2016 Leadership Summit

Transcription

1 CRISP: A Regional Health Information Exchange Serving Maryland and D.C Leadership Summit Ross Martin, MD, MHA Program Director, Integrated Delivery 24 May 2016

2 Maryland State-Designated Health Information Exchange Chesapeake Regional Health Information System for our Patients District of Columbia Health Information Exchange 2

3 Vision Mission Guiding Principles CRISP is a non-profit health information exchange, or HIE, serving Maryland and the District of Columbia. Our Vision To advance health and wellness by deploying health information technology solutions adopted through cooperation and collaboration. Our Guiding Principles 1. Begin with a manageable scope and remain incremental. 2. Create opportunities to cooperate even while participating healthcare organizations still compete in other ways. Our Mission We will enable and support the healthcare community of Maryland and our region to appropriately and securely share data in order to facilitate care, reduce costs, and improve health outcomes. 3. Affirm that competition and marketmechanisms spur innovation and improvement. 4. Promote and enable consumers control over their own health information. 5. Use best practices and standards. 6. Serve our region s entire healthcare community. 3

4 History of CRISP 2006: CRISP begins at a Spring meeting between John Erickson and the CIOs of Maryland s three largest hospital systems, asking how to make medical records for seniors available when they visit the hospital Erickson Retirement Communities funds a part time staff position to work on a pilot project 2008: CRISP partners with MHCC to plan an HIE for Maryland, in a process which engages dozens of healthcare stakeholders The MHCC provides a $250k grant, and the Erickson Foundation contributes another $250k to expand the work Administration of the finances and staff is done through Erickson Retirement Communities 2009: CRISP finishes incorporation as a non-profit corporation, is named Maryland s designated statewide HIE (July), is awarded a $10M HSCRC grant (August), and hires staff (September) Administration of the finances and staff shifts to Johns Hopkins 2010: CRISP connects first provider organizations (September) and wins a $6M REC grant 2011: Clinicians begin using the Query Portal (February) and every Maryland hospital is connected (December) 2012: CRISP turns on ENS service (August) and Board is expanded (December) 2013: CRISP begins sending CRS reports (January), goes live with the MHBE Provider Directory (September), connects the first District of Columbia hospital (November) and turns on PDMP service with DHMH (December) 2014: Health plans begin accessing records through a special CRISP portal (March), and CRISP begins routing CCDAs at hospital discharge (June) 4

5 CRISP Governance Board of Directors Patty Brown, President Johns Hopkins Healthcare CRISP services are those best pursued through cooperation and collaboration. To make that possible 65 people participate in CRISP leadership through our governance committees. Executive Committee Mark Kelemen UMMS, Tricia Roddy DHMH, Adam Kane Erickson, Mark Schneider MedStar Clinical Committee Dr. Mark Kelemen, CMIO University of Maryland Medical System Privacy & Security Committee Mark Schneider, CIO MedStar Analytics & Reporting Committee Alicia Cunningham, VP Reimbursement UMMS Finance Committee Traci La Valle, VP Maryland Hospital Association Integrated Care Network Infrastructure Steering Committee Dr. Mark Kelemen, CMIO University of Maryland Medical System Technology Committee Tressa Springmann, CIO LifeBridge 5

6 CRISP Core Services for Providers 1. Clinical Query Portal Search for your patients prior hospital records (e.g., labs, radiology reports, other dictated reports) Monitor the prescribing and dispensing of drugs that contain controlled dangerous substances (PDMP) Enabling workflow improvements such as single-sign-on and in-context notifications 2. Encounter Notification Service (ENS) Allows providers, care managers and others with a treatment relationship to be notified when patients are hospitalized in any MD, DC or DE hospital Has become a critical care coordination service in the state 3. CRISP Reporting Services (CRS) Use CRISP Data for patient identification, performance measurement and service coordination 6

7 Clinical Query Portal Query portal allows credentialed users to search the HIE for clinical data. All 47 acute care hospitals in Maryland and 7 of 8 DC hospitals share clinical data. There are currently over 110,000 queries per month. 17 hospitals have enabled single sign-on connectivity to the portal enabling singleclick access to data in CRISP. Data Available: Patient demographics Lab results Radiology reports PDMP Meds Data Discharge summaries History and physicals Operative notes Consult notes

8 Encounter Notification Service (ENS) Overview CRISP currently receives Admission Discharge Transfer (ADT) messages in real time from: All Maryland Acute Care Hospitals 7 of 8 D.C. Hospitals All Delaware Hospitals Through ENS, CRISP generates real time hospitalization notifications to PCPs, care coordinators, and others responsible for patient care. Important Current Capabilities hospitals send full Continuity of Care Documents (CCDs), which are routed through ENS to subscribing providers who elect to receive them to support transitions of care hospitals auto-subscribe so they can be alerted when one of their past discharges is being readmitted within 30 days. This same capability allows the receiving hospital to be notified when a patient arriving at their facility had been discharged from another facility within the past 30 days. 3. ENS was recently enhanced to include the ER and IP visits for a given patient with the past 6 months.

