Secure. Proven. Easy to Use. Mission: Improve the quality of care and lives in behavioral health for clients, families, providers, and

Transcription

1

2 Key Strategic Information You Need to Make Critical Decisions: Planning To Use Your EHR Dataset to Support Executive Decision Making

3 Key Strategic Information You Need to Make Critical Decisions Using Your EHR to Support Executive Decision Making Cathy P. Pumphrey, MA LPC DCC Director of Informatics Fairfax-Falls Church Community Services Board

4 Key Strategic Information You Need to Make Critical Decisions Fairfax-Falls Church CSB 1 of 40 Public agencies providing behavioral health and developmental services in Virginia Accountable to the Federal, State and local government Broad continuum of services- OP, Day, Resi, Employment, Crisis/Emergency Services Serving about 20,000 individuals per year 1200 staff

5 Key Strategic Information You Need to Make Critical Decisions Best Case Scenario for Executive Decision Making 1 of 40 Public agencies providing behavioral health and developmental services in Virginia Accountable to the Federal, State and local government Broad continuum of services- OP, Day, Resi, Employment, Crisis/Emergency Services Serving about 20,000 individuals per year 1200 staff

6 Key Strategic Information You Need to Make Critical Decisions Evaluate and display results *Goals Analyze GETTING STARTED Define Data Set Process QA Warehouse

7 Key Strategic Information You Need to Make Critical Decisions Where We Were Last Year Deteriorating data set Transforming the Organization Choosing a new EHR Changing budget situation Needing data to make decisions!!!

8 Key Strategic Information You Need to Make Critical Decisions No Stranger To Data Utilization data reported to state beginning in 1985; electronic transmission 2005 Performance Measures reported as part of County budget beginning in 1998 Dashboard started in 2007 Migrated to Balanced Scorecard st EHR implemented in 1998

9 Key Strategic Information You Need to Make Critical Decisions BSC Reporting

10 Key Strategic Information You Need to Make Critical Decisions What We Want to be Different Reliance on EHR data, not hand counts and hunches Data available real time and in different formats Some self sought, others provided Move toward outcomes, away from widgets

11 Key Strategic Information You Need to Make Critical Decisions The Dashboard Experience

12 Key Strategic Information You Need to Make Critical Decisions Data Principles What Who Why

13 Key Strategic Information You Need to Make Critical Decisions Design A Decision Making Process and Follow It

14 Key Strategic Information You Need to Make Critical Decisions Type of Data Needs

15 Key Strategic Information You Need to Make Critical Decisions Our Audience Individuals, families, the public Federal, State and Local Governments Agency Executive Director Service Director Supervisor Line staff

16 Key Strategic Information You Need to Make Critical Decisions Questions We Thought About Standard for the data What s the agency data set? How can we ensure quality? Who puts in what? Access Who sees what and when? Management of the info Who runs reports? How is information distributed? Where do we start?

17 Key Strategic Information You Need to Make Critical Decisions Our Steps Collecting the data Decided what to collect and built around it Ensured consistency and streamlined elements Required key elements to be collected Designed and wll monitor ongoing the processes to collect information Constant review of status Reporting it out Trained staff to run their own filters, advanced searches Creating a repository of data reports (templates) Info that is regularly needed is available on the BI Dashboard and will be run automatically Central request and discussion about data needs

18 Key Strategic Information You Need to Make Critical Decisions Our Steps Activity Signed contract Train EHR support staff Train agency staff EHR Go live Develop ad hoc reports Draft dashboard Service area dashboards Pilot and refine Expand info Time Frame Aug 2011 Sept 2011 Nov 2011 to March 2012 March 2012 April 2012 Aug 2012 Oct 2012 Oct 2012 Jan 2013 Jan ongoing

19 Key Strategic Information You Need to Make Critical Decisions Plans for BI Dashboard Vanilla data for agency as a whole and each service area, by month: Number of consumers Number of new consumers, discharged consumers Hours of service Drill down to staff member productivity Identify service specific data Access to services, Medical info, fiscal Establish access criteria Principle of sharing data broadly Benchmark data against previous data

