Banner Health

William Holland, MD

VP, Chief Medical Informatics Officer

• Integrated governing process• Single Board of Directors

• Centralized management structure

• Centralized corporate functions

• Designed to achieve results• Enhance clinical quality

• Affordable cost model

• Patient/member experience

• Alignment from strategy through initiatives• Drives common strategy from senior leaders down through entire organization

• Allows IT leaders to tightly align technology strategies with Banner strategy

• Aligns IT sub-strategies and tactics across IT operations

The Banner Operating Model

Banner’s

Operating

Model

CRITICAL

CARE

Michael Simon

Gary Foster

WOMENS

HEALTH

Michael Urig

Cathy

Townsend

CV SURGERY

Michael

Maxwell

Marianne

LaFleur

PEDIATRICS

Bill Schneider

Sandra Marken

BEHAVIORAL

HEALTH

Gagan Singh

Nancy Sylvester

PHARMACY &

THERA-

PEUTICS

Joe Lozon

Nathan

Spence

CARE MANAGEMENT COUNCIL

ED

David Cohen

Dan Lingle

CARDIOLOGY

Paul Hurst

Lynn De

Guzman

ANESTHESIA

Josh

Bloomstone

Susan Eubanks

HOSPITAL

MEDICINE

Cheryl O’Malley

Julie Reister

NEURO-

SCIENCES

Maninder Kahlon

Al Wildman

MEDICAL

IMAGING

Kevin Hirsch

Erica Dorward

PRIMARY

CARE

Mary Ellen

Dirlam

Judy Reddin

INFECTIOUS

DISEASE

Edwin Yu

Joan Ivaska

ORTHO

David

Jacofsky

Young An

NEPHROLOGY

Dharminder

Marwah

Debbie Kohm

ONCOLOGY

Daniel

Chamberlain

Kathy Altergott

LONG TERM

CARE

Natalya

Faynboym

Kelly Johnson

SURGERY

Jon King

Nancy

Adamson

PULMONARY

Rajeev Saggar

Chuck Ramirez

NICU/Newborn

Greg Martin

Kathleen

Walker

Evidence Based Practices• Medical Imaging for Dx Community Acquired Pneumonia

• Chlorhexidine Alcohol for Surgical Skin Preparation

• Seprafilm Use in Cesarean Sections

• Knee High SCDs and TEDs

• Early Sepsis Identification

• Acute Respiratory Distress Syndrome (ARDS)

• Delirium

• Newborn Hypoglycemia Screening & Mgmt

• Medical Imaging for Peds Appendicitis

• Large/Small Bowel Surgical Care

• Diagnosis of Diarrheal Disease

• Pooling of Bronchoscopy respiratory specimens

• Diagnosis of Coccidioidomycosis by Serological Means

• Diagnosis of Clostridium difficile Associated Diarrhea

• Elective Deliveries Prior to 39 Weeks

• Behavioral Health Medical Clearance

• Ventilated Patient Management (oral care, sedation)

• CT Scan in ED for Atraumatic Headache

• Dysphagia Management for peds patients

• Subcutaneous Insulin

• Syncope

• ED Ischemic Stroke tPA

• Scorpion Envenomations

• ED to Critical Care Admissions

• Intra Op Goal Directed Therapy

• PET Scan

• Admin Intravenous Contrast Media

• Vertebroplasty

• Pre-Term Labor

• Ambulatory Lower Back Pain

• Insulin Drip Transition Post Cardiac Surgery

• Palliative Sedation

• Readmission Risk Assessment and Management

• Pediatric Sepsis

• Enhancing Progression of Labor

• Indwelling Catheters in Laboring patients

• Pharmacy Drug Level/Lab Monitoring Service

• Appropriate Use of PPI’s (Proton Pump Inhibitors)

• DKA Hyperglycemic Crisis

• Moderate-Severe EtOH-Substance Withdrawal

• Pediatric Bronchiolitis

• Pediatric Fevers

• Adult Implantable Automatic Cardio-Defibrillators (ICD’s)

• Epoetin-Adult

• Orthopedic Care for Total Knees, CPMs, Cold Therapy

• Anesthesia Administration

• Post Partum Hemorrhage

• Early Warning System for Adult Patients

• ED Pulmonary Embolism Rule-Out Criteria (PERC)

