Financial Analytics What's Your VNA 'Really' Going to Cost You? - PowerPoint PPT Presentation

Financial Analytics – What's Your VNA 'Really' Going to Cost You? Financial Governance post VNA Implementation James Forrester Univ. Rochester Medicine

Financial Analytics – What We Will Cover • Background Information • UR Medicine • URM Imaging Informatics • URM Corporate Structure • Financial Considerations • Governance

Financial Analytics – Background Information UR Medicine • University’s integrated health care delivery network western New York • Anchored by main campus of the University of Rochester Medical Center with 4.4 million sq. feet of space supporting core missions patient care, research and education • Strong Memorial Hospital 800 bed tertiary care, regional trauma center • Multiple geographically disbursed satellite locations including multiple surgical centers as well as satellite ED • Golisano Children’s Hospital, 100 bed 250,000 square foot dedicated facility • Wilmot Cancer Center, 84 bed dedicated facility • Regional Hospitals • Highland Hospital • FF Thompson Hospital • Jones Memorial Hospital • Noyes Memorial Hospital • St. James Memorial (affiliation in progress)

Financial Analytics – Background Information UR Medicine • > $2.5 Billion overall annual budget • > 1450 full time faculty with additional 650 volunteer clinical faculty • External research funding totaling approximately $300 million during the last fiscal year • Student rosters include approximately 400 medical students, 550 graduate students, and 600 residents and fellows

Financial Analytics – Background Information URM Imaging Informatics • ~ 1 Million Annual studies • 620,000 Diagnostic Radiology • 110,000 Foreign • 105,000 Regional Radiology (Integrated HL7 and DICOM) • 65,000 FF Thompson • 50,000 Cardiovascular • 30,000 OBGYN (MFM US) • Annual images • ~ 150,000,000 unique images stored to VNA last 12 months (including migrations) • > 400,000 unique images per day • Organizational Structure • Imaging Informatics team consists of a systems administration team and application administration team • Direct report to CIO and CIIO (Dr. David Waldman Chief Imaging Informatics Officer)

Financial Analytics – Background Information URM Imaging Informatics • Deconstructed PACS (Diagnostic Radiology) • Philips ISP PACS diagnostic radiology & enterprise viewer • Primordial workflow manager • Lexmark Acuo VNA • PS360 Reporting • Departmental\Specialty Viewers • Heart & Vascular Center Echocardiography Ultrasound • OBGYN Maternal Fetal Medicine • Supported Systems • Enterprise Imaging Core Infrastructure (4) • Advanced Visualization & Processing (4) • Departmental & Specialty Systems (7)

Financial Analytics – Background Information URM VNA • Implemented for Radiology 2013 • OBGYN 2014 • Heart and Vascular 2015 • Multiple migrations in progress for acquisitions • Point of Care Ultrasound current implementation focus to be followed by scope VL data • Regional systems – act as off site archive

Financial Analytics – Background Information URM Organizational Structure • Medical Faculty Group • Includes contracted services to non-UR entities such as urgent cares and external hospitals • Hospitals • Strong Memorial • Highland Hospital • FF Thompson • Noyes Memorial • Jones Memorial • St James Memorial • University Medical Imaging – separate corporation which contracts services from Univ. of Rochester and requires due diligence and fair market cost allocation

Financial Analytics – URM Imaging Financials Cost Allocations • How to assign costs back to respective divisions – Study volume as logical approach

Financial Analytics – URM Imaging Financials Cost Allocations • How to assign costs back to respective divisions – by volume • All studies are not equal with regards to • file size & number of images • complexity • Post processing • Specialty viewers\PACS

Financial Analytics – URM Imaging Financials Cost Allocations • How to assign costs back to respective divisions – by volume • All studies are not equal • Group study types and define costs by: • Software • Storage • Support

Financial Analytics – URM Imaging Financials Interactive Question – for UR Medicine which component is most significant contribution to cost per study? • Software • Storage • Support

Financial Analytics – URM Imaging Financials Interactive Question – for UR Medicine which component is most significant contribution to cost per study? Answer - Software

