better outcomes. delivered. impacting the healthcare of our community through quality measures and...
TRANSCRIPT
Better Outcomes. Delivered.
Impacting the Healthcare of our Community Through Quality Measures and Community Collaboration
www.ihie.org
The nation’s largest health information exchange: over 80 Indiana hospitals and over 18,000 physician participation.
www.ihie.org
IHIE Network
Participation includes over 80:
• Hospitals
• Long-term care facilities
• Immediate Care centers
• Rehabilitation centers
• Behavioral Health centers
• Free-standing labs and imaging centers
www.ihie.org
Vision and History
• IHIE’s vision:
• IHIE was launched in February 2004 by Regenstrief Institute, 5 major health systems, local and state public health, and other key business and community leaders
• The Regenstrief Institute is the key partner – an international leader in health information technology research and development for over 40 years
— Improve the quality, safety and efficiency of healthcare in the state of Indiana
— Create unparalleled research capabilities for health researchers
— Establish a model of health information exchange for the rest of the country
www.ihie.org
www.ihie.org
Indiana Network for Patient Care™
The INPC™ provides a secure ‘virtual’ patient record for:
• Safer, better care through access to a complete, aggregated clinical record
• Reduction in redundant testing
•Medication lists to improve the quality and reduce the time of med reconciliation
• Access to the clinical record in the ED, Inpatient, and outpatient setting
• Electronic data sharing into hospital EMRs
www.ihie.org
INPC Stats
• 3 billion pieces of clinical information
• 11 million patients
• 1,400 interfaces
• 5 large payers
• laboratories
• radiology centers
• State and Local public health agencies
www.ihie.org
www.ihie.org
DOCS4DOCS® Service
Provides Value By:• Improving provider’s access to data in
their offices• Providing incremental step to moving
providers to information based practice
• Creating data flows from many sources
• Engaging physician practices directly
• Contributing sustainable funding for HIE
• Providing standardization of clinical information
www.ihie.org
Provider Reach
• Over 18,000 physicians
• 5,800 practices
• 6 million messages/month
www.ihie.org
www.ihie.org
Quality Health First® Program
The Quality Health First Program is a multi-payer, value-based reimbursement program:
• Helps physicians identify and prioritize health screenings and other testing; provide early interventions and consistent support
• Enhances reimbursement for physicians
• Focuses on cancer screenings, diabetes care, heart disease care
• Payor participants include: Anthem BCBS, UnitedHealthcare, Unified Group Services, Medicare, Medicaid
• 1,600 physicians in over 50+ communities participate
• Covers over 1 million patients
www.ihie.org
Quality Health First® Program
Uses clinical data from the IHIE and claims data from payers in a multi-payer, value-based reimbursement program. Includes patient-specific alerts and reminders to physicians.
• Improved quality of care
• Clinical decision support at no cost to hospitals or physicians
• Increased reimbursement for primary care practices
• More credible and “user friendly” P4P program for physicians
www.ihie.org
QHF Program Data Sources
Labs
Outpatient Rx
Hospitals
Ambulatory Centers
Physicians Office
Public Health
CommercialPayers
Medicaid / Medicare
Point-of-CareTesting
www.ihie.org
Process Flow
Clinical DataSources
Providers
Payers
RulesEngine
ProviderLevel
Summary
PatientLevelDetail
Claims
Clinical Data
In Office Tests
Provider & Patient-specific Reports
Payor-specific Reports
www.ihie.org
Priority Measures
Measure Definition
AWC Adolescent Well Care Visit
BCS Breast Cancer Screening
CCS Cervical Cancer Screening
CHL Chlamydia Screening
DC1 Diabetic HBA1c Screening
DC3 Diabetic LDL-C Screening
W15 Well Baby Visits
W34 Well Child Visits
www.ihie.org
View of the Provider Summary Report
Delivered regularly, these reports provide an overall view
of the provider’s score of each
priority measure the provider
falls into compared to the
Adjusted Peer Score.
