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HRIF-QCI Reporting System2016 Data Trainings - October 2015 Part 1

Erika Gray, BAProgram Manager

ì CCS HRIF Program

ì How To Get Access

ì Reporting System Usage

ì HRIF Data Finalization Process (DFP)ì Resources/Tools availableì Feedback from CPQCC/HRIF

ì 2011 Data Closeout - Summaryì Award Winnersì Improvements

ì CCS Billing Work Group

ì NEW Website Launch

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Brief Backgroundì 1979 CCS Standards for “Tertiary”NICUs were developed addressed

CCS HRIF examinations. “CCS may pay for follow-up examination of high risk NICU graduates even though a CCS eligible condition does not exist“.

ì July 1, 2006 restructured CCS HRIF Program went into effect Core Diagnostic ServicesìComprehensive History & Physical Exam with Neurologic AssessmentìDevelopmental AssessmentìFamily Psychosocial AssessmentìHearing AssessmentìOphthalmologic AssessmentìCoordinator Services

ì CCS & CPQCC designed the High Risk Infant Follow-up Quality of Care Initiative (HRIF-QCI) Reporting System to:

ì Identify Quality Improvement Opportunities for NICUs in the Reduction of Long Term Morbidity

ì Allow HRIF Programs to Compare their Activities with All Sites Throughout the State

ì Allow the State to Assess Site-Specific Successes

ì Support Real-Time Case Management

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Reporting Requirements

This web-based HRIF-QCI Reporting System

was developed for CCS HRIF Program

medically eligible infants, regardless of

insurance status or CPQCC eligibility.

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How To Get Access

ì Submit a Help Ticket at www.cpqccsupport.org

ì With the following information:ì Center Nameì Does your center provide HRIF Services?ì Full Nameì Titleì Phone Numberì Email Addressì User Account Access

How To Get AccessUser Account Access: (contacts can have multiple accounts):

ì Data User: CCS-approved HRIF Program staff submits all data forms (Referral/Registration (RR), Standard Visit (SV), Additional Visit (AV) and Client Not Seen/Discharge (CNSD) for infants/children receiving follow-up services from their own HRIF Program. Data Users can generate HRIF Program and Patient Summary reports.

ì Referral User: CCS-approved NICU and/or HRIF Program staff refers HRIF eligible infants to a CCS HRIF Program and only has access to submit the “Referral/Registration Form”. Currently no access to generate/view reports.

ì NICU User: CCS-approved NICU staff (read-only access) generate/view NICU reports.

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Duo Secure Loginì Effective June 2014, in order to access the online HRIF-QCI Reporting

System, you will have to use the Duo Two-Factor Authentication security software. Two-factor authentication enhances the security of your online accounts by using your phone to verify your identity. This prevents anyone but you from accessing your accounts, even if they know your password. For more information about Duo Security visit: http://guide.duosecurity.com/.

ì Two-factor authentication adds a second layer of security to your account to make sure that your account stays safe, even if someone else knows your password. And you'll be alerted right away (on your phone) if someone does know your password and tries to log in with it.

ì This second factor of authentication is separate and independent from the username and password step — Duo never sees your password.

(Mobile  and/or  Landline  Phone)

(Request  Bypass  Codes)

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Reporting System Usage

ì 69/118 (58%) CCS NICUs have a HRIF Program

ì 69 (100%) HRIF Programs Reporting Onlineì 22 Regionalì 47 Community

ì 39/49 (79%) Referring CCS NICUs Reporting Onlineì 30/36 (83%) Communityì 9/13 (69%) Intermediate

Total System Users: 437

BIRTH YEAR2011 2012 2013 2014

Ref/Regs 7430 7483 7555 8429Standard #1 5162 (70) 5214 (70) 4934 (65) 4129/7065

(58)Closed Other/

Not Seen 2232 (30) 2232 (29) 2589 (34) 2911 (41)*

Standard #2 3855 (52) 3956 (53) 3540 (47) 800/1510 (52)Closed Other/

Not Seen 3530 (48) 3484 (47) 3969 (52) 706/1510 (46)

Standard #3 2910 (39) 2696/5385 (50)* 1016 (100) 17 (100)Closed Other/

Not Seen 4467 (60) 2657/5385 (49)

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HRIF Data Process Finalization

The purpose of this finalization process is to assist HRIF Programs with complete and accurate data submission of records for infants born in 2012 AND referral/registrations for infants born in 2015. For technical assistance submit a help ticket at www.cpqccsupport.org.

Data Finalization Process (DFP)

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Data Finalization Process (DFP)

DFP Schedule for 2016

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CPQCC Deliverable

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cpqccreport.org

ì On November 2014 – HRIF Programs were able obtain access to view the reports, available at www.cpqccreport.org

ì Each CPQCC CCS NICU may request a CCS NICU/HRIF Program user access to cpqccreport.org. HRIF user access is designed for referring NICU or HRIF Program Coordinator and provides access to the HRIF Summary and HRIF Infant Status Reports ONLY. NOTE: It does not give access to any of the other reports available on cpqccreport.org.

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HRIF Infant Status Report and HRIF Linked Summary Report

Per request from HRIF, a NICU report option was added that shows HRIF registration status for each infant coded as initially discharged home or discharged home from the reporting CCS NICU after one prior transfer out and re-admission. If available, the report lists the basic information that should always be included in an infant's HRIF.

