Agenda

Delivery System Transformation Committee February 8, 2018 4:30 – 6:00 pm

Samaritan Walnut Building, Endeavor Conference Room

Dial in: 866-439-0933 Code: 5093665467

1. Introductions Kim Whitley, COO, Samaritan

Health Plans

4:30

2. Transformation Update

• Pilot Quarterly Report

• Calendar

p. 3

Jenna Bates, Transformation

Manager, IHN-CCO

4:35

3. OHA Update p. 8-12 Joell Archibald, Innovator Agent,

OHA

4:45

4. Alternative Payment Methodologies (APM) Closeout p. 13-19 Carla Jones, Reimbursement

Manager, IHN-CCO

4:55

5. DST Planning

• RFP Calendar Update

• Crosswalk/Target areas

• 2017 Letter of Intent Question 2

• Pilot Closeout – See Strategic Planning document

p. 21

p. 22-24

p. 25-27

Kim Whitley, COO, Samaritan

Health Plans

5:15

6. How to Get the Story Out

• Awareness Survey

• How to Get the Story Out Grid

p. 29-31

p. 33

Kim Whitley, COO, Samaritan

Health Plan

5:45

7. Wrap Up

• February 22, 2018 Strategic Planning

• APM: https://www.surveymonkey.com/r/_APM

Kim Whitley, COO, Samaritan

Health Plans

5:55

COMMONLY USED ACRONYMS AND MEANING 

 Acronym  Meaning  ACEs  Adverse Childhood Experiences  APM  Alternative Payment Methodology CAC  Community Advisory Council CCO  Coordinated Care Organization CEO  Chief Executive Officer CHIP  Community Health Improvement Plan CHW  Community Health Worker COO  Chief Operations Officer CRC  Colorectal Cancer DST  Delivery System Transformation Committee ED  Emergency Department EHR  Electronic Health Records ER  Emergency Room HE  Health Equity IHN‐CCO  InterCommunity Health Network Coordinated Care Organization LCSW  Licensed Clinical Social Worker MOU  Memorandum of Understanding OHA  Oregon Health Authority PCP  Primary Care Physician PCPCH  Patient‐Centered Primary Care Home PMPM  Per Member Per Month PSS  Peer Support Specialist PWS  Peer Wellness Specialist RFP  Request for Proposal RHIC  Regional Health Information Collaborative RPC  Regional Planning Council SDoH  Social Determinants of Health SHP  Samaritan Health Plans SHS  Samaritan Health Services SOW  Statement of Work THW  Traditional Health Worker TQS  Transformation Quality Strategies UCC  Universal Care Coordination WG  Workgroup  

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DST 2018 Calendar

Acronym Pilot Name End Date

APM Alternative Payment Methodology 12/31/16

APMWG Alternative Payment Methodologies Workgro N/A

BSS Breastfeeding Support Services 9/30/18

C2C CHANCE 2nd Chance 6/30/18

CHWL Community Health Workers in N. Lincoln 12/31/17

COMPAR Community Paramedic 2 6/30/18

CSAS Children's SDoH and ACE Screening 12/31/18

DOUL Community Doula Program 12/31/18

EDCT Eating Disorders Care Teams 2/28/18

EHCC Expanding Health Care Coordination 4/30/18

FSP Family Support Project 4/30/18

HEST Health Equity Summits and Trainings 12/31/18

HEWG Health Equity Workgroup N/A

IICH Improving Infant and Child Health 6/30/18

IPRP Improving the Pain Referral Pathways 6/30/17

OHEV Oral Health Equity for Vulnerable Pop. 6/30/18

PDBC Pre-Diabetes Boot Camp 12/31/17

PMP Pain Management in the PCPCH 12/31/17

PPC Pharmacist Prescribing Contraception 5/31/18

PSWT Peer Support Wellness Training 12/31/18

RHEH Regional Health Education Hub 12/31/18

SANE Sexual Assault Nurse Examiner 7/31/17

SDoH Social Determinant of Health Screening 6/30/18

SDoHWG Social Determinants of Health Workgroup N/A

SNN School/Neighborhood Navigator 6/30/17SPC SHS-Palliative Care 9/30/17THWH Traditional Health Worker Hub 6/30/18THWWG Traditional Health Worker Workgroup N/AUCCWG Universal Care Coordination Workgroup N/AVRxL Veggie Rx in Lincoln County 12/31/18

Tentative update Booked update WPNT The Warren Project: Nature Therapy 4/30/18Tentative workgroup Booked workgroup YCRC Youth & Children Respite Care 3/31/18

Tentative miscellaneous Booked miscellaneous

Key

WorkgroupsJan.

2019

Proposal Presentations

Proposal Presentations

Tentative extension Booked extensionTentative closeout

Workgroups

July

12th

26th

Augu

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23rd

Sept

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6th

20th

Decisions

LOI Review/Invite

Strategic Planning

Booked closeout

Strategic Planning

Strategic Planning

SANE

PMP

13th

Oct

ober 4th

18th

Nov

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r 1st

15th

29th

Dec.

Strategic Planning

Workgroups

CHWL

SPC

IPRP

SNN

EDCT

PDBC

Workgroups

APM2 Strategic Planning

Janu

ary

Febr

uary

Mar

chAp

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28th

5th

19th

3rd

17th

31st

14th

11th

25th

8th

22nd

8th

22nd

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Minutes Delivery System Transformation Committee

January 25, 2018 4:30 – 6:00 pm Samaritan Health Services Walnut Building: Endeavor (conference room)

Dial in: 866-439-0933 Code: 5093665467

Introductions Kim Whitley Present: Charlie Fautin, Sherlyn Dahl, Charissa White, Jenna Bates, Kim Whitley, Molly Mew, Kevin Cuccaro, Ronda Lindley-Bennett, Clarice Amorim Freitas, Bettina Schempf, Danny Magana, Karen Douglas, Annie McDonald, Kevin Ewanchyna, Joell Archibald, Yuberca Pena, Heidi May-Stoulil

Jenna Bates Transformation Update

• Physician Wellness Initiative Research Study has been received from Oregon State University.o Emailed to DST 01/26/18.o Three main causes of burnout are morale, paperwork, and lack of autonomy.o Outcomes from the study that show decrease physician burnout:

▪ Scheduling less patients or longer appointments,▪ Reducing physician time in the Electronic Health Records using Scribes, and▪ Organizational resilience, or the ability of the organization to bounce back from disruptive

occurrences.

