Workshop #3 Connecting Long-Term Care with the Continuum Under the State Innovation Model 2015 Minnesota e-health Summit June 17, 2015, 9:30 a.m. 1
Connecting Long-Term Care with the Continuum Under the State Innovation Model THIS WORKSHOP WILL HELP ATTENDEES LEARN ABOUT THE REAL WORLD CHALLENGES FACING LTC PROVIDERS ADOPTING AND UTILIZING EHEALTH TO IMPROVE BEHAVIORAL, MENTAL HEALTH, HOME CARE, ASSISTED LIVING, NURSING FACILITY, AND PHYSICIAN SERVICES. THESE PROVIDERS WILL SHARE THE BENEFITS, CHALLENGES AND LESSONS LEARNED THROUGH THEIR EXPERIENCES IMPLEMENTING A STATE INNOVATION MODEL GRANT AS WELL AS THEIR PERSPECTIVES ON UTILIZING AND IMPLEMENTING E- HEALTH AS A LTC PROVIDER. SOME OF THE DISCUSSION WILL INCLUDE WORKING IN A COLLABORATIVE WITH COMPETING PRIORITIES, THE CONVERGENCE OF MULTIPLE TECHNOLOGIES AND MOBILE DEVICES AS WELL AS HELPING BUILD STAFF OR TEAM KNOWLEDGE AROUND HEALTH INFORMATION AND NEW MANDATES. 2
Presenters / Moderators Dave Carlson Manager of Technology Services Touchstone Mental Health Dcarlson@touchstonemh.org Mary Chapa ACP Specialist Ebenezer mchapa1@fairview.org Coral Lindahl PointClick Care Coordinator Ebenezer Ridges Care Center codell1@fairview.org Harriet Wicklund Health Information Manager LB Homes harriet.wicklund@lbhomes.org Todd Bergstrom Director of Research & Data Analysis Care Providers of Minnesota tbergstrom@careproviders.org Darrell Shreve Vice President of Health Policy LeadingAge Minnesota dshreve@leadingagemn.org 3
Project Fergus Falls Area HIE Community of Practice SIM Project Add Logo Minnesota Accountable Health Model e-health Grant Program 4
About the Participants Otter Tail County Public Health Otter Tail County Human Services Lakeland Mental Health Center SOS Behavioral Health Pioneer Care LB Homes Productive Alternatives (PAI) Stratis Health Lake Region Healthcare Corporation Hospital and Clinic Ringdahl Ambulance (Community Paramedic Program) 5
Project Goals With client consent, share health information across settings for care coordination to enhance patient satisfaction, reduce cost, and improve outcomes. To support the secure exchange of medical or health-related information in a seamless manner across the settings of primary care, hospital, home health, long term care, behavioral health, public health and human service providers. 6
Development and implementation Operational with PointClickCare (PCC) EHR PCC can send and receive Continuity of Care Document in C-CDA format Can view in PCC but cannot yet consume individual data elements Developing Use Cases for Exchange with Lake Region Health Care Goal is to reduce faxing by using DIRECT messaging but only if more efficient 7
Technology to Be Used / Vendors PointClickCare / Medicity Brightree GrandCare CHIC HIE Bridge / Inpriva / Orion Relay Health McKesson Allscripts Bradoc / EMR Direct MyAvatar 8
Project Implementation Barriers CHIC de-certification means migration to another DIRECT messaging provider Medicity (HISP used by PointClickCare) is not certified in the state of Minnesota EMR-Direct (HISP used by Bradoc) is not certified in the state of Minnesota Inability to use SIM grant funds for non-certified HISP even though EHR works that way DIRECT messaging challenges: More efficient than faxing if not embedded in EHR? Can documents other than CCD be sent and embedded? How to know if message will get to recipient? Does the HISP have a trust relationship with the recipient s HISP? Need a directory of DIRECT addresses 9
Outcomes Our project began in November, 2014, so we have several months to continue working on our implementation. This is a work in progress and too early to claim an outcome. We are optimistic that advancements will be made in interoperability to support transitions of care in our community. 10
Fairview Ebenezer MDH SIM ehealth Development Grant Project Fairview Health System University of Minnesota partnership 21,000+ employees 2,300 aligned physicians 7 hospitals/medical centers (1,475 staffed beds) 40+ primary care clinics 55+ specialty care clinics 62+ senior housing locations 30+ retail pharmacies 50% owner PreferredOne health plan Largest Home Care/Hospice agency in the state Ebenezer part of Fairview Senior Services Ebenezer was founded by Minneapolis Lutherans to provide communitycentered care for homeless older adults and others in need Affiliated with Fairview in 1995 1400+ employees Approximately 65 sites continued growth Touch the lives of 5000 seniors daily throughout MN 11
