Earlier this spring, healthcare alliance Premier Inc. announced a first-ever statewide initiative to eliminate preventable healthcare-associated infections (HAIs) while safely reducing associated costs. This “voluntary collaborative,” as Premier officials call it, involves Health Sciences South Carolina (a research arm of the state government), the South Carolina Hospital Association, the Charlotte, N.C.-based Premier, and all 65 acute-care hospitals in the state.
As part of this initiative, hospitals are making use of a special information-sharing portal developed for all South Carolina hospitals to research the causes of HAIs and to identify and promote new processes to eliminate infections. Hospitals can now track their improvement against state and national benchmarks in this work. Contributing Editor Mark Hagland recently spoke with Premier’s incoming president and CEO, Susan DeVore, regarding this unique initiative and its implications for the industry.
Mark Hagland: When was the key conceptual work done to lay the foundation for this collaborative?
Susan DeVore: From the October to December timeframe, we really finalized the structure of this. And basically, we’re making our performance improvement portal available to all 65 South Carolina hospitals, so that they can communicate as a state and share best practices and knowledge, and so that they can all access the experts whom we regularly access. It’s a way to provide information-sharing, so they can all learn from each other and share.
MH: Does this seem to be the first time this has been done statewide?
SD: Yes, this does seem to be the first time. The problem for all the states is that this information is out there, but it’s all fragmented. And as we’ve built HQID and Quest [two nationwide quality improvement initiatives], we’ve tried to make things available at a national level. But this does seem to be a first-time-ever cooperative, with private hospitals, a government arm, and a private organization like Premier involved. And we really think it’s through these public/private partnerships working together to make it happen, that will help healthcare reform and transformation really take place. Patient care organizations will be able to measure their own performance against state and national benchmarks. And through this research, they’ll be able to do more study about what seems to move the marks the most, the fastest.
What holds organizations back the most sometimes is that they’re using multiple, diverse collection tools, and their systems are organized in different ways. In this case, 16 different South Carolina hospitals use the Premier tools already, and those 16 account for 50 percent of the discharges in the state. And what’s great is that all those hospitals have standardized tools for measurement. So for half of the hospitals in that state already, they’re already using our data tools, which essentially take whatever system they have, and map that data to our standard. What the others have initially is the portal access. So they’ll be able to measure their success against what they see in the portal. And they’ll all have the opportunity down the road to move to those standardized tools if they want to.
MH: What would you say to CIOs about the lessons you’ve been learning through this initiative?
SD: What I would say to CIOs is that if you don’t have a real-time surveillance tool for hospital-acquired infections, you need to have it. And if you don’t have a tool that helps you find those infections when they’re in the hospital and start to appear, and if you don’t have an automated way to do this, you need to get such a tool. The challenge in hospitals is that so much is still manual. So the question is, how can I measure the causes of harm, and automate that measurement? And how can I take a bunch of disparate tools and systems, and make them work together, and make them work beyond just my system? CIOs want to know, how do you take all this information from disparate systems and optimize the measurement and analysis of that data? At Premier, we’re actually interested in shaping where policy goes, so that the information coming out of these systems can help make health care safer and more affordable. We’re all trying to eliminate preventable HAIs while safely reducing associated costs. In fact, our database actually shows you your resource consumption. So you can actually see how much hospital-acquired infections cost you, and the difference in the per-case cost between with and without infection. There could be as much as $14,000-15,000 in cost difference for the average hospital case, based on the presence or not of infection.
MH: What are the chances that other states might try to do something like this?
SD: I think the chances are high, if states look at the high costs of health care and want to do something effective. One of the things South Carolina’s been able to do is that they’ve been able to establish an identifier for the state’s population, so that they can make use of a unique state identifier for any person who accesses schools, hospitals, police records, any entity that has an association with the state. And that makes them a little bit different from other states
MH: Are you pleased with the progress so far?
SD: We’re very pleased. As you might guess, it takes a fair amount of collaboration; these are competing health care systems; and this program is statewide, for all the hospitals in the state. And the state had to fund a part of this, and all the hospitals in the state had to agree to participate. So I think it’s a huge movement forward in health care. I also think it’s a first step. If they want to take on diabetes or stroke or heart disease or cancer, I think there are ways to evolve this forward on other important things.
