David Groves HealthBridge Executive Director, Tri-State Regional Extension Center

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David Groves HealthBridge Executive Director, Tri-State Regional Extension Center CSOHIMSS 2011 Slide 1 May 13 th, 2011

Cintas Center at Xavier University 7:30am to 4:30pm May 20, 2011 CSOHIMSS 2011 Slide 2 May 13 th, 2011

Breakfast Keynote Greg Moody, Director, Ohio Governor s Office of Health Transformation Luncheon Keynote Dr. Farzad Mostashari, National Coordinator, Office of the National Coordinator for Health IT Breakout session topics include: Proposed MU Requirements for Stages 2&3 Healthcare Transformation and PCMH Care Coordination and Transitions in Care Quality Reporting and Quality Improvement Accountable Care and Payment Reform Register online at; http://2011meaningful-use-conference.eventbrite.com/ CSOHIMSS 2011 Slide 3 May 13 th, 2011

CSOHIMSS 2011 Slide 4 May 13 th, 2011

2000 PPCP Monthly Enrollment 1800 1600 1400 1200 1000 800 600 400 200 0 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 GOAL CSOHIMSS 2011 Slide 5 May 13 th, 2011

1079 Enrolled PPCPs 18% 19% 15% 48% Family Practice Internal Medicine OB/GYN Pediatrics CSOHIMSS 2011 Slide 6 May 13 th, 2011

19% 30% Paper Based EHR User 51% Achieved Milestone Two CSOHIMSS 2011 Slide 7 May 13 th, 2011

1. Introduce concept of Patient Centered Medical Home 2. Understand the distinct characteristics of an effective PCMH 3. Explore the significant changes made to the 2011 NCQA requirement for PCMH Recognition? 4. Understand how Meaningful Use of EHR technology has been integrated into the PCMH program? 5. Identify the essential Health IT capabilities that support PCMH 6. Understand how PCMH may influence Stage 2 and Stage 3 Requirements for Meaningful Use CSOHIMSS 2011 Slide 8 May 13 th, 2011

Personal Physician - each patient has an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care. Team Care - the personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care of patients Whole Person Orientation - the personal physician is responsible for providing for all the patient s health care needs or taking responsibility for appropriately arranging care with other qualified professionals. Care is Coordinated - across all elements of the complex health care system (e.g., subspecialty care, hospitals, home health agencies, nursing homes) and the patient s community (e.g., family, public and private community-based services). Care is facilitated by Information Technology EHRs, Registries and Health Information Exchanges are utilized to support optimal patient care, performance measurement, patient education, and enhanced communication Enhanced access to care is available through systems such as open scheduling, expanded hours and new options for communication between patients, their personal physician, and practice staff. Quality and safety are hallmarks of the medical home and Physicians in the practice accept accountability for continuous quality improvement Source: Patient-Centered Medical Home Collaborative - CSOHIMSS 2011 Slide 9 May 13 th, 2011

1. Enhance Access and Continuity: Accommodate patient needs with access and advice during and after office hours; provide patients with team-based care 2. Identify and Manage Populations: Collect and use data for population management 3. Plan and Manage Care: Use Evidence-based guidelines for preventive, acute and chronic care management. 4. Provide Self Care Support and Community Resources Assist patients and their families in self-care management with information, tools, and connections to community partners 5. Track and Coordinate Care: Track and manage referrals, care transitions, and clinical results. 6. Measure and Improve Performance: Use data to continuously measure and improve care quality and patient experience. CSOHIMSS 2011 Slide 10 May 13 th, 2011

"The proof is in. This document shows that primary care that is more comprehensive, integrated and coordinated, that follows the model of the patient centered medical home, delivers better care and better quality at lower costs.. said Paul Grundy, MD, M.P.H, president of the Patient-Centered Primary Care Collaborative, director of healthcare technology and strategic initiatives at IBM. http://www.pcpcc.net/files/evidence_outcomes_in_pcmh.pdf CSOHIMSS 2011 Slide 11 May 13 th, 2011

Value-Driving Elements of Patient Center Medical Home and Accountable Care Organizations 1. Enhanced Access 2. Better Care Coordination 3. Better Health IT 4. Payment Reform for Primary Care CSOHIMSS 2011 Slide 12 May 13 th, 2011

Dear Colleagues: As you may know, the topic of patient-centered care is dear to my heart. I believe that, of the six IOM Aims for Improvement - safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity - patient-centeredness is the keystone and that, from it, the others properly devolve. To me, patient-centered care is care that respects each person as an individual, honoring his or her backgrounds, their families and their choices. Source: Better to Best Report - Value-Driving Elements of the Patient Centered Medical Home and Accountable Care Organizations, March 2011 CSOHIMSS 2011 Slide 13 May 13 th, 2011

NCQA Releases New Standards for PCMH PCHM 2011 More Patient-Centeredness required Increase emphasis on Patient Feedback Federal Meaningful Use Language is embedded in the standard Greater emphasis on the use of HIT Reinforces incentive to use HIT to improve quality Implements 6 must pass elements CSOHIMSS 2011 Slide 14 May 13 th, 2011

CSOHIMSS 2011 Slide 15 May 13 th, 2011

Meaningful Use Requirement 1. Electronic Prescribing 2. Drug Formulary, drug-drug, drug-allergy checks 3. Maintain active problem list and current diagnosis and meds 4. Record patient demographics including race, ethnicity and preferred language 5. Record and chart changes in vital signs 6. Record smoking status 7. Report quality measures 8. Implement clinical decision support Found in PCMH Standard 3E: Use Electronic Prescribing 3E: Use Electronic Prescribing 2B: Clinical Data 2A: Patient Information 2B: Clinical Data 2B: Clinical Data 6F: Report Data Electronically 3A: Implement Evidence-based Guidelines CSOHIMSS 2011 Slide 16 May 13 th, 2011

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Health IT is essential to PCMH recognition Health IT elements that enable practice transformation Certified EHR system Disease Registry (within or integrated with the EHR) Patient Portal supporting Electronic receipt of patient care information and results Schedule requests Prescription refill requests Secure patient-provider e-mail Information about the primary care practice and services Patient surveys Health Information Exchange supporting Results delivery Electronic Referrals and Transitions of Care Future EHR Certification and Meaningful Use Requirements will be influenced by evolving aspirations for PCMH CSOHIMSS 2011 Slide 26 May 13 th, 2011