Community Care of WV, CMO and David Campbell, CEO

Slides:



Advertisements
Similar presentations
Update on Recent Health Reform Activities in Minnesota.
Advertisements

Using EHR to improve Quality and Patient Care: Lessons Learned from FQHCs Chiricahua Community Health Centers Inc. Edith Sampson, Risk Manager/Compliance.
Care Coordination in the Patient-Centered Medical Home New York Academy of Medicine May 24, 2011.
Using medicaid with HUD’s Homeless Assistance Programs
The Rhode Island Chronic Care Sustainability Initiative: Building a Patient-Centered Medical Home Pilot in Rhode Island.
Population Management & Reporting. Federally-designated Regional Extension Center for the State of Missouri  University of Missouri:  Department of.
© 2013 The McGraw-Hill Companies, Inc. All rights reserved. Chapter 1 The Electronic Health Record.
What Happens after You Sign with Missouri Health Information Technology Assistance Center?
Medicare Quality Improvement and Provider Technical Assistance: An Overview of the Next Five Years December 8, 2014 Mary Fermazin, MD, MPA, Chief Medical.
Paul Kaye, MD VP for Practice Transformation Hudson River HealthCare October 1, 2010.
HIT Policy Committee Accountable Care Workgroup – Kickoff Meeting May 17, :00 – 2:00 PM Eastern.
Using Outreach & Enabling Services to Support the Goals of a Patient-Centered Medical Home Oscar C. Gomez, CEO Health Outreach Partners Health Resources.
Robert Margolis, M.D. Chairman & CEO HealthCare Partners ACO’s – Getting from Here to There Benefits / Risks / Opportunities.
1 NATIONAL ADVISORY COUNCIL ON HEALTHCARE RESEARCH AND QUALITY Subcommittee on Quality Measures for Children's Healthcare in Medicaid and CHIP Overview.
Memorial Hermann Healthcare System Clinical Integration & Disease Management Dan Wolterman April 15, 2010.
American Association of Colleges of Pharmacy
1 The Three Phases of Collaboration: Chronic Disease Management, Cancer Prevention, and Capacity Kim Salamone, Ph.D. Vice President, Health Information.
Foundations for a Successful Patient-Centered ACO: First Steps Frank E. Belsito, DO, MMM and James J. Dearing, DO, FAAFP, FACOFP.
Health Care Reform: Where are the Pharmacists? Opportunities and Challenges for Pharmacists in Health Care Reform Anthony D. Rodgers CMS Deputy Administrator.
Affiliated with Children’s Medical Services Affiliated with Children’s Medical Services Introduction to the Medical Home Part 2 How does a Practice adopt.
HealthBridge is one of the nation’s largest and most successful health information exchange organizations. Quality Improvement and Medical Home Models:
1 VistA-Office EHR CAPT Cynthia Wark Deputy Director, Information Systems Group Office of Clinical Standards and Quality Centers for Medicare and Medicaid.
An Integrated Healthcare System’s Approach to ACOs Chuck Baumgart, M.D., Chief Medical Officer Presbyterian Health Plan David Arredondo, M.D., Executive.
Alliance for Health Reform Briefing: Medicaid and Health IT Community Health Centers and HIT Driving Innovation in the Patient-Centered Medical Home Presented.
EHR Implementation by Clinch River Health Services, Inc. Clinch River Health Services, Inc. A Community Health Center in Dungannon, Virginia; population.
West Virginia Medical Home Initiative Through the Health Improvement Institute AAFP Southeast Family Medicine Forum Briefing and Overview August, 2008.
Access to Care Where Are We All Going to Get Care? Bruce A. Bishop Senior Counsel/Director of Compliance Northwest Permanente, P.C., Physicians and Surgeons.
HIT Policy Committee Quality Measures Workgroup October 28, 2010 Fred D Rachman, MD.
Veterans Health Administration Office of Rural Health VA Advisory Committee on Women Veterans Office of Rural Health Office of the ADUSH for Policy and.
Steps for Success in EHR Planning Bill French, VP eHealth Strategies Wisconsin Office of Rural Health HIT Implementation Workshop Stevens Point, WI August.
Dana Erpelding, MA Interim Director, Center for Health and Environmental Information and Statistics Colorado Department of Public Health and Environment.
