Embed Size (px)
Citation preview
1
MI-WIC Updates
MI-WIC – the first online EBT web-based WIC system
1
WIC Division Bureau of Family, Maternal and Child Health Michigan Department of Community Health
Agenda
1. Project Status – Alethia Carr
2. Planning for MI-WIC – Fenris Daniel
3. Data Conversion – Kobra Eghtedary
4. The Local Perspective – Kate White, S f & C
2
Stefanie Horning & Christopher BendekgeyStefanie Horning & Christopher Bendekgey
5. Closing Remarks – Stan Bien
6. Project Recognition
2
MI-WIC
MI-WIC is the first web-based system with online EBTMany unique features that help in clinic operational efficiencies Staff very much pleased with the implementation
3
The SystemImplementation Process
MI-WIC
Project Timeline Design, Development, and Implementation g , p , pstarted in February 2007 Pilot Operations began July 2008 Statewide rollout began October 2008Statewide rollout will be complete by May 2009
4
2009
3
Project Metrics
15 Local Agencies implemented 35 % of the caseload
88,778 EBT transactions processed 147,111 clients in MI-WIC (includes converted and newly added) 46,266 appointments made
5
pp$ 36,344,791 food processed
Project Status
Starting February – Southeast MI rollout will begin
Detroit Detroit Urban League Wayne County Macomb CountyOakland County
6
By Mid-March (in less than two months) MI-WIC will start to serve 75% of Michigan's caseload
4
Project Status
All agencies notified of their implementation date pUpper Peninsula will be implemented in May 2009
CAT V for UP will be a webcast – scheduled in mid-February
7
MI-WIC Objectives
Improve Clinic Workflow Reduce client time spent at clinic pIncrease staff time spent with client Integrate with other human health service systems Increase client satisfaction I l d th h i d
8
Improve caseload through increased enrollment and participationSupport EBT
5
MI-WIC – a maturing system
Enhancements have been implementedimplemented
A six week release plan1.0 was Pilot release 1.4 is the current release
9
Major software updates
Simplification Adjunct Eligibility verification processj g y pPrinting documents
Benefit Validation process improved between MI-WIC and EPPIC Appointment scheduling
10
6
Changes with MI-WIC
Electronic Clinic OperationsIntegration with other systemsIntegration with other systems
MICR www.wichealth.orgMIHP EPPIC for EBT
11
CHAMPS (planned)
Client Categories
Expanded to 11 category codes to moreExpanded to 11 category codes to more clearly reflect client’s status
Women - PG, BE, BP, NPPInfants - IBE, IBP, IFFChildren - C1, C2, C3, C4
12
7
MI-WIC Process
Client Active Record – Demographics Toggling between records gg g
Online Help Screens Income calculation Automated growth charts (36)
VLBW
13
WHO charts for Breastfeeding Auto Risk Suggestion
MI-WIC Process
Suggested Nutrition Education Topics Integration with www.wichealth.orgg g
Suggested Referrals Your own Community Resources
Simplified Food Package selectionFormulary
14
8
MI-WIC Process
Breast Pump Issuance & Tracking Time Study RecordingTime Study Recording Tracking Outreach activities Compliance Documentation and Tracking
15
System Roles
Users’ access managed through roles SSO – an automated process pCoordinators manage roles
Module Screen Button
16
9
M-TRACX – MI-WIC
M-TRACX user authorization managed by State
SSO is an automated process. After SSO
managed by State
Data entry and reporting solution that relies on paper data
ID, the process managed by the Coordinator Service oriented solution – for real time decision s pportrelies on paper data
collectionClerks primarily entered data
decision support All users enter data (CPA validation of food package data)
M-TRACX – MI-WIC
Validation and edits minimal
Rules based processing
Manual calculation of income, BMI, certification dates,…PAR
Extensive automation
Robust appointment schedulingscheduling functionality with post cards and auto-dialer
10
M-TRACX – MI-WIC
Income rules/form Automated calculation, Short Certification
Manual tracking of Proxy
Manual calculation of anthropometric data
CertificationUp to two proxy names captured. Assignment of EBT card to a proxyAssigns risks,
anthropometric datag
calculates BMI, converts between English & metric, plots charts
M-TRACX – MI-WIC
Food Package Guide MOMS
