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Pre-Conference Intensive: Using
Health IT Tools: The What, the Why and
the How Part II
July 29, 2018
Investing in and Choosing an IT Platform.
Presenters:
Sharon Fusco, Vice President - Business Services Group for
Council on Aging of Southwestern Ohio Cincinnati, OH
Sandy Atkins, Vice President, Strategic Initiatives, Partners in
Care Foundation San Fernando, CA
IT to Support Networks & Contracting
Sandy Atkins, MPA, VP, Strategic Initiatives
What’s it for? History/Evolution
Something for everyone…
A patchwork quilt
LTSS/Waiver:
CM, purchase & billing
CCTP:
Workflow/billing
HomeMeds:
Risk screen
CDSME
Outreach, Ops & Outcomes
Network Contracts
Assessment, CP & Process
Phase I: Do Whatever it Takes!!
Copy Data TO HomeMeds Export PDFs to Excel
70-Column Log
Pharmacist Log Data
Example of a real workflow
Ouch!!!!
Learning from the Pain
This Photo by Unknown Author is licensed under CC BY-SA-NC
Seeking IT Solutions: Discovery • Discuss pain points & aspirations
• Review contractual requirements
− Same-day documentation of every attempt to contact member
− Provide access for Plan to internal record-keeping systems
− Secure File Transfer Protocol (SFTP) & Secure Email required
• Review accreditation requirements
− Population health management
− Reminders/notifications
• Billing requirements
• Reporting requirements
• Management & oversight requirements
• Plan workflows
Demos – Lessons Learned
• Make sure you’re seeing a live, implemented site and not screenshots
• Get a login to do a test run − If they can’t/won’t…don’t!
• Beware of demo fatigue – the best one may be last
• Beware of shiny, glitzy, overkill systems that create unrealistic expectations in your price range
• Beware of group think & letting others’ feelings (positive or negative) carry you away
• Have a rating tool and make everyone use it
RFP & responses – lessons learned
• Don’t let anyone get away with not answering questions as stated and in the format requested
• Make sure it’s abundantly clear what is required and what is a “nice to have”
− Consider eliminating the nice-to-have elements from RFP
• Response must specify openly what is—and is not—included in pricing
• Create a point-by-point rating tool − Have someone designated to pull info from RFP response
into rating tool
Choosing – Lessons Learned (sort of)
• False economies − Sometimes the cheapest isn’t
• False economies − Sometimes the most expensive isn’t the best
• Sometimes pressure leads to good decisions − Sometimes it doesn’t
• A good working relationship can be more important than the best product
− But it’s not about being friends; it’s about working together to develop a great system
Contract Terms – Lessons Learned
• Read and really think through every term; some may not be as benign as they look
• When do you start paying?
• What if it’s not done to your satisfaction?
• Who decides when it’s ready to use? − He said/she said – who’s “fault” is it?
• Look for minimum volume requirements − New contracts tend to be small
− You may be paying for more than you need
Implementation: Multiply by 3
This Photo by Unknown Author is licensed under CC BY-ND
Next challenges
• Integrating data across multiple systems
• Linking up to health systems/plans
• A system that works for a network − Automates more
− Assumes less
− Wake-up calls for required steps & timeliness
Happy to Help! Sandy Atkins, VP, Strategic Initiatives
www.picf.org
818.837.3775x111
818.632.3544 (m)
USING HEALTH IT TOOLS: INVESTING IN AND CHOOSING AN IT PLATFORM SHARON FUSCO, VICE
PRESIDENT, BUSINESS SERVICES
LESSONS LEARNED IN SELECTING SOFTWARE
Create a cross functional team to determine system specifications.
Include strategic and operational thinkers.
Identify early the “go/no go” criteria.
Determine early if you are willing to change business practices to adopt a new system and move to industry standards. (Customization is expensive and makes it easy to “fall behind” the technology trends).
Check references.
TAKE TIME TO DEFINE THE FUTURE STATE
VENDOR EXPECTATIONS
Define what you want from the vendor.
How do they manage projects?
Meeting schedules
Communications
How do they get into the details of your business
and translate that into system specifications?
How do they define and mitigate risk?
QUALIFICATIONS
Communications.
Manage through influence
Goal oriented
Highly organized.
Multi-task
Not an expert but knows
your business.
WHY?
Need for single point of
contact.
Internal impact is
significant.
