Transcript Collaboration and IT Systems

Collaboration and IT Systems
Linda M. Kinney, MHA
Care Share Health Alliance
Director, Collaborative Network Development
Jennifer Tyner
Program Manager
Access II Care
Introduction
• Supersonic overview of
national and state HIT
• Collaborative Networks’
need for linked IT systems
• Lessons learned from
Communities
• Tools and Resources
• Questions and Answers
ARRA, HIT, HITECH, EMR, EHR, HIE……
American Recovery and Reinvestment Act (ARRA) of 2009
• Authorized nearly $36 billion in funding for health information
technology (HIT) infrastructure over 6 years.
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The majority of the funding ($34 billion) is set aside for incentive
payments for Medicare and Medicaid for incentives to providers who:
• Adopt certified electronic medical records
• Demonstrate Meaningful Use of the medical records
• Provide data for quality reporting
ARRA, HIT, HITECH, EMR, EHR, HIE……
Health Information Technology for Economic and Clinical Health (HITECH)
•provides a framework for how this HIT funding is to be spent.
HITECH has 3 major components:
1.Wide adoption of Electronic Medical Records (EMR)
1.Establishment of interoperable systems for health information
exchange (HIE)
1.Aggregate data reporting (individual and population)
ARRA, HIT, HITECH, EMR, EHR, HIE……
Meaningful Use – federal standards for using EMRs to:
• Improve clinical care
• Reduce medical errors
• Control health care costs
Providers will receive incentives to implement meaningful usage
through the use of EMRs by 2014, and reduced reimbursement if
not in place by 2015
Electronic Health Record (EHR) – contains a subset of information from
several health delivery organizations – pulls information from EMRs –
to create a cohesive patient record
ARRA, HIT, HITECH, EMR, EHR, HIE……
Health Information Exchanges (HIE) are national/state/regional
technologies that allow for exchange of health information between
providers and other exchanges.
• Has a master patient index – so a patient has one record with
multiple providers contributing (EHR)
• Information can be exchanged across HIEs as the patient moves
from community to community…
• Patients have access to their EHR/EMR – potential for Personal
Health Records (PHR) to connect as well
Health
Information
Exchange
Health
Information
Exchange
Health
Information
Exchange
(HIE)
Electronic
Medical
Record
Electronic
Health
Record
Electronic
Medical
Record
Electronic
Medical
Record
Electronic
Medical
Record
John W. Loonsk, MD FACMI
Some Things That May Be Available From HIEs
•Clinical data
•EHR
•Utilization data
•Information about patients seen
outside of your network
•Quality measures
•Referral management
Some information Collaborative Networks need
from and IT system
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A way to count things specific to your network – with the partners you have at the table –
• Unduplicated patients across providers – the holy grail
• Patients enrolled in the network and for specific programs – enrollment data
• Utilization data – visits (by provider) and service (by type: medications, medical visits,
ER visits, ….) including community, social, supporting services
• Quality measures – disease management measures, others
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Demographic and screening information for patients enrolled in network/programs – that
everyone in the network can access
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Referral Management – where was it made, by whom, and did the patient receive a service
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Value of services – claims data and other – helps with return on investment measures
Some Features to consider as you look for a
system
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Allow you to easily screen patients for eligibility in your network,
Medicaid, and other insurance programs – health insurance
exchanges in the future
Allow you retain the information you gather from the screening
Enroll patients in multiple programs (network being one, then
other programs)
Referral management
Track utilization across providers
Ability to REPORT ON YOUR OUTCOMES
Ability to connect to HIEs in the future – you’ll need some kind of
EHR or..
HIPAA compliant
Things to Keep in Mind as you look for a system
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The HIT/HIE world is still under construction – there are many unknowns
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Minimize duplication of features that may be more robust through
EMR/HIEs – ie: clinical data
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Your partners IT systems are the building blocks for the Collaborative’s
system. Connect partners to resources:
• NC AHEC Extension Center
• NC Medical Society Foundation – loan repayment program
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You will need a system or process to manage the Collaborative’s work
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Your system needs to connect to future systems – will need an EHR
Lessons Learned
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IT systems are about people and relationships – it’s collaboration
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Buy-in is essential – communication is key, involve partners
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The legal documents are a foundation – you can’t move ahead without them
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Pay for what you need.
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Define the outcomes you will use to measure progress at the start.
•Plan tangible milestones, and keep
them coming every four to six
months.
•You need a translator.
•Triple the timeline.
•IT is not a magic bullet
As you prepare for a linked IT System consider
these factors…
•Legal costs, to build the
“foundation” of documents
•Consulting, to acquire technical
expertise and “translator” skills
•Staff time, from CCC personnel
and partner organizations alike
What can you do to prepare
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Put agreements in place:
-Patient authorization, Business Partner Agreements, data usage,
etc…
Map out the patient flow:
-How do patients navigate the system now? What do you want it
to look like?
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Determine your business process and the data you need to collect:
-driven by your outcomes!!!!
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Focus on your assets:
-Utilize the resources you currently have at your disposal
Jennifer Tyner
Access II Care
Now What?
• Where are you now?
• Where do you want to be?
• What do you need to do to
get there?
Just START!
S
T
A
R
T
Set Goals, Objectives, Measures
Technology Subcommittee
Act
Remember the Patient
Time is Now
Health Care Reform Clock is Ticking
Technology as a Roadblock to Collaboration
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Common for collaborations to stall, as we believe we have to have
connected IT to start
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Fantasy of achieving “single entry” system
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Rapidly changing HIT/HIE environment
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Implementing IT before understanding workflow
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Implemented IT does not deliver as promised
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$$$$ always causes problems!!!!
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Easy to lose sight of original goal—patient care does not remain the
focus
What can you do today?
• Establish Shared Goals (and don’t lose sight of them!)
• Determine Collaborative Specific Objectives
• Set Target/Performance Measures
• Identify Data and Reporting Needs
• Assess What is Available TODAY for Sharing, Collecting, and
Reporting Data
• Establish Legal Relationship to Share this Information
• Let IT Committee Work on technology plan
Using What You Have
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Data
• We all have it!!!!
Database(s)
• Purchased software
• Homegrown
• Free products - CMIS, MARP, others
Office Software
• Spreadsheets
Internet
• If you don’t have, this should be #1 priority
Data Czar
• Identify one entity to be responsible for collecting shared information
IT Tools for Collaboration
google sites – free: https://sites.google.com/site/transcwp/
Meetingwizard.com – free:
See Handout for others
Questions?
Thank You!
Linda M. Kinney, MHA
Care Share Health Alliance
Director, Collaborative Network Development
[email protected]
(919)861-8356
Jennifer Tyner
Program Manager
Access II Care
[email protected]
(828)259-3879 ext 306
Links To Resources
National Coordinator for Health Information:
http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__home/1204
NC HIT website
www.ncdhhs.gov/healthIT
North Carolina Healthcare Information & Communications Alliance, Inc. (NCHICA)
www.nchica.org
WNC Health Link (HIE)
www.wnchn.org
AHEC Extenstion Center
www.ncahecrec.net
NC Medical Society
www.ncmedsoc.org/practice_management/hit.html
Capital Care Collaborative
www.wakedocs.org/CapitalCareCollaborative.html