The Leapfrog Groups Impact on Patient Safety and Future Information Technology - PowerPoint PPT Presentation


PPT – The Leapfrog Groups Impact on Patient Safety and Future Information Technology PowerPoint presentation | free to view - id: 7186a-ZDc1Z


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation

The Leapfrog Groups Impact on Patient Safety and Future Information Technology


The Leapfrog Group's Impact on Patient Safety and Future Information ... ORYX. NCQA. Physicians. Health plans (HEDIS) Leading Edge Efforts. The Leapfrog Group ... – PowerPoint PPT presentation

Number of Views:98
Avg rating:3.0/5.0
Slides: 36
Provided by: arni53


Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: The Leapfrog Groups Impact on Patient Safety and Future Information Technology

The Leapfrog Groups Impact on Patient Safety and
Future Information Technology
Founded By The Business Roundtable With Support
Steve Wetzell April 11, 2003
Patient Safety and the Impact on CPOE
  • Why should we care?
  • Leading-edge efforts
  • Whats next?

National Standards Essential
  • Comparability across markets
  • Credibility
  • Reporting burden
  • Economies of scale and leverage

The Good News Lots Going on The Bad News
Lots Going on
Leading Edge Efforts
  • IOM
  • To Err is Human
  • Crossing the Quality Chasm
  • Leadership by Example
  • Next National health improvement priorities
  • National Quality Forum
  • Safe Practices
  • Initial Hospital Measurement Set

Leading Edge Efforts
  • CMS
  • Hospitals
  • Nursing Homes
  • Doctor Office Quality
  • QuIC

Leading Edge Efforts
  • ORYX
  • NCQA
  • Physicians
  • Health plans (HEDIS)

Leading Edge Efforts
  • The Leapfrog Group
  • 3 hospital safety standards
  • 125 large public and private purchasers
  • 17 local regional rollouts

Who we are
  • More than 137 large health care purchasers
  • Approximately 33 million Americans
  • More than 56 billion in health care expenditures

Elements of Gridlock
  • Purchasers Not Buying Right
  • Plans Not Letting Provider Value Show Through
  • Providers Not Seeing Business Case for
  • Consumers/Patients Not In the Quality Game
  • New thinking needed to leapfrog
  • gridlock in the health care marketplace

The Silent Calamity
  • Needless mortality and morbidity
  • 44,000-98,000 plus deaths each year from medical
    errors during hospitalizations (IOM, 1999)
  • 7,000 deaths from medication errors alone
  • 17-29 million in added costs
  • Number of avoidable deaths in ambulatory care

The Leapfrog Groups Mission
  • Trigger a giant leap forward in quality,
    customer service, and affordability of healthcare
    of all types by
  • Making the American public aware of a small
    number of compelling and easily understood
    advances in patient safety
  • Specifying a simple set of purchasing principles
    designed to promote these safety advances, as
    well as overall customer value

Leapfrog Purchaser Strategy
  • Organized effort to buy right
  • Purchasing principles that strongly reward
    higher provider value
  • Purchaser accountability
  • Push via plans or directly
  • Create a Business Case for Providers
  • Emphasize tangible safety leaps
  • Mobilize Consumers and Patients

Purchasing Principles
  • Educate and inform enrollees
  • Compare at the provider level
  • Reward superior provider value
  • Patient volume (select/deselect/freeze,consumer
    incentives, consumer decision support)
  • Unit price (pay for performance)
  • Public recognition
  • Initially highlight 3 tangible safety Leaps
  • Annually increase provider rewards

Criteria for Safety Leaps
  • Whats the Difference? Leap will produce big
    improvement in safety
  • Value Self-Evident Leap can be appreciated by
  • Feasible Now Implementation steps are doable
  • Easily Ascertainable Purchaser or health plan
    can see if Leap is in place
  • Keep the List Short Leaps can be remembered

Initial Safety Leap Summary
  • An Rx for Rx
  • Computer Physician Order Entry (CPOE)
  • Up to 8 in 10 serious drug errors prevented
  • Sick People Need Special Care
  • ICU Daytime Staffing with CCM Trained M.D. live
    or via tele-monitoring, or risk-adjusted outcomes
  • 29 mortality reduction (JAMA, 11/02)
  • Practice Makes Perfect
  • Evidence-based Hospital Referral (EHR) or
    risk-adjusted outcomes comparison
  • gt 30 mortality reduction for 7 complex

