OCHIN’s 2012 Learning Forum California Users Group Bi-Monthly Meeting Presentation

1. OCHIN’s2012 Learning ForumCalifornia Users GroupBi-Monthly Meeting Presentation Thursday, November 15th, 2012 Meeting begins at 2:45 pm PST

2. Agenda 2:45 Welcome and Introductions 2:50 CAIRS Project Update 3:10 OSHPD Reporting Review 3:25 CHDP Project Kick Off and Project Plan Review 3:40 Site Visits and Dashboard Review 3:50 New Year Revisions 3:55 Accomplishments 3:59 Adjourn

3. CAIR Immunization (IZ) Interface Scope, Status, Challenges & Next Steps

4. CAIR Immunization (IZ) Interface • Project Scope • Unidirectional Interface • IZ messages • Error reports • Yellow Card • Inventory Reports • All California members • Workgroup of SME’s

5. CAIR IZ Interface Status Completed Work In-Process Work Scenario Testing IZ Letter (Yellow Card) Inventory Reports Immunizations Given Flu Vaccines Training Plan MU Attestation • Interface Programming (HL7) • Error Reports • Automation • Basic Workflow Documentation

6. CAIR – IZ Interface • Challenges • HL7 is new to CAIR • Stable testing environment (at CAIR) • Maintaining resources among all stakeholders (momentum) • Implementation Date: 01-08-2013

7. OSHPD Reporting California Primary Care Annual Utilization Report

8. OSHPD Reporting • The OSHPD reports contain descriptive information on services and encounters, staffing, capital expenditures, changes, operating costs, services offered and payment source information. • Demographics, Encounters, Clinical Services, and some financial reports are available to the OCHIN membership.

9. OSHPD – Comparing to UDS • Similarities with UDS: • Same definition of reportable encounters: Face-to-face visit with a health care professional, the professional is licensed, the professional exhibits independent judgment and the encounter is recorded in a patient chart. • Same reporting period 1/1 – 12/31. • Reports are due on 2/15. • Differences with UDS: • OSHPD reports are by site (OSHPD clinic license) as opposed to one report by organization like UDS (330 grant). • Different demographic, clinical services and payer source categories, in most cases the OSHPD categories are more detailed.

10. OSHPD – Groupers & Physical Sites • OSHPD Specific Master File Groupers and OSHPD sites: • The OSHPD provider category is stored in Report Grouper 7 of the Epic Provider master file (Grouper 8 is used for UDS). • The OSHPD payor category is stored in Report Grouper 9 of the Epic payor master file. • Epic departments are mapped to OSHPD physical sites, OCHIN stores the department-OSHPD site crosswalk information in the custom X_CLARITY_PHYS_SITE Clarity table. This information is used to generate the reports by site.

11. OSHPD Reporting

12. OSHPD Reporting – Build Validation • It is crucial to validate the OSHPD/UDS build for your organization. Before running any OSHPD or UDS reports, you will need to run the “UDS Grouper Report for All Encounters in a Date Range”. • This report shows the current UDS designation for Departments, Places of Service and Providers, for all relatedencounters that took place within a user specified date range. • A list of current provider category types for UDS and OSHPD is included on the report, as well as the current UDS designation for Visit Program.

13. OSHPD – Sample Grouper Report

14. OSHPD – Grouper Report Cont.

15. OSHPD – OCHIN Reports OSHPD reports are organized by sections: Section 1: This section contains basic information about the clinic and the person completing the report. OCHIN doesn’t provide these reports. Section 2: This section includes information on patient care services provided, information about languages spoken by patients and staff, and the composition of the clinic’s primary care providers. It also provides staffing level and volume of services delivered for each type of primary care practitioner at the clinic.

16. OSHPD – Section 2 Reports • Clinic Services: • This section includes information on patient care services provided, information about languages spoken by patients and staff, and the composition of the clinic’s primary care providers. It also provides staffing level and volume of services delivered for each type of primary care practitioner at the clinic.

