Patient Care Alerts Integration into Clinician Workflow€¦ · REALIZE FULL POTENTIAL • PURSUE...
Transcript of Patient Care Alerts Integration into Clinician Workflow€¦ · REALIZE FULL POTENTIAL • PURSUE...
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Patient Care Alerts... Integration into
Clinician Workflow
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
1 Introductions
2 Alabama Landscape & Opportunity
3 Direct Messaging
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Provider Feedback & Lessons Learned
Care Alerts & Current Status
Agenda
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
11,381 Network Providers • 4,085 PCPs (Including OB-GYN)
4,072 Primary Care Extenders (NP, PA)
Average PCP Clinic Size = 5 Physicians
90 Short-term, Acute Care Hospitals
Over 120 Unique Ambulatory EHRs
Alabama Landscape
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Opportunity
Goal: Integrate actionable data into the provider’s EHR systems and workflow. New Measures: Readmission Rates & Medication Reconciliation Provider Feedback & Demand: Visibility when their patients utilize the hospital or the emergency room. Connectivity: Near real-time ADT messages from 46 of the 90 hospitals in Alabama, representing approximately 73% of the short-term acute care hospital beds. Member/PCP Attribution: Established processes to identify the appropriate provider-to-member healthcare relationship. EHR Adoption: 79% of physicians utilizing an MU Certified EHR system (Direct Message capability).*
*Office of the National Coordinator for Health IT (ONC)
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Direct Messaging
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Deliver Care Alerts to providers within their EHR workflow to trigger the appropriate follow-up care after a member utilizes an emergency room or is admitted/discharged from an inpatient facility.
• Began February 26, 2018
• 10 Unique EHR Systems
• 25 Clinics/50 Physicians
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Direct Messaging
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Actionable Message
ALERT: A patient attributed to you was discharged from the hospital. Remember to contact this patient within 2 days of discharge to schedule a follow-up appointment and to reconcile medication no later than 30 days post discharge. Once discharge medications are reconciled with the patient’s current medication list, document it in your electronic medical record system and submit CPT Category II code 1111F on a claim to confirm that medications have been documented and reconciled.
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Do Care Alerts provide better visibility into
treatment your patients receive outside of
your practice?
Survey Results
NO 85%
15%
YES
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Has your practice incorporated Care Alerts
into your office’s processes to follow-up
with patients?
0%
10%
20%
30%
40%
50%
60%
70%
80%
Yes No
Survey Results
Establishing a Process
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Provider Feedback
…This is huge for continuity of care and medication reconciliation! …Information is helpful and allows us to follow up with the patient.
…I get these messages faster than what I get from the hospital.
…Other discharge notices would be useful to us as well.
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Lessons Learned
Not All EHRs Are Created Equal
Set Provider Expectations
Minimal Provider Setup
Plan for Flexibility
Self-service Enrollment
Scalable Solution
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Care Alerts Enrollment
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Lessons Learned
Not all EHRs are Created Equal
Set Provider Expectations
Minimal Provider Setup
Plan for Flexibility
Self-service Enrollment
Scalable Solution
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Care Alerts Workflow
Hospital
Provider
• HISP/Connectivity • Data Transformation • Provider Matching • Provider Enrollment • Reporting
• Connectivity • Data Normalization • Member Matching • Data Filtering • Data Transformation • Monitoring
• Patient Attribution • Check provider enrollment • Delivery method(s)
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Care Alerts
Over 1,300 providers enrolled
Over 59,000 notifications sent
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Future Care Alerts
Gaps in Care Quality/Risk/Medication Adherence
Electronic Medical Records Specialist and Urgent Care
Discharge Summary
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Clinical Information Exchange
RESPECT OUR CUSTOMERS • ACHIEVE EXCELLENCE • RETAIN FINANCIAL STRENGTH REALIZE FULL POTENTIAL • PURSUE KNOWLEDGE • ACT WITH INTEGRITY • GIVE BACK TO THE COMMUNITY
Patient Care Alerts... Integration into
Clinician Workflow