Rocky Mountain Chapter CMSA Annual Conference Golden, CO

Transcription

1 Rocky Mountain Chapter CMSA Annual Conference Golden, CO Climbing the Peaks: Reaching New Heights In Case Management Friday, October 9, 2015 Presentation by Pamela Russell, CORHIO

2 Objectives What is HIE Health Information Technology and how does it impact Case Managers? What is HIE in Colorado and national picture of HIT? Results of LTPAC Challenge Grant Care transitions and work flow Understand the TEFT Grant (Testing Experience and Functional Tools) and PHR Personal Health Records Overview of the Advanced Interoperability Grant Award to Colorado July 2015 Wrap-up Questions and Answers

3 Who We Are What We Do Vision About CORHIO Colorado Regional Health Information Organization A nonprofit, public-private partnership Facilitate health information exchange (HIE) among healthcare providers Assist providers with EHR adoption & Meaningful Use Shared health information for all individuals in every Colorado community promoting the right care, at the right time and the right place. Support population health programs

4 CORHIO Health Information Organization Health Information Exchange (HIE) Transformation Support Services Quality improvement services to practices Medicaid EHR Incentive Program Outreach Care Transitions: Long-Term & Post- Acute Care Behavioral Health Integration

5 About HIE CORHIO provides the ability to electronically exchange patient health information including: Lab and pathology results Imaging and radiology reports ADT and H&P information Transcription notes Continuity of Care Documents (CCDs) Secure Direct Messaging when it s needed for patient care.

6 How Does HIE Work? The Clinician Perspective Paper & phone based with some limited electronic connections One electronic connection to the HIE to access/share patient information across the state

7 How Query-Based HIE Works Public Health Departments Laboratories Hospitals CIIS Pharmacy Information Radiology Centers Immunizations Reportable Conditions Immunizations Hospital ADT Info Consult Reports Transcription Notes Lab/Rad Public Health Alerts Newborn Screening Results Medications lists Lab Results Radiology Reports Pathology Reports Community Health Record Diagnostic-Quality Medical Images (with CTN) Data Analytics Immunizations Future Orders CCD CCD Upload 2013 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved CORHIO Proprietary - Not For Redistribution 7

8 Last updated 7/20/2015 CORHIO By the Numbers 48 Hospitals Connected (11 more underway) 2,600+ Providers Connected (7,200+ total users) 4,000,000+ Patients in the Community Health Record

9 Statistics through July 20, 2015 CORHIO HIE Network Growth 70 Hospital Participation Growth 8,000 Community Provider Participation Growth 60 7, , , ,000 3,000 2, (to date) Hospitals - In Implementation Hospitals - Connected 1, (to date) HIE Users Community Providers (prescribers) More than 500 additional providers in queue to be connected

10 Last updated 7/20/2015 Hospitals - Connected Banner Health System (8/2012) Banner Fort Collins Medical Center (4/2015) East Morgan County Hospital McKee Medical Center Northern Colorado Medical Center Sterling Regional MedCenter HealthONE Health System (12/2014) North Suburban Medical Center Presbyterian/St. Luke s Medical Center Rocky Mountain Hospital for Children Rose Medical Center Sky Ridge Medical Center Spalding Rehabilitation Hospital Swedish Medical Center The Medical Center of Aurora Centura Health System (10/2011) Avista Adventist Hospital Castle Rock Adventist Hospital Littleton Adventist Hospital Mercy Regional Medical Center OrthoColorado Hospital Parker Adventist Hospital Penrose Hospital Porter Adventist Hospital St. Anthony Hospital St. Anthony North Hospital St. Anthony Summit Medical Center St. Catherine s Hospital, Kansas (09/2014) St. Francis Medical Center St. Mary-Corwin Hospital St. Thomas More Hospital Connection dates in parentheses

