TEHDI CONTINUUM OF CARE FOR AUDIOLOGISTS

Transcription

1 TEHDI CONTINUUM OF CARE FOR AUDIOLOGISTS COORDINATING CARE USING HEALTH INFORMATION TECHNOLOGY (HIT) 101 Presented By: Mary Catherine Hess, MA OZ Systems Sponsored by the Texas Early Hearing Detection and Intervention Program

2 TEHDI Program Health Information Technology (HIT) 101 EHDI and HIT TEHDI and HIT Audiologists and TEHDI Topics Covered

3 Texas Early Hearing Detection and Intervention (TEHDI) Program Newborn hearing screening provides a system for identifying infants with hearing loss before they reach the critical stage for language development. 3

4 Texas Department of State Health Services >390,000 births annually > 240 Birth Hospitals Web-Based EHDI Information System, TEHDI esp >4 million patient records in TEHDI esp TEHDI Program 4

5 5 The goal of early hearing detection and intervention is to identify hearing loss and provide intervention services as early as possible in an effort to prevent speech, language, and other delays so that newborns, infants, and children reach their maximum potential.

6 TEHDI Team and Stakeholders

7 Birth hospitals offer hearing screening to newborns Babies suspected of having a hearing loss receive appropriate and timely follow-up services Newborns/infants identified with a permanent hearing loss receive audiologic and early intervention services. TEHDI Ensures

8 Improve parent and provider understanding of the importance of early diagnosis and referrals Increase the amount of follow-up data in the TEHDI MIS to better identify newborns, infants and children who need further follow-up care; Improve the quality of the data in the TEHDI MIS to successfully connect providers with parents of newborns, infants and children in a timely manner for an optimal outcome. Overarching TEHDI Goals

9 Opt-out versus opt-in consent process Require all birthing facilities to screen and report to the statewide system Transfer agreement Birth center requirement for screening Legislative Updates & HB 411

10 Track infants through the screening, diagnosis, and intervention process using a management information system (MIS) Provide technical assistance to all TEHDI stakeholders Reduce the rate of children categorized as loss to follow up and/or loss to documentation (LTF/LTD) TEHDI Activities

11 TEHDI MIS

12 Technical Assistance and Training

13 Nearly one-half of infants screened for hearing loss at birth are lost to follow-up or lost to documentation. Close to one-third of babies diagnosed with hearing loss are not documented as having entered intervention. The gap in the system of care for newborns with potential hearing loss threatens to undermine the development of these infants, as well as the success of the screening program. Source: IHSIS Background 13

14 DID NOT RECEIVE OR COMPLETE the recommended diagnostic or intervention process Source: American Speech Language Hearing Association Website Loss to Follow-Up in Early Hearing Detection and Intervention, Technical Report 14

15 Screening, diagnostic or intervention status HAS NOT BEEN REPORTED to the EHDI program Source: American Speech Language Hearing Association Website Loss to Follow-Up in Early Hearing Detection and Intervention, Technical Report 15

16 Snapshot of Texas in 2013 (Q4) 51.9% of Infants Received Follow Up Care Infants Who Needed Follow-up Care After Birth Screen (N = 2,384) Children Who Received Follow-Up Care 1,237 (51.9%) Follow-up Care Outpatient Screen 1,148 (92.8%) Diagnostic Evaluation 89 (7.2%) Outpatient (OP) Screen Outcome Pass 964 (84.0%) Did Not Pass 184 (16.0%) Diagnostic Evaluation No Diagnostic Evaluation 131 (71.2%) Received Diagnostic After Did Not Pass OP 53 (28.8%) Total Diagnostic Evaluations 142 (53+89) Diagnostic Evaluation Outcome Normal Hearing 88 (62.0%) Hearing Loss 27 (19.0%) Diagnosis, Not Determined 27 (19.0%) 16

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18 Health Information Technology 101 Electronically populate Public Health IS with ALL births born at a hospital using standardized messaging. 18

19 Health Information Technology, or Health IT, is defined by the HHS Office of the National Coordinator for Health IT (ONC) as the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making. What is Health IT?

