Presenter: Jessica Foy, RN, BSN IT Supervisor Analytics and Clinical Documentation

Transcription

1 Presenter: Jessica Foy, RN, BSN IT Supervisor Analytics and Clinical Documentation EvergeenHealth

2 Introduction Background: NICU and Clinical Informatics Implemented DI in 2012 and have witnessed incredible growth and adoption throughout the organization Heavily-focused on bringing clinical data together with financial data to help drive informed decision-making

3 Agenda Our Goals for the Primary Care QM Dashboard Challenges Developing Requirements How Data Gap Analysis and Documentation Updates Solution Dashboard Design Considerations Our Results Dashboard Utilization Lessons Learned Future Plans

4 About EvergreenHealth Primary Service Area: Northern King and South Snohomish Counties of Washington State

5 About EvergreenHealth 2 Inpatient Facilities 3 Emergency Department Locations Primary and Specialty Ambulatory Care 10 Primary Care Clinics Clinically Integrated Network Main source of clinical data = Cerner Millenium

6 Our goals Increase visibility on Key Quality Indicators to drive performance improvement Drivers: Public Reporting (WHA Website) Regulatory Reporting (PQRS, Meaningful Use ecqms) Value -Based Payer Contracts Part of the 2015 and 2016 Quality and Safety Plan Improve Population Health

7 The challenge How do we prioritize what measures to build? Value -Based Contracts Regulatory Clinical Relevance/Importance Public Reporting What measures CAN we build? Where are the data gaps? What Specifications do we use? PQRS NQF ecqms Custom

8 The challenge How do we close data gaps? How do we make the least impact on workflow? Who should be involved? Quality Management Clinical Informatics IT-Analytics Clinical Leadership Physician, Operations, Nursing

9 How we did it First Step - Awareness Explain the data challenges for chosen measures Next Steps Data Gap Analysis Where are we missing results to capture required elements? Next Steps Developing Documentation How do we implement? Timeframe: 5 months

10 How we did it Initial Gap Analysis Developing Awareness

11 How we did it Initial Gap Analysis Developing Awareness Measure Title Breast Cancer Screening Colorectal Cancer Screening Diabetes: Eye Exam Chlamydia Screening for Women Cervical Cancer Screening Adolescent Well-Care Visits Preventive Care and Screening: Influenza Immunization Pneumonia Vaccination Status for Older Adults Documentation of Current Medications in the Medical Record Diabetes: Hemoglobin A1c Poor Control Falls: Risk Assessment Falls: Plan of Care Diabetes: Foot Exam Radiology: Reminder System for Screening Mammograms Controlling High Blood Pressure Diabetes: Medical Attention for Nephropathy Numerator Capture EH Results Posted EH Results Posted Ophthalmology Notes Scanned EH Results Posted PAP Result Notes Scanned CPT Code Count Powerform/Immunization Tab Documentation Powerform/Immunization Tab Documentation Med Rec Completed at Visit EH Results Posted/OL Powerform Results None Currently Existing None Currently Existing Powerform (Monofilament Exam) Documentation HM Due Date Present BP Results EH Results Posted/OL Powerform Results

12 How we did it Developed Quality Measure Workgroup Focus: How to get the data IN Met every two weeks Developed Documentation and Workflow to Capture Data Documentation Forms Orders MA and Provider workflow adjustments

13 How we did it

14 Solution Develop DI Dashboard and reporting mechanisms to track performance Request: 19 Measures Primary Care Level Provider Level Patient Level

15 Solution High-level view

16 Solution Measure-level view

17 Solution Measure-level view

18 Solution Patient-level view

19 What was the benefit? Increased awareness and visibility for measuring the quality of care Focus on documentation and workflow will impact claims Improve performance at the public and regulatory-level

20 Our results 2015 Stretch Target met Meet at least 9 measure goals Use data for other benefits: Patient Outreach Supplemental Quality Data to Payers Supports Care Management and Overall Population Health Strategy

21 Lessons learned Strong partnership with Quality Management and Clinical Informatics imperative Guidance on Specifications Guidance on Workflows Go-between with Leadership Awareness when developing Clinical Documentation Balance between workflow and quality data needs Consideration for the future as landscape evolves

22 Lessons learned Provide guidance on what meets the measures Simplify a complex process as much as possible

23 Where we go from here Keep up with the Changes! New measures for 2017 Focus on Utilization measures Imaging Studies for Headaches and Low Back Pain Prescribing practices for URIs and Bronchitis Questions?