Transcript LCC Pilots WG 2013-09-30

Longitudinal Coordination of Care
Pilots WG
Monday, September 30, 2013
Meeting Etiquette
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From S&I Framework to Participants:
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All Participants
Agenda
Topic
Presenter
Introductions and Purpose
Lynette
Overview of CORHIO
Pam
Overview of Pilot wiki and tools
Lynette
3
Pilot Work Group Purpose and Goals
• Purpose
– Provide tools and guidance for managing and evaluating
LCC pilot Projects
– Create a forum to share lessons learned and best
practices
– Provide subject matter expertise
– Leverage existing and new partnerships
• Goals
– Bring awareness on available national standards for HIE
and care coordination
– Real world evaluation of parts of most recent HL7 C-CDA
Revisions Implementation Guide (IG)
– Validation of ToC and Care Plan/HHPoC datasets
4
Aug-Sept 13
Oct- Nov 13
Dec- Jan 14
Feb- Mar 14
Apr- May 14
Jun- Jul 14
Aug- Sep 14
HL7 Ballot
LCC Pilot WG
LCC Pilot WG Timeline: Aug 2013 – Sept 2014
LCC Pilot Proposal Review
LCC Pilot Monitoring & Evaluation
LCC Pilot Wrap-Up
HL7 Ballot & Reconciliation
HL7 C-CDA IG Revisions
LCC Pilot
WG Launch
HL7 Ballot
Publication
Updated HL7 CCDA IG
Complete
Milestones
HL7 Fall Ballot Close
LCC Pilot Test Spec.
Complete
IMPACT Go-Live
NY Care Coordination Go-Live
LCC Pilots Close
LCC Pilot WG Tasks
Target MM
Pilot WG Tasks (Agenda)
WG Homework
Sept 13
• Launch LCC Pilot WG
• Review Pilot Planning Tools
• Review and submit LCC Pilot
Documentation Templates
Oct 13
•
•
•
•
Present MA IMPACT Go-Live Plan
Review Pilot Requirements Traceability Matrix (RTM)
Review Pilot Proposal Criteria Matrix
Present Pilot Proposals
• Review: LCC Pilot RTM
• Submit LCC Pilot Proposals
• Evaluate Pilot Proposals
Nov-Dec 13
•
•
•
•
Present NY Downstate Go-Live Plan
Present and evaluate Pilot Proposals
Present IMPACT Pilot Status
Present NY DD Pilot Status
• Review: Pilot Evaluation
Template
Jan-Feb 14
• Present LCC Pilots Status
• Review Phase 1 Performance Metrics for IMPACT & NY DD Pilots
• Gather Pilot Performance Data
Mar-Apr 14
• Present LCC Pilots Status
• Review Phase 1 Performance Metrics for NEW* Pilot Sites
• Gather Pilot Performance Data
May-Jun 14
•
•
•
•
Present LCC Pilots Status
Review Phase 1 Performance Metrics for NEW* Pilot Sites
Review Phase 2 Performance Metrics for IMPACT & NY DD Pilots
Review recommended revisions to C-CDA IG
• Gather Pilot Performance Data
• Submit recommended C-CDA
revisions
July-Sept 14
•
•
•
•
Review Phase 2 Performance Metrics for NEW* Pilots
Review and consolidate recommended revisions to C-CDA IG
Close out Pilots
LCC Pilots Open House
• Gather Pilot Performance Data
• Review recommended C-CDA
revisions
6
Longitudinal Coordination of Care
Pilots WG
CORHIO-LTPAC Transitions Program
September 30, 2013
Pamela Russell, LTPAC Program
Agenda
• About CORHIO
• Initial Outreach through surveys and letters
• Participating LTPAC Providers
• Milestones and Measures
• Statistics on Usage and Queries
• Lessons Learned
• Q&A
• Colorado Regional Health
Information Organization
• A nonprofit, public-private
partnership
• The state-designated
entity for health
information exchange
(HIE) in Colorado
Vision
Who We Are
About CORHIO
• Shared health
information for all
individuals in every
Colorado community
promoting the right
care, at the right
time and
the right place.
