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Predictive Modeling and Analytics Drive Rush's Quality Improvements

Analysis  |  By Christopher Cheney  
   March 15, 2018

Rush University Medical Center is applying data technology in several areas, including documentation improvement, value-based care, dashboard development and implementation, readmissions reduction, and cost of care.

At Rush University Medical Center, an effort to investigate low quality scores has blossomed into a highly ambitious data analytics and machine learning initiative.

In early 2015, the Chicago-based medical center had three stars in Medicare's Hospital Compare rating system, and the organization's new CMO, Omar Lateef, DO, wanted to know why, says Bala Hota, MD, MPH, vice president and chief analytics officer.

"We are both practicing physicians. We saw patients at Rush, and we knew the quality of care for a lot of the service lines was excellent, but we weren't seeing that reflected in the ranking systems," says Hota.

While systematically reviewing documentation data, Hota and his colleagues found clinicians were underreporting the severity of patient illness. "We were consistently seeing that our severity of illness ranked among the lowest—in the bottom decile," he says.

The need for documentation improvement became even clearer after a review of patient transfers from other facilities, Hota says. "Patients were getting transferred to us and they were getting a lower acuity than they had at the hospital they were transferred from, which made no sense."

Documentation improvement that has improved severity of illness reporting has helped raise Rush's Hospital Compare rating to five stars.

Documentation is the key ingredient in most ranking systems at the Centers for Medicare & Medicaid Services, he says. To help find opportunities to improve documentation, Hota's team developed customized algorithms and gathered documentation data.

"We do see variation between different provider groups and different providers. There is more opportunity with some, with others there's less. Just being armed with that information helps us to educate, guide, and change behavior," Hota says.

Rolling out dashboards

After using data analytics to delve into Rush's quality ratings, Hota's team continued to seek opportunities for data to drive change.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.

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