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Downstate New York Care Coordination Project September 16, 2013

Downstate New York Care Coordination Project September 16, 2013. Context. NYS Medicaid Health Homes have implemented (or are implementing) care coordination solutions to meet their near term requirements Each Health Home currently uses a separate care management system or EHR

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Downstate New York Care Coordination Project September 16, 2013

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  1. Downstate New York Care Coordination ProjectSeptember 16, 2013

  2. Context • NYS Medicaid Health Homes have implemented (or are implementing) care coordination solutions to meet their near term requirements • Each Health Home currently uses a separate care management system or EHR • In the Downstate NY region, there are many providers who are in multiple Health Homes and multiple RHIOs and their patients will cross borders • If various care management tools do not support interoperability, providers may have to use 2 or 3 different systems and this is not sustainable • Current state leaves untenable situation of no care plan interoperability

  3. Goals and Objectives Develop consensus around functionality that would enable enhanced care coordination, care plan management and interoperability across Health Homes and RHIOs through the SHIN-NY Align activity with developments at the national level Develop Requirements to support the interoperability and joint management of Care Coordination Plans across organizations Phase I implementation - Demonstrate the ability for two sites with two different care management tools to exchange Care Coordination Plans

  4. Requirements The DCC Workgroup agreed upon the following seven functions: Enrollment of Health Home patients Linking of patients and providers: care teams Exchange of interoperable care plans Clinical Event Notifications Secure Messaging Access to medical records for clinicians Access to care plans for non-clinicians

  5. NY Downstate Pilot Participants

  6. Care Coordination Plan (CCP) CollaborationWhat is a CCP? Care Coordination Plan (CCP) refers to a shared document that is used to track problems, goals, interventions and outcomes related to both clinical and social issues CCPs are a focus of collaboration for diverse care teams across organizations

  7. Care Coordination Plan (CCP) CollaborationUse Case • 2. Editor will view the CCP in their local care management tool, and suggest edits to the Author for review and approval. The Author retains editorial control of the CCP • 1. Author will create and edit the CCP in a care management tool that uses a national agreed upon structure for interoperable CCPs Iterative process based on interoperability standards • 3. Reader can view the most recent CCP in the RHIO, and provide comments to the Author through secure messaging

  8. Healthix HEAL 17 – Project Highlights • Identified two sites with two different vendors to participate in Phase 1 implementation, both part of Continuum Health Partners • Addiction Institute of New York • Methodone Treatment Program (Netsmart) • Outpatient Treatment Program (Caradigm) • Held kick off meeting with stakeholders in early June • Agreed on Requirements and Phase 1/2 development • June – July: Design phase; engaged Lantana to align the data model with proposed standard as closely as possible • July - August: Development, finalize draft data model for the standard Care Coordination Plan with the LCC Standards Workgroup • September: Testing, Acceptance • October: Phase 1 Implementation, Evaluation

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