Rush Health in Chicago started its journey toward data analytics a decade ago, with an initial focus on picking a core function as an example to show why analytical capabilities were needed.

Payer contracting was selected as the function for a simple reason, Brent Estes, president and CEO recalled at Health Data Management’s Healthcare Analytics Symposium in Chicago. “While people say it’s not about the money, it’s always about the money.”

Rush Health found that that licensed contracting software enabling providers to assess how well payers adhere to their own payment terms made it easy to collect base data, but that couldn’t be matched with hospital data in four facilities using disparate information systems. So, the need for a data warehouse became the priority.

Rush had to build a team of programmers to understand how physician practices were collecting data, integrate systems, and create a master patient index that spans all data systems. The MPI created a “golden record” to which other data attributes could be added, such as clinical conditions.

The MPI creates a “clean zone,” Estes said. “It helps us understand how many unique patients we have in our system and which ones are appropriate for outreach.” About six years ago, Rush Health thought it had two million unique patients, but through the MPI learned the number was closer to 650,000, and now is about one million. Rush Health now is converting its core systems to Epic and it will be a number of years before the task is complete. But already there’s enough data to conduct “leakage analysis,” which identifies patients needing subsequent care following a physician visit and whether they got it, and automatic identification of claims suspected of not being appropriately paid.

Rush Health now is focusing on developing patient-centered medical homes as it prepares for accountable care, and the medical home model has six core areas of focus, Estes said. These include recruiting and training physicians, practice redesign to incorporate NCQA elements, EHR revisions to improve data collection, nurse care management coordinators, a patient registry for case management, and coordination of multiple hospital and ambulatory functions.

Seven practices currently have adopted the medical home model, and results show a 16 percent increase in ambulatory visits, an eight percent decrease in emergency department visits and a 10 percent drop in hospitalizations after one year.

In total, the delivery system is analyzing 121 measures coming from multiple sources and calculating physician scorecards on how well they perform, and the amounts earned or not earned based on performance.

Rush Health also is offering private physicians free access to the Epic EHR system, but not getting the uptake envisioned as the software isn’t appropriate for many small practices. Consequently, Rush will endorse other EHR vendors with negotiated terms that include access to data in common formats, Estes said.

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