PRIMARY HEALTH CARE OPERATIONAL GUIDELINES

Transcription

1 Operatinal Guideline: MIS Mnthly Data Cllectin Apprved By: Cmmunity Primary Care Cuncil Apprval Date: 1 f 6 Octber 21, INTENT T streamline MIS data cllectin t ensure all indicatrs cllected are meaningful and useful at a clinic level while als meeting Primary Care reprting requirements t Manitba Health, Senirs and Active Living (MHSAL) and Canadian Institute fr Health Infrmatin (CIHI) T better supprt and reduce the administrative burden being experienced by all members f the Primary Care team while further aligning hw real data f value in infrming strategic directin is cllected and used T prvide guidance t all Primary Care prviders n hw t the cmplete the Mnthly MIS Data Cllectin-Individual (APPENDIX C) frm T prvide guidance t the designated Primary Care Assistant regarding cllating the data received frm all prviders via the Mnthly MIS Data Cllectin-Individual (APPENDIX C) frm int the clinic specific Primary Care MIS Mnthly Statistics Site Template (APPENDIX A); in additin t defining the prcess fr submissin f MIS t the Prgram T prvide guidance t the designated Prgram Administrative Supprt regarding cmpilatin f each clinic specific Primary Care MIS Mnthly Statistics Site Template (APPENDIX A) int an Aggregate Primary Care MIS Summary; in additin t defining the prcess fr submissin f MIS t WRHA Financial Reprting T assist Primary Care prviders in identifying claimable patient cntacts in the MIS data cllectin system 2. DEFINITION / BACKGROUND Management Infrmatin Systems (MIS) - a prvincially and natinally established system f reprting financial infrmatin and ther activities. Primary Care MIS captures specific patient cntact infrmatin and activities that ur prviders engage in. MIS reprting is mandatry fr all WRHA Primary Care prviders. Current MHSAL General Ledger Minimum Statistical Reprting Requirements applicable t Primary Care include: Direct Cntacts-Individuals (95010) Direct Cntacts-Grup (95030) Current CIHI Statistical Reprting Requirements applicable t Primary Care include: Visits-Face t Face-Client Cmmunity ( ) Primary Care Teen Clinics funded thrugh Healthy Child Manitba are required t reprt MIS data (i.e. Elmwd Teen Clinic). Unfunded Teen Clinics shuld cntinue t reprt under their clinic. Where des Primary Care MIS data that is cllected and reprted g? Aggregate Primary Care MIS data is frwarded t WRHA Financial Reprting mnthly WRHA Financial Reprting uplads all MIS data int SAP mnthly A text file frm SAP, cntaining YTD Financial and Statistical data, is submitted by WRHA Financial Reprting t MHSAL mnthly A file cntaining all Financial and Statistical data fr all Reginal Health Authrities in Manitba, is submitted by MHSAL t CIHI annually

