1. Stratis Health Prevention Project June 30, 2011

2. 2 Stratis Health Stratis Health is a non-profit organization that leads collaboration and innovation in health care quality and safety, and serves as a trusted expert in facilitating improvement for people and communities Under federal contract, Stratis Health serves as Minnesota’s Medicare Quality Improvement Organization (QIO) Stratis Health is also involved in state and national projects funded through government contracts, foundation and corporate grants, and health systems www.stratishealth.org

3. 3 Agenda Prevention Project Review Clinic Presentations Project Results Upcoming Project Opportunities Discussion / Questions

4. 4 PREVENTION PROJECT REVIEW

5. 5 Prevention Theme Overview Focus on assisting adult primary care clinics in utilizing the care management capabilities of electronic health records (EHR) Improve cancer screening (colorectal and breast cancer) and immunization rates (influenza and pneumococcal) for Medicare beneficiaries Care/population management Maximize EHR and office efficiency

6. 6 Prevention Theme Goals Improve relative improvement rate of colorectal cancer screening by 15% Improve relative improvement rate of breast cancer screening by 10% Improve relative improvement rates of pneumococcal and influenza immunizations by 10% Relative Improvement Rate (RIR) = [(Quarter Rate – Baseline Rate)/Baseline Rate] Relative Improvement Rate (RIR) = [(Quarter Rate – Baseline Rate)/Baseline Rate]

7. 7 Process Clinic Assessments Review of data specs Data submission and analysis –Baseline data –Quarterly data pulls throughout project Development of work plans and interventions Monthly conference calls/meetings Group Educational Webinars

8. 8 CLINIC PRESENTATIONS

9. 9 Alexandria Clinic, P.A. Quality Improvement Committee Involvement Process Improvements –Beyond Prevention Project measures Physician Involvement –Education –Template development

10. 10 Renville County Hospitals & Clinics Using data to implement process changes/improvements Identifying gaps and implementing interventions Involving staff in the Prevention Project

11. 11 Ridgeview Clinics Pulling the data/running reports Immunization process improvement –Email blasts Sharing of data results –Physicians –Board

12. 12 Stillwater Medical Group Changing from one EHR vendor to another Cleaning up EHR data Using data to implement process changes/improvements –Quality Improvement Committee –Physician involvement –Staff involvement

13. 13 PROJECT RESULTS

14. 14 Opportunities Track preventive care given to a patient –Both at the clinic and outside the clinic Track tests/screenings given –Both at the clinic and outside the clinic Clinical reminders –At time appointment is scheduled –At point of care Reports of patients not receiving tests/screenings

15. 15 Interventions Improve data entry related to screening measures Integrate clinical reminders and tracking into everyday practice Redesign workflows to improve outcomes Use of clinical reports to identify patients not receiving screenings

16. 16 Implementing Change Review of current care practices and performance gaps Identification of appropriate interventions to reduce performance gaps Monitoring and refinement

17. 17 Challenges Pulling the data Understanding what your EHR can and can’t do Understanding the clinics’ patient population Changing processes/workflows

18. 18 Results Measure Baseline – March 2009 Current Rate – June 2011 Relative Improvement Rate Absolute Improvement Rate EHR Influenza Vaccination 44%48%11% 4% EHR Pneumococcal Vaccination 25%60%304%35% EHR Colorectal Cancer Screening 28%41%68%13% EHR Breast Cancer Screening 36%46%153%10% Relative Improvement Rate (RIR) = [(Quarter Rate – Baseline Rate)/Baseline Rate] Absolute Improvement Rate = Current Quarter Rate – Baseline Rate

19. 19 UPCOMING PROJECT OPPORTUNITIES

20. 20 Upcoming Project Opportunities CMS next scope of work –Physician Quality Reporting System (PQRS) EHR reporting –Preventive Health Learning Network –Cardiac Population Learning Network Regional Extension Center –REACH http://www.khareach.orghttp://www.khareach.org Health Information Technology projects

21. 21 DISCUSSION / QUESTIONS?

22. 22 Thank You! Contact Information: Jerri Hiniker, BSN, RN, CPEHR Email: jhiniker@stratishealth.orgjhiniker@stratishealth.org Ph: 952-853-8540

23. 23 Stratis Health is a nonprofit organization that leads collaboration and innovation in health care quality and safety, and serves as a trusted expert in facilitating improvement for people and communities. This material was prepared by Stratis Health, the Medicare Quality Improvement Organization for Minnesota, under contract with the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. June 30, 2011.