“HHQI Cardiovascular Data Registry Playbook” Home Care Association of Washington April 16, 2015 Carol Higgins, OTR (Ret.), CPHQ Quality Improvement Consultant, Qualis Health

2 Qualis Health is one of the nation’s leading healthcare consulting organizations, partnering with our clients across the country to improve care for millions of Americans every day Serving as the Medicare Quality Innovation Network Quality Improvement Organization (QIN-QIOs) for Idaho and Washington QIN-QIOs: the largest federal network dedicated to improving health quality at the community level

3 Goals for Today By the end of this session, you will better understand: Why your agency should focus on cardiac care What your options are for identifying areas to improve What difference this could make for you and your patients How this work can improve your business and marketability within your healthcare community

4 Increased Performance Transparency

5 Payment Reform On the Horizon Based on previous P4P programs, key metric on Home Health Compare likely to be included in future HHA P4P programs: How Often Home Health Patients Had to be Admitted to the Hospital Hospitals Physicians SNFs HHAs

6 Link Between Rehospitalizations and Cardiac Care Top Primary Diagnoses for All HHA Patients Top Chronic Conditions for All HHA Patients Top Primary Diagnoses for Re-hospitalized HHA Patients 1. Rehab 2. Heart Failure 3. Pressure Ulcer 4. Late Effect CVD 5. COPD 1. Hypertension (51%) 2. Diabetes (28%) 3. Heart Failure (20%) 4. Dementia (18%) 5. COPD (14%) 1. Heart Failure 2. Septicemia 3. Pneumonia 4. Device Complication 5. Dysrhythmia Data based on Medicare FFS claims for beneficiaries living in WA and ID and receiving HHA care between Q and Q

The Heart of Quality Courtesy of Cindy Sun, MSN, RN, COS-C

National Cardiovascular Disease George, Tong, Sonnernfeld, & Hong, 2012; Roger VL, et al. Circulation. 2012;125:e2-e220. & Heidenriech PA, et al. Circulation. 2011;123:933–4 Heart Disease is #1 cause of death Stroke is #4 cause of death 1 out of 3 deaths related to CVD Greatest contributor to racial disparity in life expectancy

Home Health Cardiovascular Improvement Initiative  Aligns with national Million Hearts® initiative  Focuses on the ABCS of preventive cardiovascular care The Million Hearts® word and logo marks are owned by the U.S. Department of Health and Human Services (HHS). Use of these marks does not imply endorsement by HHS. Use of the Marks also does not necessarily imply that the materials have been reviewed or approved by HHS.

Cardiovascular Health Best Practice Intervention Packages - Integrated

Home Health Cardiovascular Data Registry

ABCS Data ASPIRIN Was the patient taking ASA or other antithrombotic? BLOOD PRESSURE What was the patient’s final BP & was HTN addressed? CHOLESTEROL Did the patient have a lipid screening in the past year? LDL-C? SMOKING Was the patient screened for tobacco use? If a user, was an intervention implemented?

Data Access

Selecting month to abstract

Making monthly selection

1 st page in monthly registry

Top portion of Registry

Dual-Eligibility

Aspirin

Blood Pressure

Cholesterol

Tobacco

HHCDR Report

HHCDR Details  Access HHCDR through normal Data Access portal  Each month, HHA will select which measures (A, B, C and/or S)  Patient demographic information will be prepopulated on the 15 th of every month  All data ‘closed’ by the 14 th of the month will be used to create HHCDR Report to be posted ~23 rd of the month

HHQI CardeioLAN Sharing of cardiovascular knowledge & application of resources Networking Identifying opportunities for improvement Direct access to the HHQI Team CardioLAN

Cardio Milestones  Join the Progressive Cardiovascular Learning & Action Network (CardioLAN)  Download all Cardiovascular Best Practice Intervention Packages (BPIPs)  Complete HHQI Data Access registration  Close one month of required patients’ data in the Home Health Cardiovascular Data Registry (HHCDR)  Download one HHCDR report  Enter patient data & close a total of six months of required patients’ data for HHCDR  Validate data  Achieve noted improvement in one or more cardiovascular outcomes

Join Today

Cardiovascular Learning & Action Network

HHQI University  Platform for learning with HHQI – Monthly educational opportunities – Access to an evolving catalog of educational topics Easy to use Focus on applying best practices for improving patient outcomes – Engaging clinicians – Approved by American Nurses Credentialing Center (ANCC) – Learn more at

This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality Improvement Organization supporting the Home Health Quality Improvement National Campaign, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The views presented do not necessarily reflect CMS policy. Publication number 11SOW-WV-HH-MMD

34 Experiences from our Agencies Several agencies have signed up for the Cardiovascular Data Registry but not had a chance to enter data as yet Many agencies have been downloading and using the BPIPs for resources for their staff Feedback from participants…

35 Sharing Information and Ideas What are you currently doing to improve the care of cardiac patients? Are you utilizing the HHQI BPIPS? What would you like to be doing to improve care? How can Qualis Health support your efforts?

36 Summary – Urgency for Cardiac Care Improvements Strong need in all our communities Nationally recognized, evidence-based interventions are already available Educational resources are free and easily adaptable to home health schedules Data Registry is ready to demonstrate both your opportunities and your progress

37 Next Steps Participate in the HHQI Cardiovascular Data Registry Determine your specific areas of opportunity Download the BPIPs as needed for your area(s) of focus Work together to generate improvements Contact Qualis Health for assistance

38 Questions For more information: This material was prepared by Qualis Health, the Medicare Quality Innovation Network - Quality Improvement Organization (QIN-QIO) for Idaho and Washington, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. WA-C3-QH Carol Higgins, OTR (Ret.), CPHQ QI Consultant, Qualis Health T (206) F (206)