2 Operatinal Guideline: MIS Mnthly Data Cllectin Apprved By: Cmmunity Primary Care Cuncil Apprval Date: 2 f 6 Octber 21, Designated Primary Care Assistant (PCA) will pre-ppulate the belw fields and distribute a hardcpy r electrnic cpy (at the discretin f the site s preferred prcesses) f the Mnthly MIS Data Cllectin-Individual (APPENDIX C) frm t all Primary Care prviders prir t the first day f each mnth. This will be helpful in ensuring cnsistent frmat and cmpletin f: Prvider Name Mnth/Year Prvider Rle - Optins include Physician, Physician Assistant, Nurse Practitiner, Primary Care Nurse, Dietitian, Cunsellr, Outreach Wrker, and Student. All ther disciplines (i.e. Speech Therapist, Audilgist, etc) shall be captured under Other. Clinic Lcatin One cpy t each Primary Care prvider fr each functinal centre they are cllecting MIS data fr (i.e. a Primary Care Nurse that wrks at Access River East and Elmwd Teen Clinic will require 2 cpies ne fr each functinal centre). 3.2 Each Primary Care prvider is t cmplete ne rw fr each day wrked n the Mnthly MIS Data Cllectin-Individual (APPENDIX C) frm. If a prvider des nt wrk n a given day, there is n need t fill in that rw. It is recmmended that cntacts be recrded as tick marks (i.e. llll) as they ccur thrughut the day. At the end f the day ttal the tick marks and circle the ttal fr ease f data entry at mnth end. MIS data is t be cllected and submitted fr each f the fllwing measures: Direct Cntact In Persn (Z-10702) Includes all face t face therapeutic encunters with patients May ccur in the clinic, in hspital, in the cmmunity r in the hme Must be dcumented within the patient s chart and have a therapeutic benefit Excludes grup participants this data wuld be recrded under the Number Grup Attendees clumn instead If a family member, interpreter r ther persn attends the encunter, but the encunter nly deals with a specific patient, nly 1 cntact is recrded. It des nt matter whether the patient is in attendance during the visit r nt. Direct Cntact By Phne (Z-10700) Direct interactin between prvider and patient via a telephne cnversatin Must be dcumented within the patient s chart and have therapeutic benefit. Des nt include dcumented attempts t reach the patient (i.e. leaving a call back message n the patient s vic ) Direct Cntact By Mail r Fax (Z-10701) Direct interactin between prvider and patient via mail r fax Must be dcumented within the patient s chart and have therapeutic benefit Cunted when it takes the place f a verbal cnversatin Number Grup Attendees (95010) Recrd 1 cntact per participant at the grup sessin Include supprt persns wh attend with the patient, unless the persn is an infant r small child

3 Operatinal Guideline: MIS Mnthly Data Cllectin Apprved By: Cmmunity Primary Care Cuncil Apprval Date: 3 f 6 Octber 21, 2016 If a patient stays after a grup sessin and asks specific questins abut their care plan and the prvider dcuments the infrmatin prvided in the patient s chart, then this particular encunter is als cunted as a direct cntact. If n specific dcumentatin ccurs in the patient s chart, it is nt cunted as a direct cntact. *See MIS Data Cllectin-Example Scenaris (APPENDIX B) fr specific examples f each measure 3.3 Cmpleted frms (either hardcpy r electrnic) must be frwarded t the designated PCA immediately after mnth end. If a prvider is n vacatin r des nt wrk in and arund mnth end, the frm must be handed in n the last expected wrkday f a mnth. Prmpt submissin f the frms is critical fr allwing the PCA enugh time t meet Prgram, Reginal and Prvincial MIS reprting deadlines. 3.4 The designated PCA will cllate the data submitted by each prvider via the Mnthly MIS Data Cllectin-Individual (APPENDIX C) frm int the clinic specific Primary Care MIS Mnthly Statistics Site Template (APPENDIX A) and submit t the PCStatistics PCStatistics@wrha.mb.ca mailbx BEFORE the 15 th f each mnth (i.e. June MIS is due befre July 15). 4. MIS DATA COLLECTION & BEST PRACTICE 4.1 MIS is nt intended t be a wrklad measurement tl. 4.2 Primary Care MIS data reflects patient encunters that have therapeutic value and require dcumentatin. Therapeutic value may include triage, cunseling/emtinal supprt, physical, emtinal r psychscial assessment, r health educatin. Each encunter must be dcumented in the patient chart in rder fr it t be cunted as an MIS cntact; if there is n dcumentatin, then it is nt cunted. 4.3 Wh cllects MIS data? All Primary Care prfessinals wh engage in therapeutic r health educatin activities with patients. Administrative staff des nt track patient cntacts, althugh they may be requested t recrd general clinic statistics related t patient care (i.e. number patients turned away due t full caselads) frm time t time. 4.4 T determine if a situatin is claimable as a cntact ask: ISSUE - Is there a patient care issue being dealt with? INTERVENTION Is there a clinical interventin that tk place? DISPOSITION / PLAN OF ACTION - Is there a plan that has been put in place r actin that is taken as a result f the interventin? DOCUMENTATION Has the situatin been dcumented? All fur MUST be present befre the situatin can be cnsidered as a MIS cntact. 4.5 T supprt future generatin f quality Primary Care MIS data electrnically frm the EMR, it is recmmended the fllwing best practices be adpted at the clinic level.