Ensure everyone is
getting the job done
LESSONS LEARNED IN CONTRACTING FOR SOFTWARE PURCHASE
Include “carrots” and “sticks” in the contract for hitting deliverables.
Include the scope of work in the contract.
If it can’t be completed prior to contracting, include a deadline for completing the contract.
Insist on a project plan with deliverables.
Use your legal office, someone with expertise in computer software purchases.
LESSONS LEARNED IN
IMPLEMENTING SOFTWARE
Use a cross functional team of people who do
the work.
Hire your own project manager to work with
their project manager and to keep your team
on track.
Create a plan and work the plan.
Over estimate how much time each step will
take.
Track all deliverables.
VENDOR COMMUNICATIONS
Be direct. Identify and discuss
problems. Agree on resolutions.
Establish lines of communication at
the operational and executive level.
Take and share minutes – record
every meeting.
Create a system for accountability -
we use the project plan and executive
meetings for this.
QUESTIONS
Sharon Fusco
Council on Aging
175 Tri County Parkway
Cincinnati, OH 45246
513/746-2645
Strategies for Data Collection and Exchange
Presenters:
Sue Lachenmayr, State Program Coordinator, Living Well
Center of Excellence, MAC, Inc. Salisbury, MD
Leigh Ann Eagle, Executive Director, Living Well Center of
Excellence, MAC, Inc. Salisbury, MD
Donata Barnes, Director/Health Care Collaborations, CICOA
Aging and In-Home Solutions Indianapolis, IN
www.cicoa.org
Strategies for Data
Collection and
Exchange Donata Barnes, Director of Health
Care Collaboration
www.cicoa.org
Opportunities for Growth
• Utilizing the state electronic database, Access and
excel sheets for data
• Current system lacked interoperability
• System was not web-based
• Current system lacked the ability to share client
information in real time with other providers
• Developing reports to support or show
effectiveness of evidenced-based program was
challenging
• Effectively and Efficiently addressing the triple aim
www.cicoa.org
Solutions
• Embed staff at local hospitals
• Obtained funding through the Fairbanks
Foundation to develop and implement EMR that
was compatible to the Indiana Health
Information Exchange and met
• Partner with Indiana Health Information
Exchange for real time admission, discharge,
and transfer alerts
• Ability to provide partners with data based on
social determinants of health
www.cicoa.org
Indiana Health Information Exchange
• Connection to 117 hospitals / representing 38
health systems
Hospitals Physician Practices
www.cicoa.org
Questions & Answers
www.cicoa.org
Thank You!
CICOA Aging & In-Home Solutions
4755 Kingsway Drive, Suite 200
Indianapolis, IN 46205
317.254.5465
800.489.9550
Aging & Disability Resource Center
317.254.3660
800.432.2422
www.cicoa.org
Let’s Be Social
cicoa.org/facebook
cicoa.org/twitter
cicoa.org/linkedin
Strategies for Data Collection and Exchange: the Maryland Living Well Center of Excellence Partnership with CRISP MARYLAND L IVING WELL CENTER OF EXCELLENCE (LWCE)
LE IGH ANN EAGLE, EXECUTIVE DIRECTOR
SUE LACHENMAYR, STATE PROGRAM COORDINATOR
Health information exchange (HIE)
HIE is the mobilization of health care information electronically across organizations within a region, community or hospital system. In practice the term HIE may also refer to the organization that facilitates the exchange.
HIE provides the capability to electronically move clinical information among different health care information systems. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer and more timely, efficient, effective, and equitable patient-centered care.
MARYLAND’S CHESAPEAKE REGIONAL INFORMATION ABOUT PATIENTS - CRISP
Regional Health Information Exchange (HIE) serving Maryland and the District of Columbia, and collaborating with Delaware, Northern Virginia, Pennsylvania, and West Virginia
Vision: To advance health and wellness by deploying health information technology solutions adopted through cooperation and collaboration
Data source or attribute #
Live hospitals 91
Live clinical data feeds 261 (lab, rad, ADT, CCD)
Live ENS practices +1,000
Long-term and post-acute care facilities
160
Standalone labs and radiology centers
16
Unique patients in index +16 million
Patient searches +400,000/mo
Encounter alerts sent +2,500,000/mo
CRISP Core Services
1. POINT OF CARE: Clinical Query Portal & In-context Information
◦ Search for your patients’ prior hospital records (e.g., labs, radiology reports, etc.)