Oregon Health Authority (OHA) Update Joell Archibald

• The campaign program ‘OHP Now Covers Me’ is connected to Cover All Kids.o OHA is doing active outreach with community partners to support assistors.

• 10 hours of Technical Assistance available for oral health projects.

• Innovation Café is focused on strategies for improving child health.o Project proposals can be submitted to be considered for the Innovation Café, an invite was sent to pilots

and other community partners by the Transformation Department.

DST Planning Kim Whitley

• The Regional Planning Council (RPC) continues to support DST transformation efforts.

• Funding is expected, but amount is unknown.

Collective Impact Discussion – see DST Strategic Planning Document.

• Common Agendao For our common agenda, we need more individuals and providers of care to be involved to have greater

impact.o To become more proactive and reach out to specific groups, a survey was created to reach out to past

and present attendees of the DST – see pages 7-9 of DST meeting packet.▪ Suggestions:

• Comment boxes rather than give choices to get more free form answers.

• Replace #2 with “Are you aware that the DST has supported over 50 pilots and spentover $18 million sponsoring the pilots?” and make #3 open-ended.

▪ TO DO: Add to survey:

• Are you aware that the DST has supported over 50 pilots and spent over $18 millionsponsoring the pilots?

• Informational paragraph at the end about the DST, strategic planning, Request forProposal (RFP) process, and how to join.

o Performance Indicator:▪ The survey above.▪ Increased website traffic to DST Meeting Resources and the pilot information.

• Shared Measurement

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o The 8 Elements of Transformation (pre-2018) and the Transformation Quality Strategy Components (2018+).

o Community Health Improvement Plan Health Impact Areas (CHIP Areas) o CCO Incentive Metrics o TO DO: Bring back the crosswalk grid (this will also help lead the Request for Proposal (RFP) Targeted

Strategies discussion).

• Mutually Reinforcing Activities o Develop a survey for past pilots including questions around collaboration and continued relationships

(indirect effects). o Workgroups

▪ 2-3 times per year, ask the Workgroups to come and share their work at a DST meeting. ▪ Expected that the DST is sharing their vision with the Workgroups in these meetings as well.

• Continuous Communication o Current tools:

▪ IHN-CCO Website ▪ DST listserv ▪ Reports ▪ Summary Documents ▪ Workgroups

o Suggestions: ▪ Add the dialogue component; back and forth discussion and sharing. ▪ Email summary the next day; DST chooses a highlight (one key takeaway) about the previous

evening’s meeting. ▪ Increased collaboration and engagement with the RPC; the DST chairs will be bringing

information to the RPC about the DST at a meeting in March. o TO DO: Provide a one-pager orientation handout about who the DST is and list resources and contacts

for new attendees at Workgroups or the DST and new pilots.

• Backbone Support o Currently IHN-CCO Transformation Department and IHN-CCO Leadership. o How do we know if they are successful in this role?

▪ Responsiveness ▪ Ability to deliver on expectations

o TO DO: Survey pilots at closeout regarding support of IHN-CCO and if they felt supported through the proposal and pilot process.

• Cascading Levels of Collaboration o Support and flow of information - see page 7 of DST Strategic Planning Document. o Continued conversation of how to identify opportunities to amplify impact.

RFP Process

• In 2016, 7 target areas were recommended by the Community Advisory Council (CAC), a DST subcommittee, and the DST Workgroups and approved by the DST.

• In 2017, 3 areas were chosen by the DST in a regular meeting.

• RFP reverse engineering timeline – see page 28 of DST Strategic Planning Document. o The DST would like to release the RFP in April to allow more time for closeout or workgroup

presentations. o TO DO: Bring back updated RFP timeline.

• Letter of Intent – see page 8 of DST Strategic Planning Document. o Current template supported with a change to the collaboration question. o Rewrite collaboration and partnership question. o Suggestion of splitting it into two questions; current and planned partners. o TO DO: Bring back the answers from 2017 for the DST to review.

• Should the pilots be required to attend the DST? o Intrinsic versus extrinsic motivation; people should want to come to learn.

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o The DST will ‘highly recommend’ proposers attend the DST and encourage inviting a ‘buddy’ to the DST.

• Suggestion to add Workgroups to the crosswalk grid.

• Open to having 2 Q&A sessions – this is on the timeline. Wrap-Up

• The Community Doula pilot is doing well with 40 people interested in the training program. Flyer passed out.

• Next time: Discussion regarding targeted strategies.

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Innovator Agent Update IHN CCO Delivery System Transformation (DST) (February 8th, 2018)

OHA Hiring Announcements

• OHA has announced the hiring of a new Oregon State Hospital Superintendent. Dolores“Dolly” Matteucci. Dolly comes to Oregon from Napa State Hospital in California,where she has been the executive director since 2010,

• Margie Cooper Stanton began as the Interim Health Systems Division Director. She waspreviously the VP of Healthcare Management Administrators in Bellevue, WA and also aregional VP for Liberty Mutual Insurance. Margie has a Master of BusinessAdministration from the Kellogg School of Management at Northwestern University anda Bachelor of Science in Merchandising and Marketing from Texas Southern University.She is filling the position previously held by Dr. Varsha Chauhan.

OHA News of General Interest

• The 2018 Oregon Legislative Session begins on Monday, February 5th. This being aneven-numbered year, the 2018 session is scheduled to be a short session with a scheduledend date of March 11th. The Oregon Legislative Information System (OLIS) will have themost current information regarding agendas and bills proposed or under consideration.Access OLIS here: https://olis.leg.state.or.us/liz/2018R1

• OHA has posted all information related to its rate setting process, 2018 rates for CCOs,and past rate reports at this site:http://www.oregon.gov/oha/HPA/ANALYTICS/Pages/OHP-Rates.aspx

• OHSU’s Center for Health System Effectiveness has competed an evaluation of Oregon’sCMS 2012-2017 Waiver. The evaluation was a condition of the agreement between theFederal Government and the state at the beginning of our Health System Transformationefforts. The evaluation is available at:http://www.oregon.gov/oha/OHPB/MtgDocs/January%2016,%202018%20OHPB%20Retreat%20Board%20Packet.pdf#page=19

• 2017 is the first tax year that OHP members are required to report their OHP coverage ontheir income tax returns. IRS Form 1095-B identifies the months of the year that OHPcoverage was in place. For questions about Form 1085-B, go to:https://www.irs.gov/uac/About-Form-1095-B