4 Operatinal Guideline: MIS Mnthly Data Cllectin Apprved By: Cmmunity Primary Care Cuncil Apprval Date: 4 f 6 Octber 21, Direct Cntact In Persn Number f direct cntacts shuld match the number f appintments in scheduler which includes all appintments reviewed with learners and hme visits. Primary Care Assistants shuld ensure all patients are arrived within the scheduler in rder t successfully run reprts that will generate mnthly ttals fr all prviders Direct Cntact By Phne Primary Care prviders shuld use the EMR Clinical Nte Template Telephne Nte - Direct t successfully run reprts that will generate mnthly ttals fr all prviders. Clinical Teams may use Appintment Type Telephne Visit if it is helpful t ensure the telephne visit is captured frm a practice perspective. The use f Telephne Nte - Other as an EMR Clinical Nte Template is fr situatins where the MIS cntact is nt claimable (i.e. prvider leaves a vice message fr a patient t return the call) Direct Cntact By Mail r Fax Number f faxed prescriptin renewals shuld match any shadw billing cmpleted (Billing Prcedure cde 8005). *Refer t CSIS Best Practice regarding prescriptin renewals Clinicians wh wrk in mre than ne site will need t be prvided and ensure they use the specific lgin assigned fr each site. Electrnic Reprting f MIS (APPENDIX D) prvides instructin n hw a Primary Care Assistant can generate MIS data reprts electrnically ut f the EMR. Cntact CSIS Supprt fr assistance and supprt if required. 5. ADMINISTRATIVE PROCESSES 5.1 Primary Care Assistant (PCA) One designate and ne alternate PCA shuld be trained t understand the prcess fr MIS data cllectin and submissin at each Primary Care Clinic. These individuals will wrk with the Primary Care Team Manager and Site Medical Lead t ensure data is cllected accurately and submitted n time within defined deadlines. PCA will send an t all prviders a few days befre the current mnth s end t remind them that cmpleted frms are due immediately after mnth s end. Submissin f data is mandatry fr all prviders, therefre if a few gentle reminders are nt wrking, cnsult the Primary Care Team Manager r Site Medical Lead fr assistance and fllw up. PCA will cllate data frm each prvider s frm and transfer the infrmatin t the Primary Care MIS Mnthly Statistics Site Template (APPENDIX A). One line per prvider shuld be used n the reprting template summary Prcess fr cmpletin f the Primary Care MIS Mnthly Statistics Site Template (APPENDIX A) The template is designed t facilitate quick and accurate cmpletin by the PCA. The fields that cntain sites and dates are drp-dwn pick lists fr ease and cnsistency f data entry. All ther fields are free text. Cells with