Easy to use food package assignment, ffood package history maintained, Food package customization, RD approval
11
Lesson Learned
WIC has not changedFamiliarity with the system is a learningFamiliarity with the system is a learning process Processes that were common in M-TRACX may not be applicable with MI-WIC Staff duties within MI-WIC may vary depending on clinic process Local IT support – very important
Lessons Learned
Avoid walk-in clinics on day 1 of operationClean up data conversion issues in M-Clean up data conversion issues in MTRACX where possibleFamiliarize with EPPIC Recommend that Coordinators attend a JIT before their scheduled JIT Consider visiting another MI-WIC agency that has similar clinic flow Ask, if any questions
12
Data Conversion
Using the Correct recert. Process (Oct.15)Data Conversion Notification (Jan. 15)Data Conversion Notification (Jan. 15)Conversion ReportsClients Terminated Due to Invalid Cert. (Jan. 8)Data Conversion Roll-Out Plan
13
MI-WIC – the local agency view
InterCare Community Health NetworkKate White, WIC Coordinator,
Jackson County WICJackson County WICThe MIThe MI--WIC Adventure…WIC Adventure…
Stefanie Horning, RD Stefanie Horning, RD Jackson County WIC CoordinatorJackson County WIC Coordinator
[email protected]@co.jackson.mi.us(517)768(517)768--16541654
14
July 28, 2008July 28, 2008Staff anxious for MIStaff anxious for MI--WIC implementation WIC implementation after intense trainingafter intense trainingafter intense training.after intense training.Staff maintained positive attitude despite Staff maintained positive attitude despite initial “bugs” in system.initial “bugs” in system.MDCH/WIC onsite support very helpful MDCH/WIC onsite support very helpful and comforting to staff.and comforting to staff.D i h d l t l th h lf f D i h d l t l th h lf f Decreasing schedules to less than half of Decreasing schedules to less than half of normal size allowed staff to “go at their normal size allowed staff to “go at their own pace”. own pace”.
Administrative RealitiesAdministrative RealitiesPaperless environment was a big change for our Paperless environment was a big change for our staff. Had to get used to scanning documents, staff. Had to get used to scanning documents, g g ,g g ,typing notes, using MItyping notes, using MI--WIC scheduler, etc.WIC scheduler, etc.Discarding very large amounts of paper. Discarding very large amounts of paper. Incineration/shredding needs increased.Incineration/shredding needs increased.Wireless internet service and laptop use has Wireless internet service and laptop use has made client servicing more efficient. But, made client servicing more efficient. But, wireless service not as reliable as LAN connection wireless service not as reliable as LAN connection for desktopsfor desktopsfor desktops.for desktops.Battery packs for laptops would be beneficial. Battery packs for laptops would be beneficial. Staff have to constantly plug laptops in to Staff have to constantly plug laptops in to maintain battery life.maintain battery life.
15
Administrative RealitiesAdministrative RealitiesClerical staff duties greatly decreased by Clerical staff duties greatly decreased by changing to paperless environment. Had to changing to paperless environment. Had to
i MIi MI WIC “d ti ” t kWIC “d ti ” t kassign new MIassign new MI--WIC “downtime” tasks.WIC “downtime” tasks.CPA duties significantly changed with new data CPA duties significantly changed with new data entry requirements. entry requirements. MIMI--WIC reports not fully reviewed for WIC reports not fully reviewed for Coordinators at training. Have had to Coordinators at training. Have had to “experiment” with system capabilities.“experiment” with system capabilities.Schedule altering can be tricky. (Template Schedule altering can be tricky. (Template creation and changes “undoing” schedules etc )creation and changes “undoing” schedules etc )creation and changes, “undoing” schedules, etc.)creation and changes, “undoing” schedules, etc.)Creation of local formula problem form has Creation of local formula problem form has helped to streamline formula change process. No helped to streamline formula change process. No appointments needed.appointments needed.