Presented by Joell Archibald

DST 02/08/2018 8 of 33

• The Oregon Health Authority has launched a new web portal that will allow the public toeasily find inspection reports for food, public pool and lodging facilities, such asrestaurants, swimming pools and hotels across Oregon. The portal is provided as part of asoftware update to Oregon’s statewide licensing and inspection system. The site willshow semi-annual, biennial and annual routine inspections as well as re-inspections.**Please note that there is a 14-day lag from the date of inspection until information isposted on the website**. Access the portal at this link:https://healthspace.com/Clients/Oregon/State/StateWebPortal.nsf/home.xsp

• The Oregon Health Policy Board Retreat held on January 16th focused on thedevelopment of the contracting process for CCOs which will be conducted during 2019.The OHPB web page has the most current meeting information and provides anopportunity to view video-recordings of past meetings.http://www.oregon.gov/oha/OHPB/Pages/OHPB-Meetings.aspx

Supports for CCOs, Providers and Partners

• An overview of all Technical Assistance opportunities currently available through theTransformation Center for CCOs and clinics is available at:https://www.oregon.gov/oha/HPA/CSI-TC/Documents/Transformation%20Center%20TA%20Opportunities.pdf

• Find the CCO’s 2018 Incentive Measure Metrics and Benchmarks at these links:http://www.oregon.gov/oha/HPA/ANALYTICS/CCOData/2018%20Measures.pdfhttp://www.oregon.gov/oha/HPA/ANALYTICS/CCOData/2018%20CCO%20Incentive%20Measure%20Benchmarks.pdf

• Colorectal Cancer Screening Learning Collaborative: The OHA Public Health Divisionand Transformation Center are partnering to deliver targeted technical assistance toCCOs for colorectal cancer (CRC) screening with a focus on reducing disparities throughpopulation outreach and quality improvement strategies. Sustaining the CRC TAsuccesses of last year, Melinda Davis, PhD, of Oregon Health & Science University,ORPRN, and Gloria Coronado, PhD, of Kaiser Permanente Center for Health Research,will host an interactive, web-based learning collaborative on evidence-based approachesto increase CRC screening. This opportunity is open to up to six CCOs and their clinicpartners. Participants will have the opportunity to request additional technical assistancesupport from CRC screening experts. Applications are due on February 9th. More detailsare available on the application form at:https://www.oregon.gov/oha/HPA/CSI-TC/Documents/CRC Screening LearningCollaborative Program and App Combined_FINAL.DOCX

Commented [AJE1]:

Commented [AJE2R1]:

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• Patient-Centered Outcomes Research Institute funding announcement: The Patient-Centered Outcomes Research Institute (PCORI) is seeking investigator-initiatedapplications for patient-centered comparative clinical effectiveness research projectsaligned with priority areas for research. This funding covers the following four priorityareas:

• Addressing Disparities;• Assessment of Prevention, Diagnosis, and Treatment Options;• Communication and Dissemination Research;• Improving Healthcare Systems.

PCORI is looking for your best ideas to address needs of patients, caregivers, clinicians and other health care stakeholders in making personalized clinical decisions across a wide range of conditions, populations and treatments. Letter of intent is due on February 13th. See the full funding announcement: https://www.pcori.org/sites/default/files/PCORI-PFA-2018-Cycle-1-Broad.pdf

• The TQS will replace the CCO Transformation Plan and Quality Assurance PerformanceImprovement plan. This streamlined approach aims to reduce duplication, align CCOpriorities, and enhance innovation supported by targeted activities. CCOs will submit anannual TQS using a shared template (beginning March 16th) and a 6-month progressreport. Updated Transformation and Quality Strategy (TQS) guidance documents wereposted on January 26th. A summary of changes is also posted. All documents, includingwebinar recordings, are available here:http://www.oregon.gov/oha/HPA/CSI-TC/Pages/Transformation-Quality-Strategy.aspx

TQS Office hours are scheduled as follows:• February 8th, 10:30-11:30 a.m.• February 27th, 10-11 a.m.• March 6th, 10-11 a.m.• March 15th, 10-11 a.m.

• Behavioral Health and Physical Health Integration TA: The Transformation Center isoffering each CCO up to 10 hours of behavioral and physical health integration technicalassistance, focused on one topic area. All requests must be submitted to theTransformation Center by April 15th, with technical assistance hours completed byOctober 31st. Access the request form here:http://www.oregon.gov/oha/HPA/CSI-TC/Documents/BHI-TA-Request-Form-2017-

2018.docx

• Oral Health Integration TA: The Transformation Center is offering each CCO up to 10hours of oral and physical health and/or behavioral health integration technical assistance,focused on one topic area. All requests must be submitted to the Transformation Centerby May 15th, with technical assistance hours completed by November 30th. Use thisrequest form:http://www.oregon.gov/oha/HPA/CSI-TC/Documents/Oral-Health-TA-Request-Form-2018.docx

Presented by Joell Archibald

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* Note: Hours for behavioral health integration and oral health integration TA can becombined if a single project crosses both topics.

Conferences/Trainings

• Practice Coaching for Primary Care Transformation Training is available from February6th -9th in Portland via the PCPCI program. More information at www.pcpci.org

• The Oregon Office of Rural Health seeks proposals for presentations at the 35th AnnualOregon Rural Health Conference, October 3rd-5th to be held at the The Riverhouse on theDeschutes in Bend, Oregon. Interested presenters are invited to submit a proposal byFebruary 16th. Proposed presentations should inform attendees and/or share successstories and best practices to address rural health care challenges and improve the qualityof care.Proposal requirements:The proposal should be a maximum of one page and must include the followinginformation:

• Name, contact information and brief bio of presenter(s)• Name and contact information of person submitting the proposal, if different than

above• Title and description of presentation• Two learning objectives• Presentation style (PowerPoint, facilitated discussion, panel, etc.)• Description of the significance of the topic and its relevance to conference

attendeesAll correspondence, including acknowledgement of receipt of submission, will be conducted electronically. Please submit proposals to Scott Ekblad at ekblads@ohsu.edu

• Oral Health curriculum for primary care clinicians with free CMEs. Smiles for Life, anational oral health organization is acceptable for credit through March 11th. Go towww.smilesforlifeoralhealth.org for more information.