20 Key Strategic Information You Need to Make Critical Decisions Examples

21 Key Strategic Information You Need to Make Critical Decisions Examples

22 Key Strategic Information You Need to Make Critical Decisions Key Takeaways for Your Data Plan 1. Instill a culture of data in your organization create expectations and dependence 2. Don t wait until your data is perfect get going right away, use this to get people thinking about the data instead of just accepting it (or not) on face value, build it together 3. Make data easily accessible and transparent teach staff how to run reports, provide dashboards with key data 4. Work backwards from what you want to know to how to collect it build your EHR this way 5. Pay the most attention to the business processes standardize and monitor 6. Choose your EHR with the end result in mind Ability to generate the data you need to make decisions

23 Key Strategic Information You Need to Make Critical Decisions Questions

24 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: High Value Recommendations From a Vendor management.

25 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Presenter Background: Matt M. Dorman, MBA CEO and Founder, Credible Family Story 120+ implementations Fortune 500 Alumni Dark Side (Investment Banking) Former Board Member, MD PRP

26 Lesson Learned $850,000,000 Annual Medicaid, Medicare, 3 rd Party 9,600,000 Annual Progress Notes 1,200,000 Annual Electronic Scripts 350,000 Lives 12,000 Named Users 165 Partners 24 States and the District of Columbia

27 Lesson Learned 165 Partners and Growing

28 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Mission and Vision Credible Mission: Improve the quality of care and lives in behavioral health for clients, families, providers, and management. Credible Vision: Behavioral health enterprise software market leader for Clinic-based, Community-based, Youth and Residential providers with $1 million to $100 million in revenues. Differentiating on innovation, value, and customer service. (Still specifically excluding hospitals, managed care and State contracts.)

29 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Maximize Software Investment Data is the Differentiator Reporting Philosophy (your effort vs. joint effort) EHR Dataset Drives Executive Decision Making Dashboards and Business Intelligence (BI)

30 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Vendor Expectations Decision Support Evolution Reports Advanced Search Advanced Ledger Search Credible Business Intelligence (BI) Takes time, vendor responsibility?

31 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Recommendations From A Vendor It s your data, you own it It takes time Vendor s job is never done Partnership Vendor s experience = $$$

32 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Effects Staff losing confidence Admin losing credibility Company losing $$$$$

33 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: True Partnership = Action Investment in new vendor: Live in 12 weeks Receiving payments Continuous access Ability to customize Staff: Saved time, So simple INCREASED QUALITY AND REVENUE

34 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Ongoing Relationship Vendor Follow-Up - Conference Calls - On-site visits Constant support throughout implementation process Annual Conferences & Training Innovation and Pricing

35 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Skills Needed > Skills Available

36 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Implementation Infrastructure Implementation tool Realistic time commitment Communication, strategy, commitment

37 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Keys to a Successful Implementation Commitment From Team Right Map Evaluate Progress Continuously Delegate Duties Effectively Identifiable Date Billing Must Be Priority #1 Leadership Of Team Educate Your Staff

38 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Hotel Prices and Software Caribbean $199 NYC $275

39 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Hotel Prices and Software Jeffersonville, IN $395 NYC $275

40 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Who will Implement for You? 5 Vendor Capacity and Your Implementation Capacity Implementations Star 1 Star 2 Star 3 Average Newbie 1 Newbie 2

41 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Customization is Expensive

42 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Customization is Expensive

43 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Software Customization is Expensive 1. Requirements definition 2. Development and changes 3. Testing 4. Release, distribute 5. Client server specific challenges 6. Support (and staff turnover) 7. Raises for staff

44 Managing Agency/Vendor Expectations & Relationship to Maximize Your ROI: Software Customization is Expensive 1. Now you have a brand new product 2. Who wants their Agency/future dependent on a new venture 3. Let s go build a house from scratch 4. Benefits of customization v. Revamping processes Managing expectations Economies of scale 5. Part of financial model

45 Lessons Learned: Optimal Project Management Team Selection Rollout Strategies Major Failures Structural Quick Sand & Partnerships Versus Adversaries

46 Safe Harbor Behavioral Health

47 Lesson Learned Safe Harbor Behavioral Health 230 Employees 5,000 Active Consumers $9,500, SHBH services approximately 5,000 Erie County Residents at any given time, providing: Outpatient Services Psychiatric and Therapy Safe Start Services trauma-based interactive services Behavioral Health Rehabilitative Services Early Intervention Assessment Services 24/7 Crisis Services NWBG Private Practice & EAP Services

48 Lesson Learned Presenter Background: Jon Evans President and Chief Executive Officer, Safe Harbor Behavioral Health. President, Northwest Beacon Group Pennsylvania Governors e-health Collaborative. President Elect, Pennsylvania Community Providers Association

49 Lesson Learned Managing Agency/Vendor Expectations Let staff focus on care Partnership approach IT Committee meets weekly focus on operational work flow and task tickets. Scheduled conference calls with assigned vendor partner for review of progress.