Financial Analytics – URM Imaging Financials Cost Per Study Cardiology Diagnostic Vascular Cath, EP, Cardiology Annual Cost Per Study Radiology Foreign Surgery NM Echo US OBGYN POCUS Software Cost Per Study $2.93 $3.13 $2.08 $0.67 $4.58 $4.58 $0.98 Storage Cost Per Study $0.54 $0.54 $0.54 $0.54 $5.40 $0.54 $0.08 Support Cost Per Study $2.03 $2.04 $1.02 $1.02 $2.04 $2.04 $1.02 Image Library Cost Per Study ------------ $4.49 ------------ ------------ ------------ ------------ ------------ Operating Cost Per Study $5.50 $10.20 $3.64 $2.23 $12.02 $7.16 $2.08

Financial Analytics – URM Imaging Financials Cost Per Study – Value to this approach • Transparent across image generating departments • Transparent to senior leadership • Targeted focus of cost reduction and containment • Provides a crucial benchmark metric

Financial Analytics – URM Imaging Financials Cost Per Study – Value to this approach • Transparent across image generating departments • Transparent to senior leadership • Allows autonomous and independent imaging practice in an informed context • Targeted focus of cost reduction and containment • Provides a crucial benchmark metric

Financial Analytics – URM Imaging Financials Cost Per Study – Value to this approach • Transparent across image generating departments • Transparent to senior leadership • Targeted focus of cost reduction and containment • Lessons learned – where we focus our efforts • Provides a crucial benchmark metric

Financial Analytics – URM Imaging Financials Cost Per Study – Value to this approach • Transparent across image generating departments • Transparent to senior leadership • Targeted focus of cost reduction and containment • Provides a crucial benchmark metric

Financial Analytics – URM Imaging Governance Organization and Membership – senior leadership committee • Chair – Dr. David Waldman • Chief Imaging Informatics Officer (2014) • Chairman Imaging Sciences • Facilitator – James Forrester, Director Imaging Informatics • Chief Information Officer • Chief Imaging Informatics Officer • Meets monthly agenda set by facilitator

Financial Analytics – URM Imaging Governance Organization and Membership – senior leadership committee • Chief Operating Officers (3) supported hospitals and Medical Faculty Group • Chief Financial Officer supported hospitals • Chief Financial Officer UR Medicine • Program (senior) Administrators • Imaging Sciences Faculty • Imaging Sciences Operations • Heart & Vascular Service • Director Imaging Informatics (IT) • Clinical Faculty • Chief Imaging Informatics Officer, Chair Imaging Sciences • Chief Medical Informatics Officer • Heart & Vascular Physician • Chief Information Officer

Financial Analytics – URM Imaging Governance Chartered responsibilities • Medical Imaging Services Governance • Imaging Informatics Project Proposals • Imaging Informatics Procurements • Enterprise Imaging Systems - Architecture & Implementation • Policies and Procedures

Financial Analytics – URM Imaging Governance Chartered responsibilities • Medical Imaging Services Governance • Imaging Informatics Project Proposals • Imaging Informatics Procurements • Enterprise Imaging Systems - Architecture & Implementation • Policies and Procedures

Financial Analytics – URM Imaging Governance Chartered responsibilities • Medical Imaging Services Governance • Imaging Informatics Project Proposals • Imaging Informatics Procurements • Enterprise Imaging Systems - Architecture & Implementation • Policies and Procedures

Financial Analytics – URM Imaging Governance Chartered responsibilities • Medical Imaging Services Governance • Imaging Informatics Project Proposals • Imaging Informatics Procurements • Enterprise Imaging Systems - Architecture & Implementation • Policies and Procedures

Financial Analytics – URM Imaging Governance Chartered responsibilities • Medical Imaging Services Governance • Imaging Informatics Project Proposals • Imaging Informatics Procurements • Enterprise Imaging Systems - Architecture & Implementation • Policies and Procedures

Financial Analytics – URM Next Steps What we are working on • Continue to refine cost per study numbers • Focus to date has been operating cost • Incorporation of capital cost considerations such as one time licensing as well as infrastructure • Consolidation of all imaging informatics support and software licensing in to a single “account” under the broader UR Medicine corporate umbrella • “non-denominational” - health sciences division