17. OSHPD – Section 3 Reports • Patient Demographics: • This section reports an unduplicated count of all persons seen in the clinic during the report period by Race, Ethnicity, Federal Poverty Level, Age, Gender, Migrant/Seasonal worker status and Patient Coverage • This section also reports the number of patients served under episodic programs and the number of CHDP assessments, a patient could have more than one CHDP assessment during the year

18. OSHPD – Section 3 Reports Cont.

19. OSHPD – Section 3 Reports Cont.

20. OSHPD – Section 4 Reports • Encounters by Principal Diagnosis: • Total number of encounters by principal diagnosis, it must be equal to the total number of encounters in Encounters by Primary Care Provider (section 2, line 75, column 5), Encounters by Primary Services (section 5, line 45, column 1), FTE’s and Revenue and Utilization by Payer (section 6, line 1, column 19). • In the Epic diagnosis master file, Family Planning S-Codes are identified as those with the word “FAMPAC S CODES” in the Dx group: CLARITY_EDG.DX_GROUP = 'FAMPAC S CODES'

21. OSHPD – Section 4 Reports Cont.

22. OSHPD – Section 5 Reports • Encounters by Principal Service: • Report each medical encounter by CPT. Uses the “primary procedure code” to classify encounters. Does not report secondary or subsequent procedure codes, each encounter is to be counted only once. • Total encounters on line 45 must be the same as Encounters by Primary Care Provider (section 2, line 75, column 5), Encounters by Principal Diagnosis (section 4, line 25, column 1), FTE’s and Revenue and Utilization by Payer (section 6, line 1, column 19). • For visits with more than one procedure code OCHIN uses the CPT code on the first non-voided charge as the primary code.

23. OSHPD – Section 5 Reports Cont.

24. OSHPD – Section 5 Reports Cont. Selected Procedures: This table includes data for selected CPT codes that are of particular interest. Unlike the previous table, the procedure codes listed in this table do not have to be the primary service code for that encounter.

25. OSHPD – Section 6 Reports • Revenue and Utilization by Payer: • This section includes the encounters, gross revenues (charges), write-offs, and net patient revenue for each of the clinic’s payment sources. • The Report Grouper 9 in the Epic payor master file is used for the OSHPD payer source group. Please review list of payers for your clinics and let OCHIN know if any payors need to be reclassified. • Line 1, Columns 1 - 18: Encounters by Primary Payor (i.e. Medi-Medi Encounters are reported under Medicare)

26. OSHPD – Section 6 Reports Cont.

27. OSHPD – Next Steps • The OSHPD suite of reports are not currently published to the Business Objects library as they require some form of customization for each organization that wants to use them. • If your organization would like to pursue getting these reports please have one of your Business Objects Report Designers submit a JIRA under the project of ‘REPORTING’.

28. Questions?

29. CHDP Project Team and Plan Review Aryicka Frison, OCHIN California Account Manager

30. Agenda • Project Plan Overview • Project Team • Training plan • Next Steps

31. Goals and Objectives • Kick-off phase II planning activities. • Achieve a shared understanding of the project, deliverables, timelines, roles, training, and communication plans. • Create efficiencies of staff time and improve the documentation of required data in EpicCare and review of data in Resolute as it relates to the CHDP program.

32. Current CHDP State • The most recent development for this program from OCHIN was in 2006 • The current workflow for documentation has been recognized and reported as very cumbersome • Some SAs have opted to continue to document on paper instead of the designated workflow. • With the most recent upgrade to Epic’s version Summer, 2010 we have additional functionality that can streamline the workflow

33. Opportunities • Phase I [in process]: Standardizing the Immunizations • No longer the need for the distinction between standard immunizations and those affiliated with the CHDP program • Supports the CAIRs implementation of the unidirectional interface • Update all current well child smart sets to be functional • This is an interim fix until the completion of the project • List of all immunizations will be embedded for patients who are behind at ANY level. • Service Area Management of Smart Sets: • Train SAs to update and manage their own smart sets inclusive of labs from their ‘preference lists’

34. Opportunities • Phase II [tentatively planned]: Streamline the Data Capture within EpicCare • Data capture of all of the program requirements with use of a Smart Form. • Expansion of CHDP Assessments to include those not currently listed in current programming • Charges to flow the same as they do today, upon placing the order for the procedure and/or administering charges will drop into encounter.