• Oregon Health Authority’s 2018 Innovation Café: Strategies for Improving Children’sHealth will be held June 12th in Salem. This forum will engage health system championsin peer-to-peer learning and networking to spread innovation with the aim of improvingchildren’s health (prenatal to age 17), including a special emphasis on CCO earlychildhood incentive measures and cross-sector collaboration. CCO and clinic staff,cross-sector partners and other health system champions will present projects and discusslearnings and best practices in cross-sector innovations and health system transformation.Sharing will take place in café-style rounds and through plenary sessions.Pediatrician and 2015-2016 Oregon Health Authority Clinical Innovation Fellow R.J.Gillespie will provide the keynote plenary on the impacts of adverse childhoodexperiences (ACEs) and social determinants on child health and wellness; his clinicalresearch in screening for parents’ ACEs in pediatric settings; and a vision for preventingthe lifelong effects of ACEs through partnerships across sectors. Those interested in

Presented by Joell Archibald

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presenting a project that addresses one of the topic areas listed in the call for projects, please submit a brief proposal by March 23rd at: https://www.surveymonkey.com/r/6V2BDDC

• 2018 Forum on Aging in Rural Oregon: Save the Date for the conference – May 16th -18th

in Pendleton. More info at:www.ohsu.edu/xd/outreach/oregon-rural-health/about/aging-forum/index.cfm

• Oregon’s Oral Health Coalition Conference is scheduled for Friday, November 2nd

Presented by Joell Archibald

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ALTERNATIVE PAYMENT METHODOLOGY

January 2016 to December 2016

To learn more, visit IHNtogether.org.

Overview and Activities: Alternative Payment Methodology (APM) provides alternative payment methods to ensure that the

Patient-Centered Primary Care Home (PCPCH) clinics have the resources necessary to transform the

delivery system while also ensuring proper payment for services provided to IHN-CCO members as

clinics transition from quantity- to quality-based payment models. The APM workgroup provides

guidance and strategy for spreading APMs to new clinics.

All PCPCHs invested in resources to create more access

All PCPCHs worked to track touches

Created robust Care Teams including Registered Nurse Care Coordinators, Non-Clinical

Care Coordinators (Spanish speaking), and Health Navigators

Reconfiguration of clinical sites to create better processes and workflows

Clinics invested in and are developing Information Technology (IT)/Electronic Health

Records (EHR)

Collaboration of clinics with Emergency Room (ER) and hospital departments

Clinics have assigned designated resources for Primary Care Physician (PCP) assignment

management and outreach

Investment by clinics in Psychiatric or Mental Health Nurse Practitioners, Licensed Clinical

Social Workers, and Behavioral Psychologists to improve integration of medical and

behavioral health

Key Outcomes:

All clinics combined resulted in a 44% increase in number of visits and a175% increase in preventive visits

All clinics combined resulted in a 5% decrease in ER visits

All clinics combined resulted in a 204% increase in mental health/behavioral health visits

94% of IHN-CCO members are assigned to a PCPCH on an APM

Medical and Pharmacy costs increased by a combined total of 7%

Performance improved in 7 out of the 8 monitored CCO metrics

Met the CCO improvement targets for 5 out of the 7 metrics

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ALTERNATIVE PAYMENT METHODOLOGY

January 2016 to December 2016

To learn more, visit IHNtogether.org.

Next Steps:

Providers have made the shift to quality-based payment models and continue to support the

transition to a fully-integrated, enhanced model. Providers are receiving performance

scorecards, and the data to support them in continuing to achieve the goals of the CCO and

Triple Aim. Providers have built, and continue to enhance, their clinics in alignment with

medical home concepts, such as integrated mental health, and integrated oral health. A lot of

time is being spent in understanding the complexities of data related to metrics and putting

workflows into place to help with reporting outcomes. Change requires engagement by the

payer and the providers and administration. Resource constraints are still inhibiting the

deployment of resources necessary to facilitate effective engagement and operationalize

current strategies for transformation.

APMs in PCPCHs will continue, as will the transformation of the medical home, when it is

determined that change is necessary in order to better achieve the goals of the Triple Aim.

Key Terms: Alternative Payment Methodology (APM): a payment system for medical providers

based on patients’ health outcomes rather than the services provided

Care Teams: group of people focused on holistic care of the patient. Could include CareCoordinators, medical providers, mental and behavioral health providers, HealthNavigators, and other Traditional Health Workers

Electronic Health Record (EHR): electronic version of a patient’s medical history

Health Navigator: a person who provides information, assistance, tools, and support tohelp a patient to make the best health care decisions

Patient-Centered Primary Care Home (PCPCH): health care clinic that focuses onrelationships with the patient and their family to better treat the whole person

Touches: a direct service related to health that is not captured in the traditional methodof healthcare billing and payment

Touch Report: system that helps health workers such as Health Navigators track theservices they provide in order to show the value of the work they do in the community

Triple Aim: a framework that focuses on improving access to care, better healthoutcomes, and reducing the cost of healthcare

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IHN-CCO DST Final Report and Evaluation

Alternative Payment Methodology 2

Summary: Alternative Payment Methodology (APM) provides alternative payment methods to ensure that the Patient-Centered Primary Care Home (PCPCH) clinics have their resources necessary to transform their delivery system while also ensuring proper payment for services provided to IHN-CCO members as clinics transition from quantity to quality based payment models. The ultimate goal of this pilot is to achieve greater than 80% of clinics receiving payment by an APM by 12/31/2016. The APM workgroup provides guidance and strategy for spreading APMs to new clinics.

A. Budget:

Total amount of pilot funds used: $1,742,542

Please list and describe any additional funds used to support the pilot.

B. Provide a brief summary of the goals, measures, activities, and results and complete the grid below.

Goal Measure(s) Activities Final Results

Access Total combined count of PCPCH office visits and “touches” made by the clinic.

All PCPCHs have invested in resources to create more access, and document touches. Examples include Registered Nurse Care Coordinators and Non-Clinical Care Coordinators (Spanish speaking), and Health Navigators to create robust Care Teams focusing on holistic care, and focus areas such as pharmacy, nutrition, and screening for suicidality

Clinics are reconfiguring clinical sites to create better processes and workflows, and other modalities to improve efficiencies for patients and staff, thereby improving access.

All clinics combined resulted in a 44% increase in visits.

65% of the clinics with had a positive increase in services provided.

Quality of Care Count of Care Coordination “touches” captures in the Electronic Health Records (EHRs) and normalized by distinct number of IHN-CCO patients assigned.

Clinics are investing in Information Technology (IT)/EHRs to support documentation pathways and quality/performance metric monitoring and reporting, and equipment.