www.ihie.org
QHF Program Web Application View
www.ihie.org
Unique Attributes
The Quality Health First Program:
• Is managed by IHIE, an independent non-profit organization
• Integrates multiple health plans’ data to assure the provider’s reports represent a significant portion of his/her practice
• Allows physicians to reconcile reports and submit “point of care” data
• Is not only a “performance measuring program” but also a service to proactively improve individual patient care
• Reports measures that are provider-designed and approved by community physicians
www.ihie.org
Future Plans and Other Services
Addition of New Measures• Cardiology• Mental Health• Immunizations• Medication Adherence
Addition of Specialties• Cardiology• Endocrinology
PQRI Registry• Submit data on a specific set of measures: CMS Initiative
Meaningful Use• Work with Regional Extension Centers in guiding practices towards meeting
Meaningful Use Objectives.
www.ihie.org
Projects related to the QHF Program
Medicare Health Care Quality DemonstrationSection 646 of the Medicare Modernization Act
Aligning Forces for QualityThe Robert Wood Johnson Foundation
Central Indiana Alliance for HealthAligning Forces for Quality
Beacon Community Cooperative Agreement Program
www.ihie.org
Medicare Health Care Quality Demo
• Reducing healthcare costs by implementation of community-wide quality measures
• A five year project that looks at the impact of the QHF Program on reduction of healthcare costs
• Compares medical costs, per year, over a five year period, to like communities
• Opportunity to receive up to 50% of healthcare dollars saved
• Healthcare dollars saved will be distributed to physicians participating in the Demo through the QHF Program
www.ihie.org
Aligning Forces for Quality
• Robert Wood Johnson Foundation Initiative
• One of 17 Communities across the Nation
• Grant Funded – Three Phases
Phase 1 – Planning
Phase 2 – Implementation
Phase 3 – Expansion
www.ihie.org
Aligning Forces for Quality
Planning Grant – Phase I
• Build a Leadership Team by engaging community leaders• Hospitals• Providers• Health Plans• Employers• Consumer Advocates• Consumers
• Build a foundation to create and leverage opportunities to collaborate• Central Indiana Leadership Team• Consumer Participation Group
www.ihie.org
Aligning Forces for Quality
Implementation – Phase II
• Central Indiana Alliance for Health
• Implement Quality Improvement Models• Ambulatory Care• Inpatient Care
• Address Disparities• Race/Ethnicity/Language (REL) data• Standardize how it is collected• Use R/E/L data in QI
• Public Report/Consumer Engagement• Report Quality Performance • Patient Satisfaction Measures • Report on >50% providers
www.ihie.org
Aligning Forces for Quality
Phase III – Expansion
• Care Coordination across settings
• Payment Reform Models
• Meaningful Use Measures
• Cost/Efficiency Measures
• Transparency
www.ihie.org
AF4Q - Central Indiana Alliance for Health
• Website launched February 2011 www.centralindianaallianceforhealth.org
• Links to Public Reports www.ihie.org/Solutions/Quality-Health-First-Program/public-reporting.php
• Information for Consumers regarding Chronic Disease Management and Prevention
• Resource for Consumers and Providers
• Future Resource for Payers and Employers
www.ihie.org
Central Indiana Beacon Community Program
• One of 17 communities across the nation selected to participate in the Beacon Community Cooperative Agreement Program.
• The Central Indiana Beacon Community works to track outcomes related to Quality, Efficiency and Population Health.
www.ihie.org
Central Indiana Beacon Community Program
Central Indiana Beacon Community Goals:
• Increase the proportion of diabetic patients whose blood sugar and cholesterol are under control
• Reduce hospital admissions and emergency room visits for patients with conditions that could have been treated in an outpatient setting
• Increase screening for cancers of the colon and cervix
• Assist Indiana's Regional Extension Centers to support the adoption of electronic health records/Meaningful Use
www.ihie.org
Objectives to Measurable Outcomes
Measured Outcomes
National Beacon Objectives Quality Cost Population
HealthMeaningful
Use
Indiana Beacon Objectives
Diabetes Control
ACSCAdmissions
ImprovementImaging
IncreasePreventative
Screening
MeaningfulUse