Goals for 2015
• Health information exchange deployed in every community
• 85% of providers are meaningful users of electronic health
records (EHRs)
CORHIO
Health Information Organization
Health Information
Exchange (HIE)
Medicaid EHR
Incentive Program
Outreach
Regional Extension Center
Assist providers with EHRs &
Meaningful Use
Care Transitions:
Long-Term & PostAcute Care
Behavioral
Health
Integration
CORHIO By the Numbers
45
Hospitals Connected or in Implementation
(30 are already connected to the HIE)
119
Long-Term, Post-Acute Care, Home Health Facilities
Connected or in Implementation
1,800+
Office-Based Physicians/Providers
Connected or in Implementation
2,582,675
Unique Patients With Clinical Data in the HIE
Data current as of Aug 20, 2013
Labs Participating in HIE
• Cedar Diagnostics
• Colorado Lab Services
• LabCorp
• Quest Diagnostics
• Schryver Medical
Bold = Connected to HIE (Live)
Non-bold = Under agreement, in implementation
LTPAC Program –The
Beginning
•
What’s HIE?
•
Initial Outreach
– Survey letters to LTPAC Providers
•
Community Meetings in targeted communities
–
–
–
–
Area Agency on Aging
CFMC – state QIO
CHA – Colorado Hospital Association
CHCA – Colorado Healthcare Association
•
Collaborations with hospitals, physician practices, care coordinators
and care transition community groups
•
Participant Agreement Milestones and Measures
What is HIE in Colorado?
The ability to electronically exchange patient health
information including:
 Lab/pathology results
 Imaging/radiology reports
 Scheduled Orders
 ADT’s, H & P’s Discharge Summaries
 Transcribed notes
 Continuity of Care Documents (CCDs)
…when it’s needed for patient care.
CORHIO HIE
• CORHIO, as SDE, manages the State Medicaid Health IT Plan
and has a strategic roadmap for statewide HIE projects
• CORHIO currently supports HL7 2.5.1 transaction level
information, Human readable CCDs in PDF directly from
HIE.
• CORHIO is actively working on extracting structured CCDAs
from CEHRT and publishing CCDAs into the HIE by Spring
2014.
• CORHIO will align with Colorado OIT recommendations
supporting commercial technical solutions utilizing industry
standards including Direct, Blue Button, HL7, etc.
• These developments will support PHR implementations
throughout Colorado
It Takes a Community…
CORHIO Helps All
Providers in the
Community Share
Info & Coordinate
Care
LTPAC Program Outreach
• Survey letters sent to 350 long-term and post-acute care
providers
• Gathered information on IT readiness, internal resources and
interest
• Participant Agreements completed and sent
• Business Associate Agreements completed and sent – Revised
Sept. ‘13
–
–
–
–
Policies and Procedures - HIPAA
Opt Out language
User Request Forms with user name and password
Auditing Reports
• Workflow Process both internal and external assessed
Internal LTPAC Resources
• Internal CORHIO staff
– LTPAC Program Manager
– Finance/Contract Manager
•
•
•
•
PA’s
BAA’s
Milestones and payments
AARA Report
– Surveys – all three
– MarCom – video, collaterals
– Ops – Implementation and Training including
• Policy and Procedures
• Opt Out language
• User Request Forms
External LTPAC Resources
• Core Users tied to milestones
–
–
–
–
–
Admission Coordinators
Health Information Managers/Medical Records/IT
Nursing Staff – especially night and week-end
Clinical Liaisons
Medical Directors
• Users
– Therapists
– Nurse Practitioner/Physician Assistants
– Charge Nurses
LTPAC Milestones
• Milestones included:
– Implementation and Training
• 30-45 days to train LTPAC Users
• One hour training can be one on one or group setting
• Implementation “refresher” webinar training accessed
through CORHIO’s 24/7 Help Desk
– Core Usage and Monthly Utilization Reports
• Manual Process with goal to be automated
– Surveys
• Pre-Work Flow/Baseline
• Satisfaction Surveys
• Qualitative Survey
Participating LTPAC Providers
Skilled Nursing
Assisted Living
Home Health
Hospice and Palliative Care
Labs
LTPAC Participants
Long-Term, Post-Acute & Home Health Care
And Many More!