Clinics are reconfiguring

The majority of clinics put processes into place to start tracking these types of services. They are not yet consistently reporting these services to IHN CCO. Some clinics have also partnered with outside Community Health

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IHN-CCO DST Final Report and Evaluation

clinical sites to create better processes and workflows, and other modalities to improve continuity of care, Care Coordination, Chronic Disease Management programs, and thereby improving access improving care coordination.

Workers, and are tracking “touches” in this way. 6 out of 28 are sending in touch reports.

% of Eligible Providers (EP) who have achieved Stage 1 or 2 Meaningful Use certification as appropriate.

Clinics are developing electronic health records, IT support for population health, and quality performance reporting, and meaningful use.

The State reports were not available at the time this was due.

Performance in the IHN-CCO metrics.

Clinics are developing IT infrastructures that capture the data necessary for improving metrics, including but not limited to the CCO Metrics, and MACRA/MIPS metrics.

See table below for final outcomes on the CCO metrics.

Utilization Count of ER visits. Clinics are collaborating with Emergency Room (ER) and Hospital departments as well as creating Intensive Care Team meetings for high ER utilizers.

All clinics combined resulted in a 5% decrease in ER services, and 48% of all clinics reported improvement. This is measured differently than the CCO metric listed above. It does include ER with a primary diagnosis of mental health, whereas the CCO state metric does not.

Count of assigned IHN patients seeking outside PCP services (“leakage”).

Major Primary Care Physician (PCP) roster cleanup has been accomplished as well as processes for communicating ongoing changes. Clinics have assigned designated resources for PCP assignment management, and outreach.

All clinics combined resulted in a 53% decrease, and 55% of all clinics reported improvement.

Count of Mental Health/Behaviorist visits

Clinics are investing in Psychiatric-Mental Health

All clinics combined resulted in a 204%

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IHN-CCO DST Final Report and Evaluation

Nurse Practitioners, Licensed Clinical Social Workers, and Behavioral Psychologist’s to grow integrated mental health and behavioral health access

increase, and 77% of all clinics reported improvement.

Count of Preventive services

In addition to creating better access, some clinics are providing community education, and prevention in the schools

All clinics combined resulted in a 175% increase, and 90% of all clinics reported improvement.

Overall, the goal and metric for success of this proposal is to have greater than 80% of members assigned to PCPCHs receiving an APM reimbursement payment by 12/31/2016. This incentive provided to the PCPCHs will allow for PCPCHs to put workflows in place to meet performance metrics and patient engagement requirements of a PCPCH.

Distributed funds by June 2016 in three phases provider clinics.

All funds were received are being put to use.

None to report. 94% of IHN CCO members are assigned to a PCPCH on an APM.

Each clinic that moves to an APM, outcomes will be established similar to the outcomes in the three clinics that have already adapted an APM.

Utilization Count of inpatient visits. Clinics are collaborating with Hospital departments as well as creating case management and ICT’s to address patients, and to wrap services around discharges.

All clinics combined resulted in a 6% increase in inpatient stays.

Cost Did the total cost of care decrease for patients assigned to PCPCHs in year 1?

Pharmacy costs increased by 15%.

Medical costs increased by 6%.

Combined Total increase of 7%.

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IHN-CCO DST Final Report and Evaluation

C. What were the most important outcomes of the pilot?Providers have made the shift to quality based payment models beginning 2017, and continue to support thetransition to a fully integrated, enhanced model. Providers are receiving performance scorecards, and the data tosupport them in continuing to achieve the goals of the CCO and Triple Aim. Providers have built, and continue toenhance their clinics in alignment with medical home concepts, such as integrated mental health, and integratedtraditional health workers to be able to focus on performance. Provider clinics, overall decreased ER visits by 5%,were able to improve performance in 7 out of the 8 CCO metrics, and met the CCO improvement targets for 5 out ofthe 7 metrics. Providers focused on reconciling member assignment lists and were able to improve the rate ofmembers seeking services to other PCPs that were not their PCP by 53%, and increased access to services in themedical home, and in mental health services.

See the attached report on the details of the clinic outcomes.

D. How has the pilot contributed to Triple Aim of improving health; increasing quality, reliability, and availability ofcare; and lowering or containing the cost of care?Providers were successful in gaining positive results in 12 out of the 14 metrics we measured them on that wouldindicate improving health, increasing quality, reliability, and availability of care; and lowering or containing the costof care. Members are being managed at the right place at the right time, and have substantially increased thereceipt of preventive medicine. Four outcomes that support that statement include, ER visits decreased by 5%,preventive services increased by 175%, behavioral services increased by 204%, and access increased by 44%.

E. What has been most successful?Clinics have integrated other services into their clinics such as mental health, and traditional health workers. Clinicsare focusing on EHR functionality and the ability to aggregate data to be able to use to determine targets. TheirPCPCH models are very high functioning, and are allowing them to more easily transition to be able to report andmonitor CMS MIPS requirements, which include CCO metrics.

F. Were there barriers to success? How were they addressed?Benefit management decisions that are barriers for providers, such as prior authorization requirements onmedications and physical therapy have been challenging.A lot of time is being spent in understanding the complexities of data related to metrics, and putting workflows intoplace to help with reporting outcomes. It is very manual on both sides. Engaging with every single clinic to ensureunderstanding and priorities did not happen across all clinics.Making change requires engagement by the payer and the providers and administration, resource constraints arestill inhibiting the deployment of resources necessary to facilitate effective engagement, and operationalize currentstrategies for transformation.Provider roster management has been difficult. Ensuring that providers in our system are always current at eachclinic.Providers are still struggling to make the time to reconcile and manage their PCP attribution reports efficiently. It’s avery time consuming process, and due to the challenges with accurate contact information, providers get frustratedthat they have members assigned, but cannot get a hold of them to manage them.

G. How readily would the pilot be scalable or replicable? Describe cautions and considerations when consideringscaling, or replicating the Pilot. (i.e. Success dependent on personality/skills set, or activities appropriate undercertain conditions like size, target population, etc.)The pilot would be easy to replicate if the funding was available. The goal of the pilot was to reimburse providers tohave some funds to help transform their delivery models in preparation to contract with IHN CCO in the form of an

DST 02/08/2018 18 of 33

IHN-CCO DST Final Report and Evaluation

SBIRTDevelopmental

ScreenAdolescent

Wellcare

Children in DHS

Custody

Effective Contraceptive

Use

Ambulatory ER***

Colorectal Cancer Screen

Prenatal Care

All Clinics Combined 87% 44% 24% 9% 15% 7% 27% 71%% of Reportable Clinics Showing Improvement 97% 57% 70% 50% 73% 26% 89% 96%

Quality of Care

alternative payment model. This goal was achieved, and replicating the alternative payment models and implementing the new contracts is easily scalable. We have minimized the time to create the models and implement the contract effective date to approximately 2 months.

