1. © 2015 The Verden Group Wrestling The Beast Of PCMH Your Partner in Practice OP User’s Conference April 23-25, 2014

2. © 2015 The Verden Group Getting Started

3. © 2015 The Verden Group Getting Started – Understand Requirements First, understand the requirements and concepts 1.Understand the purpose http://www.youtube.com/embed/ZC4YCLG4h5k 2.Read the Standards thoroughly. Then read them again! http://ow.ly/uX6zZ 3.Take the trainings (online or in-person) http://ow.ly/uX6KJ 4.Visit practices who are already medical homes and network to learn best practices http://recognition.ncqa.org/

4. © 2015 The Verden Group Getting Started – Where Are You Today? Second, figure out where you are in the process and what points you may already have: ➢ Scan through the Standards and check off - What you are you already doing What processes you need to adjust What you need to build AND / OR you can take the PCS free survey and we will help you determine your ‘gaps’...

5. © 2015 The Verden Group Take the PCS Online Survey ▪Complete to the best of your ability – keep it simple ▪We will provide feedback to show you where you are today ▪It will help to set up your project plan by identifying the areas in which you need to do the least work (quick hits) and the most work ▪Yes, it is FREE for OP Clients! https://www.theverdengroup.com/application-process/ PCS Survey

6. © 2015 The Verden Group Example of the Survey

7. © 2015 The Verden Group Getting Started – Have Points Already? Third, what points can you get through OP? ➢ OP has applied for ‘pre-validation’ points for 2014 This means that you will receive credit for certain factors simply by having OP’s EMR... You may be able to get up to 6.375 points just for being an OP Client!

8. © 2015 The Verden Group Example of How Pre-Validation Points Work

9. © 2015 The Verden Group Getting Started – MU Points? Fourth, what points do you already have from MU1? ➢ If you are already doing MU, identify all MU related factors for which you already have the data collected MU1-MU2 PCMH Crosswalk:

10. © 2015 The Verden Group Fifth, Build & Train Your Team ➢ Form a PCMH team comprised of at least: A physician ‘champion’ for each location A nurse / clinical manager An office manager ➢ Train the members of your PCMH team ➢ Share information across the practice and keep EVERYONE informed Get Buy In

11. © 2015 The Verden Group Who should you have on your team? ▪Clinical ▪Administrative ▪Physician Champion How frequently should you meet? How will you stay on track with the project? Who should receive training? What training is necessary? ▪NCQA online webinars ▪NCQA in-person training The Team and The Plan

12. © 2015 The Verden Group Tools & Support ➢ OP has a PMCH module that includes the following features: ➢ PCMH Reports bundle via QIC ➢ Access to the PCMH user roadmap ➢ PCMH reports webinar to review the OP generated reports ➢ OP has great information, including a Roadmap, available here: PCMH User Roadmap Utilize Your Resources!

13. © 2015 The Verden Group Setting Up Your Project

14. © 2015 The Verden Group Put in place basic project management controls: Break down the work that needs to be done Start with the most important tasks first (not chronologically!) Set a timeline to accomplish each item Create an organized process for compiling the data and documentation that will be submitted to NCQA Have standing meetings on a weekly basis Share regular updates with staff in the form of memos Apply Project Management Principles

15. © 2015 The Verden Group Walk through every task, in front and behind the scenes, and follow the patient flow through the office Look for these key items: ▪Are there formalized policies and procedures ? ▪Technology utilization beside an EMR, what else does your practice have that you can leverage for recognition o Website? o Patient Portal? o Recall system? Catalogue What You’ve Got

16. © 2015 The Verden Group Keep detailed notes during your assessment ▪Enter it right into your plan. This is your roadmap to tracking the changes needed to transform Keep it simple ▪If you are not sure about something, note that and keep moving through the ‘assessment’ Catalogue What You’ve Got

17. © 2015 The Verden Group Tackle the major pieces first: ➢ Figure out what ‘conditions’ you want to focus on first and set up visit templates for those While you work through the rest of the project, those most important pieces of data will already be in the process of being gathered ➢ Figure out the best ways to identify and stratify your ‘high- need’ patients (vulnerable and high risk populations) ➢ Determine what data you can get at readily for items like recalling, tracking preventive care and immunizations and improving quality Focus On The Important Work First

18. © 2015 The Verden Group Zero in on Red first and make decisions about important conditions. Implement Green early – these are the processes that are easiest to adapt. Understand what you need to do for Black and plan accordingly as you work through the project.

19. © 2015 The Verden Group Tackle the Conditions and ‘Must Pass’ Elements First

20. © 2015 The Verden Group Recap - How the Scoring Works

21. © 2015 The Verden Group Focus on Must Pass & High Scores

22. © 2015 The Verden Group Processes & Procedures

23. © 2015 The Verden Group Set Up Protocols Create visit templates for your important conditions ▪The longer you are collecting data, the more likely you will reach your percentage targets when it comes time to compete the workbook. Set up Standing Orders and utilize them ▪Example (2D4): testing protocols, defined triggers for prescription orders, medication refills, vaccinations, routine preventive services

24. © 2015 The Verden Group Processes Preformed But Not Written? First, use what you’ve got ▪Job descriptions, meeting notes, training handouts etc. Start drafting! ▪Don’t do an individual policy or procedure for each factor - group them together, and keep it simple ▪Have everyone pitch in Ask staff to draft what they do and those can be edited / refined from there

25. © 2015 The Verden Group No Process At All? Start by adding the easy ones first ▪Example – collecting race & ethnicity, PCP ➢ Have your staff begin doing that right away. ➢ The longer you have them collecting data, the more likely you will reach your percentage targets when it comes time to submit your supporting data and documentation OR ▪Take a short cut and purchase MGMA’s fully customizable Policies and Procedures templates if you do not have any of your own- http://www.mgma.com/store/books/electronic/patient-centered- specialty-practice-medical-home-p http://www.mgma.com/store/books/electronic/patient-centered- specialty-practice-medical-home-p

26. © 2015 The Verden Group Manage Your Documentation

27. © 2015 The Verden Group Capture As You Go ▪Create a ‘Master Copy’ binder / electronic file folder and have one person manage it ▪Keep working versions and final versions separate to avoid version control issues ▪Tag documents with the specific factors that each section is addressing using Word notes, PDF markers, etc. ▪Consistently name your files specific to the Element and Factor(s) addressed Use a tool like Basecamp! Compiling the Material

28. © 2015 The Verden Group There Are Resources Available to Help You!

29. © 2015 The Verden Group AAP Resources: www.pediatricmedhome.org

30. © 2015 The Verden Group PCS PCMH Program Project Management and PCMH Consulting Packages in Conjunction with OP

31. © 2015 The Verden Group Contact Information The Verden Group, Inc Your Partner in Practice www.TheVerdenGroup.com Susanne Madden, MBA, NCQA CEC madden@theverdengroup.com Julie Wood, MSc, NCQA CEC julie@theverdengroup.com Q & A