20 2009 American Recovery and Reinvestment Health Information Technology for Economic and Clinical Health (HITECH) Act Certification of HIT Systems Provider s Meaningful Use (MU) of those systems Improve quality of care Establish foundation for health care reform HOW the HIT Initiative Began

21 "You need information to be able to do population health management. You can serve an individual quite well; you can deliver excellent customer service if you wait for someone to walk through the door and then you go and pull their chart. What you can't do with paper charts is ask the question, 'Who didn't walk in the door?'" Dr. Farzad Mostashari, Former National Coordinator for Health Information Technology

22 Centers for Medicaid & Medicare Services (CMS) incentivized health sector to implement EHRs: incorporated standards for information exchange Provider Quality Reporting System (PQRS) established to increase reporting. CMS uses incentive payments (in 2015 payment adjustments read less money) to promote reporting to PQRS for services provided for Medicare Part B Fee-for- Service (FFS). And how it continues

23 CMS Eligible Professionals include audiologists; though we are not being called out yet. CMS Eligible Professionals reports to Qualified Clinical Disease Registries (QCDR) QCDR collects patient disease/disorder data related to diagnosis, condition, or procedure for tracking and surveillance and improving quality of care provided In Stage 2 Meaningful Use (MU) eligible providers engaged in ongoing electronic identification and submission of specific case information from Certified EHR Technology to specialty registries receive credit Provider Quality Reporting (PQR)

24 CDC EHDI staff and EHDI vendors participated in the HIT standards meetings One of the first newborn encounters between public health and providers CDC submitted a series of quality measures to the National Quality Forum (NQF). CMS selected an EDHI measure Stage 2 MU Proportion of newborns screened before hospital discharge How can this be achieved? Why EHDI HIT?

25 CDC EHDI is asking whether implementing a PQR measure could increase EHDI reporting by Audiologists. Pay per performance or lack of performance? EHDI HIT and Provider Quality Reporting (PQR)

26 TEHDI and HIT

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28 The TEHDI MIS (esp ) is a state funded HIT tool for providers. It provides a central repository of outcome information from a child s team of providers. It facilitates the sharing of patient information for the purposes of decision making related to care coordination. 28

29 Accurate denominator of births to know who needs care Newborn Admission Notification Information (IHE NANI) Accurate Result from screening devices so no one tampers with the result or simply enters wrong information HL7 V 2.6 for EHDI Results Accurate information sent to providers about screening outcomes with next steps of care Early Hearing Care Plan Examples of HIT Activities for TEHDI

30 Ensure results and other clinical details are consistently communicated to providers Standardizes care coordination for suspected hearing loss Provides interoperability between EHRs and EHDI Increased efficiency Better data quality Benefits for EHDI Source:

31 1,183 Audiologists licensed in Texas (July 2013) 350 # of Audiologists/Audiology practices listed in TEHDI MIS 89 # of Audiologists/Audiology practices reporting to TEHDI MIS Audiologists using HIT in Texas

32 Workflow

33 Reporting

34 Searches

35 Patient Information 35

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39 Triage tool to help with care coordination Review record prior to appointment to determine needed care Identify caregiver information Refer patients to other specialty providers Identify current providers PCP ENT Audiologist ECI Provider How to Use TEHDI MIS

40 How to Use TEHDI MIS Schedule appointments Create tickler list of patients Identify providers for referrals Reporting for TEHDI Scheduler Data Clerk Student Intern Create correspondence for families or providers

41 Topics Covered

42 TEHDI Educational Materials Topics across TEHDI continuum Free & shipped at no cost In English and Spanish

43 Department of State Health Services TEHDI Team TEHDI Coordinator Doug Dittfurth: TEHDI Quality Assurance Cheri Grimm: TEHDI Education and Outreach James Goolsby: OZ Systems TEHDI MIS Technical Team Child Health Program Coordinator Mary Catherine Hess , Ext.2455 Customer Support DaShondra Daniels , Ext Audiologist Lisa Payne, Audiologist Questions