1. Meeting 2 Brownsville Regional Campus

2. School of Public Health NameOrganizationContact John BenderUTHealthjohn.p.bender@uth.tmc.edu Susan Fisher-HochUTHealthsusan.p.fisher-hoch@uth.tmc.edu Anaelle MoalUTHealthanaelle.moal@uth.tmc.edu Kristina VatchevaUTHealthkristina.p.vatcheva@uth.tmc.edu Pablo SanchezUTHealthpablo.sanchez@uth.tmc.edu Andrew LombardoRio Grande Valley HIEandrew@rgvhie.org Janie MartinezRio Grande Valley HIEjanie@rgvhie.org Kelley ChesterWellcentivekelley.chester@wellcentive.com Emily AlpertBrownsville Community Health Centerealpert.bchc@tachc.org Humberto GonzalezSu Clinicahgonzalez@suclinica.org Judith PerezSu Clinicajperez@suclinica.org Justin RockValley Baptist Health Systemjustin.rock@valleybaptist.net Michael PaezValley Baptist Health Systemmichael.paez@valleybaptist.net

3. Wellcentive and the RGVRegistry Architecture Brownsville Regional Campus School of Public Health

4. Brownsville Regional Campus School of Public Health Wellcentive Data Flow

5. The Registry Review Purpose – Define means Brownsville Regional Campus School of Public Health Identify provider/case manager/admin needs Conduct BCHC and Su Clinica survey Evaluate and document existing workflows Identify where the chronic disease registry (RGVRegistry) will fit in Create revised workflow documents Evaluate the potential performance of the RGVRegistry Create potential use case documentation Demonstrated use cases for the RGVRegistry Create demonstrated use case documentation Establish RGVRegistry best practices Create best practice documentation Evaluate the adoption of the RGVRegistry Evaluate the usability of the RGVRegistry Evaluate the efficacy of the RGVRegistry Evaluate the impact of the RGVRegistry Evaluate the accuracy/reliability of the data inside of the chronic disease registry

6. Wellcentive: Data quality Brownsville Regional Campus School of Public Health Data quality practices PowerPoint (July 2014) summary: Pro-active detection and correction of data quality issues: Interface data flow Incomplete or missing data Incorrect mappings PCP attribution Duplicate patients Unexpected changes in source data Monthly Scorecard Metrics: Interface Integrity: % messages processed within 48 hours of receipt PCP Attribution: % active patients with PCP assigned Data Mapping Management: % successful mappings of PHM-related data Duplicate Patient Management: % active patients not tagged as duplicate The Registry Review data quality analysis: De-identified.csv file from Wellcentive for statistical analysis

7. The Registry Review Member Roles Brownsville Regional Campus School of Public Health NameOrg.Role (flexible) John BenderUTOrganizer/coordinator Susan Fisher-HochUTPopulation health expert Anaelle MoalUTSalud y Vida liaison Kristina VatchevaUTData quality analyst Pablo SanchezUTData quality analyst Andrew LombardoRGVHIETechnical/adoption analyst Janie MartinezRGVHIETechnical/adoption analyst NameOrg.Role (flexible) Kelley ChesterWellcentiveWellcentive expert/data quality analyst Emily AlpertBCHCBCHC registry analyst Humberto GonzalezSu ClinicaSu Clinica registry analyst Judith PerezSu ClinicaSu Clinica registry analyst Michael PaezVBHSSalud y Vida liaison/workflow evaluation specialist Justin RockVBHSSalud y Vida liaison/workflow evaluation specialist More team members? Provider representation Nuestra Clinica Del Valley representation? Rio Grande State Center representation? South Texas Health Center representation?

8. RGVHIE/Chronic Disease Registry Updates Super user training Access to training videos Wellcentive documentation Salud y Vida Implementation Status Patients in registry Limited information Demographics and HbA1c PCP and other information to be updated with more connections Workflow document Su Clinica Implementation Status Technical documentation exchanged between Centricity and Wellcentive Kickoff call to be scheduled Brownsville Regional Campus School of Public Health

9. Salud y Vida Workflow Brownsville Regional Campus School of Public Health Salud y Vida Liaison/Workflow Evaluation Specialists Identify where Wellcentive can fit in? Redundancy is good

10. Preparing for Interviews Create a survey How would you use a population analysis tool like Wellcentive? Would a population analysis tool assist your practice of medicine? Ideas? Who to interview? Kelley’s recommendation: Case managers Documentation for how they use system? Providers Ideas? Interview assignments: Emily Alpert: Brownsville Community Health Center Humberto Gonzalez: Su Clinica Brownsville Regional Campus School of Public Health

11. Use cases Brownsville Regional Campus School of Public Health Community aspect: RGVRegistry as a community disease registry Hospital participation: Identify HbA1c > 8 and frequent flyers and enroll them into programs, like Salud y Vida (CCM) Ideas? Team assignment to create use cases?

12. Questions/Next Meeting Questions/comments: How can we make these meetings better? Format, topics, perspectives, etc. Any other questions/comments? Next Meeting: RGVRegistry use cases Survey (if not determined in this meeting) Report from Kelley Chester on past experience with disease registry successes/failures and existing Wellcentive registries Kelley Chester Wellcentive demo? Any other proposed topics? Report from Emily Alpert (BCHC) Report from Humberto Gonzalez (Su Clinica) Brownsville Regional Campus School of Public Health

13. Thank you! Brownsville Regional Campus School of Public Health