50 Lesson Learned Managing Agency/Vendor Expectations Let staff focus on care Partnership approach IT Committee meets weekly focus on operational work flow and task tickets. Scheduled conference calls with assigned vendor partner for review of progress.

51 Lesson Learned Relationship Senior management got on phone to solve problems Physician s Orders No erx The critical importance of an Interpreter It s a Marriage! Commit to a long term relationship.

52 Lesson Learned Realized ROI Eliminated chart room, converted space to revenue generating space, enhanced HIPAA compliance and simplified access to charts and data. Earned an additional $150,000 from the space that used to be a cost driver. Increased features, no new costs Meaningful Use ROI.

53 Chestnut Ridge Counseling Service

54 Lesson Learned Employees: 210 Chestnut Ridge Counseling Service We treat each person as if they are family. Client Served: 10,374 Gross Revenue: $13M 85% Fee for Service 15% Grant / Program funding 384,584 Units of Service billed

55 Lesson Learned Decision Drivers Weak Revenue Cycle FFS, Grant / Program funding Continuity in Treatment Planning Tele-psychiatry Behavioral Health Focus OP: Efficiency of Documentation

56 Lesson Learned Implementation Story 40 Programs / Specialized Treatment tracks Range of services : Residential- Crisis-Outpatient OP Clinic: 1600 Clients / week 6 Distinct sites

57 Lesson Learned What We Were Looking For Comprehensive software package: clinical, fiscal, scheduling Customizable software and user friendly Strong fiscal / billing functions County billing, client liabilities Specialization in behavioral health Experience in Pennsylvania

58 Lesson Learned Oops Not So Good! Internal procedures / processes not well defined Us versus Software : who s going to change first. Understanding of how Software infrastructure works Clarity of deliverables / timelines with vendor Implementation Team Leadership

59 Lesson Learned What We Did Right! Strong Implementation Team Key Functional leaders Line Level Staff Super Users will surface Sequential Approach to Go-live Strong Relationship with Vendor

60 Lesson Learned Keys to a Successful Implementation Understand Internal processes Written protocols Flow charts Goals of software purchase: Know thyself Clinical: OP, High volume focus Fiscal: Billing 101, Ease of use, reporting capabilities

61 Lesson Learned Keys to a Successful Implementation Assign a Task Master Mechanism to communicate activities Method to remember that Keep Agency informed of progress Daily / Regular: Credible Tips Have Fun

62 Lesson Learned

63 Lesson Learned

64 Lesson Learned

65 Families, Inc

66 Lesson Learned Families, Inc. Counseling Services Serving children, adolescents and adults throughout Northeast, North Central and Central Arkansas Outpatient services: Case management Therapy Psychological Testing Psychiatric Services

67 Lesson Learned About Presenter Bob Puckett, Director of Human Resources Admin Clerical Billing IT Project Manager QA Training Clinical

68 Lesson Learned Implementation Attempt Frustration for Two years Account Management Internal Confidence Weakens Lack of Communication Evidence Decision Time

69 Lesson Learned Implementation Success 1/20/10 Demo 4/2/10 Kick-Off 6/28/10 GOLIVE 12 WEEKS!

70 Lesson Learned Implementation Success

71 Lesson Learned Keys To Successful Implementation Commitment From Team Road Map Evaluate Progress Continuously Delegate Duties Effectively Identifiable Target Date Billing Must Be Priority #1 Leadership Of Team Educate Your staff

72 Lesson Learned Keys To Successful Implementation Commitment From Team Road Map Evaluate Progress Continuously Delegate Duties Effectively Identifiable Target Date Billing Must Be Priority #1 Leadership Of Team Educate Your staff

73