To Safely Restart Elective Procedures, Look to the Data

© 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Martina Brooks, MHI, CSSBB
Surgical and Procedural
Standardization Program Director,
Banner Health
This article is based on a 2020 Healthcare Analytics Summit (HAS 20 Virtual)
breakout presentation by Nirav Patel, MD, Medical Director for Surgical and
Procedural Services, Banner Health, and Martina Brooks, MHI, CSSBB,
Surgical and Procedural Standardization Program Director, Banner Health,
titled, “Effectively Restarting Elective Surgery After COVID-19.”
Safely Restarting Elective Procedures
Nirav Patel, MD
Medical Director for Surgical
and Procedural Services,
Banner Health

In March 2020, healthcare organizations
across the U.S. suspended elective
surgeries and procedures to reserve
resources for patients with COVID-19.
Though the delay in care has been a
critical part of the COVID-19 response, it
has resulted in significant revenue loss.

The American Hospital Association estimates
that four months of halted elective procedures
have led to $202.6 billion in losses for U.S.
hospitals and health systems, an average of
$50.7 billion per month.
Some experts estimate that the pause in elective
surgeries has led to the biggest financial hurdle
the healthcare industry has faced in years
because these procedures are a primary income
source for many health systems.

Facing financial strain (and even
collapse), health systems welcomed
the opportunity to resume elective
procedures later in the spring of
2020—critical to financial recovery
and sustainability—if they met CMS’s
recommended criteria by state.
However, the green light for health
systems to restart elective procedures
has highlighted a lack of data
infrastructure and analytics tools to
support an effective reactivation plan.

To overcome this data and analytics
barrier, work towards recovery, and prevent
more lost revenue, organizations need a
data-informed roadmap and analytics tools,
including data visualization dashboards
and predictive models.

Robust Analytics: The First Step to
Safely Restart Elective Procedures
To understand the full-scale consequences
of COVID-19 and restart elective proced-
ures, health systems must first have
access to robust analytics (clinical,
financial, and operational).
Without comprehensive analytics, leaders
only see one piece of the picture, such
as the clinical data without operational
and financial context.
Instead, with comprehensive information,
leaders can see all of the opportunities
to optimize the reactivation plan, avoid
wasting resources, and generate income.

Access to complete data sets in one
comprehensive platform (e.g., the Health
Catalyst Data Operating System (DOS™))
allows health systems to view all of the data,
then select specific data aligned with their
reactivation goals.
This broad data access enables
organizations to measure progress and
ensure they are on track to meet their
procedural volume goals.

For example, if a health system wants to
understand procedural case volume and
canceled cases to inform the elective
procedures reactivation plan, it needs
access to analytics reflecting canceled
cases, cancelation reasons, and completed
cases with case completion details.
Ideally, all members of the team, including
providers, administrators, and other leaders,
can access the same data and leverage the
same information to drive decision making.

Data and Analytics Tools Drive an Effective
Elective Procedure Reactivation Plan
Once the clinical, operational, and financial
data is accessible in one place, a health
system can focus on creating the data and
analytics tools (e.g., data dashboards) to
direct the reactivation process from the start.
When health systems stopped elective
surgeries, many relied on their existing data
tools (typically delayed, manually-configured
reports based on available data) to identify
opportunities and inform a reactivation plan.

However, without more effective data and
analytics tools in place, leaders couldn’t
quickly review real-time data to understand
clinical resources, staffing, and supplies
(e.g., personal protective equipment (PPE)
and ventilators).

Effective information-sharing tools, such as
data displays or dashboards (Figure 1),
allow leaders to maximize data by seeing
high-level information in a format that
calls attention to outliers or trends.

Figure 1: Example of a procedural recovery planning dashboard with completed case data.

Building dashboards that can dynamic-
ally reflect new data also allows support
staff to avoid scrambling to build one-off
dashboards on partial data sets.
With data and analytic tools in place,
health systems are prepared to restart
elective procedures as soon as they
meet the CMS guidelines.

Another important piece of creating
effective analytics tools is to include
stakeholders from a variety of
departments in the development process.
Hearing different viewpoints about which
data sets to include leads to a more
comprehensive reactivation strategy.
Systemwide access to the dashboards
combined with the data visualization tools
are also an opportunity for leaders to
promote data-driven decision making and
data sharing throughout the organization.

