Pre-Conference Intensive: Using

Health IT Tools: The What, the Why and

the How Part II

July 29, 2018

Investing in and Choosing an IT Platform.

Presenters:

Sharon Fusco, Vice President - Business Services Group for

Council on Aging of Southwestern Ohio Cincinnati, OH

Sandy Atkins, Vice President, Strategic Initiatives, Partners in

Care Foundation San Fernando, CA

IT to Support Networks & Contracting

Sandy Atkins, MPA, VP, Strategic Initiatives

What’s it for? History/Evolution

Something for everyone…

A patchwork quilt

LTSS/Waiver:

CM, purchase & billing

CCTP:

Workflow/billing

HomeMeds:

Risk screen

CDSME

Outreach, Ops & Outcomes

Network Contracts

Assessment, CP & Process

Phase I: Do Whatever it Takes!!

Copy Data TO HomeMeds Export PDFs to Excel

70-Column Log

Pharmacist Log Data

Example of a real workflow

Ouch!!!!

Learning from the Pain

This Photo by Unknown Author is licensed under CC BY-SA-NC

Seeking IT Solutions: Discovery • Discuss pain points & aspirations

• Review contractual requirements

− Same-day documentation of every attempt to contact member

− Provide access for Plan to internal record-keeping systems

− Secure File Transfer Protocol (SFTP) & Secure Email required

• Review accreditation requirements

− Population health management

− Reminders/notifications

• Billing requirements

• Reporting requirements

• Management & oversight requirements

• Plan workflows

Demos – Lessons Learned

• Make sure you’re seeing a live, implemented site and not screenshots

• Get a login to do a test run − If they can’t/won’t…don’t!

• Beware of demo fatigue – the best one may be last

• Beware of shiny, glitzy, overkill systems that create unrealistic expectations in your price range

• Beware of group think & letting others’ feelings (positive or negative) carry you away

• Have a rating tool and make everyone use it

RFP & responses – lessons learned

• Don’t let anyone get away with not answering questions as stated and in the format requested

• Make sure it’s abundantly clear what is required and what is a “nice to have”

− Consider eliminating the nice-to-have elements from RFP

• Response must specify openly what is—and is not—included in pricing

• Create a point-by-point rating tool − Have someone designated to pull info from RFP response

into rating tool

Choosing – Lessons Learned (sort of)

• False economies − Sometimes the cheapest isn’t

• False economies − Sometimes the most expensive isn’t the best

• Sometimes pressure leads to good decisions − Sometimes it doesn’t

• A good working relationship can be more important than the best product

− But it’s not about being friends; it’s about working together to develop a great system

Contract Terms – Lessons Learned

• Read and really think through every term; some may not be as benign as they look

• When do you start paying?

• What if it’s not done to your satisfaction?

• Who decides when it’s ready to use? − He said/she said – who’s “fault” is it?

• Look for minimum volume requirements − New contracts tend to be small

− You may be paying for more than you need

Implementation: Multiply by 3

This Photo by Unknown Author is licensed under CC BY-ND

Next challenges

• Integrating data across multiple systems

• Linking up to health systems/plans

• A system that works for a network − Automates more

− Assumes less

− Wake-up calls for required steps & timeliness

Happy to Help! Sandy Atkins, VP, Strategic Initiatives

satkins@picf.org

www.picf.org

818.837.3775x111

818.632.3544 (m)

USING HEALTH IT TOOLS: INVESTING IN AND CHOOSING AN IT PLATFORM SHARON FUSCO, VICE

PRESIDENT, BUSINESS SERVICES

LESSONS LEARNED IN SELECTING SOFTWARE

Create a cross functional team to determine system specifications.

Include strategic and operational thinkers.

Identify early the “go/no go” criteria.

Determine early if you are willing to change business practices to adopt a new system and move to industry standards. (Customization is expensive and makes it easy to “fall behind” the technology trends).

Check references.

TAKE TIME TO DEFINE THE FUTURE STATE

VENDOR EXPECTATIONS

Define what you want from the vendor.

How do they manage projects?

Meeting schedules

Communications

How do they get into the details of your business

and translate that into system specifications?

How do they define and mitigate risk?

QUALIFICATIONS

Communications.

Manage through influence

Goal oriented

Highly organized.

Multi-task

Not an expert but knows

your business.

WHY?

Need for single point of

contact.

Internal impact is

significant.