Chapter 6 – Data Handling and EPR. Electronic Health Record Systems: Government Initiatives and Public/Private Partnerships EHR is systematic collection.
The Center for Health Systems Transformation
Understanding How THE HEALTHCARE CONNECT FUND will assist Meaningful Use 3/11/2014 Mark Renfro, HTH Hometown Health.
Applying Science to Transform Lives TREATMENT RESEARCH INSTITUTE TRI science addiction Mady Chalk, Ph.D Treatment Research Institute CADPAAC Conference.
Together.Today.Tomorrow. The BLUES Project Karen C. Fox, PhD Chief Executive Officer.
American Recovery and Reinvestment Act: Summary of Health-related Provisions April 15, 2009.
Modernizing Clinical Communications, Analytics, and the Revenue Cycle Process in the Era of ACOs Jason Tipton, Director of Value Operations – Holston Medical.
Maine State Innovation Model (SIM) August 2, 2013.
Better, Smarter, Healthier: Delivery System Reform U.S. Department of Health and Human Services 1.
Physician Utilization: Driving Acceptance & Adoption Janice Clark IT Product Manager - Physician Computing Sentara Healthcare Norfolk, Virginia June 28,
This material was developed by Oregon Health & Science University, funded by the Department of Health and Human Services, Office of the National Coordinator.
Chronic Care in the 21 st Century Building an Infrastructure for Quality and Efficiency March 2, 2009 Philadelphia, PA John Tooker MD,MBA,FACP Chief Executive.
Community Health Network of WV & MedLynks A Case Study Vivian Kost, CHNWV World VistA Meeting June 16, 2007.
West Virginia Information Technology Summit November 4, 2009.
Adoption and Use of Electronic Medical Records (in Federally Qualified Health Centers) and Supporting an ASP Community Care Network of Virginia, Inc.
Population Health Janet Appel, RN, MSN Director of Informatics and Population Health.
HRSA Health Disparities Collaboratives 2006: Perinatal & Patient Safety Pilot Ada Determan, M.P.H Division of Clinical Quality Bureau of Primary Health.
Electronic Health Records in Small Latino Practices Antonio Fernandez National Advisory Council Director, Ponce School of Medicine Regional Extension Center.
A NEW REIMBURSEMENT STRUCTURE FOR AMERICA ADVANCED DISEASE CONCEPTS.
Patient Engagement Today’s presenter:
Health IT for Post Acute Care (HITPAC) Stratis Health Special Innovation Project Candy Hanson, BSN, PHN December 5, 2012.
H EALTH 2 R ESOURCES Taconic Health Information Network and Community w w w. t h I n c. o r g Transforming Care Delivery in the Hudson Valley Susan Stuard,
1 Medicaid Transformation Grants & HIE Initiatives Jessica P. Kahn, MPH Centers for Medicare & Medicaid Services.
Practice Transformation Initiative AlignmentCCPNHHNPTN Practice Transformation Network is a 4-year CMS sponsored program that prepares NC and SC providers.
11 Kansas Heart & Stroke Collaborative September 22 and 23, 2014.
Clinical Project Meeting NYHQ PPS Delivery System Reform Incentive Payment (DSRIP) Project Implementation Plan Development Asthma (3dii)
Bronx Health Access: IT Requirements Gathering IT REQUIREMENTS GATHERING 1.
The Importance of Training on Clinical Workflow Adoption Patty Nedved, Rush University Medical Center and Maria Rubio, Burwood Group DISCLAIMER: The views.
Who’s in Your Neighborhood? The Patient-Centered Medical Community David C. Willis, MD Medical Director Greater Ocala Health Information Trust, Inc.
PHSKC Health Dialogue: New Opportunities for Public Health, Workforce and Innovative Pilot Projects under Health Care Reform Charissa Fotinos, MD Chief.
The Learning Collaboratives at PDI Leads Workshop Wave Hill March 25, 2014.
Challenges to integrating technology in healthcare settings
All-Payer Model Update
A Foundation for Paul Grundy MD, MPH IBM Chief Medical Officer Director, Healthcare Transformation Healthcare Industry A Foundation.
Prospects for New Delivery Systems and Reimbursement Models
Rural Health Network Development Program Funding Opportunity Released By: U.S. Department of Health and Human Services Health Resources and Services Administration.
Synopsis of CCNC Initiatives
Electronic Health Record Update
All-Payer Model Update
Presentation transcript:

