Community Health Care Association of New York State / Arcadia Solutions

Transcription

1 Community Health Care Association of New York State / Arcadia Solutions Building the New York State Center for Primary Care Informatics: CHCANYS Data Warehouse Monday, October 17, 2011

2 Today s Objectives 1. Learn benefits of statewide data and why CHCANYS and many PCAs nationwide are establishing data warehouses. 2. View examples of reports from the Arcadia reporting platform. 3. Learn about the pilot project and what it means for a participant health center. 2

3 Agenda Statewide Center for Primary Care Informatics Overview About Arcadia Challenges and Arcadia Perspective Pilot Demonstration: Data Aggregation and Reporting Demonstration Summary and Next Steps 3

4 Project: Statewide Data Warehouse of Health Center Data Identified as a priority goal in CHCANYS Strategic Plan. Will be known as the Center for Primary Care Informatics. 4

5 Statewide Primary Care Informatics Benefits Phase 1 Phase 2 Proposed Scope Practice management (EPM) Health records (EHR) Payer Federal (e.g., census, labor) State (e.g., SPARCS) Benefits Analysis and reporting to support the following: Quality Improvement -quality measurement & benchmarking with peers PCMH Health Home MU UDS Analysis & Reporting to support the following: Demonstration of VALUE delivered by the FQHC model - the Triple Aim: higher quality, better outcomes, lower cost Advocacy Pay-for-Performance (P4P) Partnerships Planning for growth Fund development 5

6 About Arcadia: Our Primary Care Associations Clients Arcadia is helping PCAs and FQHCs across 10 states and our list of clients is growing. 6

7 Bending The Cost Curve = Opportunity Under healthcare reform, there is an opportunity to share in the cost savings achieved $4.6 Trillion 2009 $2.5 Trillion 1990 $724 Billion Source: CMS 7

8 Landscape Is Changing Quickly Aug. 30, 2011 Sept. 26, /16/2011 8

9 FQHCs Should Embrace Reform Health Centers are better equipped to thrive under health reform than private physician networks. Emerging payment models align with comprehensive primary care. Success will require care delivery transformation: New technical tools & methods for measuring success. Rethinking roles and responsibilities. Leaders of our Health Centers should be focused on the cultural challenges of making the leap. 9

10 Advocacy Must Change As Well Can you precisely articulate and demonstrate the value of primary care? Engages stakeholders to ensure their needs are met. Have a consistent understanding on how each component is measured. Leverage the primary care value formula: 10

11 Own Your Data Own Your Future FQHCs will need to demonstrate improved effectiveness, insight, and efficiency throughout the continuum of care. The depth and quality of data will be critical in determining success. Meaningful Use may not achieve all your organizational goals. 11

12 Health Home As A Methodology EHR / Registry / Meaningful Use Data Aggregation / Exchange (HIE) PCHH Performance Management ESTABLISH INFRASTRUCTURE SHIFT FOCUS OF CARE ALIGN INCENTIVES Meaningful Use of EHR will be the floor not the ceiling. Recognition as a Health Home will be a requirement, top-performers will go beyond. Competition will be increasingly fierce as the overall system re-evaluates the value assigned to Primary Care. How you are paid is how you should pay. This creates more opportunities than down-side, but will be a painful transition. 12

13 Demonstration Program Value for Health Centers Participation in the pilot program will deliver substantial cost savings to the health centers and their providers and serve as the foundation for continued savings through improved healthcare quality and outcomes. Quality of Document = Quality of Clinical Care Delivered: Get credit for the high quality work your providers are delivering. Ensure clinical care delivered is reflected accurately and reportable from your EHR. Increase Transparency: Know where how ALL your patients stand. No need for selective sampling (70 pt manual chart audit). Identify Best Practices And Benchmarking: Identify your best performers and bring everyone up to their level. Improve Quality: Use the information to identify and prioritize the areas of opportunity. Baseline performance and track progress against your improvement programs. Easily manage your patients by population. Easy to Run Reports (UDS, MU, PCHH): Run your reports with the click of a button. Drill down to health center, location, provider and patient levels to understand where you stand. Make course corrections long before the submission date. Improve Reporting Efficiency: Free up analyst time for analysis vs. spending hours, days or even weeks on data collection. Drive More Patients To Your Health Center: Demonstrate improved quality and cost effectiveness of CHCs; driving more patients to CHCs. Seize the opportunity provided in 2014 by the health benefits exchange. Prepare for Uncertain Future & Assure Sustainability: Empower your providers and staff to address patient center health home, Pay For Performance contracts, Accountable Care Organizations, and develop evidence based guidelines

