mass.-based consulting firm.
The nation’s Blues plans, however, are continuing to study whether to take reimbursement action similar to Medicare, according to the Blue Cross and Blue Shield Association.
Meanwhile, the Blues plans that are helping hospitals pay for data mining are reaping impressive results in reducing the number of hospital-acquired infections.
Horizon has spent about $2.8 million on the MedMined software since 2005, paying for about 60% of the expense for 20 hospitals so far, says Bill Finck, director of network initiatives. The plan estimates it already has saved $2.9 million by avoiding paying for hospital-acquired infections. The first 14 hospitals to participate, Finck estimates, saved a total of about $6.4 million for their patients enrolled in the Blues plan or covered by other insurers. The savings are the result of such factors as shorter hospital stays stemming from a 10% cut in hospital-acquired infections.
“But most important of all, these patients don’t have to deal with the debilitating effects of an infection,” Finck adds.
Horizon based its efforts on a groundbreaking program at Blue Cross and Blue Shield of Alabama, launched in 2002 in collaboration with the Alabama Hospital Association. A total of 55 hospitals now participate in the data mining portion of that program, which has reduced hospital-acquired infection rates an average of 27%, says Janet Stewart, vice president of health information services.
The Alabama plan, based in Birmingham, pays for 75% of the implementation cost of the software, as well as monthly fees, as long as hospitals continue to participate, Stewart says.
Following A Trail Of Savings
The Alabama Blues plan, and others that have followed in its footsteps, are trailblazers, says Finlay, the consultant. “Blues plans tend to be leaders in investing money to save money,” she adds.
The data mining software uses information from a hospital’s laboratory and admission-discharge-transfer systems. MedMined reviews this data and applies algorithms to create “nosocomial infection marker” scorecards for each inpatient unit and identify patterns of statistical changes that have occurred. Infection control personnel then use this data to assess trends at the unit level and examine processes with the unit staff, says Wendy Hess, R.N., director of infection control at 775-bed Hackensack (N.J.) University Medical Center.
For example, using this data, nurses on a particular floor might investigate why they’re seeing a spike in indicators of potential urinary tract infections, Hess says. They’ll take such steps as investigating whether clinicians are following appropriate processes for insertion, care and maintenance of urinary catheters and initiate process improvement strategies, she says. “It’s wonderful to be able to capture all this information without the time investment that would be needed to do it manually,” Hess says.
Thanks to data mining, “infection control professionals are no longer spending their time detecting patterns,” says Horizon’s Finck. Instead, they automatically get the data they need to support decisions on how to improve processes to avoid infections unit by unit, he adds.
“Any time you can use technology to help identify negative trends or to help medical professionals attack infection rates it’s a good thing,” adds Terry Andrus, CEO at 334-bed East Alabama Medical Center, Opelika. “The software enables our infection control professionals to focus not on abstracting data, but on preventing infections.”
All participating hospitals in Alabama have access to blinded benchmarking data that they can use to compare infection rates on specific units to similar units at other institutions, Stewart says. The Horizon plan soon will launch a similar effort in New Jersey.
In addition, East Alabama is one of several hospitals participating in a new study that involves sharing hospital-identified data. In this way, these hospitals will be able to more closely collaborate and learn from those with lower infection rates for certain procedures and conditions, Andrus says.
In addition, the Alabama Blues plan holds quarterly user meetings that enable participants to share best practices, Stewart says. “Back in 2002, not everyone was raising their hands about information they’d like to share about the infections at their hospitals. But now Alabama hospitals are very open with each other.”" " By using the data mining software, hospitals are able to launch much broader infection control initiatives than they could if they painstakingly reviewed information manually, Stewart says.
“Before this initiative, many hospitals might have only manually tracked infections in certain units or for certain devices. This program helps create hospitalwide infection surveillance.”
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