What are the Three Leaps Worth?
  • Annual Gain Projected by Dartmouth
  • ? 522,000 serious med errors
  • ? 58,300 deaths
  • ? 58,300 X disabilities
  • (if fully implemented in U.S. urban hospitals)

Leap Refinement Creating More Sophisticated
  • CPOE Online evaluation tool developed by First
    Consulting Group
  • ICU Staffing Joint project with JCAHO to
    develop risk-adjustment methodologies and
    reporting program
  • EHR Process indicators being developed by Zynx
    Health, and outcomes reporting programs being
    considered by LF for national relevance

Potential Future Leaps
  • NQF safe practices and general hospital measures
  • Recognition for participation and superior
    performance via existing outcomes reporting
  • Physician office clinical decision support
    (working with CMS and AHRQ)

Physician Office Clinical Decision Support
  • Office based physicians electronically guided to
    evidence-based path
  • Histogram-style reporting format encourages
    single baby steps and five-dimensional giant
  • Partner with CMS/AHRQ to focus on e-prescribing
    and e-lab result retrieval

Regional Roll-Out Strategy
Leapfrog is a national movement using targeted
regions to develop Best Practices, creating early
successes and learning from all Stakeholders
  • Regions must have
  • Effective leadership
  • Competitive HC market
  • Concentration of Leapfrog lives

On the Web NOW!
Hospitals Are Reporting from All Over the Country
Survey Participants
  • As of December 31, 2002
  • 18 Roll-Out Regions reporting
  • 952 urban hospitals invited to submit results
  • More than half, 543 hospitals (57), submitted
  • 4 Regions had 100 participation from invited
    hospitals, 12 had greater than 60 participation
  • 53 percent meet at least one of Leapfrogs
    standards for the safety practices

Safety Practices Results 18 Regions
  • CPOE
  • 5 of the responding hospitals have fully
    implemented CPOE
  • An additional 24 say they have specific plans to
    implement such systems by 2004
  • IPS
  • 20 of responding hospitals have fully
    implemented IPS
  • Another 16 of responding hospitals indicate
    plans to enlist intensivists by 2004

Safety Practices Results (cont.)
  • EHR
  • Among participating hospitals, the following meet
    Leapfrogs volume recommendations
  • 12 meet Leapfrogs recommended volume for
    coronary artery bypass
  • 29 meet coronary angioplasty
  • 21 meet abdominal aortic aneurysm repair
  • 19 meet carotid endarterectomy
  • 11 meet esophageal cancer surgery
  • and 23 have NICUs that meet
  • Leapfrogs specifications.

(No Transcript)
(No Transcript)
Growing Efforts to Buy Right
  • Common Leapfrog RFI questions
  • Common Leapfrog health plan contract language
  • Focusing on value-based purchasing
  • Empire BCBS-Xerox-IBM-Verizon-Pepsi
  • PBGH
  • GE-PG-Ford-UPS-Humana
  • Blue Shield of CA tiering including Leapfrog
  • Healthcare 21s hospital report card

Health Plans Providing Data-based Consumer
Decision Support
  • Aetna, HealthNet, BCBS of RI talking to
  • BC of CA, PacifiCare sign deal with Subimo
  • Empire BCBS, UHC engages HealthShare, and CIGNA
    in discussion with them
  • Humana working with DoctorQuality

Implications for Information Technology
  • Employers and Plans
  • Data collection
  • Disseminate results
  • Consumer decision support
  • Sophisticated use of the web
  • Feedback systems for providers

Implications for Information Technology
  • Hospitals
  • Invest in information systems (NOW)
  • Safety and quality improvement
  • Data reporting
  • Decision support
  • Physicians
  • See hospitals

  • Not a question of if, a question of when

More on the Web
  • Hospital specific information (via HealthGrades)
  • Enrollee communications toolkit (via FACCT) and
    consumer materials clearinghouse
  • Cost and savings information on the 3 leaps
  • CPOE reports
  • Common RFI questions (V-8 2002)
  • Fact Sheets and FAQs about the
  • safety leaps
  • Hospital survey (via MEDSTAT)
  • And more

How to become a Frog
  • Commitment to implement Leapfrog purchasing
  • Sign up forms on the Web Site (www.leapfroggroup.o
  • click on Purchasers
  • click on Join The Leapfrog Group
  • review cover letter and participation forms
  • sign commitment
  • submit action plan check list within 2 months