5 Operatinal Guideline: MIS Mnthly Data Cllectin Apprved By: Cmmunity Primary Care Cuncil Apprval Date: 5 f 6 Octber 21, 2016 built in frmulas are inaccessible t users by prtectin s that the frmulas cannt be erased r mdified by accident. Transfer the cllated data frm each prvider nt the Primary Care MIS Mnthly Statistics-Site Template (APPENDIX A) ensuring it is entered int the apprpriate Prvider Type sectin f the summary Blank rws must be left blank they cannt be deleted Primary Care Team Manager shuld review the summary prir t it being submitted t the Primary Care Prgram All MIS MUST be submitted electrnically BEFORE the 15 th f each mnth and will be accepted nly n the standardized template The PCA will the summary t the PCStatistics PCStatistics@wrha.mb.ca mailbx nce cmplete. Depending n preference f the clinic, the Primary Care Team Manager may instruct the PCA t cpy ther team members n the final submissin f site MIS each mnth. All site submissins and reprts shuld be filed electrnically within the clinic prcedures flder. Since the submissin cntains prvider specific data, it shuld nt be stred n a shared drive Prcess fr revising a previusly submitted Primary Care MIS Mnthly Statistics-Site Template (APPENDIX A) Summary Frm time t time is may be necessary fr clinics t revise their MIS statistics previusly frwarded t the PCStatistics mailbx. In rder t standardize this revisin prcess while making it easier fr the Prgram Administrative Supprt t understand what the actual revisins are, the PCA respnsible fr this task shall adhere t the fllwing prcess. PCA t frward a new t the PCStatistics mailbx each time a revisin is required indicating REVISED MIS SUBMISSION (MONTH) in the title PCA t detail in the bdy f the the changes that have been made including t which mnth, which prvider, prvider type, and hw the hurs have changed Any revisins made t previusly submitted MIS statistics will be frwarded t WRHA Financial Reprting alng with the fllwing mnth s submissin. Fr example - February revisins will be frwarded alng with March MIS data s that bth files can be updated by WRHA Financial Reprting at the same time. 5.2 Prgram Administrative Supprt Each mnth the designated Prgram Administrative Supprt will access the individual clinic Primary Care MIS Mnthly Statistics Site Template (APPENDIX A) summaries thrugh the central PCStatistics accunt and use t generate an Aggregate Primary Care MIS Summary. The Aggregate Primary Care MIS Summary will cnsist f a rll-up f each f the fllwing MIS indicatrs: Direct Cntact In Persn Direct Cntact By Phne Direct Cntact By Mail r Fax

6 Operatinal Guideline: MIS Mnthly Data Cllectin Apprved By: Cmmunity Primary Care Cuncil Apprval Date: 6 f 6 Octber 21, 2016 Ttal Direct Cntacts Number f Grup Attendees The Aggregate Primary Care MIS Summary nce cllated will be frwarded mnthly t the Primary Care Prgram Specialist fr review. The Primary Care Prgram Specialist will then frward the reprt t the assigned WRHA Financial Reprting Crdinatr fr data entry int SPA and submissin t MHSAL. Additinally, the Primary Care Prgram Specialist will the Aggregate Primary Care MIS Summary t all Primary Care Team Managers, Directrs respnsible fr Primary Care and Site Medical Leaders fr awareness and/r discussin with their respective Primary Care teams related t quality imprvement pprtunities. 6. REFERENCES Primary Health Care Prgram partnered with Clleen Lambert (WRHA Financial Standards and Infrmatin); reviewed current Primary Care MIS reprting (summer/fall 2017) t ensure nly that infrmatin required/used by MHSAL, CIHI, WRHA and Prgram was being cllected MHSAL General Ledger Minimum Statistical Reprting Requirements (2017/18) - Primary Care CIHI Statistical Reprting Requirements (2017/18) - Primary Care Cnsultatin with Team Managers at WRHA Primary Care Direct Ops (August & Octber 2017) and Primary Health Care Leadership (Nvember 2017) 7. PRIMARY CONTACTS J-Anne Kilgur Prgram Specialist, Primary Health Care Kevin Mzdzen Prgram Specialist, Primary Health Care 8. ALTERNATE CONTACT Margaret Kzlwski Directr, Primary Health Care and Cmmunity Nursing 9. APPENDICES APPENDIX A Primary Care MIS Mnthly Statistics Site Template APPENDIX B MIS Data Cllectin-Example Scenaris APPENDIX C Mnthly MIS Data Cllectin-Individual APPENDIX D Electrnic Reprting f MIS SCOPE: Applicable t all WRHA Primary Care Direct Operatin Clinics, Walk In Cnnected Care Clinics (Access Winnipeg West, Access Frt Garry, and McGregr), Nrthern Cnnectin Medical Centre and any Primary Care Teen Clinic funded thrugh Healthy Child Manitba. While Midwifery, Health Services n Elgin, SMILE Plus, My Health Teams, Interprfessinal Team Demnstratin Initiative and Healthy Aging Resurce Teams are ut f scpe f this guideline, they shall cntinue t reprt and submit MIS infrmatin per standard prcesses already in place.