DSRIP HIT Phase 2 Update March 13, 2015
Agenda Introductions HIT Scope Update Original Scope of HIT Revised Scope Roll Played by Aspen Advisors Phase 2 Update Current State to Future State EMR Rollout Strategy Integration of HIT with Selected Clinical Projects PHM Vendor Selection and Implementation Framework IT/Data Governance Next Steps March 19, 2015 Page 1
Level 1 Diagram March 19, 2015 Page 2
HIT Phase 2 Update 5 primary work streams: Current state provider readiness assessment EMR rollout strategies Integration of HIT into CNYCC selected clinical projects PHM vendor selection and implementation framework IT & Data governance strategy formalization HealtheConnections central hub for HIE March 19, 2015 Page 3
Current State Provider Assessment Number of providers in network 1656 Number of practices 223 MU participation 49.5% of those who have an EMR EMR landscape over 48 different vendors Number of no responses 262 providers (48 organizations) March 19, 2015 Page 4
EMR Strategy March 19, 2015 Page 5
EMR Burning Platform Meaningful Use certification is a priority for all providers Provider investment equals ownership in the technology Adoption of EMR allows for community integration with HeC RHIO Also allows for participation in programs like DSRIP By waiver year 5 all MCOs must employ non-fee-for-service payment systems that reward value over volume (>90%) March 19, 2015 Page 6
Current State Fragmented ~6 % of providers are paper-based (no EMR), 78 % have an EMR and 16 % did not provide responses or responses were unclear Only 49.5% of providers have achieved MU Over 48 vendor systems across the region This highly fragmented and disparate HIT ecosystem will not support the requirements of DSRIP without significant investment and collaboration with the CNYC Collaborative and provider network March 19, 2015 Page 7
Desired Future State Coordinated and Patient Centered 100% of providers have an approved and certified EMR solution 100% of providers have achieved MU by the end of DY3 100 % compliance (meeting requirements) with providers across the region The future provider ecosystem has strong collaboration, sustainable solutions, highly integrated and coordinated information flow. Care delivery and information flow is patient centered March 19, 2015 Page 8
Provider Readiness Tiers to Achieve Requirements Solutions & Services Technology Does Not Meet Requirements Technology Ready Services Needed Fully Meets Requirements Test Readiness OR Services to Achieve Readiness OR Sponsored Vendor or Provider Partner EMR Not in Place March 19, 2015 Page 9
Provider Readiness Tier 3 Fully Ready Early adopter Test HIT/HIE infrastructure Health Information Exchange Population Health Data Analytics Active and collaborative care management Review training and communication material Evaluate and test use cases Demonstration sites Super users and advisors Assist provider network to reach Tier 3 March 19, 2015 Page 10
Provider Readiness Tier 2 Technology Ready Technology early adopters Define gaps (process, people, policy) Develop individual plans to address gaps Establish checkpoints on remediation activity Fully integrate into care collaborative Health Information Exchange Population Health Care Plans Data Analytics When requirement are met, move to Tier 3 status March 19, 2015 Page 11
Provider Readiness Tier 1 & 0 Limited or No Technology Providers require full service (solution and support) Establish provider segmentation Extend services and solutions from: Vendor partner Provider partner (Tier 3 sites) Hybrid (Vendor and Provider partner) Develop Individual Plans Timeframe Costs Resources Monitor and test sites When requirements are met, move to Tier 3 March 19, 2015 Page 12
Partnerships Keys to Success Vendor Partnerships Industry position Quality and performance Economics (Total Cost of Ownership) Future direction Alignment Provider Partnerships Commitment Quality and performance Economics (Total Cost of Ownership) Organizational strategy and alignment Quality & Performance Economics March 19, 2015 Page 13
Vendor Partner Selection Process Schedule at a Glance Month 1 Month 2 Month 3 Month 4 Month 5 Define Strategy and Requirements Draft/ Distribute RFI Evaluate RFI Response Vendor Demos & Workshops Develop Selection Committee Define Evaluation Criteria Develop Use Case (Demo) Scenarios Narrow Vendors Evaluations Develop Performance Metrics Conduct Reference Calls Conduct Site Visits Findings Findings Preliminary Planning, Project Scope, Timing and Phasing Total Cost of Ownership Model Development and Review Application and Technical Review Contract Review Vendor Partners Contracting March 19, 2015 Page 14
HIT Integration with Clinical Projects March 19, 2015 Page 15
Integration of HIT into Clinical Projects Project 2.b.iii - ED care triage for at-risk populations HIT requirement secure global messaging required within the CNYCC infrastructure CNYCC HIT solution enablement of Direct messaging through the Healtheconnection (HEC) RHIO or other HISPs CNYCC action work with HEC to connect all participating providers to Direct messaging through the Mirth email network by end of DY3 March 19, 2015 Page 16
PHM Vendor Selection and Implementation Framework March 19, 2015 Page 17
Population Health Management (PHM) Defined March 19, 2015 Page 18
Organizational vs Community-Wide PHM Radiology Images/Results Clinical Documentation Radiology Images/Results Clinical Documentation Lab Results Demographics Lab Results Demographics Organizational PHM Model Community PHM Model Integrated PHM Infrastructure Pharmacy Data Social Determinants Claims Data March 19, 2015 Page 19
Requirements DSRIP Patient registries Dashboards for performance metrics Collaborative care planning Provider-specific security; ability to segment population Transitions of care - real time access to information across providers Support of multidisciplinary care plans Additional Requirements Member engagement Cross-continuum care Quality management and outcomes reporting Operational performance management and business intelligence Risk and revenue management Integration and infrastructure March 19, 2015 Page 20
