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Leveraging Data for Performance Improvement Jack Millaway, LPHI Chatrian Kanger, AHL.

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Presentation on theme: "Leveraging Data for Performance Improvement Jack Millaway, LPHI Chatrian Kanger, AHL."— Presentation transcript:

1 Leveraging Data for Performance Improvement Jack Millaway, LPHI Chatrian Kanger, AHL

2 Why is it Important? Data has always been important in healthcare, but its scale continues to expand – Individual patients – Chart Sampling – Patient Registries – Organization-wide – Whole population (community and beyond)

3 Pay-for-Performance, Alternative Payment Models and Value Based Care Initiatives In the past few years, data and its impact on payment has expanded drastically: – ACO’s and other shared savings or incentive contracts with payers – UDS Quality Awards – Patient Centered Medical Home – Meaningful Use

4 Pay-for-Performance, Alternative Payment Models and Value Based Care Initiatives And its impact will only continue to expand! – Medicare payments 30% of contracts by the end of this year 50% by the end of 2018 MIPS and MACRA – Meaningful Use Stage 3 – UDS whole population reporting – Grants and other initiatives

5 Electronic Health Records and Data Timeline

6 THE FUTURE Image source: SAS Analytics (blog.SAS.com)

7 Source: bobdylan.com Healthcare Analytics Evolution

8 Best Practices to adopt today 1.Evaluate your current environment a)Active payer contracts b)UDS, PCMH, Meaningful Use, and other Quality Incentive programs 2.Make a plan a)Where does it make sense to target efforts? b)Capacity to implement change 3.Make it a priority a)Regular monitoring b)Integrate data into all QI projects

9 DATA IN PRACTICE Chatrian Kanger, MPH Quality Assurance Manager Access Health Louisiana

10 Who We Are Established as St. Charles CHC in 2002 27 practice sites (CHCs + SBHCs) 9 parishes 92 providers total 40k patients & ~125k visits / year

11 Internal Structure: Care Teams Support Teams Training Department, QA/Reporting/ EMR staff, Call Center Athena

12 Current Performance / Quality Improvement Process Collect and review data from multiple data sources Prioritization of Quality Measures Categorize by roles Leverage internal structures & technologies when feasible (e.g. EMR, call center, training team, etc)

13 Priority Area – Care Coordination AHL focus: Ensure timely access to follow-up care after a hospital discharge

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15 Emergency Dept / Hospitalizations GNOHIE

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17 Issues with Current Flow:  Introducing RISK: – Losing patients to timely f/u care – Increasing likelihood for readmission or inappropriate ED usage again  Losing $$$  Ability to document & track: - Scheduler (appt types) -Pre-built Templates -Pre-built Reports

18 What’s on the Horizon? increase Patient load in GNOHIE is about to increase once our interface completes with Athena Additional patient load & awareness of ED / hospital visits w/ other interfaces + payers Reducing ED/ hospital visits Incentive $$$ focus on ensuring timely access to f/u care Care coordination

19 Emergency Dept / Hospitalizations GNOHIE Scheduling:  Add drop down for appointment reason Clinical Documentation:  Rx reconciliation  HPI template – “Emergency F/U Record” Reporting Templates:  Use “ED Followup Report” & “Hospitalizations Report” Other Systems

20 Considerations: Added workload on Nurse Care Managers: – Explore opportunities to reduce inefficiencies Suggestion: Triage to Medical Records? Give lookup access to Patient Care Coordinators  Training Nurse Care Mgrs on Scheduling? Leverage templates within Athena – HPI Template: “Emergency F/U Record” – Report: “ED Followup” & “Hospitalization Report” – Scheduling: Add in drop-down for “appt reason”

21 RECAP: “Data” can be quantitative and qualitative Work backwards Steps or Tools: – Review data reports to id trends against targets – Workflow mapping of current state & future state – Explore options within our EMR system to automate functions: Scheduling Documentation Reporting – Deliver training / update protocols accordingly


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