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Collaboration and IT Systems

Collaboration and IT Systems. Linda M. Kinney, MHA Care Share Health Alliance Director, Collaborative Network Development Jennifer Tyner Program Manager Access II Care. Introduction. Supersonic overview of national and state HIT Collaborative Networks’ need for linked IT systems

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Collaboration and IT Systems

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  1. Collaboration and IT Systems Linda M. Kinney, MHA Care Share Health Alliance Director, Collaborative Network Development Jennifer Tyner Program Manager Access II Care

  2. Introduction • Supersonic overview of national and state HIT • Collaborative Networks’ need for linked IT systems • Lessons learned from Communities • Tools and Resources • Questions and Answers

  3. ARRA, HIT, HITECH, EMR, EHR, HIE…… • American Recovery and Reinvestment Act (ARRA) of 2009 • Authorized nearly $36 billion in funding for health information technology (HIT) infrastructure over 6 years. • The majority of the funding ($34 billion) is set aside for incentive payments for Medicare and Medicaid for incentives to providers who: • Adopt certified electronic medical records • Demonstrate Meaningful Use of the medical records • Provide data for quality reporting

  4. ARRA, HIT, HITECH, EMR, EHR, HIE…… • Health Information Technology for Economic and Clinical Health (HITECH) • provides a framework for how this HIT funding is to be spent. • HITECH has 3 major components: • Wide adoption of Electronic Medical Records (EMR) • Establishment of interoperable systems for health information exchange (HIE) • Aggregate data reporting (individual and population)

  5. ARRA, HIT, HITECH, EMR, EHR, HIE…… • Meaningful Use – federal standards for using EMRs to: • Improve clinical care • Reduce medical errors • Control health care costs Providers will receive incentives to implement meaningful usage through the use of EMRs by 2014, and reduced reimbursement if not in place by 2015 • Electronic Health Record (EHR) – contains a subset of information from several health delivery organizations – pulls information from EMRs – to create a cohesive patient record

  6. ARRA, HIT, HITECH, EMR, EHR, HIE…… • Health Information Exchanges (HIE) are national/state/regional technologies that allow for exchange of health information between providers and other exchanges. • Has a master patient index – so a patient has one record with multiple providers contributing (EHR) • Information can be exchanged across HIEs as the patient moves from community to community… • Patients have access to their EHR/EMR – potential for Personal Health Records (PHR) to connect as well

  7. Health Information Exchange Health Information Exchange Health Information Exchange (HIE) Electronic Medical Record Electronic Medical Record Electronic Health Record Electronic Medical Record Electronic Medical Record

  8. John W. Loonsk, MD FACMI

  9. Some Things That May Be Available From HIEs • Clinical data • EHR • Utilization data • Information about patients seen outside of your network • Quality measures • Referral management

  10. Some information Collaborative Networks need from and IT system • A way to count things specific to your network – with the partners you have at the table – • Unduplicated patients across providers – the holy grail • Patients enrolled in the network and for specific programs – enrollment data • Utilization data – visits (by provider) and service (by type: medications, medical visits, ER visits, ….) including community, social, supporting services • Quality measures – disease management measures, others • Demographic and screening information for patients enrolled in network/programs – that everyone in the network can access • Referral Management – where was it made, by whom, and did the patient receive a service • Value of services – claims data and other – helps with return on investment measures

  11. Some Features to consider as you look for a system • Allow you to easily screen patients for eligibility in your network, Medicaid, and other insurance programs – health insurance exchanges in the future • Allow you retain the information you gather from the screening • Enroll patients in multiple programs (network being one, then other programs) • Referral management • Track utilization across providers • Ability to REPORT ON YOUR OUTCOMES • Ability to connect to HIEs in the future – you’ll need some kind of EHR or.. • HIPAA compliant

  12. Things to Keep in Mind as you look for a system • The HIT/HIE world is still under construction – there are many unknowns • Minimize duplication of features that may be more robust through EMR/HIEs – ie: clinical data • Your partners IT systems are the building blocks for the Collaborative’s system. Connect partners to resources: • NC AHEC Extension Center • NC Medical Society Foundation – loan repayment program • You will need a system or process to manage the Collaborative’s work • Your system needs to connect to future systems – will need an EHR

  13. Lessons Learned

  14. Capital Care Collaborative (Wake County) • IT systems are about people and relationships – it’s collaboration • Buy-in is essential – communication is key, involve partners • The legal documents are a foundation – you can’t move ahead without them • Pay for what you need. • Define the outcomes you will use to measure progress at the start.

  15. Capital Care Collaborative (Wake County) • Plan tangible milestones, and keep them coming every four to six months. • You need a translator. • Triple the timeline. • IT is not a magic bullet

  16. As you prepare for a linked IT System consider these factors… • Legal costs, to build the “foundation” of documents • Consulting, to acquire technical expertise and “translator” skills • Staff time, from CCC personnel and partner organizations alike

  17. What can you do to prepare • Put agreements in place: • -Patient authorization, Business Partner Agreements, data usage, etc… • Map out the patient flow: • -How do patients navigate the system now? What do you want it to look like? • Determine your business process and the data you need to collect: • -driven by your outcomes!!!! • Focus on your assets: • -Utilize the resources you currently have at your disposal

  18. Jennifer Tyner Access II Care

  19. Now What? • Where are you now? • Where do you want to be? • What do you need to do to get there?

  20. Just START! • S Set Goals, Objectives, Measures • T Technology Subcommittee • A Act • R Remember the Patient • T Time is Now Health Care Reform Clock is Ticking

  21. Technology as a Roadblock to Collaboration • Common for collaborations to stall, as we believe we have to have connected IT to start • Fantasy of achieving “single entry” system • Rapidly changing HIT/HIE environment • Implementing IT before understanding workflow • Implemented IT does not deliver as promised • $$$$ always causes problems!!!! • Easy to lose sight of original goal—patient care does not remain the focus

  22. What can you do today? • Establish Shared Goals (and don’t lose sight of them!) • Determine Collaborative Specific Objectives • Set Target/Performance Measures • Identify Data and Reporting Needs • Assess What is Available TODAY for Sharing, Collecting, and Reporting Data • Establish Legal Relationship to Share this Information • Let IT Committee Work on technology plan

  23. Using What You Have • Data • We all have it!!!! • Database(s) • Purchased software • Homegrown • Free products - CMIS, MARP, others • Office Software • Spreadsheets • Internet • If you don’t have, this should be #1 priority • Data Czar • Identify one entity to be responsible for collecting shared information

  24. IT Tools for Collaboration google sites – free: https://sites.google.com/site/transcwp/ Meetingwizard.com – free: See Handout for others

  25. Questions?

  26. Thank You! • Linda M. Kinney, MHA • Care Share Health Alliance • Director, Collaborative Network Development • lkinney@CareShareHealth.org • (919)861-8356 • Jennifer Tyner • Program Manager • Access II Care • jtyner@accessiicare-wnc.org • (828)259-3879 ext 306

  27. National Coordinator for Health Information: http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__home/1204 NC HIT website www.ncdhhs.gov/healthIT North Carolina Healthcare Information & Communications Alliance, Inc. (NCHICA) www.nchica.org WNC Health Link (HIE) www.wnchn.org AHEC Extenstion Center www.ncahecrec.net NC Medical Society www.ncmedsoc.org/practice_management/hit.html Capital Care Collaborative www.wakedocs.org/CapitalCareCollaborative.html • Links To Resources

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