11 Last updated 7/20/2015 Hospitals - Connected SCL Health System (Exempla) (5/2014) Good Samaritan Medical Center Lutheran Medical Center Saint Joseph Hospital University of Colorado Health System Medical Center of the Rockies (12/2011) Memorial Hospital Central (7/2012) Memorial Hospital North (7/2012) Poudre Valley Hospital (12/2011) University of Colorado Hospital (6/2013) Independent Hospitals Boulder Community Hospital (2/2011) Boulder Community Foothills Hospital (2/2011) Children's Hospital Colorado (12/2012) (new South Campus added 1/2014) Conejos County Hospital (9/2014) Craig Hospital (receiving data only) (7/2013) Estes Park Medical Center (8/2014) Evans Army Community Hospital (12/2013) Longmont United Hospital (12/2011) Parkview Medical Center (4/2012) Prowers Medical Center (12/2014) San Luis Valley Regional Medical Center (8/2011) Connection dates in parentheses

12 Last updated 7/20/2015 Hospitals - Under Agreement Independent Hospitals Animas Surgical Hospital Arkansas Valley Regional Medical Center Colorado Plains Medical Center Denver Health & Hospital Authority Kit Carson County Memorial Hospital Melissa Memorial Hospital Mt. San Rafael Hospital Pagosa Springs Medical Center Rio Grande Regional Hospital Southwest Memorial Hospital Vail Valley Medical Center

13 Last updated 7/20/2015 Labs Participating in HIE Under Agreement: Cedar Diagnostics Gastroenterology of the Rockies (in-house pathology lab) MetroPath UniPath Connected to HIE: Colorado Lab Services LabCorp Quest Diagnostics (9Health Fair) Schryver Medical

14 Last updated 7/20/2015 About CORHIO Electronic Health Record (EHR) Connectivity Status: CORHIO is a nonprofit, public-private partnership that is improving health care for all Coloradans through health information technology and the implementation of electronic health information exchange (HIE). CORHIO manages and maintains the technology infrastructure that supports secure, efficient clinical information sharing among health care providers across Colorado. Improving Health Care Quality HIE improves health care providers ability to administer timely and effective patient care with more accurate, up-to-date patient information at the point-of-care HIE saves lives in emergency situations, giving medical professionals information they need at their fingertips Reducing Costs HIE reduces the number of duplicate tests performed on patients, lowering costs and improving patient satisfaction For providers, HIE reduces administrative costs including those associated with printing, faxing, mailing and overall management of patient medical records Green: Connected to CORHIO AllMeds Allscripts Pro Allscripts TouchWorks Amazing Charts Answers on Demand Aprima AthenaHealth CareTracker Cerner Millennium/ PowerNotes CoCentrix (formerly UNI/CARE) eclinicalworks e-mds Elekta Mosaiq Epic GE Centricity Greenway CareCloud Connexin Software OfficePracticum CureMD MacPractice HealthFusion HealthTronics McKesson Horizon McKesson Practice Partner Meditech MicroMD ModuleMD Netsmart NextGen Red Planet Sevocity SRSoft/SRS EHR Vitera/Intergy Yellow: In process to connect to CORHIO or verified as being able to connect MediTab Point Click Care Pulse Systems Red: Unlikely to connect to CORHIO in the near term Practice Fusion

15 Patients & Health Information Exchange National Survey: Nearly 75% of American adults believe it is very important that their critical health information should be easily shared between physicians, hospitals and other health care providers. Nearly 20% of Americans felt that they, or a family member, experienced a problem receiving medical care because their health records could not be shared between different healthcare providers. 87% of respondents are overwhelmingly against any fees being charged to either healthcare providers or patients for the transfer of critical health information. Source: Society for Participatory Medicine Survey, March 2015

16 Vision for HIE No Wrong Door for Patients Providers have access to a patient s more complete health history during the visit Providers have access to the information needed to evolve with health reform (e.g., ACOs) Patients are active participants in their healthcare Communities and policy makers have accesses to aggregated, de-identified health data to improve community and public health