H. Will the activities and their impact continue? If so, how? If not, why?The APMs will continue as will the transformation of the medical homes when it is determined that change isnecessary to better achieve the goals of triple aim, and to work more efficiently in the medical home.

ATTACHMENT A: Clinic Outcomes

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Request for Proposal (RFP) ReleasedApril 9, 2018

Question & Answer (Q&A) Session 

for Pilot Proposers                               April 26, May 10

MANDATORY Letter of Intent (LOI) Due May 28 5:00 pm

LOI Distributed to DST                     

by June 7 

Full Pilot Proposals Due July 30 5:00 pm

MANDATORY Technical Assistance 

Meetings June 25 – July 27

LOI Feedback Due from DST               by June 14

 

Pilot Proposal Presentations to DST 

August 9

Pilot Proposal Presentations to DST                       

August 23

DST Decisions                        September 6

InterCommunity Health Network Coordinated Care Organization Delivery System Transformation (DST) Request for Proposal Timeline 

01/29/18

Invitations Issued to Submit Full Pilot Proposal 

by June 18

Regional Planning Council (RPC) 

Funding DecisionsSeptember 21

Proposers Notified of DST Decision

by September 10

Proposers Notified of Pilot Denial or 

Approvalby September 24

Contracting Begins by November 1

Pilot Invoices/Payments Begin

January 1, 2019

Pilot Proposer Action

Key 

Transformation Team Action

DST Member Action

Scheduled DST 

Meeting

DST 02/08/2018 21 of 33

IHN-CCO DST Transformation Pilot List and Acronym Key

Acronym Project Acronym ProjectAPM Alternative Payment Methodology LCSW Licensed Clinical Social Worker PCPCHBH PCPCH Behavioral Health PCPCH MHC Maternal Health ConnectionsBSS Breastfeeding Support Services MHL Mental Health LiteracyC2C CHANCE 2nd Chance OHEV Oral Health Equity for Vulnerable PopulationsCAPEI Child Abuse Prevention & Early Intervention PCPC Primary Care Psychiatric ConsultationCCCM Complex Chronic Care Management PDBC Pre‐Diabetes Boot CampCHW Community Health Worker PHLI Prevention, Health Literacy, and ImmunizationsCHWL Community Health Workers in North Lincoln PMH Pediatric Medical HomeCMAS CMA Scribes PMP Pain Management in the PCPCHCOMPAR Community Paramedic PPC Pharmacist Prescribing ContraceptionCPCB Child Psychiatry Capacity Building PWI Physician Wellness InitiativeCRSC Colorectal Screening Campaign PWST  Peer Wellness Specialist Training CSAS Children's SDoH and ACEs Screening  RHEH Regional Health Education HubCTSG Chrysalis Therapeutic Support Groups SANE Sexual Assault Nurse ExaminerCVAIS Childhood Vaccine Attitude & Information Sources SDoH Social Determinant of Health Screening Veggie RxDMID Dental Medical Integration for Diabetes SNN School/Neighborhood NavigatorDOUL Community Doula SPC SHS ‐ Palliative CareEDCT Eating Disorders Care Teams SUPS Universal Prenatal ScreeningEHCC Expanding Health Care Coordination TFAT Tri‐County Family Advocacy TrainingFSP Family Support Project  THWH Traditional Health Worker HubHEST Health Equity Summits and Trainings VRxL Veggie Rx in Lincoln CountyHHPI Health & Housing Planning Initiative WPNT The Warren Project: Nature Therapy HPC Home Palliative Care YCRC Youth & Children Respite CareIICH Improving Infant and Child Health in Lincoln County YWES Youth WrapAround & Emergency ShelterIPRP Improving the Pain Referral Pathway in the PCPCH

DST 02/08/2018 22 of 33

IHN‐CCO DST Transformation Pilot CrosswalkEight Elements of Transformation, Transformation and Quality Strategy Components (TQS), and Community Health Improvement Plan Health Impact Areas (CHIP Areas)

APM

BH PCP

CH

CAPEI

CCCM

CHW

CHWL

CMAS

CPCB

CRSC

CTSG

CVAIS

DMID

HHPI

HPC

IPRP

LCSW

MHC

MHL

PCPC

PDBC

PHLI

PMH

PMP

PWI

SANE

SNN

SPC

SUPS

TFAT

YWES

BSS

C2C

COMPA

R

CSAS

DOUL

EDCT

EHCC

FSP

HEST

IICH

OHE

V

PPC

PWST

RHEH

SDoH

THWH

VRxL

WPN

T

YCRC

Healthcare Integration

Patient‐Centered Primary Care Home

Alternative Payment Methodology

Development of CHIP/CHA

Electronic Health Records

Cultural Communications

Cultural Diversity of Providers and Staff 

Eliminate Disparites in Access, Care, Outcomes

Access: Availability of Services

Access: Cultural Considerations

Access: Quality and Appropriateness of Care

Access: Timely

Access: Second Opinions

Culturally & Linguistically Appropriate Services (CLAS)

Complaints and Grievances

Fraud, Waste, and Abuse

Health Equity: Data

Health Equity: Cultural Competency

HIT: Health Information Exchange

HIT: Analytics

HIT: Patient Engagement

Integration of Care

PCPCH Development 

Severe & Persistent Mental Illness 

Social Determinants of Health 

Special Health Care Needs

Utilization Review 

Value‐based Payment Models

Access to Healthcare

Behavioral Health

Child Health

Chronic Disease 

Maternal Health

~Active pilots and pilots active in or after 2015~

CHIP Areas

CLOSED PILOTS ACTIVE PILOTS

Tran

sformation Elem

ents

Tran

sformation an

d Qua

lity Strategy Com

pone

nts

rev 02/01/18DST 02/08/2018

23 of 33

IHN‐CCO DST Transformation Pilot CrosswalkCCO Incentive Metrics ‐ Active Pilots

BSS

C2C

COMPA

R

CSAS

DOUL

EDCT

EHCC

FSP

HEST

IICH

OHE

V

PPC

PWST

RHEH

SDoH

THWH

VRxL

WPN

T

YCRC

Adolescent well‐care visits

Ambulatory care: Emergency department (ED) visits

CAHPS composite: Access to care

Childhood immunization status

Cigarette smoking prevalence

Colorectal cancer screening

Controlling high blood pressure

Dental sealants

Depression screening and follow‐up plan

Developmental screening (0‐36 months)

