1. MiPCT Spotlight ADT Alert Overview and Workflow Training for Care Managers and PO Leads February, 2014

2. AGENDA 1.What Is Spotlight and What Does it Provide? 2.A Detailed Look at ADT Alerting in Spotlight 3.Care Management Workflows ▫Prompt action on Transitions of Care ▫How ADT alerts can be used to prioritize and manage your caseload

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4. What Functionality Does the MiPCT Spotlight Offering Provide? 1) Web-based access to MiPCT member lists 2) Near real-time alerts when patients are hospitalized or discharged.

5. More Details on the MiPCT Spotlight Offering At no cost to POs (cost is absorbed by the MiPCT administrative budget) To receive ADT alerting, PO signature on Carebridge MOU is required ADTs added as available (schedule provided in later slide) Up to two PO CTC Leads from each organization ▫Changes to Leads must be communicated to MiPCT and CTC ▫PO CTC Leads responsible for CM/practice mapping and updating.

6. Spotlight Data Security External security audit review performed in 2012 with CynergisTek and subsequent review planned for 2013 upon CCM Version 2 rollout completion Annually CTC undertakes: ▫Risk analysis of the company, our processes, assets, applications, data (under a NIST 800-30 based risk management program) ▫Review of all our policies and BAAs internally and with lawyers ▫Disaster recovery test ▫External network/application security tests Worked with Healthcare Law Consultancy (CCM) to address new HIPAA omnibus regulations (September 2013) ▫Policies in place and updated as HIPAA regulations change to address things such as security breaches including notification to affected parties. 6

7. Changes in Care Manager /Physician/Practice Mapping Apprising CTC ASAP about changes in mapping is a critical link for information security for your PO How to make changes: ▫Highlight rows with changes in spreadsheet ▫When adding care managers, MUST add to physicians, practices AND users tabs ▫When removing care manager assignments, explicitly indicate in “changes description” column for each row Process for change acknowledgement and processing at CTC ▫Upon receipt of mapping change, CTC sends email confirmation to PO CTC Lead ▫CTC makes mapping change within five business days and sends email confirmation to PO CTC Lead

8. Functionality 1: MiPCT Member Lists CTC Spotlight

9. Functionality 1: MiPCT Member Lists CTC Spotlight, cont.

10. Functionality 1, cont. : New Member Alerts via CTC Spotlight 10

11. Functionality 2: Admission/Discharge Alerting 11

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13. ADTs: From Alert to Care Delivery 13

14. Through partnership with MiHIN Leverages MiHIN/CareBridge ADT work Expands ADT availability with additional feeds with prioritization of ADT feeds of greatest value to MiPCT practices 14 Spotlight Leverages ADT Access

15. Admission, Discharge, Transfer MiPCT Data Flow and Progress Over half of our POs participate in the Crimson Care Management (CCM)/MiPCT partnership Care managers now receive member lists electronically via a web interface ADT notifications being added

16. ADT Progress to Date “Soft Launch” PO (Partners in Care) for Beaumont ADTs went live 12/9/13 ▫Partners in Care has developed customized care management workflows ▫Useful learnings will improve expansion to full launch Management tracking and reporting tool Working on clinical record access for MiPCT CMs with Trinity and HFHS (pilot development in progress) 16

17. ADT Next Steps and Timing Expansion to full launch early to mid-February Addition of other health system ADT feeds ▫HFHS Macomb (target: March 9th) ▫Trinity (target: April; confirming resources)  Mercy General Health Partner  Mercy Health Partners-Hackley Campus  Mercy Health Partners- Lakeshore Campus  St. Joseph Mercy- Oakland  St. Joseph Mercy- Ann Arbor  St. Mary’s Mercy-Livonia  St. Mary’s Healthcare- Grand Rapids ▫Remaining HFHS facilities (W Bloomfield, Main Hospital, Wyandotte: (target: May; confirming resources) Continued monitoring of alert tracking and impact on care 17

18. ADT Progress –Alert Contents 18 Beaumont HSHenry Ford HS Message Types All Patient ID / Medical Record (MR) XX Patient Name XX Date of Birth XX Administrative Sex XX Address If Available Phone number – home If Available Patient Account Number XX Patient Death Indicator If Applicable Primary Care Physician (ID, Name) XX Patient Class IP, EROBS, IP, ER Assigned Patient Location (Room / Bed) XX Prior Patient Location N/A Attending Physician (ID, Name) IP Only Referring Physician (ID, Name) XX Consulting Physician (ID, Name) XX Admit Source XX Admitting Physician (ID, Name) IP Only Patient Type XX Discharge Disposition IP Only Admit Date XX Discharge Date XX Plan ID / Name XX Group Number XX Policy Number XX

19. Phase 2: Admission/Discharge Alerting Patient Admitted Email Alert

20. Phase 2: Admission/Discharge Alerting Patient Discharged Email Alert

21. Phase 2: Admission/Discharge Alerting Patient ER Visit Email Alert

22. Alerting – Acknowledge via email Login to Spotlight

23. Alerting – Acknowledge via email Close Alert

24. Admission/ER Visit Information

25. Discharge Dispositions:

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27. St. John Providence, Partners in Care MiPCT-P.O.- Soft launch Partner

29. Workflow for Inpatient Alert

31. CM Workflow for Discharge Alert

33. CM Workflow for ED Alert

35. ADT Alerts Best Practice Process The following steps are completed by the CM 24-48 hrs. after alert notice. Acknowledge receipt of admission, discharge or ER alert from CCM. Investigate patient change in status and determine care management intervention. Document receipt of alert, intervention(review of EMR and follow up with facility contact, patient and physician) and planned follow up with patient in EMR.

36. Transitions of Care Integrated Workflow (displays inpatient, discharge and ED flows in one screen)

38. ADT/CTC Summary of Key Points Alerts need to be acknowledged on a timely basis throughout the day to minimize multiple alerts on the same patient. (i.e. admission alert that is not acknowledged by the time of discharge will generate another alert -> discharge alert) When acknowledging an alert by email, click on “view care plan” button once logged in CTC. Clicking “close” will remove alert from your home page and require you to look up patient by name. ( Patient hospitalization report is being developed via CTC website to see patient TOC activity.) It is recommended that review of the discharge disposition code be incorporated into your process.

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40. Contact Information For Care Management Workflow and Transition of Care Activity Upon ADT Receipt ▫Paula Amormino (amorminp@med.umich.edu) For PO Participation Agreement in MiPCT/CTC Spotlight Partnership and MOU ▫Diane Marriott (dbechel@umich.edu)dbechel@umich.edu For Care Management/Practice/Physician Mapping Changes; CTC System Issues ▫CTC Help Desk (877-736-4631 or support@careteamconnect.com ) support@careteamconnect.com ▫ if no response, contact Jeff Scehovic (ScehoviJ@advisory.com)