17 New CMS Rules May Spur EHR Uptake in Long Term Care National picture, if that uptake occurs, it could be the missing link to making the health system digitally whole. The long-term care sector was left out of the government's meaningful use program, which, through the HITECH Act, dangled billions of dollars in incentives for EHR uptake in front of medical practices, hospitals and health systems along with the prospect of penalties further down the road. More than 15,000 long-term, post-acute care facilities large and small, nonaffiliated and networked provide care for about 1.5 million Medicare and Medicaid patients across the country. The proposed CMS rules, detailed in 403 pages, go broad and deep, focusing on improving the quality of care for these beneficiaries. Posted Jul 22, /22/ Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved CORHIO Proprietary - Not For Redistribution 17

18 Triple Aim now CDS Five Rights Clinical Decision Supports 1. The right information: Evidenced based guidelines, response to clinical need 2. To the right people: Entire care team including the client 3. Through the right channels: i.e. PHR, patient portals, mobile devices, EMR, etc. 4. In the right formats: Flow sheets, patient lists, order sets, dashboards 5. At the right times: For key decisions or actions 9/22/ Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved CORHIO Proprietary - Not For Redistribution 18

19 ONC s HIE Challenge Grant Awardees Long Term & Post Acute Care (LTPAC) Colorado Regional Health Information Organization (CORHIO) Maryland Dept. of Health & Mental Hygiene Massachusetts Health Data Consortium $1,718,783 $1,683,171 $1,717,610 Oklahoma Health Care Authority $1,719, Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved CORHIO Proprietary - Not For Redistribution

20 CORHIO s Grant Implementation Five targeted communities: Boulder County Colorado Springs Pueblo/Canon City San Luis Valley Metro Denver Three principal components: 1. Encourage LTPAC provider participation in community-based HIE Goal: Pilot HIE with 125 providers in 5 communities 2. Define and implement community goals, processes and protocols for LTPAC transitions; integrate with Clinical Advisory Committees 3. Develop statewide template and standards for improving LTPAC transitions, using HIE as integral tool Partnerships for success: CIVHC, Telligen (formerly CFMC), Colorado Hospital Assn, Colorado Health Care Assn, DRCOG/AAA, HCPF, other existing community initiatives, 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved CORHIO Proprietary - Not For Redistribution

21 LTPAC Participants Long-Term, Post-Acute & Home Health Care And Many More!

22 Workflow Improvement Average Time Spent Locating Patient Health Records Average Time Pre-HIE 29 hours 46 minutes Average Time 30 days Post- HIE 11 minutes 42 seconds Average Time 60 days Post- HIE 6 minutes 30 seconds HIE saves LTPAC practices an average of 29 hours per admission

23 Grant Results Queries and CCD s (Continuity of Care Documents) # of Queries via PatientCare 360 June Jan ,055,740 # of CCDs Created June 2012 Jan # of CCDs Printed June 2012 Jan

24 LTPAC Challenge Grant Measures, continued Providers in targeted communities respond to 100% of patient requests for copies of care summary information All LTPAC providers have the ability to create and print CCD s for their patients/family members upon request CCD s are documented on a monthly basis Manual process Beginning stages of person-centered care

25 Patient Care 360 LTPAC Customer Satisfaction Survey Results Has PatientCare 360 improved your patient care transitions? 100% of participants polled answered YES. We are able to obtain more current information and to obtain additionally requested information more quickly. Has PatientCare 360 made your job easier? 100% of participants polled answered YES. I get access to info more promptly than before. Do you believe that PatientCare 360 helps you provide better care to your patients? 100% of participants polled answered YES. Information needed is often readily available improving response time to physician inquiries. 9/22/ Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved CORHIO Proprietary - Not For Redistribution 25

26 Person-Centered Approach in CO 90/10 HIE Maximization Medicaid SIM Grant (State Innovation Model) Money Follows the Person No Wrong Door Testing Experience and Functional Assessment Tools (TEFT) Foundation = Health Information Technology

