IHC Care Coordination Conference

Transcription

1 The Meadows Events & Conference Center Altoona Long - Term Care Public Health Hospital Physician Patient Centered Pharmacy Home Health Family Hospice

2 Purpose The IHC Care Coordination Conference will bring together health care professionals from across the care continuum to drive partnerships and collaboration, learning about current transitions of care topics prevalent in today s health care environment. Best practices will be shared and discussed to increase knowledge of those in attendance. Conference Agenda 8:00 am - Registration/Continental Breakfast 8:30 am - Welcome and Iowa Healthcare Collaborative Update Tom Evans, MD, President/CEO, Iowa Healthcare Collaborative, Des Moines 9:00 am - Patients as Experts, Patients as Partners: Partnering with Patients and Families to Enhance Quality and Safety Julie Ginn Moretz, Associate Vice Chancellor, Patient and Family-Centered Care, University of Arkansas for Medical Sciences, Little Rock, AR Every health system s quality improvement journey may be different, but a common element in achieving better and safer outcomes is engaging patients and families. Can the value of health care be enhanced and overall community health improved by partnering with patients and families in the design and delivery of services? Involving patient and family champions in quality improvement initiatives is best practice in patient- and family-centered care among forward-thinking health care systems. Moretz will share her poignant personal journey as a family leader and how health systems can be a collaborator with patients and families to accelerate sustainable change that transforms an organization. Describe key concepts of patient- and family-centered care and strategies to engage patients and families in all aspects of health care. Discuss how personal stories and patient engagement can affect change in hospital policies and practices and lead to improved clinical outcomes. Recognize how to encourage health care colleagues develop meaningful, effective and sustained partnerships with patients and families. 10:00 am - Break 10:15 am - Provider-Community Pharmacist Team Management of Hypertension William R. Doucette, PhD, Professor and Division Head, Health Services Research Division, University of Iowa College of Pharmacy, Iowa City Dr. Doucette will describe an initiative to foster care teams comprised of providers in clinics working with community pharmacists. The team-building activities, team care and evaluation of teams from Year One and progress in Year Two will be discussed. Potential next steps will be presented. Describe activities to stimulate and evaluate provider-community pharmacist teams to manage hypertension. Discuss progress and future steps for care coordination through provider-community pharmacist teams. 11:15 am - Community Care Coordination: Sometimes it Does Take a Village Chi Martin, MBA, Director of Population Health, Mercy Medical Center-North Iowa, Mason City Although Mercy Medical Center-North Iowa is just beginning its journey toward community care coordination it has seen some great successes in improving the collaboration and communication between the organizations that serve their region. Focus has centered around understanding the true ecosystem of patients, helping to align them with the resources they need to be successful and focusing on patient-centered goals. Recognize Mercy-North Iowa s initiatives around community care coordination, its relationship with accountable care and the volume to value transition. Describe how Mercy-North Iowa is working with community partners to care for patients. Discuss a new way of looking at patients understanding their socio-economic circumstances. 12:15 pm - Lunch (included) 1:10 pm - Breakout Sessions