About the Participants Collaborative focus on the Burnsville Campus 1. Fairview Ridges Hospital, Burnsville 2. Fairview Pharmacy 3. Ebenezer Ridges SNF 4. Ebenezer Ridges Housing 5. Fairview Home Care & Hospice 6. Burnsville EMS 12
Project Goals Identify and transfer patient data elements that are critical to ensure coordination and continuity of care through the effective use of health information technology during patient care transitions. Increase patient safety including reducing medical errors. Increase communication about care and or care transitions between providers and family. Decrease overall cost of care. 13
Development and implementation Development Grant Only 1. How to keep the HIE momentum going from the HITPAC Project? 2. DHS PIPP Grant Submission: Secure Conversations/Texting Lab Integration Inbound Outbound CCD 3. MDH SIM Grant Submission 14
Technology to Be Used / Vendors Fairview Ebenezer This was a Development Grant for us so we identified CHIC but it was more for exploration and understanding. EHR Vendors include EPIC, Point Click Care, Eldermark, McKesson 15
Project Implementation Barriers Development Grant 1. Change Management, people/relationships/understanding 2. Resource Needs and Priorities 3. Understanding of HIE and an Strategy from silo to systemness 4. Short Timeline from Development Grant Plan to Implementation Grant 16
Outcomes and or Lessons Learned Over all outcome is to have the necessary information to submit an Implementation Grant. Journey on the road to Interoperability 1. Terminology and Understanding is a part of new skills and competencies 2. Size, Silos, Resources (adding one more thing to our plate) 3. Infrastructure is foundational --- addition of mobile devices and Apps as part of EHR optimization 17
Project State Innovation Model Implementation Grant for Health Information Exchange Touchstone Mental Health, in collaboration with Minnesota Community Healthcare Network 18
About the Participants Touchstone Mental Health - Is an organization of excellence creating innovative, person- centered care to individuals whose lives are affected by mental illness. Founded in 1982, TMH fulfills its mission to inspire hope, healing and well-being by serving approximately 950 individuals annually with a serious and persistent mental illness such as major depression, bipolar, schizophrenia, and borderline personality disorder. Mission Hennepin Community Collaborative An alliance of five metropolitan area behavioral health organizations called the Minnesota Community Healthcare Network (MCHN pronounced mission ), Hennepin Health, Hennepin County Medical Center, and Hennepin County Human Services and Public Health Department. These organizations partnered as a community collaborative to explore opportunities to provide intensive care coordination for high-risk, complex patients with serious mental health and/or substance abuse conditions. 19
Project Goals To achieve an effective and sustainable collaboration of interconnected safety net providers, nonprofits and governmental agencies to provide the full range of services needed to maintain or improve health, support recovery, improve client/patient engagement and experience of care, and reduce the total cost of care, consistent with Triple Aim and Accountable Health Model objectives. Specific goals include: Establish Health Information Exchange (HIE) connectivity between MCHN members Establish connectivity between MCHN and the Hennepin System Enable Stage 2 Meaningful Use Sharing of Continuity of Care documents Secure communication between providers and agencies Data Analytics 20
Development and implementation Started 18 Month Project in November 2014, Completion in April 2016 Currently Working On: HIE vendor selection criteria Consent and data privacy Next Steps: HIE Vendor Selection HIE Establishment Workflow and Process Changes 21
Technology to Be Used / Vendors Consultants: Stratis, Halleland Habicht EHR s Involved: Credible, CoCentrix, Procentive Health Information Exchange Method: Direct Health Information Exchange Partner: To Be Determined 22
Project Implementation Barriers Lack of federal standards Fragmented exchange networks Immature technology Limited vendor selection Lack of EHR compatibility 23
Outcomes Below are the expected outcomes for our project: Increased access for Hennepin county clients and patients to needed psychiatric and behavioral health services Quick access to prescribers and medication management services, Improved transitions of care Enhanced community-based services and supports Strengthened outreach and patient/client engagement in community settings 24
Panel Discussion 25