Disparity measure: ED visits among members with mental illness

Diabetes: HbA1c poor control

Effective contraceptive use

Health assessments within 60 days for children in DHS custody

Patient‐Centered Primary Care Home enrollment

Timeliness of prenatal care

Weight assessment and counseling for children and adolescents

CCO In

centive Metric

s

rev 01/31/18 DST 02/08/2018 24 of 33

2017 Letter of IntentList any partners you plan to inlcude in your pilot; such as a Patient‐Centered Primary Care Home or a community agency. Describe how you plan to colalborate 

with these agencies or individuals. We will work with the Benton County CHW program, as well as many community agencies that provide resources such as Family Tree Relief Nursery (therapeutic child care, peer support specialists) Willamette Neighborhood Housing (housing stability), WIC (food security), LBCC (parenting education).We will also be able to integrate this information into the IHN‐CCO workgroups of Health Equity and CHW.Community Outreach has a contract with Oregon Department of Human Services and Oregon Youth Authority to provide wraparound services for individuals experiencing homelessness. Additionally, we have reached out to Duerksen and Associates Property Management to lease a property at a reduced rate. Program participants also benefit from COI’s partnership with Jackson Street Youth Shelter by receiving referral services, housing opportunities, attending community networking events, and our joint program, PS541, brings local youth ages 16‐25 for peer support and resource sharing.The HE Workgroup will play a key role in setting the agenda and identifying trainings that will best meet local needs at each participating county. LBHEA (through is fiscal agent, Willamette Neighborhood Housing Services) will also help define the agenda, but also will take the lead in organizing the three Health Equity summits and any additional local trainings. The LBHEA coordinator will participate on all HE Workgroup meetings in order to ensure continuing communication and engagement.We plan to collaborate with Western University, by including Medical students and future PT students to work with us on this program. We have also started conversations with OSU Public health to see if their interns would like to participate in this program.  We will also approach Linn‐Benton Mental Health to develop cross‐referral/access pathways for patients who start in one treatment modality (e.g. physical therapy based) but whom another treatment modality (e.g. behavioral Mental Health First Aid (national) and Trauma Informed Oregon for resources of best practices.  PCPCH: provide staff education on TIC, ways to lower barriers/stigma and info on how to talk to patients about links between mental and physical health. Pilot staff has existing relationships with PCPs, school districts, Strengthening Rural Families and other agencies and organizations throughout LBL counties. InterCommunity Health Network Coordinated Care Organization: We will ask IHN to help us identify pregnant IHN members. Oregon State University: OSU College of Public Health and Human Sciences and Department of Anthropology will provide faculty expertise to assist with the formal evaluation of the program. Heart of the Valley Birth and Beyond: Grantee organization. We will oversee the project, and be the liaison among all stakeholders.Partners include: Oregon Cascades West Council of Governments/Lincoln County's Geriatric Mental/Behavioral Health; Alzheimer's Foundation (Dementia Screening Program); North Samaritan Hospital Foundation; and all willing local PCPCHs. Our partners include Samaritan Health Services (SHS), Linn County Mental Health (LCMH), Albany Boys and Girls Club (BGCA), and Linn County Juvenile Department. SHS serves as the medical sponsor that delivers health care at the school; LCMH provides mental health services; and BGCA provides dental services. We will meet monthly as the steering committee to review operations and identify opportunities to grow toward an integrated and collaborative system of care that aligns with the COI has offered to place an MSW intern in our clinic 10‐20 hours a week to provide brief behavioral health interventions and resource navigation. Samaritan's GME department is interested in partnering with us in developing and sustaining the group pregnancy care model. We would like to expand the role of the Maternity Care Coordinator at GSRMC to incorporate in‐clinic screening and care coordination services. The group prenatal care curriculum offers multiple opportunities for collaborating with outside agencies as we cover topics such as dental care, nutrition, breastfeeding, and self‐care.

DST 02/08/2018 25 of 33

SHS Health Education Department, Benton County Health Services, OCWCOG, PCPCH and Specialty clinics plan to partner to streamline the process in which community members/participants are connected with health education programming in our region with the main goal of creating a regional model for health education. We are also exploring the possibility of working with the RHIC to include data from classes to close the loop for agencies outside of SHS who refer patients PCMHs in Albany (Geary Street Clinic), Lebanon (Mid Valley Medical Plaza) and Benton Health Center. Physician champions will be identified and will lead the efforts to integreate the platform  into the clinic model.  They will also provide assistance in data acquisition. OSU department of epidemiology; Kannact has worked in partnership with Dr Marit Bovbjerg who will assist with IRB approval, study design and outcomes analysis.addition of school site based afterschool programs in Lebanon Community Schools.  Sweet Home Schools are still working with us on space and referrals and we expect to have a plan in place to address the needs of the highest poverty / transient student population that is located at Foster Elementary.  Existing partners including Linn County Health Department, Local Youth Service Teams, Local Adult Service Teams and Samaritan. We have been in contact with Samaritan Health Services to use 4 primary care clinics in Corvallis.  One that has been identified is the Resident Clinic. Other prospective, but unconfirmed clinics, with be nephrolgy, family care, and pediatrics.  These students will be focusing on health promotion, patient education with medications, activity, diet, and follow‐up care. In the school setting, we are looking at, but have not yet confirmed Central Linn and Harrisburg school districts.  Here students will focus on age ‐appropriate educational activities on healthy lifestyles.We plan to partner with Benton County Health Services, Linn County Health Department Behavioral Health, CHANCE, Willamette Community Housing and other members of the Traditional Health Worker work group as well as other groups that have pilots that include Community Health Workers or Peer Support Specialist.  We will include these groups and others in the community in our needs assessment project and work with them to identify the certification trainings and continuing While we have not confirmed all of our community partners, our goal is to train social service organization, community groups, State and County organizations, churches, recovery homes, and any other group who would like to seek training and request kits. Provide training and offer resources that they can in turn, train and provide support and kits. We would depend on community partnerships to build a network of training sites kit distribution.   Albany General/Geary Street Clinic/Lebanon Oncology:  identify patient cohorts, prescribe nutritional content of custom food boxes, recommend additional food to source, assist in peer support training, participate in creating the project logic model, & record, report & share outcomes.  Mid‐Valley Gleaning Group:  prepare & deliver boxes, peer support activities, share community resources & provide feedback on their experience. Extension Service: demos of culturally appropriate food substitutions with more nutritional value.  Local farms: possible custom growing for the program.OCWCOG plans on including primary care home physicians, hospital discharge planners, technology consultants, Aging and Disability Resource Connection partners, organizations that provide chronic health management training, and technology companies in our pilot. As the  regional planning organization for Linn, Benton, and Lincoln Counties, OCWCOG has existing working partnerships with many of these organizations and individuals. Staff will build upon these partnerships for this pilot The Linn Benton Lincoln Breastfeeding Coalition, health providers in the acute and outpatient settings, community agencies who provide family support, county public health programs in Linn, Benton, and Lincoln counties, and the College of Osteopathic Medicine of the Pacific, Northwest would all be invited to attend lactation training sessions that match their needs and also invited to participate in ongoing joint ventures. Leadership and IT support staff of the electronic medical record used locally (EPIC) would be contacted to create appropriate modules for data collection.

