As a leader in revolutionizing post-acute care with its “medical resort” model for patients in need of care following a hospitalization, Ignite Medical Resorts is on the forefront of using data and technology to manage patient care.
John McFarlane, the organization’s chief clinical officer, is deeply involved in managing the available data points and the ways in which clinical leaders can use them.
In this Clinical Dashboard Series interview, McFarlane shares what his ideal clinical dashboard looks like, as well as how such a dashboard could be game-changing for determining acuity, connecting skilled nursing providers to reimbursement, and more.
Skilled Nursing News: What are the three most important data points that you would want to see each day on your ideal clinical dashboard, and why?
John McFarlane: Just on the opening screen, I would be looking at things like metrics that are essentially driven by quality measures. So these are things like falls, weight loss, return to hospital, ED visits. Those would be some of the primary examples of things I’d like to see.
How would the ideal clinical dashboard drive patient care decisions?
The ideal clinical dashboard would be real time, ideally. It would impact where clinical leaders spend their focus in terms of creating things like performance improvement projects, or maybe driving where onsite visits are going to occur from different clinical leaders and things like that.
How would the ideal clinical dashboard help optimize reimbursement?
It would essentially capture the necessary pieces that are the driver of reimbursement in terms of pulling data from the MDS. This is obviously a very lofty idea, which isn’t something I could necessarily create myself, but it would essentially pull things from the MDS that drive reimbursement — perhaps a prioritization with diagnosis groups of the facility, for example. Also, it would give some sort of an acuity picture that is essentially MDS-driven and not only affects reimbursement, but also helps determine acuity.
I love the lofty vision for this. How can the clinical dashboard improve staffing efficiency?
I think it could improve it immensely by just what I said earlier in terms of acuity. Right now, most nursing facilities don’t have a real robust and automated way to determine acuity. A lot of it is manual, and I would just say that about just most skilled nursing facilities in general. [There is a need to pull] this information up in real time, [and that would replace] a lot of those reports right now have to be pulled manually by clinical leadership in a facility.
I think if we had something that could give us an acuity picture, maybe with a score that’s broken down, that would help us determine not only where we’re going and what our staffing level should be, but also for help with bed management in terms of where we’re going to admit, let’s say, a particular patient from the hospital.
How would you like to see the clinical dashboard integrated with predictive analytics tools?
Right now we have a feature from PCC that has predictive analytics. That exists in a dashboard format currently. That piece essentially identifies residents that are at a higher risk to return to the hospital in a particular facility. I think having that piece added into a clinical dashboard would be extremely helpful.
What would you say are the most important roles in the organization to also have access to the clinical dashboard?
Primarily clinical leadership would be the highest priority in a facility. Then outside of that, the administrators of the facility as well should have access to it. We call the latter, ‘Ignite Team Partners’ whereas other companies might refer to them as corporate-level staff. Giving those nurses and leaders access and perhaps even a different way to view [the information would be beneficial]. For example, instead of just viewing one facility, [ideally] they could view the portfolio to view an average of some of these data points for all the facilities.
When you say primarily clinical leadership at the facility level, is that the director of nursing? Are there any other specific roles you think would be really important to have access to the clinical dashboard?
Yes, I would say the director of nursing and the assistant directors of nursing, and then any other staff members that have a management-level role in terms of clinical oversight.
What would you do if you could do something to improve the collection of patient health data?
Right now we operate in many different states from Wisconsin down to Texas. In some of our markets, the hospitals partner with us and allow us to have essentially read-only access to their hospital EMR, and that is extremely helpful for error prevention and things like that. Then, the other piece that PCC currently has that we utilize – and it’s free – is the ability to pull that information.
In other markets where we don’t have read-only access to the hospital EMR, we can essentially pull in the hospital records using the current technology PCC offers. That’s extremely helpful for things like preventing medication transcription errors, ensuring vaccines are addressed, verifying of diagnoses, and things like that.
Would you want more robust access to hospital-level data aside from what you’re already getting from either the PCC tapping into it or where you have direct access to the hospital EMR?
I think so. Right now there are some limitations to what is pulled from PCC in terms of the hospital documentation. I think there’s definitely some opportunities there to improve that piece to make it a little bit more comprehensive.
To circle back to one of your other answers, in terms of the most important data points you said you’d like to see metrics driven by quality measures. Can you maybe elaborate a little bit on why?
Quality measures are not a reflection of the current facility’s performance, but they are essentially a report card and they tie directly into the five-star rating which is very important for skilled nursing facilities. That is how we’re ultimately graded by potential families or residents looking to admit to the facility. That’s how hospitals will determine which facilities they’re referring to. Ultimately, looking at the quality measures in terms of your real-time data gives you a sense of whether or not we are improving.
We may have an issue with falls, for example, but that data might be pulling from quarter one or two of 2022 to 2023, and here we are in quarter four of 2023. [We can determine] how are we looking today versus how we’ve been performing in the past? Essentially, it leads us to understand if we need to put different action plans in place to drive those results.