And…And…MIMI--WIC Helpline very useful, resolving problems WIC Helpline very useful, resolving problems quickly and efficiently. Their followquickly and efficiently. Their follow--up is also to up is also to q y yq y y ppbe commended.be commended.Automatic documentation of internet NE helpful, Automatic documentation of internet NE helpful, but process still needs tweaking.but process still needs tweaking.Breast pump inventory and issuance data much Breast pump inventory and issuance data much easier to enter and follow. Ordering pumps also easier to enter and follow. Ordering pumps also greatly simplified.greatly simplified.Hi h i k d t ti b RD t d Hi h i k d t ti b RD t d High risk documentation by RDs easy to use and High risk documentation by RDs easy to use and easy to follow by other staff, though care plans easy to follow by other staff, though care plans designed in a SOAP note fashion. (Some RDs like designed in a SOAP note fashion. (Some RDs like this, some do not.)this, some do not.)
16
CPA RealitiesCPA RealitiesMust now use computer. Some CPA Must now use computer. Some CPA veterans struggle with laptop use in clinicveterans struggle with laptop use in clinicveterans struggle with laptop use in clinic.veterans struggle with laptop use in clinic.Growth chart/prenatal grid plotting Growth chart/prenatal grid plotting accuracy no longer an issue. CPAs accuracy no longer an issue. CPAs thankful for this feature.thankful for this feature.Food package changes can be confusing, Food package changes can be confusing, such as date changing, disabling such as date changing, disabling
k t i i k t A k t i i k t A packages, customizing packages, etc. As packages, customizing packages, etc. As time goes on, CPAs become more time goes on, CPAs become more comfortable with this responsibility.comfortable with this responsibility.
CPA RealitiesCPA RealitiesReferral letters are convenient tools Referral letters are convenient tools for families who need help in addition for families who need help in addition for families who need help in addition for families who need help in addition to WIC. to WIC. NE plans give clients ownership of NE plans give clients ownership of goals set with CPA.goals set with CPA.Entry of health history data Entry of health history data
titi h ki ith f ili titi h ki ith f ili repetitive when working with families repetitive when working with families containing two or more participants. containing two or more participants. Can be time consuming. Can be time consuming.
17
Clerical RealitiesClerical RealitiesPrecertification process much easier with MIPrecertification process much easier with MI--WIC. WIC. Chart preparation tasks eliminated.Chart preparation tasks eliminated.p pp pDual participation has been a common problem. Dual participation has been a common problem. Need to make sure you search statewide for Need to make sure you search statewide for someone before precertifying them.someone before precertifying them.Transfers (within MITransfers (within MI--WIC system) have been WIC system) have been simplified. MTRACX transfers into MIsimplified. MTRACX transfers into MI--WIC…not WIC…not so much. (This will eventually be resolved, so much. (This will eventually be resolved, obviously!)obviously!)obviously!)obviously!)Birth date errors are an issue. Make sure you Birth date errors are an issue. Make sure you verify all birthdates!verify all birthdates!
Clerical RealitiesClerical RealitiesScheduling system has been an advantage Scheduling system has been an advantage and easy to use.and easy to use.yyFoster care situations and income Foster care situations and income requirements was not reviewed well at requirements was not reviewed well at training. Need to make sure clerks training. Need to make sure clerks understand system requirements for understand system requirements for foster children.foster children.Needed more education on NE data entry Needed more education on NE data entry t t i i ifi ll f Ed ti M ll t t i i ifi ll f Ed ti M ll at training, specifically for Education Mall at training, specifically for Education Mall
setting. setting. Predicting appointment needs can be Predicting appointment needs can be difficult at times. difficult at times.
