A Day in the Life. How I use i2i Tracks and EHR. Vince Surra, CPHQ

Transcription

1 A Day in the Life How I use i2i Tracks and EHR Vince Surra, CPHQ

2 About Me Community Health Centers of the Central Coast Began using i2itracks in 2008 for diabetes tracking, perinatal tracking, pap tracking, referral tracking, Began using NextGen EPM in 2008 Began using NextGen EHR in 2010 >77,000 patients resulting in >330,000 annual encounters 25 Clinics and >45 providers throughout two counties Migrant, Homeless, High School, and Public Housing Manage entire County Health Safety Net via County Grant

3 Today s Premise Why do we continue to use i2itracks with our EHR? How does i2itracks optimize our system? Why does Administration continue to support our efforts with i2itracks? I am a user of i2itracks AND NextGen EHR! But I want to focus on the proven benefits of i2itracks. I will discuss my experience with the EHR but I do NOT represent NextGen and cannot speak to any other EHR. I have the same issues and problems as many of you and am trying to find the best tools to provide the best care! 4 areas of discussion today Pre-planning, Population Management, Reporting, Referral Tracking Key Focus: EFFECTIVE, EFFICIENT, RELEVANT

4 A Healthcare Compass? A compass is a navigational instrument that measures directions in a frame of reference that is stationary relative to the surface of the earth. When the compass is in use, the rose is aligned with the real directions in the frame of reference, so, for example, the "N" mark on the rose really points to the north. Points us in the right direction Allows us to know our relative location Stays factual; highly accurate

5 Follow-up Systems Healthy Person Patient Education Information Systems Competent Providers and Staff Access to Care Clinical Guidelines Decision Support

6 i2itracks + EHR for Clinical Excellence Population Health Management Pulls data from EHR and PM to deliver higher level value: Identify populations of interest and analyze their care and status through patient search and reports Proactively manage populations to standard of care Used by care team to ensure guidelines of care are followed Uses data to drive clinical excellence Practice Management Patient demographics Billing Scheduling Electronic Health Record Used by the provider and care team document care + decision support at point of care Data base, stores data

7 4 Ways to Optimize your System Pre-visit Planning Population Management Reporting Referral Tracking

8 Why is pre-planning so important? =LX0kTIZKzY8

9 Pre-Work/Workflow EHR i2itracks

10 Pre-Work / Workflow Process Pre-Work using i2itracks Pre-Work w/o i2itracks No Pre-Work Run i2itracks Query Find all patients that meet criteria you ve requested Print Overdue Profile Items Pre-Work All charts Somebody reviews all charts for the day to see what patients may be due for No Pre-work Nothing is done prior to patient check in Prep EHR Chart Review Overdue Profile Items; create orders as necessary Review for updated/overdue labs, referrals, etc. Like paper charts, EHR chart needs to be prepped. Review for labs, referrals, hospital reports, etc. Chart Review By an MA during intake May take time/cause delays Allows for more error Document in EHR i2itracks will automatically get the data it needs to ensure accuracy at next visit Document in EHR i2itracks will automatically get the data it needs to ensure accuracy at next visit Document in EHR i2itracks will automatically get the data it needs to ensure accuracy at next visit

11 Pre-Visit Planning i2itracks allows you to see the big picture and be better prepared! (Relevance) i2itracks allows you to know what your patients are due for before they come in providing proactive care! (Effectiveness) i2itracks is easy to use so more of your clinical personnel can utilize the features; getting the data they need in real time! (Efficiency)

12 4 Ways to Optimize your System Pre-visit Planning Population Management Reporting Referral Tracking

13 Population Management requires multiple systems speaking to each other! EHR Lab Manual i2i Tracks EPM EHR LAB EyePacs Partial EPM

14 Population Management Patient Queries How many of our diabetic patients need a referral for an eye exam? Let s start scheduling for the Eyepacs Camera! What patients have an HbA1c that s above 9.0 but haven t been seen in more than 6 months? Let s get them in for a test! How many patients are due for a pap? Let s start utilizing our OB/GYN providers better. How many of our children have never seen our dental clinic? Let s get them scheduled! How many patients are over age 50 and haven t had a flu shot? Call em in.