Community Care of WV, CMO and David Campbell, CEO Begin with the end in mind…key principles in EHR adoption and use (experiences with open health architecture) Sarah Chouinard, MD Community Care of WV, CMO and David Campbell, CEO Community Health Network of WV

Community Health Network of West Virginia and PCS/CCWV The West Virginia Primary Network, Inc., dba Community Health Network of West Virginia (the “Network”) is the first health-center controlled network in the country to successfully adapt a version of the Resource and Patient Management System (“RPMS”) health information system of Indian Health Service (“IHS”) for use in the community health center setting. Primary Care System in Clay, WV (now part of Community Care of WV) was the pilot site for adaptation and implementation of RPMS by the Network. Dr. Chouinard served as Chief Medical Advisor and Chairperson of the Clinical Committee that coordinated implementation with Network support staff and contractors.

Use of RPMS as a health improvement solution by CHNWV The deployment of RPMS is part of a multi-faceted approach by CHNWV to aggressively address the chronic conditions facing West Virginia. The Network project is an integral part of the state’s approach to quality improvement through HIT deployment. The Network staff has trained more than 800 clinicians and administrative support personnel in seven CHC member organizations operating 37 clinical locations; more than 195,000 patient files are included in the Network’s RPMS database (over 10% of West Virginia’s population). The Network’s health improvement initiative supports member health center efforts to use Care Model and Medical Home concepts to meet the needs of an aging and chronically-ill population and to prepare for the newly developed “meaningful use” HIT criteria.

Open Source Healthcare and West Virginia VistA Public Domain Electronic Medical Record software operated by the Department of Veterans Affairs. Currently deployed in 7 state hospitals and long-term care facilities in West Virginia. RPMS VistA based solution developed by Indian Health Services, for ambulatory care. Operated in 37 clinics within West Virginia. First major installation outside of Indian Health Services facilities by CHNWV.

Selection of RPMS as an HIT solution The project is based upon a modified version of the Chronic Care Model (the “Care Model”) developed by Ed Wagner, M.D., (Group Health Center for Health Studies) and disseminated by the Institute for Healthcare Improvement. The Network created a “Clinical Committee” comprised of medical directors and clinical representatives of participating health centers during the evaluation and selection of RPMS as the platform for the system. The Network Clinical Committee participated in testing of the VistA Office EHR system as part of a pilot program with the Centers for Medicare & Medicaid Services (“CMS”) and members of the Committee also evaluated commercial alternatives.

Outcomes driven health improvement The Network Clinical Committee, working with Network staff and state officials identified a number of key targeted health improvement areas based upon prevalence and severity of chronic conditions facing most Network member health centers. These conditions include diabetes, cardiovascular disease, weight management and physical activity, asthma and tobacco use. The Clinical Committee started with the nationally-recognized outcome measures for these conditions and worked back to the optimum clinical processes necessary to achieve significant improvement in the outcomes. This process served as the roadmap for configuration and implementation of RPMS as a common health improvement tool shared by participating care teams.

Population-based, patient centered health care The Network Clinical Committee also premised the Network’s health improvement project on the six key components of the Care Model: the community in which the primary care center resides; the health system itself; self-management support; delivery system design; decision support; and clinical information systems. The intent of this model is to give patients control of their own care, with providers using evidenced-based care practices as members of the patient’s care team. The Committee also incorporated the Six Aims for Improvement of the Institute of Medicine and the concepts of the Medical Home developed by leading professional medical associations. The project has since been adapted to meet “meaningful use” expectations.