14 Data Aggregation & Reporting: DRVS Overview DRVS is a quality measurement and improvement platform that specializes in ambulatory measurement at community health centers. The demonstration outlined in this document represents a typical scenario covering how DRVS is leveraged to support quality improvement at provider organizations. The application contains real data that has been de-identified to protect our customers privacy and contains quality measurement data on approximately 250,000 patients

15 Reporting: DRVS Architectural Overview PCA and CHC focused solution Data from disparate EHR and EPM systems. Daily data refresh. Data unified in EHR-agnostic Data Warehouse for apples to apples comparison. Web-based reporting platform accessible from any major browser. User role differentiation and data blinding. Graphical and text based depictions of datasets. External data links geographic characteristics to patients & providers 15 15

16 DRVS Demo 16 16

17 Statewide Primary Care Informatics Approach Our approach to getting our clients to the end state consists of the following activities: Discovery and Strategy Development, Pilot Program, and Implementation Phase 1 and Phase 2. Pilot Program Current state assessment Solution roadmap Assess QD = QC and develop benchmarking for 6-10 health centers Implementation Phase 1 (EPM/EHR) Implementation Phase 2 (External Data/Claims) Business case development Discovery & Strategy Pilot Program & Quick Wins Implementation (Clinical Outcomes) Implementation (External Data) 3 Weeks 4-8 Weeks 4-6 Weeks per CHC 4-6 Weeks per CHC 17 17

18 Pilot Program Approach and Timeline The initial set of reports will be developed during the first six weeks. After our onsite meeting, we ll meet weekly to review and validate our results. Preparation Measure Analysis Continuous Improvement Select pilot site Develop metric reports Update metric reports Present draft reports and solicit feedback Review workflow Develop preliminary metric analysis Review variability analysis Finalize initial reports Connect to EHR Present draft reports and solicit feedback Present draft reports and solicit feedback Expand assessment metrics Review EHR data Create ability to self-run reports Weeks One to Three Week Four Week Five Weeks Six and Onward 18 18

19 QD = QC Data Fidelity Process Standard metric definition Agree on standard metric definitions. Where s info captured? Is smoking cessation captured in one field in the social history template or is it captured in 22 places across 5 templates? Structured or unstructured? Are results captured in free text fields? Look for impact on patient safety. Variation in definition? Check for standardization of drop down lists (e,g, white, Caucasian, WHTE, W). Provider variation Conduct analysis by provider (variations by practice, specialty, location). Root cause analysis If numbers are low, we look for reasons why (e.g., data capture, configuration). Improvement plan Provide patient level data to help resolve issues

20 Pilot Health Center Team and Time Commitment The Arcadia team will perform the majority of the analysis. However, health center collaboration is critical to the success of the project. We will need your help with the following: 30 min onsite preparation call 3 hour onsite visit Up to three 1-hr data validation review Additional time will be required for data validation and process improvement Provider (MD or NP) Review of work flows and how providers document care in EHR Quality Director Review current reports and metrics Technologist/EHR manager Help with EHR login and data validation Health Center Project Lead Health Center central point of contact 20 20

21 Summary As delivery and payment systems evolve, the most successful organizations will be those that use data to drive quality improvement and to prove their value (outcomes & costs). CHCANYS and its health center members are well positioned. Through this effort, you ll have the data you need to further enhance your position as heath care leaders. Your data becomes even more powerful when you combine your health center data with external data sources to support planning, negotiation and partnership development (e.g. payers, census, other government data bases, etc). 21

22 Next Steps Convene governance group. Continue to reach out to funding organizations. Kick off pilot program. 22