18
Clerical RealitiesClerical RealitiesClerks greatly appreciate automatic Clerks greatly appreciate automatic
l l ti d f th i i l l ti d f th i i calculations done for them in income calculations done for them in income section.section.Overall timeliness improved. Clerical Overall timeliness improved. Clerical duties completed more efficiently duties completed more efficiently and with less errors.and with less errors.and with less errors.and with less errors.
Clinic FlowClinic FlowStill using pod system and it is working well with Still using pod system and it is working well with MIMI--WIC.WIC.MIMI WIC.WIC.Now use clipboard and form stating what family Now use clipboard and form stating what family is in each pod, since charts no longer establish is in each pod, since charts no longer establish this.this.Laptop carts sometimes get in the way (7 total). Laptop carts sometimes get in the way (7 total). But, we had space issues before MIBut, we had space issues before MI--WIC as well.WIC as well.Overall service time has been reduced which Overall service time has been reduced which Overall, service time has been reduced, which Overall, service time has been reduced, which makes our clients extremely happy.makes our clients extremely happy.Now looking at possibly adding anthropometric Now looking at possibly adding anthropometric and lab duties to clerical job description to help and lab duties to clerical job description to help even out workload between CPAs and clerks.even out workload between CPAs and clerks.
19
Suggestions…Suggestions…Schedule 1/3 Schedule 1/3 –– 1/2 of clients for first “go live” 1/2 of clients for first “go live” week. This allows clerks and CPAs to work at their week. This allows clerks and CPAs to work at their
d b f t bl ith th d b f t bl ith th own pace and become more comfortable with the own pace and become more comfortable with the system.system.A dependable printer(s) is essential for increased A dependable printer(s) is essential for increased printing requirements.printing requirements.Schedule meeting with local IT and state MISchedule meeting with local IT and state MI--WIC WIC representatives in advance for clarification of needs representatives in advance for clarification of needs and to ensure all parties are on the same page.and to ensure all parties are on the same page.Plan to have someone assigned to troubleshooting Plan to have someone assigned to troubleshooting Plan to have someone assigned to troubleshooting Plan to have someone assigned to troubleshooting (e.g. data entry errors). Designate one or two staff (e.g. data entry errors). Designate one or two staff members (preferably CPAs or RDs) to be “super members (preferably CPAs or RDs) to be “super users.” For agencies with more than one clinic, one users.” For agencies with more than one clinic, one super user per clinic may be necessary.super user per clinic may be necessary.
Suggestions…Suggestions…Will need to keep card issuance signature Will need to keep card issuance signature forms Have container of some sort forms Have container of some sort forms. Have container of some sort forms. Have container of some sort available.available.ReRe--evaluate clerical duties. If you do not evaluate clerical duties. If you do not currently have techs, consider adding this currently have techs, consider adding this position or adding anthropometric/lab position or adding anthropometric/lab duties to clerical position.duties to clerical position.E iti ttit d Thi i t l E iti ttit d Thi i t l Encourage positive attitudes. This is truly Encourage positive attitudes. This is truly what made Jackson County’s transition to what made Jackson County’s transition to MIMI--WIC successful.WIC successful.
20
MI-WIC….Planning for Change
Christopher BendekgeyWIC Coordinator - Kent County Health Department
Public Notification
Misc. Clinic PreparationMI-WIC Implementation
Staff Preparation
21
Public Notification• Who should I let know about the change to MI-
WIC?• Board of Commissioners• Health officers • WIC Participants• Local MIHP Programs• Food Pantries• Local Provider Offices• United Way/ 211United Way/ 211• Formula Reps – (Ross, Mead Johnson, Nestle) • Area Hospitals
– Discharge Nurses– Social Workers– Clinical Dietitians
Public Notification
• How should I let them know?• Press release• Press release • IDVOC stuffers • Clinic Closure signs • Phone messages• Auto-Dialer• Client news letter• Health Department/ County Webpage• Letter to Providers
• Mass E-mails/ E-mail tag line
22
Clinic Preparation
• How should I prepare my clinic(s) for MI-WIC?– Clinic Workflow / Layout
• Is there a more efficient way to provide services? • Review how current services are being provided in your clinic(s).
