Sveus konferens 25 november 2014 Jens Deerberg, ICHOM
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1 Sveus konferens 25 november 2014 Jens Deerberg, ICHOM 1
2 International Standardization Of Outcomes Measurement November 2014
3 Germany is World Champion November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 3
4 Germany has the highest volume in coronary revascularization procedures Coronary revascularization procedures Source: OECD Health Report 2013 November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 4
5 Germany has the highest volume in cardiovascular drug consumption Hypertension drugs consumption Antidiabetics consumption Source: OECD Health Report 2013 November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 5
6 but Germany has below average survival rates after acute myocardial infarction 30 days in hospital mortality after acute myocardial infarction Source: OECD Health Report 2013 November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 6
7 Top 5 countries with low AMI mortality rates despite moderate procedure volume and drug use 30 days in hospital mortality after acute myocardial infarction Source: OECD Health Report 2013 November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 7
8 True champions celebrate when it s over November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 8
9 National Swedish Cardiac Registry (Swedeheart) provides full transparency about medical outcomes Source: Swedeheart annual report 2012 November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 9
10 Outcome transparency leads to improved value and sustainable competitive advantage Value cycle: starts with reliable outcomes data......to deliver competitive advantage Transparent outcomes data Analyze variation Feedback and learning Improved outcomes Value Change behavior Identify current best practices Reduced variation Reduced medical cost Continuous improvement Value created at every stage of process Improved health care value November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 10
11 Florence Nightingale one of the first women studying mathematics and statistics November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 11
12 If the function of a hospital were to kill the sick, statistical comparisons of this nature would be admissible.. Florence Nightingale, 1863 November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 12
13 Many data are collected in order to determine care quality Example coronary artery disease Physical exam, imaging, echocardio, lab tests, drug treatment, PCI, stenting, CABG( ) Patient initial health status e.g., Staff certification, facility, equipment, LoS ( ) Structure Processes Patient experience/ engagement Information, friendliness, hotel services, empathy, food, cleanliness( ) Left ventricular ejection fraction, B- type natriuretic peptide, extend of CAD by coronary angiography, ( ) Clinical Indicators (Health) outcomes November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 13
14 Outcomes are the 'real world' experience of patients Example coronary artery disease Patient initial health status Structure Processes Patient experience/ engagement Survival, complications, re- infarction, stroke, heart failure, renal failure, burden of angina, dyspnea, depression. functional status, health- related quality of life Clinical Indicators (Health) outcomes Source: ICHOM November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 14
15 Standardization is needed for global comparison November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 15
16 ICHOM is a nonprofit dedicated to accelerating development and impact of outcomes measurement ICHOM 's three founders with the desire to unlock the potential of VBHC......launched ICHOM as a nonprofit + Independent 501(c)3 organization + Idealistic and ambitious goals + Global focus + Engages diverse stakeholders Our mission: To define a global standard set of outcome measures that really matter to patients for the most relevant medical conditions...and drive adoption of these measures worldwide to unlock the potential of value- based health care November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 16
17 Active Members of Coronary Artery Disease Working Group Tomas Jernberg, Swedeheart (Sweden) Clive Weston, National Institute for Cardiovascular Outcomes Research (UK) Jack Lewin, Formerly of the American College of Cardiology (US) Mark Schoeberl, American Heart Association (US) Paul Heidenreich, American Heart Association (US) Bob McNamara, Yale (US) Louise Morgan, American Heart Association (US) David Shahian, Massachusetts General Hospital, Society of Thoracic Surgeons (US) John Rumsfeld, Veteran s Health Administration, American College of Cardiology (US) Robert Yeh, Massachusetts General Hospital (US) Larry Sadwin*, American Heart Association (US) Alba Rosas Ruiz, STEMI registry (Catalonia, Spain) Ricardo Tresserras Gaju, STEMI registry (Catalonia, Spain) Bishnu Panigrahi, Fortis Healthcare (India) Terrance Chua Siang Jin, National Heart Centre Singapore (Singapore) John Beltrame, University of Adelaide (Australia) *Patient representative November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 17
18 The ICHOM standard set for Coronary Artery Disease 1 Includes occurrence of strokes, acute renal failure, prolonged ventilation, deep sternal wound infection, and other causes of reoperations. 2 Includes occurrence of strokes, acute renal failure, significant dissection, perforation, vascular complications requiring intervention, bleeding event within 72 hours, and emergent CABG for failed PCI. 3 Tracked via the Seattle Angina Questionnaire (SAQ- 7) 4 Tracked via the Rose Dyspnea Scale 5 Tracked via the Patient Health Questionnaire (PHQ- 2) November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 18
19 ICHOM's plan is to cover more than 50 conditions by conditions 12 conditions 24 conditions 40 conditions 50+ conditions Share of disease burden in industrialized countries 37% 45% 57% 70% 9% November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 19
20 ICHOM's standard sets of outcomes in 2013 November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 20
21 ICHOM's standard sets of outcomes in 2014 November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 21
22 Standardization needs approved instruments Example foot measuring devices November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 22
23 ICHOM is providing detailed reference guides for each standard set Improvements Consolidated overview Full PROM details (individual questions and links to surveys) Scoring guides (by end of year) Variable code names for case- mix variables and outcomes Sample collection forms (by end of year) November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 23
24 ICHOM is certifying outcome measurement software providers November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 24
25 ICHOM is running a web- based implementation network Equip: Implementation Network Resources Community Tools Access to Certified Suppliers 300USD/ user / yr November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 25
26 ICHOM is helping organizations to implement outcome measurement Accelerate: Tailored support to select partners November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 26
27 ICHOM inspires interested people to measure and compare outcomes Inspire: the ICHOM book November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 27
28 We are thankful for our Sponsoring Partners, who provide great support and strength to our message PLATINUM GOLD SILVER BRONZE Cooper-Newell Foundation COFOUNDERS NEBaptist September Copyright 2014 by the International Consortium for Health Outcomes Measurement. All rights reserved.
29 For more information please visit November 2014 Copyright 2014 by International Consortium for Health Outcomes Measurement 29
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