• ED Discharge Transition

• ED Acute paint management

• Midline Sternotomy – Post Operative Management-Adult

• Point of Care Chest Ultrasonography

• Chorioamnionitis Management

• Developmental Screening for Peds

• Acute Blood Loss

• ED Chronic Pain

• T Dap Vaccine

• Use of BMP

• Nitrous Oxide

• Reducing Postoperative Pulmonary Complications

• Ambulatory Diabetes Care

• Hepatic Encephalopathy Patient Management

2012–Top 5 Health System Clinical

Quality

2010-2011 - Top 10 Health System

(Thomson Reuters)

2010 - 2011 Top 25 Connected

Facilities in US

(Health Imaging & IT Magazine)

2010 & 2011- Top 10 of the Top

100 Integrated Healthcare Systems

in the US(SDI & Modern Healthcare Magazine)

2010 - One of Arizona’s Most

Admired Companies

(Business Magazine & Best

Companies AZ)

2009 & 2010 - Top 100 best

technology innovators in US(Information Week 500)

2007 - 2010 Best Places to Work

winner

(Business Journal & Best Companies

AZ)

2011 -2012 Best Hospitals (US News/World Report)

2011 Top Leadership Team in

HealthCare(Health Leaders Media)

Truven Health Analytics

15 Top Health Systems 2013

Banner’s Vision 2020

Acute Hospital

Company

Clinical Quality

Company

Population Health

Management Company

0,0%

10,0%

20,0%

30,0%

40,0%

50,0%

60,0%

70,0%

80,0%

% CT Scans % Ultrasounds

2008 - 2015 CT Scan vs Ultrasound Use% of Peds Appendicitis Patients Who Received an Abdominal/Pelvic CT Scan or Ultrasound

63.6%

39.9%

7.4%

40.8%

9.6%

14.8% 15.5%

68.9%

54.1%

47.3%

Reporting Quarter

51.0%

36.5%34.4%

43.8%

26.3%

40.3%

Source: Josh Noble (CPA)01/04/2016Data: Quality Advisor, TSI

74%

68%71%

69%

75% 74%71%

62%

72%

68%

65%

60%

48%50%

42%

37%

51%

44%

49% 49% 48% 48%

44%

50%

54%

44%

52%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Peds Asthma Inpatient Chest X-Ray

Source: Josh Noble (CPA)1/4/2016Data: Quality Advisor, TSI

Reduce Variation in Blood UtilizationOrthopedic: Hip/Knee

16,6%

12,5%

8,4%7,8%

7,8%8,0%

6,9%6.7%

3.2%

0.9%1.6%

0,0%

2,0%

4,0%

6,0%

8,0%

10,0%

12,0%

14,0%

16,0%

18,0%

1Q 2013 2Q 2013 3Q 2013 4Q 2013 1Q 2014 2Q 2014 3Q 2014 4Q 2014 1Q 2015 2Q 2015 3Q 2015

Business Intelligence, Mature Initiatives Scorecard, Accessed 01/04/2016

65%

70%

75%

80%

85%

90%

95%

Clinical Practice:Sepsis, Delirium Identification, Prevention and Treatment

Research indicates >60% as positive

Clinical Performance Analytics, Critical Care Data Cube, Accessed 11/26/2014

Delirium and Coma Free Days

Critical Care Patients

0

20

40

60

80

100

Length of Stay in HoursIntensive Care Patients

> 20 hours Improvement

Clinical Practice:Sepsis, Delirium Identification, Prevention and Treatment

Clinical Cost Avoidance of $22 Million

Business Intelligence, Critical Care Data Cube, Accessed 05/01/2014

Banner Medical Group

Sterling, CO

Opened in January

2015. The center

offers primary care

with onsite labs

and medical

imaging

Banner Health

Center

Fernley, NV

Opened in March

2015. The center

offers primary care

and OB/Gyn with

onsite labs and

medical imaging

Banner Health

Center

Vision without execution is just hallucination

Henry Ford

How big?• Change Management

• Cultural, Workflow, Patient/Consumer

• Merging of Ambulatory and Acute• Optimization, Transitions of care

• Availability of skilled resources• Speed vs. Quality• Regulatory• Data migration• Interfaces• Growth, Acquisitions• Revenue

Projected Ambulatory Implementations

0

50

100

150

200

250

300

350

June July August September October November December

Providers (Projected)

Clinics

Specialties

Actual Ambulatory Implementations

0

50

100

150

200

250

300

350

June July August September October November December

Providers (Actual)

Providers (Projected)

Clinics

Specialties

Additional aspects of our partnership

Optimization

SMART on FHIR

Population Health

MobilityHealtheLife

Cerner Advance

PowerChartMaternity