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OCHIN’s 2012 Learning Forum California Users Group Bi-Monthly Meeting Presentation Thursday, November 15th, 2012 Meeting begins at 2:45 pm PST.

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Presentation on theme: "OCHIN’s 2012 Learning Forum California Users Group Bi-Monthly Meeting Presentation Thursday, November 15th, 2012 Meeting begins at 2:45 pm PST."— Presentation transcript:

1 OCHIN’s 2012 Learning Forum California Users Group Bi-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 1881 SW Naito Parkway Portland OR Phone Fax CAIR Immunization (IZ) Interface Project Scope – Unidirectional Interface IZ messages Error reports Yellow Card Inventory Reports – All California members Workgroup of SME’s

5 1881 SW Naito Parkway Portland OR Phone Fax CAIR IZ Interface Status Completed Work – Interface Programming (HL7) – Error Reports – Automation – Basic Workflow Documentation In-Process Work – Scenario Testing – IZ Letter (Yellow Card) – Inventory Reports Immunizations Given Flu Vaccines – Training Plan – MU Attestation

6 1881 SW Naito Parkway Portland OR Phone Fax CAIR – IZ Interface Challenges – HL7 is new to CAIR – Stable testing environment (at CAIR) – Maintaining resources among all stakeholders (momentum) Implementation Date:

7 OSHPD Reporting California Primary Care Annual Utilization Report

8 1881 SW Naito Parkway Portland OR Phone Fax 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 1881 SW Naito Parkway Portland OR Phone Fax 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 1881 SW Naito Parkway Portland OR Phone Fax 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 1881 SW Naito Parkway Portland OR Phone Fax OSHPD Reporting Visit CriteriaEpic Master File - UDS Designation Clarity FieldMaintaine d by Performing Provider (provider who exercises independent professional judgment) Determines whether the performing provider type on the visit is UDS reportable or not. (See appendix A of the UDS manual for a comprehensive list of provider types and their UDS designation) UDS: Clarity_ser_view.Rpt_grp_eight OSHPD: Clarity_ser_view.Rpt_grp_seven Service Area Department (Site/Location within the grantee’s scope of project) Report grouper 1 must be set to either 'UDS Y’ or ‘UDS Y - School’Clarity_dep.Rpt_grp_oneOCHIN Place of Service (Site/Location within the grantee’s scope of project) Report grouper 2 must be set to 'UDS Y’Clarity_pos.Rpt_grp_twoOCHIN Visit Program (Types of services) The UDS flag in the OCHIN custom “UDS_Program” Clarity table must be set to 'UDS Y'Uds_programs.UdsOCHIN Procedure Code (Types of services) Report grouper 2 must be set to 'UDS Y’ on at least one procedure code posted against the visit.Clarit_eap.Rpt_grp_twoOCHIN

12 1881 SW Naito Parkway Portland OR Phone Fax 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 related encounters 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 1881 SW Naito Parkway Portland OR Phone Fax OSHPD – Sample Grouper Report

14 1881 SW Naito Parkway Portland OR Phone Fax OSHPD – Grouper Report Cont.

15 1881 SW Naito Parkway Portland OR Phone Fax 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 1881 SW Naito Parkway Portland OR Phone Fax 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 1881 SW Naito Parkway Portland OR Phone Fax 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 1881 SW Naito Parkway Portland OR Phone Fax OSHPD – Section 3 Reports Cont.

19 1881 SW Naito Parkway Portland OR Phone Fax OSHPD – Section 3 Reports Cont.

20 1881 SW Naito Parkway Portland OR Phone Fax 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 1881 SW Naito Parkway Portland OR Phone Fax OSHPD – Section 4 Reports Cont.

22 1881 SW Naito Parkway Portland OR Phone Fax 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 1881 SW Naito Parkway Portland OR Phone Fax OSHPD – Section 5 Reports Cont.

24 1881 SW Naito Parkway Portland OR Phone Fax 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 1881 SW Naito Parkway Portland OR Phone Fax 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 : Encounters by Primary Payor (i.e. Medi-Medi Encounters are reported under Medicare)

26 1881 SW Naito Parkway Portland OR Phone Fax OSHPD – Section 6 Reports Cont.

27 1881 SW Naito Parkway Portland OR Phone Fax 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 1881 SW Naito Parkway Portland OR Phone Fax 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 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 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

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 ( , 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 707 SW Washington Street Suite 1200 Portland OR Phone Fax: 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.