NOTE: This report is only available for centers, not for regions.

www.cpqccreport.org

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CPQCC and CCS HRIF Linkage Summary Report} Includes HRIF eligible only Very Low Birth Weight during any

CPQCC stay prior to Home Discharge from the reporting CCS NICUs:

Birth Year # VLBW CPQCC Eligible

# Found in HRIF

% Found in HRIF

2009 4,056 3,069 75.7*2010 3,875 3,150 81.32011 3,870 3,391 87.62012 3,831 3,436 89.72013 3,806 3,505 92.12014 3,943 3,916 99.32015 712 540 75.8*

August  2015

HRIF Program Issues

ì Late referrals – child missed 1st or 2nd visit timeframe (100 patients referred in May 2015)NOTE: SV #1 (4 - 8 mos) and SV #2 (12 - 16 mos)

ì Missing data on registration forms, unable to contact families to schedule follow-up visits

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Discharge Registration DelayYear <=3 mos 3-6 mos 6-12 mos Over 1 yr

2009 56% 18% 14% 10%

2010 57% 16% 17% 8%

2011 65% 14% 12% 7%

2012 65% 16% 14% 4%

2013 75% 12% 10% 2%

2014 76% 12% 10% 2%

2015 94% 5% - -

All Years 68% 14% 12% 5%

2011 Data Closeout - Summary

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2011 Data Closeout

ì Programs w/NO Errors/Warnings = 57 (82%) ì 27 (39%) 2010 Data Closeout

ì Programs w/ NO Priority Cases = 63 (91%)ì 49 (75%) 2010 Data Closeout

ì 44 Programs received the “Superstar” award

ì 12 Programs received the “Follow-up Rate” awardì SV 1st => 80%ì SV 2nd => 65%ì SV 3rd => 50%

Error/Warning

2010 Close Out

ì 56 Programs (877 errors)ì 523 Missing MDOBì 72 >= 3 yrsì 33 Missing CPQCC ID#ì 17 Duplicatesì 14 >= 12 mos/No Forms

2011 Close Out

ì 12 Programs (230 errors)ì 26 Missing MDOBì 88 >= 3 yrsì 32 Missing CPQCC ID#ì 8 Duplicatesì 39 >= 12 mos/No Forms

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Superstar Winnersì Alta Bates Summit Med Ctr-Alta Bates

Campus

ì Arrowhead Regional Medical Center

ì Bakersfield Memorial Hospital

ì California Pacific Med Ctr - California West

ì Cedars Sinai Medical Center

ì Children's Hospital Of Orange County

ì Desert Regional Medical Center

ì Doctors Medical Center

ì Glendale Adventist Medical Center

ì Hoag Memorial Hospital Presbyterian

ì John Muir Medical Center - Walnut Creek Campus

ì Kaiser Fnd Hosp - Downey

ì Kaiser Fnd Hosp - Fontana

ì Kaiser Fnd Hosp - Panorama City

ì Kaiser Fnd Hosp - San Diego

ì Kaiser Permanente - Roseville

ì Kaiser Permanente - San Leandro (Hayward)

ì Kaiser Permanente - Walnut Creek

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Superstar Winnersì Kaweah Delta Medical Center

ì Kern Medical Center

ì Loma Linda University Medical Center

ì Los Robles Hospital & Medical Center

ì LPCH Stanford

ì Mattel Children's Hospital At Ronald Reagan UCLA Medical Center

ì Mercy San Juan Hospital

ì Miller Children's Hospital At Long Beach Memorial Hospital

ì Natividad Medical Center

ì North Bay Medical Center

ì Northridge Hospital Medical Center

ì Pomona Valley Hospital Medical Center

ì Presbyterian Intercommunity Hospital

ì Providence Tarzana Medical Center

ì Rady Children's Hospital - San Diego

ì Riverside County Regional Medical Center

ì San Antonio Community Hospital

ì Santa Barbara Cottage Hospital

Superstar Winnersì Santa Clara Valley Medical Center

ì Santa Monica - UCLA Medical Center

ì Sierra Vista Regional Medical Center

ì St. John's Regional Medical Center

ì Sutter Memorial Hospital

ì Tri-City Medical Center

ì University Of California Davis Medical Center

ì University Of California Irvine Medical Center

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DFP Improvements

ì Build a Close Out Check List system for deliverables:ì No Priorities (auto check)ì No Errors/Warnings (auto check)ì Reviewed/Sign-off Directory (manual check)ì CCS Report reviewed/approved (auto check)

ì Medical Director/HRIF Coordinator – sign off on CCS Annual Report (Similar to CPQCC)

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CPQCC Close-Out Check List

CPQCC Annual Report Sign-off

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CCS Billing Work Group

ì July 2014, ExCom decided to convene a small work group to identify the HRIF CCS billing issues (coordinator activities, team conferences, etc).

ì The goal of this group was to address the billing issues and then develop a QA, a process OR a form/ template, that can be shared with all CCS HRIF Programs in the State.

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Work Group Members

ì Dianne “Dini” Baker, RN, MSN

ì Anne DeBattisita, MS, PNP

ì Erika Gray, BA

ì Hallie Morrow, MD

ì Rupalee “Palee” Patel, RN, BSN, MS, DNP, IBCLC

ì Valerie Willis, RN, MSN, PNP

ì The work group met via phone conference and email

ì Program’s shared their site billing documents and CCS codes used

ì The following CCS Billing documents were compared:1. Expanded Des. and Guide for Billing HRIF Program (State)2. HRIF SCG-06 Service Code Listed by Provider (State)3. HRIF SCG-06 Service Code Listed Numeric Order of Billing

Code (State)

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NEW Website – Launch Dec 1st

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Any Questions?