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Schneck Medical Center: Improving population health management with near real-time data

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IBM Watson Health recently sat down with Susan Zabor, the vice president of clinical services and Shery Tiemeyer, director of patient volunteer and long-term care services for Schneck Medical Center, a 93-bed community independent hospital in Seymour, IN. The purpose of the conversation was to learn more about how Schneck uses data to develop programs and processes that improve its population health management efforts.


IBM WATSON HEALTH: How does Schneck Medical Center incorporate data into population health management?

SHERY TIEMEYER: Data gives us the ability to focus and drill down on areas that we feel like are important to our patients, customers and all stakeholders. It validates where we need to focus and what patient populations need attention. Data also lets us know how we’re progressing based on benchmarks against other hospitals. We use the input to drive improvements in patient care.

SUSAN ZABOR: We’re very proud that data is a foundation that drives methodical population health management improvements at Schneck Medical Center. We like to say that we’re very focused and data-driven.


IBM: What challenges did you face when shifting to a more data-driven population health management model?

ZABOR: Data in healthcare can be daunting. There are so many sources and most of the time it’s very retrospective, which is not very valuable to us. Now we have access to reliable data that enables us to really focus on what’s actually happening.

TIEMEYER: My team can more easily stay focused because we get the data as close to real- time as possible. My team looks at every single patient that returns to the hospital and drills down, doing the root cause analysis on that patient’s experience.


IBM: What factors contributed to Schneck’s focus on the patient population with chronic obstructive pulmonary disease (COPD)?

TIEMEYER: We have a huge population of patients that have COPD.  We could see from the data that there was an opportunity for us to improve in both readmissions and mortality.

ZABOR: We know, based on the population that we serve, that COPD is definitely something we need to address. When we really dug into our data, we discovered COPD is our second leading cause of readmissions and one of our leading diagnoses for admissions to the hospital.


IBM: What changes have you made in COPD patient care based on analysis of the data?

ZABOR: After we knew that COPD was an area that we needed to address by looking at our data, we pulled together a multidisciplinary team to really focus on closing care gaps and make sure our resources were deployed appropriately.

TIEMEYER: The changes that we’ve put in place based on the data are many and varied. The best thing is that patients have long term care providers caring for them on a daily basis. It’s also better for the facilities to help keep them in regulatory compliance. We’ve seen decreased patient returns to hospital. Satisfaction has gone up for patients, their families, long term care facility staff and for our providers as well because they develop a very close relationship with those residents.


IBM: What improvements are you seeing as a result?

TIEMEYER: The results that we’re able to see based on the data are a reduction in readmissions to the hospital and a reduction in cost. One thing we didn’t expect was a reduction in the first admission. The process we put in place within the hospital, in the long-term care facilities and with our long term care practice and providers caused the first admission denominator to continue to go down, followed by a reduction in readmissions.

ZABOR: With our readmission rate we saw significant improvement.  We had a 55% reduction in our raw readmission rate. Our index went from a 1.91 to below a 0.83., and that’s looking at the top ten percent of all hospitals as our benchmark. The data also shows that when we started in 2014, the cost of COPD readmissions was almost $300,000. When we look at our data now the cost of readmission has decreased to below $3,000.


IBM: What else have you learned from the COPD population management program?

TIEMEYER: In the past, we were focused on six diagnoses and going all different directions trying to nail down what worked for each one. When we focused on COPD, the majority of the processes we put in place to attack that opportunity have proven effective for other diagnoses as well. We now have good processes that flow into other types of diagnoses for other patients.


IBM: How else have you used data to drive quality improvement initiatives?

TIEMEYER: I believe the data can help with preventing provider burnout. I’m able to share outcomes and results with providers on a monthly basis. They can see how they’re doing and how they’re doing compared to others.

ZABOR: The data also proves to be very valuable with its comparable benchmarks. We want to be the best, better than any other hospital in the nation. So, we focus on the top ten percent. With today’s pressures in the healthcare delivery system, with regulations and measurements and pay for performance, there is no way that any healthcare organization in the nation could be successful without a data source that is reliable and valid.


To hear more from Schneck Medical Center, view this video. Susan Zabor was also featured in this recent article from Healthcare Informatics.


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