15 Comparing the Products for Patient Queries i2i Tracks EHR Searches are created in minutes Reports can take hours to create Results validated with a few clicks Validation requires leaving the report and re-running it Results are sortable by numerous factors with a single click Results are only sorted based on how the report is setup Tabs allow for updates to be easily compared across results No ability to compare reports unless all get downloaded Can be added to Tracks Today for quick viewing Nothing comparable in EHR Can pull from EPM and utilize second and third level reporting very easily Can t pull from EPM and requires specialized skill to create second and third level reports

16 Patient Queries Success! How many of our diabetic patients with an appt in next month, need a referral for an eye exam? Let s start scheduling for the Eyepacs Camera! Using i2itracks, solved in minutes. Using EHR, impossible! It doesn t pull from the EPM. What patients have an HbA1c above 9 but haven t been seen in more than 6 months? Let s get them in for a test! Using i2itracks, solved in minutes. Using EHR, possible once on EHR more than 6 months but requires extra training to setup and run. How many patients are due for a pap? Let s start utilizing our OB/GYN providers better. Using i2itracks, solved in minutes. Using EHR, results tainted as no ability to pull if somebody is already scheduled! How many kids have never seen our dental clinic? Let s get them scheduled! Using i2itracks, solved in minutes Using EHR, impossible as it doesn t pull from EPM How many patients are over age 50 and haven t had a flu shot? Call em in. Using i2itracks, solved in minutes. Using EHR, possible to run if properly built (what field is it pulling from as patients can get flu shots off-site).

17 Population Management Patient Tracking A very important, but often overlooked part of care delivery Essential for appropriate case management and follow-up Essential for PCMH Recognition! It s what you don t know that can hurt you! Active Patients EHR Point of Care! Patient Base i2itracks Pre-Planning! Community HIE Not here yet

18 Population Management Tracking Custom Tracking Types can be built to improve care and increase $$ Females between age 21 and 62 Medi-Cal patients for annual physical Patients with Obesity Special Projects Adolescents due for annual physical Will vastly improve ability to meet PCMH Not a feature of the EHR Types

19 Summary EHR is not built for Population Management It is designed as a patient chart! i2itracks is built to do these functions! Tracking groups of patients (Relevant) Tracking the needs of those groups (Effective) Search for patient lists proactively (Efficient) There is NO WAY I would be as effective at population management without i2itracks!

20 4 Ways to Optimize your System Pre-visit Planning Population Management Reporting Referral Tracking

21 Comparing the Products i2itracks Ability for multiple data points per report EHR Only a few data points per report; percentages are difficult to report Easily customizable; Ability to sort and compare quickly Static; not able to sort Basic Reports are fairly easy to use (some special training is useful) Complicated Reports require some specialized training Requires special training Has Crystal but requires very specialized training (and is built for business management, not healthcare!) Pulls from multiple data sources Pulls from minimal data sources

22 i2itracks Reports Health Registry Report Customizable but easy to create Easy to use for quick comparison of clinic, provider, date Canned Reports Just need mapped UDS reports, AQIC, Health Disparities, Meaningful Use Population Analytics Requires some training but completely customizable Can be shared across the organization or with other organizations!

23 Health Registry Report i2itracks

24 Population Analytics Report

25 Summary Some reporting should be done using EPM (e.g. billing reports) Some reporting should be done using EHR (e.g. functional reports) Most reporting should be done with i2itracks Reports are generated from multiple data sources (Relevant) Reports are customizable to what you need (Effective) Reports are fairly easy to create and run (Efficient) Find the software that works BEST for what you need and use it!

26 4 Ways to Optimize your System Pre-visit Planning Population Management Reporting Referral Tracking

27 Referral Tracking PCP Makes Referral Appointment created Process leaves too many unanswered questions what if? What if the appt isn t made? What if the appt isn t kept? PCP notified of results Appointment is Kept What if the PCP isn t notified? F/u Appt made with PCP What if the Specialist needed to reschedule? What if the patient has decided to refuse the appt?

28 Comparing the Products EHR Designed to track individual patient s referrals; not designed for population tracking Must create and run a static report to find open referrals i2itracks Allows for sorting by provider, clinic, patient, type, status, source, etc. Designed for population tracking

29 Referral Manager in i2itracks

30 Referral Manager Results i2itracks

31 Referral Stats Report i2itracks

32 Referral Tracking using i2itracks PCP Makes Referral Appt Made Logged Able to track if missed Appt Kept Results sent to PCP Follow-up appt made Track for follow-up If not, we know, and can follow up The loop gets closed

33 Referrals Summary i2itracks allows me to manage referrals across the entire clinic system! i2itracks allows me to quickly find open/pending referrals (Relevant) i2itracks gives me the ability to follow-up quickly and easily (Efficient) i2itracks allows me to sort based on a number of criteria (Effective) i2itracks allows me to make SMART management decisions!

34 New! Referral Manager Interface! NEW! We are now using an interface with i2itracks and NextGen that allows referral data to come into i2itracks automatically! This allows for much less double entry This allows us to verify appropriate use of referral module in NG This allows us to standardize across clinics We used to do double entry because it was that importan to us and the EHR did not allow us to know referrals were being properly followed.

35 In Summary i2itracks allows us to optimize our software to provide higher quality, more proactive care while gathering more accurate, real-time data. In addition, i2itracks offers great customer support and customizations! Relevant Efficient Effective i2itracks allows CHCCC to be more

36 Captain Jack s broken Compass

37 Let s take time to share ideas, thoughts, concerns, etc. QUESTIONS?