NextGen Reporting: Perspective Gained

Transcription

1 NextGen Reporting: Perspective Gained Douglas Mitchell, MSN, RN, BC, AIC, CPHQ, CPHRM Quality, Risk Management and Accreditation & Compliance Jay Simmons, MBA, BS, NCP-ICS, EHR, EPM Clinical Documentation System Management and Information Technology

2 Objectives Content Items: Documentation Form (aka Template) Managements Regulatory Requirements Clinical Requirements Medical Staff Structure & Support Required for a robust reporting infrastructure Required to gain clinical acumen from reporting output Lessons Learned

3 Background The facility is a multi-specialty clinic (one geographic location in a large metropolitan city): Primary Care (67%) Cardiology (13%) Rheumatology (9%) Pulmonology (5%) Endocrinology (5%) Podiatry (1%) The providers are either employed or provide care through a purchased service agreement. 12 physician providers 7 midlevel providers

4 Background The clinic has a CMO (a physician), a COO (a nurse practitioner) and a CEO (an accountant). The clinic has been approached by payers to engage in risk sharing contracts: Managed State Medicaid Plans Commercial Plans Our expertise was solicited to pull out clinical/administrative data, analyze it, develop recommendations and then identify steps needed to move forward.

5 Template Management Assessment An assessment of the documentation forms was completed: Done initially Over 260 templates were reviewed. Needs of the risk sharing contracts were reviewed and incorporated into the templates. Clinical data Administrative data

6 Template Management Ongoing Edits A ticketing system was used to collect provider and staff needs regarding the templates This permitted tracking: Requestors Changes and additions Lapsed time Reporting needs When a new field was added and passed testing, reporting on that field was developed Facilitated the entire loop from template edit to data procurement

7 Template Management Ongoing monitoring Template use monitoring This monitored what templates were being used for documentation This prevents providers for documenting on forms not designed to capture required data elements Template completeness monitoring This monitored what fields in the template were being completed This prevents providers from missing required fields

8 Template Management Ongoing Template Management Tool Field Monitoring Form/Template Monitoring

9 Template Management Clinical Practice Guidelines (CPG)s SQL Scripts Successful Reporting & Meaningful CPG Intelligence Documentation Templates or Documentation Forms Data Tables

10 Medical Staff Structure Support Required for CPG Generation Support for reporting requirements once CPGs put in place

11 Medical Staff Structure Reporting Analytics The medical staff arrived at the same conclusions we did:

12 Medical Staff Structure Support Required for CPG Generation Required guidelines that were created from the clinical data in NextGen were supported by the medical staff

13 Medical Staff Structure Support Required for CPG Generation Supported the CPG roll out by influencing the practice of the providers

14 Medical Staff Structure Physician Champions Aligned with Clinical Function Not Optional Direction

15 Medical Staff Structure Performance Monitoring NextGen Dashboard monitoring at every meeting HQM Reporting with every meeting Clinical staff members partnered with providers Medical Assistants & Nursing staff were incentivized Progress and remediation reviewed with provider and their clinical teams together

16 Medical Staff Structure Progress Buy-In Provider buy in was nearly immediate Financial Health of the practice/business Clinical staff buy in was accomplished after reporting for 2 consecutive months Results Contracts (shared savings) established with payers Effective January, 2013 Shared savings thresholds reached with % of diagnoses codes

17 Lessons Learned Reporting Identify infrastructure early! SSRS Crystal reports NextGen EPM reporting module HQM set-up Server Time prod to report back up for minimal impact Secure your servers to prevent unintentional shutdowns

18 Lessons Learned Template changes Educate on the template nuances in the testing environment Test your templates before they are rolled to production Time the promotion of templates from test to prod during time when the system is not in use/has little activity

19 Questions Doug Mitchell Jay Simmons