3 1A Community Team-Based Care: Iowa Medicaid Member Care Programs Kelly Williams, Clinical Services Manager, Iowa Medicaid Enterprise, Des Moines The Iowa Medicaid Enterprise (IME) disease management program focuses on high-risk, high-cost adult and child members with multiple chronic conditions. The program utilizes registered nurse health coaches to assist members with coordination of care to provide better health outcomes for participants. Participants also receive assistance with locating needed community-based resources, recognizing that care extends beyond the clinical. This presentation will share the work that has been done to improve care and member health. Describe the IME disease management program. Identify health coach patient engagement and targeted interventions. Summarize resulting health and quality outcomes. 1B Electronic Health Records: True Meaningful Use of Your EHR: You Have the Data, Now What? Chris Espersen, Quality Director, Primary Health Care, Des Moines Health care providers are inundated with data, reporting requirements to various agencies, internal and external quality metrics, alerts in the EHR and letters from payers letting them know how deficient they are. This session will look at how to prioritize the abundance of information and use the data to work for patients and staff. Robust tracking and follow-up systems are necessary to achieve the Triple Aim for patients and data can be very useful when systems are maximized to engage staff and produce desirable outcomes. The use of data systems to identify conditions which are often hidden to practice and how we these systems can be used to effectively engage patients will be explored. Recognize how to use data to improve outcomes for patients. Identify ways to implement and maintain a meaningful data tracking and follow-up system. Discuss how organizations can look beyond the requirements and find data that matters to patients. 1C IPOST: What You Need to Know Katrina Altenhofen, EMS for Children Program Director, Iowa Department of Public Health Kady Hodges, MPH, Clinical Strategies Coordinator, Iowa Healthcare Collaborative, Des Moines The landscape of options for end-of-life care planning is changing in Iowa with the establishment of the Iowa Physician s Orders for Scope of Treatment (IPOST). Since IPOST became law in 2012, communities across Iowa have been looking at IPOST to determine how they fit in. This presentation will provide a detailed look at IPOST and profile the statewide strategy for Iowa. Discuss the law and intent of IPOST. Describe available resources. Identify where IPOST may fit for you and your organization. 2:00 pm - Break 2:10 pm - Breakout Sessions 2A Community Team-Based Care: Chronic Disease Self-Management: The Road to Better Health through Patient Education Dennis Haney, Self-Management Coordinator and Laurene Hendricks, Linkage Coordinator, Iowa Department of Public Health, Des Moines Engaging patients as partners in their care is an integral step to improving patient health behaviors leading to better health outcomes. Selfmanagement education programs are a valuable and often underutilized resource to educate patients on their chronic health conditions and teach them skills to manage those conditions and lead healthier lives. This presentation will discuss two evidence-based, chronic disease self-management education programs currently available throughout the state of Iowa. Discuss the Stanford Chronic Disease Self-Management program. Describe community-based diabetes self-management education programs. Discuss the process for program referrals. 2B Electronic Health Records: Iowa Health Information Network Karith Remmen, Management Analyst Office of Health IT, Iowa Department of Public Health, Des Moines Karith Remmen will provide an overview of the Iowa Health Information Network (IHIN), Iowa s statewide health information exchange. She will discuss the three main services offered via the IHIN, including direct secure messaging, patient look-up and public health reporting. Additionally, she will provide insights in to how providers in Iowa are using the IHIN to improve care coordination across the care continuum. Describe the functionality of the IHIN s main services. Explain about how a variety of provider types are currently using the IHIN to support patient care. Identify ways to use the IHIN to support care coordination efforts. 2C IPOST: Death Happens, Who Decides How? Shelley Meyer, BSW, MPPA, Administrator, The Shores at Pleasant Hill, Pleasant Hill Do you ever wonder why 80 percent of deaths still occur in hospitals even though studies show that most people would prefer to die at home? This session will review the importance of advance directives and appointing a health care power-of-attorney. Participants will learn strategies to start the difficult conversation about end-of-life choices, including review of the Iowa Physician Orders for Scope of Treatment (IPOST). Explain the steps to complete life choices. Discuss how to start a dialogue about choices. Examine your own feelings about end-of-life issues. Discuss events that communities can sponsor to encourage others to complete end-of-life choices. Explain IPOST.