Ensure everyone is

getting the job done

LESSONS LEARNED IN CONTRACTING FOR SOFTWARE PURCHASE

Include “carrots” and “sticks” in the contract for hitting deliverables.

Include the scope of work in the contract.

If it can’t be completed prior to contracting, include a deadline for completing the contract.

Insist on a project plan with deliverables.

Use your legal office, someone with expertise in computer software purchases.

LESSONS LEARNED IN

IMPLEMENTING SOFTWARE

Use a cross functional team of people who do

the work.

Hire your own project manager to work with

their project manager and to keep your team

on track.

Create a plan and work the plan.

Over estimate how much time each step will

take.

Track all deliverables.

VENDOR COMMUNICATIONS

Be direct. Identify and discuss

problems. Agree on resolutions.

Establish lines of communication at

the operational and executive level.

Take and share minutes – record

every meeting.

Create a system for accountability -

we use the project plan and executive

meetings for this.

QUESTIONS

Sharon Fusco

Council on Aging

175 Tri County Parkway

Cincinnati, OH 45246

513/746-2645

sfusco@help4seniors.org

Strategies for Data Collection and Exchange

Presenters:

Sue Lachenmayr, State Program Coordinator, Living Well

Center of Excellence, MAC, Inc. Salisbury, MD

Leigh Ann Eagle, Executive Director, Living Well Center of

Excellence, MAC, Inc. Salisbury, MD

Donata Barnes, Director/Health Care Collaborations, CICOA

Aging and In-Home Solutions Indianapolis, IN

www.cicoa.org

Strategies for Data

Collection and

Exchange Donata Barnes, Director of Health

Care Collaboration

www.cicoa.org

Opportunities for Growth

• Utilizing the state electronic database, Access and

excel sheets for data

• Current system lacked interoperability

• System was not web-based

• Current system lacked the ability to share client

information in real time with other providers

• Developing reports to support or show

effectiveness of evidenced-based program was

challenging

• Effectively and Efficiently addressing the triple aim

www.cicoa.org

Solutions

• Embed staff at local hospitals

• Obtained funding through the Fairbanks

Foundation to develop and implement EMR that

was compatible to the Indiana Health

Information Exchange and met

• Partner with Indiana Health Information

Exchange for real time admission, discharge,

and transfer alerts

• Ability to provide partners with data based on

social determinants of health

www.cicoa.org

Indiana Health Information Exchange

• Connection to 117 hospitals / representing 38

health systems

Hospitals Physician Practices

www.cicoa.org

Questions & Answers

www.cicoa.org

Thank You!

CICOA Aging & In-Home Solutions

4755 Kingsway Drive, Suite 200

Indianapolis, IN 46205

317.254.5465

800.489.9550

Aging & Disability Resource Center

317.254.3660

800.432.2422

www.cicoa.org

Let’s Be Social

cicoa.org/facebook

cicoa.org/twitter

cicoa.org/linkedin

Strategies for Data Collection and Exchange: the Maryland Living Well Center of Excellence Partnership with CRISP MARYLAND L IVING WELL CENTER OF EXCELLENCE (LWCE)

LE IGH ANN EAGLE, EXECUTIVE DIRECTOR

SUE LACHENMAYR, STATE PROGRAM COORDINATOR

Health information exchange (HIE)

HIE is the mobilization of health care information electronically across organizations within a region, community or hospital system. In practice the term HIE may also refer to the organization that facilitates the exchange.

HIE provides the capability to electronically move clinical information among different health care information systems. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer and more timely, efficient, effective, and equitable patient-centered care.

MARYLAND’S CHESAPEAKE REGIONAL INFORMATION ABOUT PATIENTS - CRISP

Regional Health Information Exchange (HIE) serving Maryland and the District of Columbia, and collaborating with Delaware, Northern Virginia, Pennsylvania, and West Virginia

Vision: To advance health and wellness by deploying health information technology solutions adopted through cooperation and collaboration

Data source or attribute #

Live hospitals 91

Live clinical data feeds 261 (lab, rad, ADT, CCD)

Live ENS practices +1,000

Long-term and post-acute care facilities

160

Standalone labs and radiology centers

16

Unique patients in index +16 million

Patient searches +400,000/mo

Encounter alerts sent +2,500,000/mo

CRISP Core Services

1. POINT OF CARE: Clinical Query Portal & In-context Information

◦ Search for your patients’ prior hospital records (e.g., labs, radiology reports, etc.)