LTPAC Users - Quick Stats
# Users
# Logged In
# Queries
# CCDs created
# CCDs viewed
# CCDs printed
# CCDs exported
April
2012 Nov
2012
Dec
2012 August
2013
Grand
total
487
218
71,994
110
55
24
13
1090
2,363
414,277
308
129
81
101
1,577
2,581
486,271
418
184
105
114
© 2013 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
CORHIO Proprietary - Not For Redistribution
23
Patient Care 360® LTPAC Customer
Satisfaction Survey Results
• Has PatientCare 360® improved your patient care transitions?
100% of participants polled answered “YES.”
“We are able to obtain more current information and to obtain
additionally requested information more quickly.”
• Has PatientCare 360® made your job easier?
100% of participants polled answered “YES.”
“I get access to info more promptly than before.”
• Do you believe that PatientCare 360® helps you provide better care to
your patients?
100% of participants polled answered “YES.”
“Information needed is often readily available improving response
time to physician inquiries.”
4/6/2016
© 2010 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
CORHIO Proprietary - Not For Redistribution
24
LTPAC Challenge Grant
Measures
• 80% of transitions to and from targeted LTPAC
providers include electronic exchange of standard health
information
– Pre-Work Flow Surveys documented 0% to 10%
– Post GO LIVE survey documented 100%
• 70% of transitions to and from targeted LTPAC providers
include transmission of information within 2 hours of
discharge
– Pre-Work Flow Surveys averaged 32 hours (see slide)
– Post GO LIVE Surveys shows 6 minutes
Workflow Improvement
Average Time Spent
Locating Patient
Health Records
Average
Average Time 30
Time
days
Pre-HIE PostHIE
Average
Time 60
days
PostHIE
29 hours 46 11 minutes 6 minutes
minutes
42 seconds 30 seconds
HIE saves LTPAC practices
an average of 29 hours per
admission
LTPAC Challenge Grant
Measures, continued
Providers in targeted communities respond to 100% of
patient requests for copies of care summary information
– All LTPAC providers have the ability to create and print
CCD’s for their patients/family members upon request
– CCD’s are documented on a monthly basis
• Manual process to show # created, viewed, printed and
exported
• Need to further drill down for usage
Lessons Learned
• LTPAC Staff Resources
– Turnover
– Able to update resume with IT experience
– Competing IT efforts
• Work Flow Process
– Faxing for Data Senders (hospitals) - positive
• Hospital Discharge Flyers
– Faxing for LTPAC Data Receivers - negative
• Impact on their ability to “market” to DC Planners
• EHR/HIE Integration
– HL7 capability and ability to receive and send ADT’s and
CCD’s
Standard HIE – PatientCare 360
Clinical Inbox
Reports
Tests
CCD Exchange
How Query-Based HIE Works
Laboratories
Public Health Departments
Radiology Centers
Hospitals
Pharmacy
Information
CIIS
Immunizations
Reportable Conditions
Immunizations
Public Health Alerts
Newborn
Screening
Results
Medications lists
Radiology Reports
Lab Results
Pathology Reports Diagnostic-Quality
Hospital ADT Info
Consult Reports Community
Transcription Notes
Lab/Rad
Health Record
Medical Images
(with CTN)
Data
Analytics
Immunizations
Future
CCD
Orders
CCD Upload
© 2013 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
CORHIO Proprietary - Not For Redistribution
30
Break the Glass
Depending on your security settings,
you may not be able to get into the
patient chart without “Breaking Glass,”
establish a relationship, to view a
record
Click on Break Glass
Link…
4/6/2016
31
© 2011 Colorado Regional Health Information Organization
(CORHIO) - All Rights Reserved CORHIO Proprietary –
Not For Redistribution
Establishing a relationship…
If a user were going to break glass –
they would be presented with this
Confidentiality Alert. Staff must be
associated with a provider in order
for Long Term Access to function.
