Quality Counts: Setting You and Your EHR up for success in documenting and reporting the five standardized performance measures for SBHCs
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1 Quality Counts: Setting You and Your EHR up for success in documenting and reporting the five standardized performance measures for SBHCs October 11, 2016
2
3 Presenters Lynn Bakken, MSN, PNP-BC Medical Director, MCPN Maureen Daly, MD, MPH Clinical QI Consultant, CDPHE
4 Objectives 1. Describe why a set of standardized performance measures is essential to strengthening and sustaining SBHCs 2. Understand basic EHR terminology and how to speak to your vendor and IT support 3. Identify three potential solutions to data extraction
5 Why Measure Performance? Importance 1. Payment reform & Population health a. Payment for health outcomes not visits i. Key Performance Indicators (KPI) b. Payment for improving the health of a population i. Population could be all the patients of a clinic ii. Population could be all the students in the school 2. Colorado (among others) is taking the lead a. Train has left the station
6 Importance Why Measure Performance? 3. Demonstrate your SBHCs as the Leaders a. Having data supports SBHCs as ahead of the pack b. Be indispensable to the medical sponsor
7 Web Resources Population Health & Payment Reform Big data in health care 015/04/21/how-big-data-is-changinghealthcare/#47f45fc632d9
8 Standardized performance measures for SBHCs Core Measures Annual well child visit Annual risk assessment BMI screening and Annual well Annual risk nutrition/physical activity child BMI visit screening assessment and nutrition/physical counseling activity counseling Depression screening Chlamydia screening Stretch Measures Student disposition log (seat time saved) Depression SBHC student screening user survey Chlamydia screening
9 Electronic Health Record Data Collection Terminology 87% of SBHCs use an electronic health record (EHR) ( Census of SBHCs) All certified EHRs allow for extraction of data that is entered: CPT codes (Procedure Codes) ICD (Diagnosis codes) Demographics (DOB, gender, race/ethnicity) Discrete fields Observational terms Free text (not extractable)
10 Data Collection Quality Counts Measures Dictionary Link to Quality Counts Measures Dictionary: five-performance-measures/
11 Data Collection Annual Well Child Visit CPT Established Pt New Pt Infant years years years years ICD10 Z Child health exam w/ abnormal findings Z Child health exam w/o abnormal findings Z00.00 Adult med exam w/o abnormal findings Z00.01 Adult med exam w abnormal findings
12 Data Collection Annual Well Child Visit But how do you capture Well Child Visit done by outside provider?
13 Data Collection Aspects of Performance Measures for Which there is a CPT/ICD Well child visit done at SBHC BMI, nutrition & physical activity counseling Depression screen Chlamydia screen And maybe annual risk screen
14 Data Collection Aspects of Performance Measures for Which there isn t a CPT/ICD Well child visit done by non-sbhc provider Annual risk assessment (in some states) Depression follow-up plan Sexual activity (to determine denominator for chlamydia screening measure)
15 Data Collection Talking the talk with your EHR vendor or IT support
16 Data Collection How to convert free text into data that you can query/extract?
17 Data Collection Create Discrete Fields Discrete field = is finite and could have a numeric value Examples: 1. Are you sexually active? (Yes or No) 2. PHQ 2/9 Depression Screening Scores 3. Number of mental health follow-up visits planned for positive depression
18 Data Collection Create Observational Terms Observational term = on a continuum, not numeric Example: Where was your last well exam? Each response has no statistical reference and there are an infinite number of possibilities
19 WCV by Non-SBHC Provider
20 Depression Follow-up Plan
21 Sexual Activity
22 Data Collection TIPS Start reporting on what you already collect via CPT/ICD10. Verify that all CPT and ICD of interest are in EHR & add if not. Talk with providers to be sure all are knowledgeable of correct CPT & ICD codes to use for performance measures. Start with adding discrete fields/observational terms that are important to your agency/funders.
23 Poll question Which best describes your situation? I am part of a system with IT support and we can report the performance measures. I am part of a system with IT support and we ve been unable to report the performance measures. I am part of a system with no IT support. Other
24 Data Extraction Scenario A Your SBHC has IT support but you have been unable to report the performance measures.
25 Data Extraction Making the Case with your Medical Sponsor Know Show Be the organization s data reporting priorities where you can improve the overall scores willing to be the index site
26 Data Extraction Tips for Communicating with IT Support-Data team members The clinic quality lead- that s you! Your internal data analyst (if you have one) EHR vendor representative? Other geeks you know?
27 Data Extraction Scenario B You are part of a system with no IT support.
28 Data Extraction Creation of Customized Report Vendor/VAR Cost/Cost Sharing HIPAA Issues Specs
29 Creation of Customized Report Suggested Fields Name Patient ID DOB Gender Race/Ethnicity Date of Service Visit number Provider type Diagnosis codes (ICD) Procedure codes (CPT) Third party payer Location of service code Other discrete fields
30 Data Extraction Advanced EHR Training Data savvy staff Excel expertise for analysis Consider graduate students/interns
31 Join our next webinar Quality Counts: State and Local Perspectives and Promising Strategies for Documenting and Reporting the Five Standardized Performance Measures Presenters: CoIIN participants Date: Thursday, November 17, 2016 at 2PM EST
32
33 BECOME A MEMBER! BECOME A MEMBER!
34 Call for abstracts open September 19-November 6
35
36 Contact us: Maureen Daly Lynn Bakken Hayley Love
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