Use of RPMS in WV RPMS was most appropriate system to accomplish project objectives at the time of selection based upon population-based, patient-centered health improvement objectives. Similar challenges faced by Indian Health Service in managing chronic conditions and RPMS development has been clinically-driven and led; some IHS facilities operate as FQHCs and have same UDS and other reporting requirements. RPMS is based upon VA’s VistA but has wider range of applications for women, children and ambulatory care. RPMS is open source (with some proprietary elements) but requires extensive adaptation and configuration for use by CHCs.

Meaningful Use has reshaped the goals of EHR implementation Prior to Meaningful Use, the goal of EHR implementation was to digitize the traditional office practice. The goal of the EHR was to make seeing patients in the traditional way more efficient by replicating the workflow used in a paper world on the computer. The traditional approach will no longer suffice to meet the demands of the transformation of care delivery that is happening right now under Meaningful Use and many of the other quality and delivery initiatives (e.g., ACOs, health homes, teaching health centers).

Despite incentives and efforts to drive HIT adoption, we are still in early phase Increasing but still limited rates of adoption, particularly in small and rural practice settings. Cost of systems still a barrier to many and there is a digital divide among providers. Incentives partially offset initial cost but ongoing support is an issue in the absence of reimbursement for use of EHR. PCAST report notes limitations of current systems and need to enhance data exchange functions – systems will need to evolve over next 3-5 years to meet meaningful use and HIE objectives.

Adopter Categorization (Speed of Adoption)

Technology tools should meet clinical objectives – don’t automate an ineffective system of care Old Way New Way Doctor/Nurse Care teams Waiting Times Open Access Schedules Patients without data Personal Health Record Episodic Care Continuity Care Data in office notes Data in reportable form Doctor tracks referrals/tests Tracking Automated

Care Teams: who collects what and when and where? Front Desk Clerk—The Patient Navigator (1) The Work Up Nurse (1) The Care Manager (2) The Check-0ut Clerk (1) The Outreach Coordinator (1) The Providers (2) Ratio for a 2 provider practice 1:1:2:1:1:2 Ratio for a 6 provider practice 3:2:6:1-2:1-2:6

HIT is a tool for health improvement One of the lessons learned from the WV experience is that EHRs and HIT are technology tools; process and workflow must be aligned with technology potential to achieve health improvement objectives; Data must be meaningful to create useful information that drives continuous improvement (garbage in-garbage out); it takes a while to transform data from system into meaningful outcome information; Care teams must validate data internally to commit to the transformation process and commitment must be continually reaffirmed and celebrated; Patient engagement is essential and HIT must be integrated into the patient care process to facilitate better self management – next steps – personal health records and health information exchange.

Health Improvement at PCS

Data from RPMS is used to drive clinical improvement

What is a Personal Health Record? The EHR automates and streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a clinical patient encounter - as well as supporting other care-related activities directly or indirectly via interface - including evidence-based decision support, quality management, and outcomes reporting. Often interfaced to practice management system, radiology programs, medical equipment. Contributes entirely to patient health record.

Personal Health Record HealtheMountaineer™ Based on Design from MyHealtheVet. Utilizes federally developed standards for data exchange. Can interpret data from any Meaningful-Use Compliant EHR system (integrated with RPMS as part of demonstration project). Built in open-source technologies. Leverages existing CMS investment thru Medicaid Transformation Grant

Integration of a Personal Health Record

Why use a Personal Health Record?

Closing Thoughts: Workflow assessment and realignment is key; Reorganize your people and use care teams; Make sure your providers can be efficient and use care managers to coordinate care; Empower your nurses and patient navigators; Enable patients (and families) to actively manage health using PHR and portal tools; and EHR is tool to coordinate health, should support health information exchange and mobile health to take health management to home, workplace and daily living (i.e., interface with assistive technology).