PHM Vendor Selection Process Schedule at a Glance Current Month Month 2 Month 3 Month 4 Month 5 Define Strategy Draft/ Distribute RFI Develop Selection Committee Create Demo Scenarios Evaluate RFI Response Online Vendor Demos (if required) Narrow Vendors Onsite Demonstrations Interactive Workshops Evaluations Evaluations Evaluations Preliminary Project Scope and Phasing Conduct Ref Calls Cost Model Development and Review Application and Technical Review Findings Site Visits Findings Vendor of Choice March 19, 2015 Page 21
PHM Vendor Landscape Vendor Advisory Board Crimson Population Health Covisint eclinicalworks CCRM Epic Healthy Planet Explorys Platform & EPM Suite Forward Health Group PopulationManager i2i Systems i2itracks Kryptiq CareManager McKesson Population and Risk Manager Optum One Population Health Phytel Population Health Management Suite Verisk Health Population Health Analytics Wellcentive Advance Outcomes Manager DSRIP Experience? To be implemented by City of New York s Advocate Community Providers (ACP) In place at San Joaquin General Hospital s (SJGH) primary care clinics, participating in California DSRIP CareManager in place at Texas Tech University Health Sciences Center at El Paso, participating in Texas DSRIP Currently in use by New York and Texas DSRIP programs Aspen Experience March 19, 2015 Page 22
IT & Data Governance Strategies March 19, 2015 Page 23
The Role of IT Governance IT GOVERNANCE provides a forum for working together, making decisions, and effecting change, and LEADERSHIP to leverage planning and tools to create a data driven organization To create accountability for the strategic deployment of IT resources (people, processes, and technology) across the Collaborative. To develop and communicate IT strategies that are in line with CNYCC strategic goals and objectives To establish an IT decision-making model that ensures: Decisions are in line with the guiding principles of the Collaborative. Decisions are made in a timely and definitive manner, and at the right level. Decisions and their associated impacts are understood across the Collaborative. To manage the evaluation, approval, prioritization and budgeting for IT projects. To establish a data governance model that includes clinical, financial, and operational data standards and requirements across the Collaborative, but based on data captured at the provider level. To ensure that the expected benefits of IT investments are realized. March 19, 2015 Page 24
Example IT Responsibilities CNYCC IT will be responsible for overseeing the various IT initiatives that have impact across the network. Overseeing an initial assessment of IT systems and capabilities Deploying an EMR to participating providers Developing and identifying standards for data definitions, data elements, and data exchange Oversight of the data captured, stored, and used for reporting on behalf of the Collaborative through the HealtheConnections RHIO Establishing priorities for IT expenditures Overseeing development of the IT infrastructure for population health management Assisting partner organizations to evaluate IT systems and vendors Developing an IT change management strategy Monitoring IT benchmarks and progress toward achieving IT goals Developing a data security and confidentiality plan and overseeing the implementation of related policies and procedures March 19, 2015 Page 25
IT and Data Governance Schedule at a Glance In Process DY1 Q2 DY1 Q3 DY1 Q4 Ongoing Determine scope of responsibility for the IT and Data Governance Committee Develop data management and reporting standards, processes & workflows Determine roles and responsibilities for the RHIO and for CNYCC member organizations Evaluate project management and DSRIP reporting tools Educate, information, and engage key stakeholders Determine timing for future activities Develop the IT and Data Governance Strategy Create Board Governance Committee and hire IT support Create / Approve governance structures, subcommittees, decision-making model Establish data governance structure, guiding principles, priorities, and responsibilities Communicate plans and provide education Hold regular meetings, measure and report on progress Enact ongoing data privacy and security policies & procedures Determine organizational vision, capabilities, and future state Create Change Management Toolkit Develop the IT Change Management Strategy Develop Impact / Risk Assessment Develop Communication Strategy, Education, and Training Plan Implement new processes and workflows Measure and report on progress March 19, 2015 Page 26
CNYCC DSRIP HIT Implementation Timeline Demonstration Year DY1 DY2 DY3 DY4 Quarters 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 PPM System Selected & Implemented 2 EMR Selection Process 3 EMR Implementations for Providers 4 HeC Integration with Provider Network - Direct 5 HeC Integration with Provider Network HL7/CCD 6 PHM System Selection Process 7 PHM System Implementation March 19, 2015 Page 27
Hardcore DSRIP Requirements All eligible participating providers in the Performing Provider System s integrated delivery system will be connected to the local RHIO/SHIN-NY and be actively sharing information across all key clinical partners Ensure that EMR systems used by participating providers meet Meaningful Use and PCMH Level 3 (where applicable) standards by the end of Demonstration Year 3. Possess an ability to share relevant patient information in real time so as to ensure that patient needs are met and care is provided efficiently and effectively. Vendor Selection Process Creating use cases and employing a standards driven approach select EMRs for each provider type Convene providers by type (LTAC, BH, SNF, etc) to determine best practice for EMR adoption March 19, 2015 Page 28
Next Steps Finalize Phase 2 deliverables implementation related plans CNYCC Call to Action: IT support startup work effort to begin Begin implementation phase PPM tool implementation PHM software selection EMR software vendor short list Provider Call to Action Self-identify the tier for your practice Follow-up with the providers via webinars Establishment of groups to help facilitate the implementation phase: Board based EMR selection workgroup Board based PHM selection workgroup De-emphasize IT s role in selection process March 19, 2015 Page 29