Methodology Used to Determine Watershed Health Quality Metrics


Communication

The Watershed Health software platform (Watershed) measures the elapsed time between when each message is received by an organization and when that message is marked as read by any user of that organization. These values are recorded and an average value for a given period of time is calculated for each organization. Statistical analysis of the calculated average values for all organizations is periodically performed and thresholds are determined that are used to stratify organizations into quintiles which are expressed on a scale between 1 and 5, with 5 being best.


Quality Assurance (QA)

When certain adverse events (such as 30-day readmission) occur, Watershed will automatically send each organization linked to the patient a quality assurance request form. Users can complete the form, ignore the form or opt out if the organization was not, in fact, involved in the patient's care at the time of the adverse event. Organizations have 7 days to complete the form. Watershed calculates the percentage of time that each organization completes this form. Statistical analysis of the percentage values for all organizations is periodically performed and thresholds are determined that are used to stratify organizations into quintiles which are expressed on a scale between 1 and 5, with 5 being best.


Readmission

Certain hospitalized patients enrolled in Watershed are followed by care coordinators for a period of 30 days after hospital discharge. If the patient returns to any hospital during that period, organizations linked to the patient will be credited with a hospital readmission. The number of patients who return to the hospital is compared to the number of patients who do not return to the hospital during a 30-day period to calculate an organization's readmission rate.


Deviation from Estimated Length of Stay (DELOS)

Inpatient facilities (such as hospitals) that use Watershed to connect patients to other inpatient facilities (such as skilled nursing facilities) have the option of including an estimated length of stay on the connection form. When this is done, Watershed will compare the estimated length of stay to the actual length of stay and record the difference. An organization's DELOS metric is the average of all such measured differences over a given period of time.


Patient Ratings

Certain patients enrolled in Watershed have an opportunity to rate organizations that were involved in their care on a scale between 1 and 5, with 5 being best. Watershed aggregates and averages the numeric information for each organization to determine the patient ratings score.