◦ Monitor the prescribing and dispensing of PDMP drugs

◦ Determine other members of your patient’s care team

◦ Be alerted to important conditions or treatment information

2. CARE COORDINATION: Encounter Notification Service (ENS)

◦ Be notified when your patient is hospitalized in any regional hospital

◦ Receive special notification about ED visits that are potential readmissions

◦ Know when your MCO member is in the ED

CRISP Core Services

3. POPULATION HEALTH: CRISP Reporting Services (CRS)

◦ Use Case Mix data and Medicare claims data to:

o Identify patients who could benefit from services

o Measure performance of initiatives for QI and program reporting

o Coordinate with peers on behalf of patients who see multiple providers

4. PUBLIC HEALTH SUPPORT: Partnerships with Maryland MDH, District of Columbia DHCF, and West Virginia through the WVHIN

5. PROGRAM ADMINISTRATION: Technical and administrative support for Care Redesign Programs

MARYLAND LIVING WELL CENTER OF EXCELLENCE (LWCE) - MAC, INC. AAA

• Statewide License for CDSME Programs: Chronic Disease, Diabetes, Pain, Cancer, Spanish Chronic Disease

and Diabetes, CDSMP Toolkit and wCDSMP (worksite) • Statewide License for Stepping On, EnhanceFitness, EnhanceWellness and PEARLS • Statewide oversite for PEARLS • Learning collaborative and trainings for CDSME, Stepping On and PEARLS • Centralized referral, workforce certification and fidelity monitoring, and HIPPA-compliant training and

processes • EBP workshops on MDH statewide calendar/registration/referral website • Quarterly reports on patient activation, engagement, and long term goals • Participant satisfaction/engagement and quality assurance monitoring of leader competency • Expanded consent to collect individual and population health outcomes • Tracking of pre-/post- clinical measures

LWCE Evidence-Based

Programs

42

CHRONIC DISEASE

SELF-MANAGEMENT

EDUCATION

PROGRAMS:

Cancer Thriving and Surviving

Chronic Disease

Chronic Pain

Diabetes

Home Toolkit

Spanish Chronic Disease

Tomando

Spanish Diabetes Programa De

Manejo

wCDSMP worksite

Walk With Ease

LWCE, CRISP & Hospital Data-Sharing

• CRISP/Hospital/LWCE 6 month pre/post hospital and emergency department

utilization after completion of evidence-based program (EBPs) to establish ROI

• Partnering with CRISP to track Social Determinants of Health and referrals to

EBPs and community-based services

• Access CRISP as Care Coordination Provider to input CARE ALERTS, including

identifying patient unmet needs, services provided, etc.

Health Care Perspectives

Presenters:

Johnny Gore, MD, Sr. Medical Director, STAR+PLUS, Cigna-HealthSpring Bedford, TX

Jason Smith, Sr. Director Medicaid/Medicare Ohio, Aetna

Columbus, OH

BREAK

Breakout Activity

Breakout Questions

• What’s the greatest insight you heard at this preconference that you’re taking back to your organization?

• What action steps can you take to address the organizational IT challenge that you discussed yesterday?

• Again, thinking about that challenge, what help do you need to move forward with your action steps?

More from the Business Institute

• Webinar: Sustainability for All: A Multi-Partner Approach to Growing Evidence-Based Programs August 29 at 1pm ET

• Webinar: Understanding the Incentives and Strategies for Health Systems to Engage in Cross-Sector Partnerships September 19 at 1pm ET

• Readiness Assessment

• Website: aginganddisabilitybusinessinstitute.org

Upcoming Learning Opportunity

Learning Collaborative for decision-making support to evaluate, select and implement data sharing systems to enhance management of service delivery for program quality, client satisfaction and service reimbursement.

Call for applications coming in August!

www.aginganddisabilitybusinessinstitute.org

Sandy Markwood Chief Executive Officer National Association of Area Agencies on Aging (n4a) smarkwood@n4a.org Mary Kaschak Deputy Director, Aging and Disability Business Institute n4a mkaschak@n4a.org Karen Homer Research Associate, Aging and Disability Business Institute n4a khomer@n4a.org

Marisa Scala-Foley Director, Aging and Disability Business Institute N4a mscala-foley@n4a.org Paul Cantrell Consultant n4a pcantrell@n4a.org Elizabeth Blair Senior Research Associate, Aging and Disability Business Institute N4a eblair@n4a.org