27 Person-Centered Approach in CO These programs have in common: community-based care approach, person-centered, using shared data to improve care 90/10 provides health information exchange and practice transformation for Medicaid providers State Innovation Model integrates behavioral and physical health care Money Follows the Person helps people transition away from nursing homes and into their own homes by offering transportation, home health services, and other community-based services No Wrong Door streamlines access to LTSS options for older adults and individuals with disabilities; one-on-one counseling Testing Experience and Functional Assessment Tools (TEFT) demonstrates e-health in Medicaid community-based LTSS via personal health records

28 What is TEFT? Testing Experience and Functional Tools Joint project of The Colorado Department of Health Care Policy and Financing (HCPF), CORHIO and QHN Colorado is 1 of 8 states to receive the grant from CMS (Center for Medicare/Medicaid) and ONC Main objective is to test quality measurement tools and demonstrate Person-Centered care with Medicaid waiver community-based long-term support services (LTSS) clients. Field test an experience survey and a set of functional assessment items Demonstrate personal health records Create a standard, electronic LTSS care plan

29 TEFT Program Grant awarded to Colorado Department of Health Care Policy and Finance HCPF Sub-recipients CORHIO and QHN (Quality Health Network) Timeline - Long Term Support Services (LTSS) Waiver Populations Elderly, Blind, Disabled (EBD) - 22,384 enrollees Supported Living Services (SLS) - 4,007 enrollees State Partnerships Community Centered Boards (CCBs), Single Entry Points (SEPs), Regional Care Collaborative Organizations (RCCO s), Accountable Care Organizations (ACO s), Home and Community Based Service providers (HCBS), Colorado Health Care Association, Colorado Hospital Association, Governor s Office of IT, CIVHC, Colorado Gerontological Society and many others 9/22/

30 TEFT Components Four components or goals of the TEFT Grant Experience of Care Survey (EoC) FASI Functional standardized assessment items Personal Health Record e-ltss Care Plan S&I Framework 9/22/

31 PHR Implementation Phase Data Flows Clinical Data Paper Based Providers, Non Clinical data, Care Plans HIE Data Warehouse (Normalized) Provider HIE PHR Client State Medicaid Care Giver Patient Input Monitoring Surveys

32 TEFT Focus Groups and Pilot Sites Focus Groups started in March 2015 Pilot Sites identified from the Focus Group meetings Goal of 200 LTSS clients using a PHR by clients per community PHR vendors identified eltss standards for care plan or record to be developed

33 The TEFT Communities Metro Denver/Jefferson County/Boulder Northern Colorado Ft. Collins, Greeley and Sterling Southern Colorado Colorado Springs, Pueblo, San Luis Valley Eastern Colorado Burlington, Limon, Cheyenne Wells Western Slope Grand Junction and Montrose 33

34 National Grant Opportunities Department of Health and Human Services Secretary Sylvia M. Burwell announced $28 million in funding for HIE grants in February 2015 The two-year grant program will ask awardees to demonstrate innovative, community-based solutions to advance standardized, secure information exchange Target populations are LTPAC, Behavioral Health and Ambulatory Providers 9/22/ Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved CORHIO Proprietary - Not For Redistribution 34

35 Advanced Interoperability Grant Awarded to Colorado Center for Medicare and Medicaid (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) sent award notifications to 12 states in July 2015 HCPF received grant and both CORHIO and QHN are sub-recipients Goal is to get data from ambulatory providers, long-term and post-acute care providers and behavioral health programs into the HIE 25% of physicians connected to CORHIO 18 Skilled nursing facilities connected to CORHIO 2 Home Health agencies connected to CORHIO 1 Behavioral Health agency connected to CORHIO Transport data via CCD s and VorroHealth/KeyHIE Transport Tool Colorado only state to have both TEFT and Advanced Interoperability grants 35

36 CORHIO Making an Impact Click image to view video; Internet access required.

37 View All Participating Providers Visit and select Participating Providers Interactive Map Full List of Providers Below (sortable by column)

38 Questions and Answers Contact Information: Pamela A. Russell, BSW, MS CORHIO LTC Program Director/Government Programs /22/ Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved CORHIO Proprietary - Not For Redistribution 38