Data powers smarter patient care

Numbers help network hospitals identify areas of need

The University of Vermont Health Network is harnessing the power of data to identify high-need communities in our service area.

A team of employees from network partners Champlain Valley Physicians Hospital, Central Vermont Medical Center, The University of Vermont Medical Center, Adirondacks Accountable Care Organization, OneCare Vermont Accountable Care Organization, and the Jeffords Institute for Quality at UVM Medical Center is working to identify “ambulatory care-sensitive conditions” in our communities.

This data has allowed the UVM Health Network to identify communities that need more support for prevention measures.

Treating these conditions – which include heart failure, diabetes, asthma, dehydration and bacterial pneumonia – in a high-quality-care outpatient setting could keep more patients out of the hospital.

By combining data from network hospital admissions with OneCare Vermont admission data from surrounding hospitals, we can compare how our patients fare against national prevention quality indicators.

This data has allowed the UVM Health Network to identify communities that need more support for prevention measures. One such community is Lyon Mountain, New York, where rates of heart failure, bacterial pneumonia, chronic obstructive pulmonary disease and urinary tract infections are higher than in surrounding areas and nationally.

Lyon Mountain, a socioeconomically challenged town on the western edge of Clinton County, has very limited access to primary care and experiences a high volume of emergency room visits and inpatient readmissions.

By understanding the factors contributing to Lyon Mountain’s limited prevention abilities, network partners can help develop strategies to improve the community’s health.