In one year, Tacoma, Wash.-based MultiCare Health System reduced clinical waste directly tied to physician ordering by about $2.5 million, according to Arun Mathews, MD, regional chief medical officer at the 13-hospital system.
The average American loses between $1,800 and $5,700 every year due to excess healthcare costs, according to 2019 data. These unnecessary expenses stem from clinical inefficiencies, missed prevention opportunities, overuse, administrative waste, excessive prices, and fraud and abuse.
To address this issue, MultiCare’s investment arm collaborated with IllumiCare, a health IT company. After analyzing laboratory and pharmaceutical expenses, IllumiCare identified cost-saving opportunities related to physician orders for antibiotics and lab tests.
Most of these opportunities were tied to hospitalists, “which made a lot of sense for us,” Dr. Mathews said, “because our hospitalists managed between 80% to 90% of our total inpatient contacts in our hospitals.”
The health system integrated an EHR-agnostic tool from IllumiCare, called CDS Hooks, into Epic applications. The clinical decision support tool “hovers” above patient records and provides context-specific suggestions to reduce wasteful medical care, according to Dr. Mathews.
MultiCare also worked with its hospitalists to develop a quality metric focused on shared savings and clinical stewardship. Tying the metric results directly to each practitioner significantly boosted engagement.
“That’s when we saw the hockey stick engagement with the tool occur,” Dr. Mathews told Becker’s. “Physicians with appropriately aligned incentives, I think we’re able to practice better medicine — more thoughtful medicine.”
Over the course of a year, MultiCare reduced wasteful spending by about $2.5 million. On a more granular level, the system is now saving $81 per discharge, and each accepted alert from CDS Hooks saves an average of $179.14.
The next phase of the project will focus on radiology.
“I think not only is it the right thing to do for our patients, it’s the right thing to do from a larger healthcare economic standpoint,” he said. “Fundamentally, I think it’s good medicine. Anytime we can avoid an unnecessary CT scan where we irradiate our patients with 120 x-rays worth of ionizing radiation, anytime we can avoid unnecessary blood draws, that’s fundamentally a good thing — because those things have clinical consequences as well.”