SHP Access 6/7/2016. Objectives. SHP Alerts. You will need a user name and password

Transcription

1 SHP Alerts Objectives By the end of this session, attendees will be able to: Activate and access SHP alerts Integrate SHP alerts into the daily workflow of clinicians and the MCP role Address alerts to help manage quality measures and drive appropriate clinical care delivery Utilize SHP alert oversight (BD and DCO) Access available resources for education and training SHP Access You will need a user name and password 1

2 What Are SHP Alerts? Batches of new or modified OASIS assessments that have not yet been transmitted to CMS are sent to SHP for immediate analysis to identify: errors and/or inconsistencies in OASIS M question responses patients who may be at risk for hospitalization or adverse events (predictive alerts) quality measure outcome results based on OASIS M question responses Managing SHP alerts allow for review and/or correction of all OASIS prior to transmission to CMS. Branch Daily SHP SOC/Recert Workflow Process Job Aids for Clinician and MCP Clinician Process Prior to sending any OASIS assessment to the office, the clinician must: o Validate o Make any needed corrections o Export to SHP o Log into SHP o o Address the alerts that display (as per the Clinician Process job aid) Add notes as necessary MCP Process For OASIS that do not require coding (Discharge, TIF), the OASIS is ready for MCP review once submitted by the clinician For OASIS that require coding, (forms will have the ICD mark) the OASIS is ready for the QA process by the MCP after the central coding process is finished. o Re-export to SHP o Log into SHP o Address the alerts that display following the MCP Process job aid below o Add notes as necessary 2

3 Daily Workflow: Accessing Alerts There are 2 ways to login and access alert data: Access SHP from within KindredLink once OASIS is exported to SHP SHP can also be accessed via the web 1. Access from within KL 2. Login at Web Access All Open Unaddressed Unaddressed: Critical Unaddressed: Potential Unaddressed: Informational Under Review (currently under review by agency staff) Under Review: Critical Under Review: Potential Under Review: Informational Closed Dismissed Dismissed: Critical Dismissed: Potential Dismissed: Informational Resolve Pending (corrected OASIS record not received) Resolve Pending: Critical Resolve Pending: Potential Resolve Pending: Informational Resolved (corrected OASIS record received) Resolved: Critical Resolved: Potential Resolved: Informational Filtering Options Clinical Managers need to review all alerts make sure this box is checked 3

4 Search by Patient Use the Patient Search option to find alerts for any patient The search results will return all assessments for the selected patient Click on the patient s name to view or print the Alert Details Click on the + icon to expand and view the contents of the Open Alerts column Tree View is the default view for Alerts Data can be re-grouped by using the Group by drop-down Rows can be expanded by clicking the arrows on the left or by using the button Alert Views Grid View is the default view for the Patient Search Alerts can be accessed by clicking on the patient name Episode Einstein and HHRG Worksheets can be accessed from the HHRG and columns Printing the Alert Details 4

5 Alert Details Screen 3 Alert Levels Critical: Identify issues that violate the OASIS specifications or contain information that is contradictory. These edits nearly always result in a correction to the OASIS assessment and would rarely be Dismissed Potential: Identify potential inaccuracies that could result in a correction to the OASIS assessment. If it is determined that there is a clinical explanation that justifies the data, the alert may then be Dismissed. Informational: Identify issues that your staff should be aware of such as patient declines or patients that may be at risk of a hospitalization. These alerts are predictive and could also result in a correction to the OASIS assessment. If it is determined that there is a clinical explanation that justifies the data, the alert may then be Dismissed Alert Status (OPEN) Unaddressed: By default, all Alerts display Unaddressed to indicate that no action has yet been taken (OPEN) Under Review: signifies that the clinician or Clinical Manager did not ignore the alert, but is reviewing or gathering information and will then return to address the alert further (CLOSED) Dismissed: Dismissing an Alert indicates that the issue was researched and judged to not require any change to the data. Requires a note to be entered (CLOSED) Resolve Pend: This is an abbreviation for Resolve Pending. Selecting this status indicates that the data was changed based on the Alert. Once the corrected data is received by SHP, the status will automatically be updated to Resolved. When that happens, it will no longer be possible to modify the alert status. 5

6 Alert Notes Notes Legend: White (no lines) = no note Blue with lines = user entered note White with lines = SHP generated note Alert Categories All SHP alerts are assigned to a Category as shown below: OASIS Accuracy Alerts 6

7 Predictive Alerts Action: Review risk factors, address in POC as necessary Outcome and Process Measure Alerts Immediate notification of declines and failures to improve for all outcomes and process measures on Home Health Compare Outcome and Process Measure Alerts SOC/ROC to DC/Transfer: Official CMS decline SOC/ROC to Recert: Proactive warning for potential declines/failures to improve Process Measure 7

8 Potentially Avoidable Event Alerts Immediate notification of Potentially Avoidable Events (PAE) Action: Verify accuracy, investigate reasons, then Dismiss the Alert and enter a note Using Episode Einstein to Manage Alerts How Does Episode Einstein Help You? Comprehensive review of all assessments in an episode Reduces time involved in OASIS review Improves accuracy Immediately alerts potential outcome declines Provides a summary of all unresolved alerts Using Episode Einstein to Manage Alerts Review the Alert Summary (last page of Episode Einstein report) to see all unresolved alerts for the current assessment and drill-down to individual alerts 8

9 Clinical Leader Oversight Monitor how clinicians are utilizing and addressing the alerts Branch Director and DCO Oversight Monitor alert utilization for a single provider or group of providers Next Steps Ensure that your staff have SHP access Ensure that clinical staff are addressing alerts prior to submission of all OASIS to the office Ensure that MCP/CS/CRM staff are reviewing and addressing alerts with clinicians prior to final lock and transmission of all OASIS to CMS Ensure that SHP alert education is included in your new staff orientation process 9

10 Resources Gentiva Intranet: Departments The Virtual Mentor SHP Training Recorded classes, PowerPoint presentations, and job aids SHP Website: SHPUniversity Links and Resources User guides, on-demand webinars SHP Alert Job Aid On GHS Intranet: SHP Alert Manager Quick Reference Guide on SHP: Clinical Practice and Quality Team VP Clinical Practice and Quality Director Quality and Performance Improvement Director Quality and Performance Improvement Director, Therapy Practice and Quality Clinical Project Manager, Clinical Operations Resources SHP Alert Icons Legend Resources SHP Alert Icons Legend 10