Long-term & Post-Acute Care (LTPAC) Utilizing the Mass HIway

Transcription

1 Commonwealth of Massachusetts Executive Office of Health and Human Services Long-term & Post-Acute Care (LTPAC) Utilizing the Mass HIway March 10, 2016

2 Today s Speaker Jessica Hatch, MS, CNL, RN Mass HIway Account Management Team Massachusetts ehealth Collaborative

3 Agenda Trends in Health Information Exchange (HIE) for LTPAC What is the Mass HIway? How can the Mass HIway help your HIE strategy? Connecting to the Mass HIway Best Practices for Optimizing the Mass HIway 3

4 Interactive Session Please use the webinar s chat function to submit a question or comment to discuss during the presentation Or feel free to contact us directly after the presentation, we will provide complete contact information on the final slide and distribute this presentation via 4

5 National Trends in HIE for LTPAC Major reasons for HIE in LTPAC include: Importance of care coordination as patients transition care Efforts to reduce preventable hospitalizations, especially readmissions Drive toward new health care payment and delivery models Desire to increase patient mix from fee-for service to value-based Major barriers include: High HIT costs and ROI on technology investments, historically not eligible for MU incentives Lack of certified electronic health record technology (CEHRT) for LTPAC Different clinical processes and information needs than acute/ambulatory Issues with integrating technology into existing workflows Workforce issues (including high LTPAC staff turnover rates) Lack of common clinical data set Resource: Health IT in Long-term and Post Acute Care Issue Brief ONC

6 Local Feedback Reflects National Trends Major reasons for HIE in LTPAC include: Importance of care coordination as patients transition care Efforts to reduce preventable hospitalizations, especially readmissions Drive toward new health care payment and delivery models Desire to increase patient mix from fee-for service to value-based Major barriers include: High HIT costs and ROI on technology investments, historically not eligible for MU incentives Lack of certified electronic health record technology (CEHRT) for LTPAC Different clinical processes and information needs than acute/ambulatory Issues with integrating technology into existing workflows Workforce issues (including high LTPAC staff turnover rates) Lack of common clinical data set Reaffirmed Locally: MeHI Grant Managers and Mass HIway Account Managers

7 Additional HIE Market Drivers in LTPAC Alternative Payment Models (APMs): U.S. Dept of HHS seeks to tie 30% of traditional, feefor-service, Medicare payments to quality/value through APMs (i.e. ACOs or bundled payments) by end of % by end of 2018; and tying 85% of all traditional Medicare payments to quality/value by % by 2018 through programs like the Hospital Value Based Purchasing and Hospital Readmissions Reduction Patient Volume: age 65+ increased 15% (to 40.2 million) between 2000 to By 2020, this population is projected to rise to 54.8 million, nearly 41% of which will be HHS, Administration on Aging Workforce Demand: ~1.3M additional jobs within homecare field will be added through Home health positions will see a 69% growth through 2020 and those in personal care aide positions will see a 70% growth - Bureau of Labor Statistics Telehealth Expansion: IHS (market research firm) predicts that U.S. telehealth market will grow to $1.9B in 2018, up from $240M in 2013, signifying an annual growth rate of 56% Reporting Requirements: Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) requires the submission of standardized data by Long-Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs), Home Health Agencies (HHAs) and Inpatient Rehabilitation Facilities (IRFs) CMS

8 What is the Mass HIway? The Mass HIway is the statewide Health Information Exchange (HIE) providing secure, electronic transport of health-related information between health care organizations and providers regardless of affiliation or technology. The Mass HIway offers two services: 1. Direct Messaging - Secure point-to-point transport of electronic patient health information among healthcare organizations and authorized government agencies for purposes of patient treatment, payment, or operations. 2. Query and Retrieve Relationship Listing Service (RLS) for locating healthcare organizations that hold records for a particular patient. Medical Record Request (MRR) service for initiating a query for a patient s records. early adopter phase The Mass HIway is not a clinical data repository HIE and holds no clinical information. The Mass HIway is also not the state health insurance exchange known as the Health Connector. 8

9 What can you send? Mass HIway is content agnostic, and does not restrict message types Patient clinical information: Summary of Care / Transition of Care Record (TOC) Request for Patient Care Summaries Discharge Summaries Referral Summary Information Specialist Consult Notes Progress Notes Patient clinical alerts: Emergency Department Notification Mortality Notification Transfer Notification Disposition Notification (admit/discharge) Public Health Reporting: Securely comply with reporting regulations for the Mass. Department of Public Health Quality reporting: Information for calculation and reporting of clinical quality measures 9

