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

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

Oct 24, 2023 223 likes •494 views

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

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Financial Analytics – What's Your VNA 'Really' Going to Cost You?

Financial Governance post VNA Implementation James Forrester

  • Univ. Rochester Medicine
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SLIDE 2

Financial Analytics – What We Will Cover

  • Background Information
  • UR Medicine
  • URM Imaging Informatics
  • URM Corporate Structure
  • Financial Considerations
  • Governance
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SLIDE 3

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)
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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

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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)
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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)
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SLIDE 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
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SLIDE 8

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

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Financial Analytics – URM Imaging Financials

Cost Allocations

  • How to assign costs back to respective divisions – Study volume as logical approach
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SLIDE 10

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
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SLIDE 11

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
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Financial Analytics – URM Imaging Financials

Interactive Question – for UR Medicine which component is most significant contribution to cost per study?

  • Software
  • Storage
  • Support
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Financial Analytics – URM Imaging Financials

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

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Financial Analytics – URM Imaging Financials

Cost Per Study

Annual Cost Per Study Diagnostic Radiology Foreign Vascular Surgery Cardiology Cath, EP, NM Cardiology 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

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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
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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
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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
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SLIDE 18

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
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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
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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
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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
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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
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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
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SLIDE 24

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
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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
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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