Predictive Modeling Promotes Flexible
Approach to Restart Elective Procedures
Once health systems have created dash-
boards and given team members access to
them, data experts can take the data one
step further with predictive models.
For example, capacity planning teams can
add value to the reactivation process by
helping health systems understand how
many elective procedures they can
accommodate relative to their clinical
staff and supply resources.

While predictive models can’t accurately
forecast what will happen over the next six
months because of the rapidly changing
coronavirus, they can help health systems
prepare for the next few weeks, a more
effective approach than changing the
strategy day by day.

With data-driven tools in place, data
experts can create predictive models that
provide insight into possible outcomes and
responses.
For example, if X happens, the health
system should do Y. Or, if Y happens,
the health system will do Z.
Because COVID-19 is changing rapidly,
directly impacting a health system’s
capacity, predictive models can help
organizations prepare for unexpected
changes and support an adaptable
reactivation response plan.

With predictive models informing decisions,
health systems can create other actionable
tools, such as a resource capacity model
that incorporates information about staffing,
hospital resources, length of stay, ICU,
PPE, and ventilators.
Data science teams can leverage the
predictive models to measure the elective
procedure volume a health system can
safely accommodate.

Based on the predicted volume from the model
(taking into account historical and current
volume data), the health system can develop
criteria for which elective procedures to
restart—rather than open at full capacity and
risk shutting down due to a COVID-19
outbreak or capacity strains.

Data Fosters Sustainable Approach to
Elective Procedure Reactivation Strategy
While health systems must plan to operate with
COVID-19 for the foreseeable future, they can
safely restart elective procedures with a data-
informed reactivation plan.
Comprehensive dashboards and predictive
models offer visibility into various aspects of
hospital capacity that impact elective surgery
restart, allowing health systems to adjust
resources to tactically resume these
procedures.

Data Fosters Sustainable Approach to
Elective Procedure Reactivation Strategy
Data and analytic insight allow leaders to
compare historical information with
current circumstances, revealing insights
into filling gaps, future case volume, and
resource utilization.
These insights prioritize provider and
patient safety, helping organizations get
on the road to financial recovery.

For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

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Dr. Nirav Patel serves as the Medical Director for Surgical and Procedural Services for
Banner Health—a role that encompasses oversight over Surgical and Procedural Value
Alignment Program(SPVAP), Supply Chain, Peri-Operative and Trauma Services. He is
also Chair of the American College of Surgeons, Arizona Committee on Trauma and
President of the Arizona Chapter of the American College of Surgeons. In addition to his
clinical practice as a Trauma, Acute Care, Surgical Critical Care Surgeon, he is actively
involved in value-based care delivery, establishment of international trauma systems and minimally
invasive surgical access in low- and middle-income countries. Dr. Patel attended University of Wisconsin
College of Medicine, completed a residency in General Surgery at Gundersen Lutheran and a Trauma
Surgical Critical Care fellowship at University of California–San Diego.
Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Nirav Patel, MD

Martina Brooks is the Surgical and Procedural Standardization Program Director for
Banner Health. She started working for Banner in 2004 and has served in numerous
roles from public relations, learning, and clinical care standardization. Currently, Martina
is a program director for the Surgical and Procedural Value and Alignment Program
(SPVAP). SPVAP is dedicated to collaborating with physicians, surgical and procedural
departments, supply chain, and executive leadership to standardize clinical care and
cost for Banner Health through data review and transparency. Martina holds a BA in
communication and public relations and a master’s in healthcare innovation from Arizona
State University. She is also a certified six sigma black belt.
Martina Brooks, MHI, CSSBB

Health Catalyst is a mission-driven data warehousing, analytics and outcomes-improvement
company that helps healthcare organizations of all sizes improve clinical, financial, and operational
outcomes needed to improve population health and accountable care. Our proven enterprise data
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Health Catalyst was recently named as the leader in the enterprise healthcare BI market in
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To Safely Restart Elective Procedures, Look to the Data

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To Safely Restart Elective Procedures, Look to the Data