10 Public Health Registry Connectivity Mass DPH Registries and other state Applications connected with Mass HIway: Massachusetts Immunization Information System (MIIS) Electronic Lab Reporting (ELR) Syndromic Surveillance (SS) Massachusetts Cancer Registry (MCR) Opioid Treatment Program (OTP) Childhood Lead Poisoning Prevention Program (CLPPP) Occupational Lead Poisoning Registry (Adult Lead) E-Referral In Testing: Prescription Monitoring Program (PMP)

11 Transactions (thousands) > 4 million messages now traverse Mass HIway per month 13 Month HIway Transaction Activity 4,017,293 Transactions* exchanged in December (11/21 to 12/20/2015**) 35,265,948 Total Transactions* exchanged inception to date 4,500 4,000 3,500 3,000 2,500 2,000 1,500 1, Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Transactions (000's) 623 1,129 1,412 1,626 1,815 1,964 2,148 2,293 2,888 2,713 3,217 3,890 4,017 % Change 81% 25% 15% 12% 8% 9% 7% 26% -6% 19% 21% 3% 11 * Note: Includes all transactions over Mass HIway, both production and test ** Note: Reporting cycle is through the 20 th of each month.

12 Number of Transactions (Millions) Use Case Trends 4 PH reporting was the leading use case in there has been strong (6-18%) month-over-month growth for all uses 2015 HIway Production Transaction Trends by Use Case Type 3 Public Health Reporting 18% avg. monthly growth 42 senders, 45 receivers In December 2 Quality Data Reporting 10% avg. monthly growth 5 senders, 1 receiver in December 1 Payer Case Management 6% avg. monthly growth 4 senders, 3 receivers in December Provider Org to Provider Org 11% avg. monthly growth 212 senders, 196 receivers In December - Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Note: Reporting cycle is through the 20 th of each month 12 89% of HIway activity in 2015* was for production transactions

13 Use Case Examples Transition of Care Discharge Summary Hospital Skilled Nursing Facility Transition of Care MOLST Inpatient Rehab Facility Visiting Nursing Assoc. Webmail 20

14 2015 Year Summary Over 80% of Massachusetts Hospitals or large health systems connected to HIway and continue to enable community for improved care coordination and care transitions 650+ Connected Organizations with over Direct addresses across 50+ EHRs and 23 vendor HISP connections A strong technical backbone that successfully processed over 35 million transactions since ITD and growing consistently with about 4million transactions per month Reliable and dependable team of Outreach, Implementation and Support members that continue to facilitate, engage and empower healthcare organizations across the care continuum Deep dive engagement with participating organizations to facilitate clinical workflows for care transitions, discharge summaries, closed loop referrals and exchange other necessary and/or applicable clinical exchange needs Educate and empower all types of organizations from single provider practices, LTPACs, SNFs, social services to hospitals/large health systems. 14

15 How can Mass HIway help you? Mass HIway is foundational technology for helping healthcare organizations improve quality and safety, improve care coordination, and improve efficiency of medical records management Provides Interoperability path to exchange vital information in support of integrated networks, alternative payment models, and quality incentive programs Organizations are using the Mass HIway to satisfy requirements of many programs: Demonstrate EHR proficiency - state physician licensing requirements Satisfy the 2017 requirement to connect to Mass HIway Meaningful Use Stage 2 Transition of Care and Public Health Reporting measures equality Incentive Program (eqip) CMS Delivery System Transformation Initiatives (DSTI) Community Hospital Acceleration, Revitalization and Transformation Grants (CHART) Massachusetts Infrastructure and Capacity Building Grants (ICB) Massachusetts Prevention and Wellness Trust Fund Patient Centered Medical Home (PCMH) 15

16 Mass HIway Community Care Continuum 650+ Participants Hospitals/Health Systems Ambulatory Long-Term & Post-Acute ~58 organizations Majority of MA hospitals ranging from large health systems and medical centers to single-site community hospitals >450 organizations/providers Primary care providers and specialists across a broad range of medical services Health centers and clinics providing medical, emotional, behavioral, and additional social services Urgent care and minute clinics ~90 organizations Range of services and organization types including but not limited to: Area Agency on Aging (AAA) Aging Service Access Point (ASAP), Skilled Nursing Facilities (SNF), nursing homes, Inpatient Rehabilitation Facilities (IRF), home health, palliative care, and hospice Note: 10+ additional orgs include Labs, Payers, Imaging Centers, and Quality Reporting service 16

