ArborMetrix is a performance measurement platform in the cloud, delivered under the SaaS model. The platform is focused on acute and specialty care, which still accounts for most of the healthcare spending in the country.
The ArborMetrix platform is unique because their solution not only measures cost and efficiency but also extracts information about each episode of care with meaningful clinical data for physicians. The company then applies proprietary statistical science for real time risk and reliability adjustment that accounts for case mix, severity, procedures and devices in different specialties.
"There is a missing element in the technology space because most tools out there are simple registries for the specialty and designed as a one-size-fits-all solution," says Brett Furst, CEO of ArborMetrix. "But the nuances of spine versus bariatric surgery are so different that when you provide evidence to clinicians, it's not actionable. The gap we are trying to bridge is how C-suite executives and clinicians become engaged in performance measurement related to the value and effectiveness of care in high cost service lines."
The platform gathers data from existing electronic medical record systems, but information can also be extracted manually for collecting patient reported outcomes. The data includes quality of life, pain and suffering and follow-up that typically doesn't find its way back into the hospital EMR but has bearing on the outcome. As a result, ArborMetrix software produces full performance benchmarks.
"As risk is migrated to the providers, health systems and physician groups, understanding where variation still exists in high cost service lines is important to take on risk," says Mr. Furst. "Without this data, you'll find yourself on the losing end of bundled payments and global payment for service lines that you can't rationalize."
Data analysis can show where variation exists in the service line and the opportunity to lower costs and improve quality with standardization. The company can put this data into a clinical context to show what causes variation and develop practical solutions with very little disruption to the physician's workflow.
At the C-suite level, the platform provides information about where contribution margin is being produced by service line, case and surgeon. The platform can also blind data to compare physicians without highlighting who the individual data points belong to.
"We've had one particular case on bariatric surgery where a certain device was being used pervasively across Michigan to capture blood clots and reduce the chance of mortality," says Mr. Furst. "Our data provided the clinical evidence that the use of the device had no bearing on improved outcomes or resolution of comorbidities and were shown to increase the chance of mortality. When you don't have comparative analysis against your peers, you don't know what the mortality rates should be for a procedure or device. Transparency in risk-adjusted environments for peer comparison by specialty provides evidence clinicians need to change practice patterns."
The bariatric surgeons in Michigan were able to eradicate the device quickly and went from two in 1,000 to one in 10,000 mortality rate. ArborMetrix has run state and nationwide quality initiatives and found significant variation between the cost and quality of care.
"We collaborated with the BCBS of Michigan and were able to show where in a price-adjusted fashion the episodic cost varied 52 percent from provider to provider," says Mr. Furst. "As we moved to bundled or fixed payment, those areas will be scrutinized. It's imperative for providers to understand where they are on the spectrum."
Data sets can also provide predictive models for which procedures are the most appropriate — or have the best likelihood of positive outcomes. Physicians can use the web-based solution within their practices to benchmark their performance against peers within the health system or specialty across the country.
"They are able to drill down into very granular clinical detail," says Mr. Furst. "They can see variation and anomalies across complication rates, quality forums and episodic analysis. Our goal is to show something you can empirically move the needle on immediately by providing evidence and actionable intelligence for insight into better quality and more cost-effective care."
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