Quality improvement is no longer just a nice-to-have. It's a critical must-do for any health system that hopes to survive in the era of value-based care. But opinions vary widely on the best way to manage data for better outcomes.

As Robert Altemose, RN, clinical operations analytics director at Altamonte Springs, Florida-based AdventHealth (which until this past August was known as Adventist Health System) explains, doing so retrospectively isn't effective – true quality improvement has to be done proactively and in real time.

At HIMSS19, in a presentation with his colleague, Judi Reed, senior manager of clinical operations analytics and user experience at AdventHealth, Altemose will show how his team has helped the health system make the leap from retrospective to real-time analytics, nudging its clinical staff toward higher-quality care as it's delivered.

They'll show how AdventHealth got buy-in from top leadership and the clinicians in the trenches, combined new technologies with its existing IT infrastructure and designed efficient and effective dashboards to bring analytics to the bedside.

First things first: "Leadership engagement is key to the deployment and effective use of real-time analytics," said Altemose. "Without analytics of this kind being driven from the top down there is no impetus for the front-line users to engage."

In addition, for those clinical end-users, "it is best for processes to be as standardized and as well defined as possible prior to building a real time analytics platform," he explained. "However, it is not a prerequisite for success. Real-time analytics, when properly built, tend to quickly identify where a process breaks down or has not been followed."

But the "most important aspect of successfully leveraging real-time analytics is metric selection," said Altemose. "When deciding on what to include there isn't much value in exposing metrics that cannot inspire action."

At AdventHealth, for example, "I handpicked metrics that allow clinicians to take action before there is a negative impact to the patient and left anything that was classified as 'good to know' on the cutting room floor," he explained.

And what should be the bigger emphasis in projects such as these? People or technology?

"Neither can function independently," said Altemose. "The staff needs to be engaged in using the tool for the organization to realize the value the application can provide. However, if the application is difficult to use, requires a lot of work to find the actionable items, or is filled with metrics that don't drive change then there can be no improvements. Both must work in concert to maximize the value the tool can bring."

Indeed, buy-in from docs and nurses is non-negotiable for effective real-time analytics, which "cannot be successful without clinician involvement," he said. "Feedback from the end users and process owners throughout the design, and building phases is an absolute must. Continuing to listen following go-live is also necessary for continued success."

That said, however, there is a also "a significant risk of analysis paralysis," Altemose warned. "A strong, politically savvy, application owner is necessary to ensure that only the content with the greatest opportunity for having the most impact is included."

At AdventHealth, the clinical ROI of real-time data is already showing itself.

"This application has impacted CLABSI scores, CAUTI scores, as well as flu vaccine and pneumo vaccine compliance rates," said Altemose. "These are all metrics that impact a hospitals CMS Star rating and we have seen improvements in our star ratings as well."

Altemose and Reed's presentation, "Using Real-Time Analytics to Improve Patient Clinical Outcomes," is scheduled for Wednesday, February 13, from 4-5 p.m. in room W206A.

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

Healthcare IT News is a publication of HIMSS Media.