17 Mass HIway Community There are currently 650+ participant organizations signed up for the HIway. The full participant list is available at The Provider Directory contains over 7,000 addresses (department and individual level addresses included) - The latest Provider Directory extracts are available at the Mass HIway website You will need to sign up to receive monthly notifications of PD extract updates Your account manager will assist you in operationalizing the Provider Directory, identifying who of your trading partners are in the Mass HIway Community today and how to engage additional trading partners to exchange on the HIway 17

18 How to Get Started? If your organization is interested in connecting to the Mass HIway improving Care Coordination Simply, contact the lead for the Mass HIway Account Management Team Murali Athuluri, Mass HIway Account Managers Len Levine Jessica Hatch, RN Kelly Luchini The Mass HIway Account Manager will be your personal liaison to take you through Enrollment Onboarding Addressing Connection steps Use case identification Exchanging with your trading partners 18

19 Connectivity Options User types Connectivity options HIE Services Physician practice EHR connects directly Hospital EHR connects through LAND Appliance Long-term care Other providers Public health Health plans webmail Vendor HISP 19

20 Participating HISP vendors Aprima ASP.MD (Testing) Athenahealth Care Accord (Oregon) CareConnect (NetSmart HISP) Cerner DataMotion eclinicalworks eclinicalworks Plus (Testing) elinc EMR Direct Inpriva MaxMD MedAllies (for Allscripts and others) Medicity MyHealthProvider (Mercy Hospital) NextGen Share NHHIO (New Hampshire) RelayHealth (McKesson HISP) SES Surescripts UpDox Wellport (By Lumira) 20

21 EHR Vendors Connected or Implementing ADS Allscripts Amazing Charts Aprima Athenahealth BayCIS/ehana/AMS Care at Hand Carelogic Cerner CPSI Credible Dentrix Eaglesoft Clinician eclinicalworks EMA Modernizing Medicine emds encite EPIC Flatiron (oncologyehr) GE Centricity gehrimed Greenway HealthWyse HermesIQ Homecare Homebase InterSystems LMR Lytec MatrixCare McKesson Medflow MEDITECH MediTouch MedNet Medical Solutions 21 Netsmart Nextech NextGen OCHIN (Epic) Office Practum Point N Click PointClickCare Practice Fusion Practice Partners Quest Siemens SMART Soarian Spring Charts STC Unitcare WebOMR Zoll epcr

22 HISP Connections Mass HIway is interconnected with 23 private HISPs A rich network for Direct Messaging is fully available to MA providers 23 Private HISPs connected successfully and can exchange with Mass HIway Participants ~7,000 addresses now available in the Mass HIway provider directory 22

23 Best Practices across HIE Create a sense of urgency by aligning strategic goals and vision Leadership support and engagement from day 1 Stakeholder identification - clinical, business, and technical representation Use cases for quick, short-term wins and long-term, sustainable workflows Timelines with milestones for achievement and communication of progress

24 Level of Coordination with Other Organizations Low High TOC and Change Management From Implementation to Impact An Organization s ehealth Progression 3 4 Update policies, processes, and people 5 Connect with information trading partners & edge services Send and receive health information Improve patient care 1 2 Connect to the Mass HIway (directly or indirectly) Feedback and Continuous Improvement Implement an EHR/Webmail Low Anticipated impact on care quality, cost efficiency, and patient convenience 24 High

25 Open Forum Discussion Questions Use Case Creation Best Practices from Webinar Participants

26 Account Management Team If your organization is interested in connecting to the Mass HIway or improving Care Coordination Simply, contact the lead for the Mass HIway Account Management Team Murali Athuluri, Mass HIway Account Managers Len Levine Jessica Hatch, RN The Mass HIway Account Manager will be your personal liaison to take you through Enrollment, Onboarding, Addressing, Connection steps, and Exchanging with your trading partners 26 Kelly Luchini The Massachusetts Health Information Highway MAHIWAY ( ) Option 1 General Support: masshiway@state.ma.us

27 Additional Information Appendix 27

28 Rate Card 28

29 Enrollment Process/Timeline Discovery Implementation Testing Go Live Week 1 2 Week 3 5 Week 6 8 Week 9 Connection Type Forms/Certs Installation Work Loop back test Transaction testing Migrate to production Connection to the Mass HIway is dependent on capabilities of your EHR vendor and your organization s technical architecture. Your Account Manager will walk you through the connectivity options to find the best solution for you: Direct connection to EHR Local Area Network Device (LAND) solution Webmail Your account manager will also help you set up your addresses for the Provider Directory The implementation team will configure and test the solution and bring your organization live Note: Above timelines are indicative of a typical effort time spent by the Mass HIway team from the time all of the completed requirements are obtained from the participant and vary by connection type/ehr vendor. 29