DST 02/08/2018 26 of 33

Lincoln County School Based Health Center staff and Homeless Education and Literacy Project Advocates will screen school‐aged youth and their families for food insecurity and refer to the pilot program via vouchers to the vendor site. Food Share of Lincoln County will act as the fresh food vendor site. Food Share partners with the Oregon State University Extension office to provide cooking and other nutrition education programming.Linn County School Districts, Benton County School Districts, and Lincoln County School District  support services staff. County Health departments and Mental Health departments. Good Samaritan nursing resources.Over the course of the last 18 months we have relied on the expertise and advisement of several individuals and organizations for the advancement of this project including: Oregon State University, NW Permanente, First Christian Church, Strengthening Rural Families, and many more. We will utilize all of these relationships and connections to build future partnerships,develop an advisory board, as well as to ensure we are building on the needs of the community as a whole. One agency that we have developed a partnership with is the First Christian Church. They are a well‐respected and deep rooted member of the community. Together, we have sought out potential funding sources and leveraged an experienced development team to build out a working system. Another agency we have begun partnering with is Community Services Consortium (CSC) OFSN regularly collaborates with local providers, state and local governmental agencies, and other social service organizations throughout the IHN region. These existing partnerships will provide the organization with low or no‐cost access to facilities as well opportunities to recruit project participants. OFSN management and staff will continue to develop and utilize these partnerships in order to meet project goals and better serve families and youth in the region. OFSN is currently contracted with Benton County Behavioral Health to deliver peer support to families participating in wraparound, as well as parent education and support groups to parents in the community. This project will enable OFSN to build on the success of these efforts and bring services and supports to county clients who may not meet wraparound criteria. As part of the Benton County Mental Health children’s team, the OFSN Regional Director will work with Behavioral Health management and staff in order to recruit class participants and identify families who may benefit from systems navigation support. In addition, OFSN is contracted with Samaritan Family Mental Health to provide peer support for the child and youth emergency department diversion program. This partnership will allow OFSN to identify families who CHANCE, the CareTeam Link staff, the members of the Housing Opportunity Action Committee in Benton County, the members of the HEART (Homeless and housing services team) in Linn County, the Adult Services Teams in Linn and Benton counties, Corvallis Housing First, the Daytime Drop‐in Center, and Social Well to start.  With the direction of CHANCE and under the guidance of developers and programmers we will work in a selection of agencies to create and test a standard model of 

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Thank you for taking the time to complete this survey. As a past or present DST attendee, we appreciate

your feedback. This short 7 question survey is completely anonymous. Please email

transformation@samhealth.org with any questions.

Delivery System Transformation (DST) Attendees

2018 IHN-CCO DST Awareness Survey

1. How many times have you attended the DST in the past year?*0

1-3

4-6

7-9

10-12

13+

Other (please specify)

2. Are there any reasons you do not attend the DST on a regular basis? Choose all

that apply. *

Pilot ended

Resource limitations

Location

Meeting time

Distance

Relevance

Value

I do attend regularly

DST 02/08/2018 29 of 33

3. What industry or sector do you work in?*

4. Are you aware that the DST materials are available for reference on the IHN-

CCO website, IHNtogether.org?*

Yes

No

5. Are you aware that the DST has supported over 50 pilots and spent over $18

million sponsoring the pilots?*

Yes

No

6. What areas of value do you most appreciate about the DST meetings?*

7. Are there any other areas of interest that the DST might consider?*

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The DST is a committee with the objective to build on current resources and partnerships within the tri-

county region to support transformation of the healthcare delivery system for the Medicaid population.

Pilot projects are one way the DST supports transformation. The DST welcomes innovative ideas, plans

and transparently implements collaborative strategies with a focus on the Medicaid population that align

with IHN-CCO goals, described outcomes, and pursues the Triple Aim. Members include anyone that can

positively affect the health outcomes of IHN-CCO members.

Right now, the DST is in the strategic planning phase for 2018. Decisions are currently being made for the

upcoming Pilot Request for Proposal (RFP) process. The DST will be releasing the RFP on April 9, 2018

and Letters of Intent are welcome until May 28, 2018. For more information about the RFP process, please

email Transformation@samhealth.org.

The DST welcomes you to attend the next meeting, February 22, 2018 at 4:30 pm, and every two weeks

thereafter.

Thank you for providing your feedback and for your interest in the transformation of the healthcare

delivery system. We look forward to connecting with you.

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Action Item Resource Provide a universally approved logo for use on materials/presentationsRecord videos of pilot champions and post on the IHN‐CCO websiteCreate one page summary documents on key findings, successes, etc. Transformation Dept.Create an Elevator Speech that aligns the message of the DSTShare stories from the patient perspective/experience (written/video) and use on the IHN‐CCO website, at the legislature level, in newspapers, local media, etc.Add a question to the quarterly reporting form asking pilots if they have presented at any local, state, or national conferences and share this information out. Transformation Dept.

Hire a storyteller to tell the story; documents, toolkit for pilots, telling the story along the way of the pilot, show the impact of the pilots. Potential resource suggested by Joell Archibald is the Center for Digital Storytelling (www.StoryCenter.org).

Inform pilots/workgroups of upcoming conferences asking for poster submissions, focused presentations, etc. Transformation Dept.Educational Roadshow Transformation Dept.

How to get the story out – generated from DST discussion

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