9 ENS PROMPT Encounter Notification Service Proactive Management of Patient Transitions ENS PROMPT is a new web-based user interface that allows a user to quickly and efficiently view and work a list of ENS notifications PROMPT helps users: Detect recent admits (IP, ED) Detect recent discharges Find High Utilizers Find Care Team Members Perform analytics (utilization by condition, facility, zip code, etc.)

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11 CRISP Key Performance Indicators 2016 Portal Queries 125,760 1,000 CRS Report Accesses ENS Notifications 1,032,6 06 Query Portal Users 7,885 (Mar) 6,310 2,597 0 Report Accesses in CRS Portal Report Accesses in CRS Tableau 100 CRS Reports Users Active Clinician accounts Unique Users who logged in to CRS Portal

12 Integrated Care Network (ICN) Why?: The all-payer waiver and GBR will motivate new population-health efforts and care management initiatives And: Stakeholders will need new infrastructures and access to data to support these activities It follows that: Elements of these infrastructure could be shared, i.e. pursued cooperatively, both to avoid duplication of costs and to give care managers more complete data And if so: CRISP was chartered and is governed to be the place where health IT solutions are deployed through cooperation and collaboration. 12

13 CRISP ICN Infrastructure Workstreams Diatta Harris Calvin Ho Ryan Bramble Steve Caramanico Ryan Bramble 1. Ambulatory Connectivity: We are connecting more practices, physicians, long-term-care facilities, and other health providers to the CRISP network. 2. Routing Data: We are building a data router: including data normalization, patient consent management, patient-provider relationships for sharing patient-level data. 3. Clinical Portal Enhancements: We will enhance the existing Clinical Query Portal with a patient care overview; a provider directory; information on other known patient-provider relationships; and risk scores. 4. Notification & Alerting: We will create new alerting tools so that notifications happen within the context of a provider s existing workflow. Project Manager Craig Behm Lindsey Ferris Ross Martin 5. Reporting & Analytics: We will expand existing CRISP reporting services and make them available to a wider audience of care managers. 6. Basic Care Management Software: We will support care management software platforms through data feeds, reports and potentially a basic shared care management tool. 7. Transformation: We will train providers in all settings on leveraging CRISP data and service, sharing best practices and workflows, and supporting collaborative partnerships. 13

14 Basic Care Management Software Strategy We are conducting pilots on two core strategies Offer basic care management software as a shared platform Mirth Care Upper Chesapeake Care Manage r Encounter Notifications Care Plans / C-CDAs ENS Subscribers Prior Admissions Care Manager Attribution Care Plan Availability Shared Care Management Software Platform Regional Partnership Care Manage rr rr Care Manage rr Small Practice Care Manager Support customer-selected care management software with data feeds Caradigm Southern MD ACO / Continuum Encounter Notifications Care Plans / C-CDAs ENS Subscribers Hospital System CM Software Care Manager eqhealth TLC Care Plans Patient Panels HRAs Prior Admissions Care Manager Attribution Care Plan Availability Regional Partnership CM Software Care Manager Easy to Scale One Size Fits All Custom Fit Multiple Integrations 14

15 Ambulatory Integration Tier 1 Tier 1 - View Clinical Data & Receive Hospitalization Alerts Access to core services: ENS, Clinical Query Portal and Prescription Drug Monitoring Program (PDMP) Monitor the prescribing and dispensing of drugs that contain controlled dangerous substances (PDMP) Enabling workflow improvements such as single-sign-on and incontext notifications WHY?: 1. Notification your patient had a hospital encounter 2. Access to clinical records 3. View all schedule II-V prescriptions that have been filled by your patients 4. Meet requirements for Medicare & Payor Reimbursements 15

16 Ambulatory Integration Tier 2 Tier 2 - Send Encounter Information About Your Patients Contribute to more comprehensive patient profiles and improve data sharing among providers treating the same patients Autosubscribe (automatically integrate with your EHR) Patient Lists for ENS (eliminate spreadsheets) WHY?: 1. Improve care coordination & information flow 2. Help build comprehensive patient profiles 3. Eliminates the need to create your patient panel via a spreadsheet 16

17 Ambulatory Integration- Tier 3 Tier 3 - Send Clinical Information About Your Patients WHY?: Further contribute to comprehensive patient profiles Increase and enhance the data available among providers treating the same patients CAliPHR: Clinical Quality Measures (CQM) Reporting Tool Enhanced Analytic Reporting 1. Automate CQM Reporting 2. Improve Your Quality Measures Performance 3. Begin Preparing for Future Reimbursement Models 4. Reduce Repeat Testing & Treatment 5. Easily communicate treatment provided at your practice to other providers 17

18 Thank You! Ross D. Martin, MD, MHA Program Director, Integrated Care Network Calvin Ho Director of Ambulatory Integration Sharice Spinner Marketing Analyst 18