(i.e. Pod vs. non-Pod, wireless laptops vs. desktops, CPA/RD issuing benefits vs. clerks, etc.)
• Involve staff in making decisions on clinic flow and on where new clinic equipment (Scanners & Signature Pads) should be set up.
– Clinic Procedures• Identify past/current clinics procedures that may change as a result
of MI-WIC (i.e. medical request subpoena, change of custody documentation, scanning of formula Rx, etc.)
Staff Preparation
• Should I reduce schedules for the first weeks of MI-WICShould I reduce schedules for the first weeks of MI WIC rollout?
• Week 1: 50% schedule reduction• Week 2: 50% schedule reduction• Week 3: 25% schedule reduction• Week 4: Full Schedule
• How should I staff for MI-WIC rollout?– Recommend Scheduling staff as if running full schedules– Part time / Per Diem staff– Phone Coverage
23
Clinic Preparation
• Computers, Scanners and Signature P d Oh !!Pads…. Oh my!! – Be sure to include your IT staff on MI-WIC
updates, implementation dates, etc.– Sketch a clinic floor plan and label the
locations of various equipment.– Utilize Three Sigma Software IT Support
Other Things to Think About
• Should I have a back up service plan for MI WIC?MI-WIC?– Keep hard charts readily available– CDE– Income Forms– MI-WIC Health History Forms
Sh ld till h t ld• Should we still have access to our old scheduling system? (i.e. PAR, Teletask, paper schedules)
24
Implementation Plan
Group 7 – Washtenaw, Monroe, CAA, and Livingston – February 2, 2009 g yGroup 8 – Detroit – February 16, 2009 Group 9 – Wayne, DUL – March 2, 2009 Group 10 – DCS, Oakland, Macomb –March 16, 2009 Group 11 – St. Clair, Lapeer, Tuscola, Huron, Sanilac – March 30, 2009
Implementation Plan
Group 12 – Genesee, Bay, HDI, Mid-MI CAA, Saginaw – April 6, 2009 Group 13 – DHD #10, Grand Traverse, Benzie-Leelanau – April 20, 2009 Group 14 – DHD #2, DHD #4, Northwest –May 4, 2009 Group 15 – Keweenaw Dickinson-IronGroup 15 Keweenaw, Dickinson Iron, Western UP, Marquette, Delta-Menominee, LMAS, Chippewa – May 18, 2009
25
Planning Preparation
Clinic Administrator Training Conference CallsConference Calls Just-In-Time MI-WIC Computer Based Training (CBT)
Planned Trainings
Reports Project FRESHProject FRESH Time Study Auto-dialer Breast PumpsNutrition Education & Care PlansNutrition Education & Care PlansME with MI-WIC
26
Local Agency Facilitation
Steering Committee
Doris Goodman
27
Local Agency Core Team
Anne Bianchi - DHD # 10Kelly Conley - Central MI DHD y ySuzette Daly - HD of Northwest MIDebra Dudewicz - Saginaw County DPHDiana Hazard - Calhoun CHDDiane Jovanovich - St. Clair CHDKate White - InterCare Deborah Wendt - Wayne CHD
MI-WIC Pilot Agencies
Barry-Eaton District Health Department Cindy Englehart y g
Calhoun County Health DepartmentDiana Hazard
Jackson County Health Department Stefanie Horning
Ingham County Health Department Doris Goodman
28
MI-WIC Project Team Leads
Kobra Eghtedary Kristen HanulcikKristen HanulcikLaurie Perrelli Rosendo ReyesDavid Sachau
Questions
56
29
Contact Information
Fenris DanielProject Manager, MI-WIC, MDCH
(517) 335-9530
57
