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Collaboration and Integration: Health Choice Network

Collaboration and Integration: Health Choice Network. Margarita Ollet, RN Senior Vice President Health Choice Network, Inc. Health Choice Network - Overview. In 1994, Founding Members strategically recognized need to collaborate to improve efficiency and effectiveness of care.

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Collaboration and Integration: Health Choice Network

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  1. Collaboration and Integration:Health Choice Network Margarita Ollet, RN Senior Vice President Health Choice Network, Inc.

  2. Health Choice Network - Overview • In 1994, Founding Members strategically recognized need to collaborate to improve efficiency and effectiveness of care. • HCN became new organization. Centers maintained independence as separate corporations. • HCN is a 501c(3) organization governed by its CHC members, who serve as Board of Directors • Currently HCN has 32 member centers (185 sites) in seven states (FL, UT, NM, HI, KS, IA, NE)

  3. Vision To be model for effective collaboration among health care partners, positioning our members as an integral part of the health care delivery system.

  4. Early Integration Efforts • Initially, HCN received BPHC and local funding for Integrated Services Network. • Initial Integration Efforts: • Managed care partnerships • Centralized Information Technology/ shared CIO • Centralized financial systems/ Shared CFO • Healthy Body, Healthy Soul

  5. Current Integration Domains • Information Technology – CIO • Centralized Network environment • Strong Disaster Planning / Recovery • Central training, help desk, project management • Comprehensive Electronic Health Record system • Finance – CFO • Centralized Billing Office (CBO) • Managed Care • HMO Contracts • Credentialing • Referrals • Programs • Jessie Trice Cancer Prevention Project • Pediatric Asthma Project • School Health Connect

  6. Integration: Clinical Operations

  7. Integration “on the ground”- Clinical Operations • Since 1996, monthly Clinical Committee meetings • Developed productivity standards • Adopted standard clinical practice guidelines • Created provider and ARNP agreements • Common Quality Care Guidelines – reviewed annually • Standardized Peer Review Tool • Coding and Documentation training • Developed Network QI Plan

  8. Integration “on the ground”- Clinical Operations • Electronic Health Records Implementation • Develop and revise EHR form templates by patient group • Best practice sharing of best practice sharing • Identified, piloted and implemented key clinical indicators to report at Network • Average HbgA1c of Diabetic Patients • Annual Lipid test for Diabetic Patients • Women with documented Pap Smears • Sharing of best-practices: monthly JCAHO measures • Monthly risk management scenario and discussion

  9. Leveraging IT – Improving Clinical Outcomes

  10. Diabetes HbA1c Trending and Benchmarking Report

  11. Future Pathways- Clinical Operations • Clinical Operations • Sharing of specialty staff and services • Exploring opportunities for revenue enhancement through economies of scale (lab, supplies, lab vendor) • Clinical Trials/ research • Provider Profiling • Network-wide process improvement efforts

  12. THANK YOU HEALTH CHOICE NETWORK

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