35. Project Scope and Team • Maria Vazquez- Santa Cruz • Carmen Aguila- Monterey County • Pamela Duncan-Placer County • Daniel Buchanan- Placer County • Gail Kuwahara- Open Door CHC • Tammy Flint- Open Door CHC • Marcy Chavez- Community Health Alliance of Pasadena Agree on design of Smart Form Agree on exactly what data will be captured within the form Agree on how billing staff will access clinical data for patient visits

36. Stakeholders • OCHIN Project Development Team • Subject Matter Expert’s from your organizations • Workgroup members • Leadership from your organizations

37. Project Activities • Review of configuration options • Understand the benefits and constraints of each option • Consensus on deliverables and boundaries • Training preparation and delivery to staff on changes to workflow • Assistance with testing prior to implementation.

38. Project Plan • Tentative Plan • Mid March 2013 • Gain consensus for project goals • Kick-Off workgroup call • Early May 2013 • Review configuration collectively • Schedule bi-weekly workgroup calls • Perform Gap Analysis (verify all required data is being collected and is retrievable) • Begin testing if no revisions needed • Early July 2013 • Determine Go or No-go to begin training • Implement new functionality by end of August 2013

39. Communication Plan • Communication Considerations • Delivery (email, existing workgroups, etc.) • Frequency • Level/Depth of Communication

40. Conclusion • Next Steps • Convene workgroup- Completed • Schedule Phase II Meeting • Determine and agree on configuration and data capture • Test • Review • Continue testing • Develop training materials • Train • Establish go-live date • Evaluate impact to operations • Other Related Questions?

41. Site Visits and SA Dashboard Review Aryicka Frison, OCHIN California Account Manager

42. Summary • As part of OCHINs account management strategy, organization specific data will be reviewed with key staff every six months whether through a site visit or webinar. • The information shared represents use of the OCHIN hosted software and its impact on day-to-day operations. This data will fundamentally support semi-annual objectives set during this review to uphold or advance your organization’s operations. • While the forthcoming slides are conceptual, they do however reflect the idea of data we will review with key staff. 707 SW Washington Street Suite 1200 • Portland OR 97205 • Phone 503.943.2501 • Fax: 503.943.2501 • Email: info@ochin.org • www.ochin.org

43. Summary of Dashboard Components • Basic Service Area Information and Tenure • Site Specialist and Development Milestones • No Show Rate and Number of Encounters • JIRA: Number Open, Closed and Average • Labs: Number Ordered, Errors and Error Rate • Revenue Cycle: Total Claims, Claim Error Rate through the Clearinghouse and Accounts Receivable • Meaningful Use Milestones • PCHH Milestones • Workgroup Participation

44. Dashboard Components Basic Information Site Specialist Development

45. Dashboard Components Appointments, Encounter & JIRA Labs, Claims & Claim Errors

46. Dashboard Components A/R by Payer Class & Aged Totals A/R Aged w/o Self Pay & Avg. Days

47. Meaningful Use Dashboard Components 707 SW Washington Street Suite 1200 • Portland OR 97205 • Phone 503.943.2501 • Fax: 503.943.2501 • Email: info@ochin.org • www.ochin.org

48. Meaningful Use Dashboard Components 707 SW Washington Street Suite 1200 • Portland OR 97205 • Phone 503.943.2501 • Fax: 503.943.2501 • Email: info@ochin.org • www.ochin.org

49. Meaningful Use Dashboard Components 707 SW Washington Street Suite 1200 • Portland OR 97205 • Phone 503.943.2501 • Fax: 503.943.2501 • Email: info@ochin.org • www.ochin.org

50. PCHH Dashboard Components Placeholder 707 SW Washington Street Suite 1200 • Portland OR 97205 • Phone 503.943.2501 • Fax: 503.943.2501 • Email: info@ochin.org • www.ochin.org