2017 HIMSS DAVIES APPLICANT

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1 2017 HIMSS DAVIES APPLICANT

2 Introduction of NOMS Team Members

3 Melissa Thomas IT Project Director

4 Joshua Frederick, CPA, MT Chief Executive Officer

5 Jennifer Hohman, MD Executive Vice President, NOMS Healthcare

6 Rebecca Rohrbach, DNP Vice President of Population Health

7 Holly Tyson, RN Director of Care Management

8 Stephanie Huntington, LPN Clinical IT Analyst

9 NOMS Healthcare currently serves the upper portion of North Central Ohio.

10 Fun Facts About NOMS Healthcare The mission of NOMS Healthcare is to provide excellent, personalized, team-based care Northern Ohio Medical Specialists was formed with 32 Physicians NOMS physicians formed an information technology (IT) committee to explore conversion from paper charts to an electronic health record (EHR ) platform. Later that same year - NOMS newly formed IT department began implementing an EHR system wide NCQA Level 3 PCMH Recognition Chronic Care Management Team, NOMS 360, was instituted of 35 Advanced ACO s across the nation CPC+ designation Present 186 Providers and 646 Team Members

11 700 NOMS Team Members Total Team Members

12 NOMS Providers Total Providers

13 Case Study Increase Access

14 Increase Provider Access

15 Local Challenge When NOMS Healthcare began the Patient Centered Medical Home (PCMH) journey, we recognized the need to increase our provider access. Our 1 st third report revealed appointments were not always available within the 24-hour timeframe as required by PCMH guidelines.

16 1 st Third Available Appointment In 2013, more than 75% of our providers did not have availability within the 24-hour time frame. Today, 100% of our providers are compliant and have same-day appointments available for sick and chronic patients.

17 Steps to Increasing Provider Access Interventions Design Implementation How HIT was utilized Value Derived

18 Interventions Added three same-day acute visit appointment slots to all providers daily schedules Utilized for same-day sick appointments as well as same-day chronic appointments Monitored for same-day scheduling NOMS Urgent Care Sheffield opened 2015 Increased our Advanced Practitioners at each office Extended office hours 2016 Norwalk, Fremont, Clyde, Sandusky, Tiffin and Huron Instituted healow - May 2016 Allowed patients the opportunity to request an appointment anytime, anywhere NOMS Open Access - June 2016 Three Locations: Sandusky, Fremont and Clyde

19 Same Day Acute Visit Appointment

20 Advanced Practitioners Today

21 Provider Extended Office Hours % of our offices were open evening hours, 2 or more nights a week 80% of our offices did not have extended hours available 40% of our offices are open late every evening and have Saturday hours 13% of our offices are open 2 evenings or more a week 47% of our offices do not have extended evening hours All NOMS Healthcare offices participate in NOMS Open Access

22 ecw healow Two ways to request an appointment 24 hours a day 7 days a week NOMS Healthcare Patient Portal ecw healow Smartphone App

23 NOMS Healthcare Patient Portal

24 Book an Appointment with your doctor

25 Send Appointment Request

26 ecw healow App

27 NOMS Open Access Acute care clinic for established NOMS patients Extended hours, including Saturdays Multiple locations

28 Benefits to NOMS Open Access Only established NOMS patients are permitted to utilize Open Access All Offices have instant access to the Open Access schedule Everyone has access to the patient s medical record NOMS Open Access phone line rings in all offices Should an office close early, all offices can cover their phones Visit Summary instantly sent to the PCP

29 NOMS Open Access Sandusky Location June evenings a week and Saturdays October evenings a week 530pm-800pm and Saturdays 900am-200pm May 2017 Monday-Friday 1200pm-800pm and Saturdays 900am 200pm

30 NOMS Open Access evening hours after 5pm and Saturdays locations locations 40420

31 NOMS Open Access Extension to office hours for 6 locations 2016 a total of 40,420 patients were seen after 5pm M-F and Saturdays Of those 40,420 patients seen at $70 per visit = 2.8M Of those 40,420 patients seen at the average $2100 per visit = 84.8 M Containing the cost of care by saving payers a total of 82 Million Dollars *Disclaimer: These offices also see their own patients during these hours

32 NOMS Open Access Total Monthly Appointments Sandusky Location Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17

33 Access Cost to Patient Average Emergency Room copay $100 Average Emergency Room charges $1200

34 How HIT was Utilized Same Day Acute Visit Type Created Reports Extended Hours ecw Provider Templated Schedules Lunch and Learn Staff Training healow Open Access

35 Value Derived: Increased Patient Satisfaction Scores Ensured our patients received the right care, at the right time and place Decreased overall out-of-pocket cost to the patient. An office visit co-pay vs an ER co-pay ($20/$100 respectively) Contained the total cost of healthcare. An office visit vs an ER visit ($70/$2108 respectively)

36 Patient Satisfaction Survey Results PCP Overall Average NOMS OVERALL PCP AVG In the last 6 months, when you made an appointment for a CHECK UP OR ROUTINE CARE with this provider, how often did you get an appointment as soon as you needed? NOMS OVERALL PCP AVG 4.77 In the last 6 months, when you contacted this provider's office to get an appointment for CARE YOU NEEDED RIGHT AWAY, how often did you get an appointment as soon as you needed? In the last 6 months, when you contacted this provider's office AFTER regular office hours, how often did you get an answer to your medical question as soon as you needed? In the last 6 months, when you contacted this provider's office during REGULAR OFFICE HOURS, how often did you get answer to your medical question that same day?

37 Utilization (per 1000 person years): Emergency Department ( ED) Visits

38 NOMS ED Utilization For Medicare Patients Q Data

39 NOMS ED Utilization For Medicare Patients Q Data

40 NOMS Healthcare ED Utilization per

41 100% ED Avoidance Savings $12,000, $11,500, $11,500, $11,000, $10,500, Increasing PCP s access has the potential to decrease avoidable ED visits drastically therefore containing the cost of healthcare. $10,000, $9,744, $9,500, $9,000, $8,500,

42 Saving Medicare $1.8 Million

43 Future Goals for NOMS Healthcare Continue to increase access Telemedicine Available through ecw. Plan to Pilot this program to our Family Practice Offices 4 th quarter 2017 Begin to offer more than the traditional face to face visits with the patients and providers Continue growth of our provider network Anticipated to double in size within the next 12 months Decrease cost by utilizing our ancillary services within our organization NOMS Lab and Imaging Centers opening Fall 2017 Urgent Care and Open Access expanding to our Eastern market in 2018

44 Satisfy the Patient Provider Satisfaction Quadruple Aim Contain Cost All while Improving Quality Care

2017 HIMSS DAVIES APPLICANT

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