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 Category Metric Member Organization Basics Project Manager:*** Account/Engagement Manager:*** SA #:*** Go Live Type:PM & EHR Annual Visits:34,000 Tenure Go Live Date*** # Days Live*** # Weeks Live*** Site Specialist Development CategoryMetricValue Site Specialist *** Site Specialist Readiness Provider Master FileNo To Date TrainedYes Project CompletedNo User RecordsYes TrainedYes Project CompletedYes Maintaining Preference Lists:Yes TrainedYes Project Completedn/a Maintaining Fee Schedules:No TrainedYes Project CompletedYes Web Utilities:Yes WorkstationsYes PrintersYes Order Transmittal w/s AddsNo Remote AccessYes

45 Dashboard Components Appointments, Encounter & JIRA Appointments No Show Rate2287 [Date Range] Average Per Day2094 Average Per Provider91.6 Encounters # of Encounters:2287 [Date Range] Closed Same Day or Day After:2094 % Of Visits Closed On Same Day or Day After:91.6 Avg Days To Close:0.5 Duplicate Patients:53 Duplicate Patients (as % of visits):0.156% JIRAs Tickets Opened155 [Date Range] Tickets Closed118 Tickets Still Open37 Avg Tickets Opened Per Week24.7 Labs, Claims & Claim Errors Lab (EHR Only) Lab Orders:935 [Date Range] Lab Errors :11 Lab Error Rate :1% Revenue Management Total Claims:4145 [Date Range] Total Charges $ 579, # Gateway EDI Claim Errors36 $ Gateway EDI Claim Errors $ 5, % Of Gateway EDI Claim Errors0.9% # Payer Claim Errors189 $ Payer Claim Errors $ 28, % Payer Claim Error4.6%

46 Dashboard Components A/R by Payer Class & Aged TotalsA/R Aged w/o Self Pay & Avg. Days AR by Payor Class %: Self Pay:-7.97% Commercial:65.14% Family Planning: Managed Medicaid0.89% Medicaid FFS:6.72% Medicare:35.21% Aged AR Total %: 0-30 days:92.77% days:-7.12% days:3.02% 91 and greater days:11.34% Aged AR w/o Self Pay %: 0-30 days:84.14% days:4.67% days:2.80% 91 and greater days:8.39% Avg # of days in AR by Payor Class as of [insert date]: Self Pay: Commercial: Family Planning: Managed Medicaid 29 Medicaid FFS: Medicare: 21.98

47 Meaningful Use Dashboard Components 707 SW Washington Street Suite 1200 Portland OR Phone Fax: Year to Date Report This report card is based on EP's meeting MU Measures on a YTD basis, not 90 days 90 days of meeting all measures can be analyzed via the Solutions "MU Provider Roster" Report Meaningful Use Core Measures # EP's Meeting MU Measure Total # EP's at SA % Meeting YTD Measure CPOE Medication Orders (by patient) % Maintain Active Problem List7887.5% E Prescribing (by prescription) % Maintain Active Medication List7887.5% Maintain Active Allergy List7887.5% Demographics7887.5% Record and Chart Vitals7887.5% Smoking Status7887.5% Provide Copy of e-Chart (w/in 3 days) % After Visit Summary (MyChart or Print)7887.5%

48 Meaningful Use Dashboard Components 707 SW Washington Street Suite 1200 Portland OR Phone Fax: Meaningful Use Menu Set Measures # EP's Meeting MU MeasureTotal # EP's at SA % Meeting YTD Measure Structured Lab Results % Electronic Access to Patient Record7887.5% Patient Specific Education7887.5% Transition of Care or Referral Summary5862.5% YES/NO Attestation Measures Drug-Drug and Drug-Allergy checksYES Report quality measures to CMSYES Launch/track one clinical decision support ruleYES Capability to exchange key clinical informationYES Security risk analysis Generate lists of patients by specific conditionsYES Immunization RegistriesBY STATE

49 Meaningful Use Dashboard Components 707 SW Washington Street Suite 1200 Portland OR Phone Fax:

50 PCHH Dashboard Components 707 SW Washington Street Suite 1200 Portland OR Phone Fax: Placeholder

51 Committed to improving the health of the medically underserved through the best use of information and information technology. QUESTIONS?

52 2013 Revisions Aryicka Frison, OCHIN California Account Manager

53 2013 Proposals  Do we need to meet on the same schedule?  Currently bi-monthly  3 rd Thursday from 10 am -11:30 am  Best time for annual conference?  Currently June  Volunteers to host this years conference?  Last years host: Alliance Medical Center, Healdsburg, CA  SA specific meetings needed in conjunction with the collective?  Tried this year, very little interest.

54 California Member Recognition Presented by Aryicka Frison

55 Elite Club Accomplishment! Gateway EDI’s 99% Club [Error-Free Claims] Criteria Submit at least 200 claims a month Maximize their EDI rate for transactions Utilize the Gateway EDI website Demonstrate a low “AVG Days to File” rate Be a member for at least 6-months One of our own reached this status for the months of September & October 2012

56 Elite Club Accomplishment! Santa Cruz County and Don Carlisle’s team for such an accomplishment! Keep up the good work and keep sharing your practices with the other collaborative members. Together we’ll all reach such a status.

57 Next California Users Group Meeting January 17 th, 2013 Please send agenda items and volunteer to present! Thank you, enjoy the rest of the learning forum’s informational offerings!


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