◦ Monitor the prescribing and dispensing of PDMP drugs
◦ Determine other members of your patient’s care team
◦ Be alerted to important conditions or treatment information
2. CARE COORDINATION: Encounter Notification Service (ENS)
◦ Be notified when your patient is hospitalized in any regional hospital
◦ Receive special notification about ED visits that are potential readmissions
◦ Know when your MCO member is in the ED
CRISP Core Services
3. POPULATION HEALTH: CRISP Reporting Services (CRS)
◦ Use Case Mix data and Medicare claims data to:
o Identify patients who could benefit from services
o Measure performance of initiatives for QI and program reporting
o Coordinate with peers on behalf of patients who see multiple providers
4. PUBLIC HEALTH SUPPORT: Partnerships with Maryland MDH, District of Columbia DHCF, and West Virginia through the WVHIN
5. PROGRAM ADMINISTRATION: Technical and administrative support for Care Redesign Programs
MARYLAND LIVING WELL CENTER OF EXCELLENCE (LWCE) - MAC, INC. AAA
• Statewide License for CDSME Programs: Chronic Disease, Diabetes, Pain, Cancer, Spanish Chronic Disease
and Diabetes, CDSMP Toolkit and wCDSMP (worksite) • Statewide License for Stepping On, EnhanceFitness, EnhanceWellness and PEARLS • Statewide oversite for PEARLS • Learning collaborative and trainings for CDSME, Stepping On and PEARLS • Centralized referral, workforce certification and fidelity monitoring, and HIPPA-compliant training and
processes • EBP workshops on MDH statewide calendar/registration/referral website • Quarterly reports on patient activation, engagement, and long term goals • Participant satisfaction/engagement and quality assurance monitoring of leader competency • Expanded consent to collect individual and population health outcomes • Tracking of pre-/post- clinical measures
LWCE Evidence-Based
Programs
42
CHRONIC DISEASE
SELF-MANAGEMENT
EDUCATION
PROGRAMS:
Cancer Thriving and Surviving
Chronic Disease
Chronic Pain
Diabetes
Home Toolkit
Spanish Chronic Disease
Tomando
Spanish Diabetes Programa De
Manejo
wCDSMP worksite
Walk With Ease
LWCE, CRISP & Hospital Data-Sharing
• CRISP/Hospital/LWCE 6 month pre/post hospital and emergency department
utilization after completion of evidence-based program (EBPs) to establish ROI
• Partnering with CRISP to track Social Determinants of Health and referrals to
EBPs and community-based services
• Access CRISP as Care Coordination Provider to input CARE ALERTS, including
identifying patient unmet needs, services provided, etc.
Health Care Perspectives
Presenters:
Johnny Gore, MD, Sr. Medical Director, STAR+PLUS, Cigna-HealthSpring Bedford, TX
Jason Smith, Sr. Director Medicaid/Medicare Ohio, Aetna
Columbus, OH
BREAK
Breakout Activity
Breakout Questions
• What’s the greatest insight you heard at this preconference that you’re taking back to your organization?
• What action steps can you take to address the organizational IT challenge that you discussed yesterday?
• Again, thinking about that challenge, what help do you need to move forward with your action steps?
More from the Business Institute
• Webinar: Sustainability for All: A Multi-Partner Approach to Growing Evidence-Based Programs August 29 at 1pm ET
• Webinar: Understanding the Incentives and Strategies for Health Systems to Engage in Cross-Sector Partnerships September 19 at 1pm ET
• Readiness Assessment
• Website: aginganddisabilitybusinessinstitute.org
Upcoming Learning Opportunity
Learning Collaborative for decision-making support to evaluate, select and implement data sharing systems to enhance management of service delivery for program quality, client satisfaction and service reimbursement.
Call for applications coming in August!
www.aginganddisabilitybusinessinstitute.org
Sandy Markwood Chief Executive Officer National Association of Area Agencies on Aging (n4a) [email protected] Mary Kaschak Deputy Director, Aging and Disability Business Institute n4a [email protected] Karen Homer Research Associate, Aging and Disability Business Institute n4a [email protected]
Marisa Scala-Foley Director, Aging and Disability Business Institute N4a [email protected] Paul Cantrell Consultant n4a [email protected] Elizabeth Blair Senior Research Associate, Aging and Disability Business Institute N4a [email protected]