4 3:00 pm - Break 3:10 pm - Breakout Sessions 3A Community Team-Based Care: Supporting the Community-Centered Health Home Concept in Iowa: Dallas County s Health Navigation Program Shelley Horak, MPH, Executive Director, Dallas County Public Health Nursing Services, Adel Iowa s rural communities need a simple, practical approach to implementing a care coordination system utilizing their existing resources. Integration of the ACA s health home concept with community prevention perspectives produces a set of practices called by the Prevention Institute a communitycentered health home. It is the goal of the Dallas County Health Navigation Program that residents will have access to available health resources through one point of contact, with emphasis on more timely referrals, fewer steps to receipt of care, efficiency, increased options and improved outcomes. Explain the community-centered health home concept. Describe the Dallas County s Health Navigation program. Identify strategies to replicate a model like this in other community by connecting current practices to existing community infrastructure. 3B Electronic Health Records: Health Information Technology and Care Coordination: The Palmer Lutheran Experience Steve Stark, MHA, MSOP, ACHE, President and CEO, Palmer Lutheran Health Center, West Union This presentation will provide participants with a valuable first-person experience in the utilization of health information technology (IT) throughout the continuum of care. Recognizing this potential, Palmer Lutheran Health Center has integrated health IT tools as part of their care coordination practices between the hospital and affiliate and community clinics. Describe the Palmer Lutheran care coordination experience. Discuss the value of health IT in care coordination processes. 3C IPOST: Implementing IPOST in the Pediatric Community Sheila B Frascht, RN, CHPPN, CPLC, Nurse Clinical-Specialist and A. Paige Volk, MD, Pediatric Intensivist, University of Iowa Children s Hospital, Iowa City IPOST law has been in effect since July 1, Since that time, how have appropriate patients in Iowa benefitted? The presenters will share the successes and challenges they have seen when using IPOST in the pediatric community. Discuss IPOST and determine who can benefit from carrying this form. Describe ways to successfully utilize IPOST with appropriate pediatric patients. Identify barriers to educating families and health care providers about IPOST. 4:00 pm - Adjournment Conference Location & Lodging The Meadows Events & Conference Center 1 Prairie Meadows Drive Altoona $89 plus tax. IHC room block expires May 5, 2014, reference Iowa Healthcare Collaborative room block, group code IHC. Continuing Education.66 Nursing CEUs will be awarded for this conference by IHA Iowa Board of Nursing provider #4. Note: Iowa Nursing CEUs will not be issued unless your Iowa license number is provided on the certificate completed the day of the conference. NOTE: To receive CEUs or a certificate of attendance, you must attend the entire conference. No partial credit will be granted. Conference Notes This will be a paperless conference; handouts and presenters biographies will be available on the IHC website. Dress for the conference is business casual. Layered clothing is recommended for your comfort. Registration/Cancellation/Refund Policy No-shows will be billed, substitutions welcome anytime via fax or . A full refund will be given to all cancellations received 10 or more business days prior to the conference. A $25 administrative fee will be charged to all cancellations received six to nine business days prior to the conference. No refunds will be given to cancellations received five or fewer business days prior to the conference. Refunds will be calculated by the date received and the business days remaining prior to the conference. IHC reserves the right to cancel the conference due to insufficient enrollment, in which case pre-registered participants will be notified and full refunds provided. All cancellations and substitution requests must be sent to Penni Upah (upahp@ihaonline.org) by or faxed to or ADA Policy IHC does not discriminate in its educational programs on the basis of race, religion, color, sex or handicap. IHC wishes to ensure no individual with a disability is excluded, denied services or segregated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services. If you need any of the auxiliary aids or services identified in the Americans with Disabilities Act in order to attend this conference, please call , fax or write to the Department of Education at IHC.

5 Three Ways to Register Online: Fax: or Mail: IHC, 100 East Grand, Suite 360, Des Moines, IA Last Name First Name Nickname (to appear on badge) Title Organization Name Organization Address City State/Zip Telephone No. ( ) Fax No. ( ) Address (required to receive confirmation) I would like a vegetarian entree for lunch. Conference Fees Individual $145 For IHC Office Use Only # Date Received Program Fee Amount $ Check # Check Total $ Organization Personal Payment Information Check (payable to IHC) Bill my institution Credit Card American Express MasterCard Discover VISA Cardholder Name (please print) Credit Card No. Security Code (the last three or four numbers on the back of the card) Expiration Date Cardholder s Phone No. ( ) Cardholder Signature