4/6/2016
© 2011 Colorado Regional Health Information32
Organization (CORHIO) - All Rights Reserved CORHIO Proprietary –
Not For Redistribution
CCD
CCDs allow you to compile historical summaries of the care
that a patient has received through the community.
Select in the upper right
corner of any patient
chart
4/6/2016
33
Previewing CCD
4/6/2016
Click Save
34
LTPAC Initiatives
•
•
•
Regional and statewide meetings to encourage HIE adoption for LTPACs
Multi-state meetings to share LTPAC experience
Collaborating with HCPF on the TEFT (Testing Experience and Functional
Tools in Community-Based Long Term Services and Supports)
–
–
•
•
•
•
Demonstrate use of personal health record (PHR) systems with beneficiaries of CB-LTSS
Identify, evaluate and harmonize an electronic Long Term Services and Supports (e-LTSS)
standard in conjunction with the Office of National Coordinator’s (ONC) Standard and
Interoperability (S&I) Framework
CORHIO’s Consumer Engagement Strategy and PHR
State Innovation Model (SIM) Grant
CFMC/CORHIO Patient Transfer Form in Northern Colorado
True North EMS and LTPAC Providers
4/6/2016
© 2010 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
CORHIO Proprietary - Not For Redistribution
35
CORHIO Making an Impact
Click image to view video; Internet access required.
Other Participating Providers
Visit
www.corhio.org
and select
“Participating
Providers”
Interactive Map
Full List of
Providers Below
For More Information
www.CORHIO.org
Click on
Long-Term
Care Under
For Providers
LTPAC
video
Contact Info at CORHIO
Pamela Russell
Manager
Business Development & Outreach
Long Term Care
[email protected]
720-285-3257
How Can You Participate in the LCC Pilot SWG?
•
http://wiki.siframework.org/LCC+Pilots+WG
40
Summary of Documentation Templates &
Reference Materials (Pilot Materials)
Document Name
Pilot Overview
Document
Work Group Planning
Presentation
Pilot Documentation
Template
Pilot Plan Template
Description
An overview of the LCC Pilots Workgroup including a Value Statement for
Participating Entities, Benefits of Participation as an LCC Pilot Site and steps
for How to Get Started.
A Reference presentation for potential pilots that provides an overview of
the Transition of Care and Longitudinal Coordination of Care Problems, the
Role of Standards for Problem Resolution, and Overviews of the IMPACT
and Downstate New York Care Coordination Projects.
A PowerPoint template for potential pilots to use to present their Pilot
Team; Goal of the Pilot; C-CDA of Interest; Use Case Scenario and
Actors/Systems; Minimum Configuration; Timeline; Success Criteria; In
Scope/Out of Scope; and Risks & Challenges details of their pilot.
A word template for potential pilots to use to present their Pilot Team; Goal
of the Pilot; C-CDA of Interest; Use Case Scenario and Actors/Systems;
Minimum Configuration; Timeline; Success Criteria; In Scope/Out of Scope;
and Risks & Challenges details of their pilot.
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Next Steps
• Homework Assignment:
– Complete Pilot Survey
– Sign up as an LCC Committed Member
– Submit Pilot Documentation Templates
• Available on the LCC Pilot SWG Wiki:
http://wiki.siframework.org/LCC+Pilots+WG
• Email to Lynette Elliott
([email protected])
• NO Meeting next week due to HL7 WGM in Boston, MA
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LCC Initiative: Contact Information
•
•
•
•
•
LCC Leads
– Dr. Larry Garber ([email protected])
– Dr. Terry O’Malley ([email protected])
– Dr. Bill Russell ([email protected])
– Sue Mitchell ([email protected])
LCC/HL7 Coordination Lead
– Dr. Russ Leftwich ([email protected])
Federal Partner Lead
– Jennie Harvell ([email protected])
Initiative Coordinator
– Evelyn Gallego ([email protected])
Project Management
– Pilots Lead: Lynette Elliott ([email protected])
– Use Case Lead: Becky Angeles ([email protected])
LCC Wiki Site: http://wiki.siframework.org/Longitudinal+Coordination+of+Care
43