Vitera Intergy CHC Annual Reports
Transcript of Vitera Intergy CHC Annual Reports
Presenters
• Tim Mullen, Director of Product Management
• Leslie Marshall, Senior Business Consultant
UDS Updates for 2013 & Proposed Updates for 2014
• Gabriel Lopez, Product Analyst
Ryan White Updates for 2013 & Proposed Updates for 2014
• Shannon Feighny, Senior Business Analyst
Intergy and Practice Analytics Updates
Welcome
• Welcome to the Intergy CHC Annual Reports Webinar
• You may submit questions during the webinar via the general chat
feature at the right of your screen
• Additional questions can be submitted to [email protected]
until Friday January 10, 2014
• FAQ document will be available after the webinar on the Support Center
addressing the submitted questions
• The Slide presentation and a recording of today’s session will be
available shortly after the webinar on the Support Center
Agenda
• Intergy Version Requirements and Availability
• UDS Changes for Reporting Year 2013
• Intergy and Practice Analytics Changes for Reporting Year 2013
• Summary of Proposed UDS Changes for Reporting Year 2014
• Summary of Ryan White Changes for Reporting Year 2013
• Summary of Proposed Ryan White Changes for Reporting Year 2014
• Additional Resources
Version Requirements
• Intergy and Practice Analytics UDS updates will be available shortly, the following versions will contain the updates:
Intergy
▪ Version 8.10.00.15 or higher (Target release date 1/17/14)
▪ Version 9.00.00.03 or higher (Target release date 1/17/14)
Practice Analytics
▪ Version 8.10.01.05 or higher (Target release date 1/24/14)
▪ Version 9.00.01.01 or higher (Target release date 1/24/14)
• Customers on v8.10 and v9.00 will receive their software updates via auto
delivery
• Customers on v8.00 should request their upgrade to v9.0 by visiting the Vitera Support Center at www.viterahealthcare.com
NACHC Intergy User Group
• NACHC Vitera User Group on Linkedin.com
• Group objectives: Focused on Community Health Centers providing
user interaction, idea exchange, and improved product utilization
• Monthly meeting: Fourth Thursday of the month 1-2 pm ET
• 224 members and growing
• Group contact:
Melissa Mitchell
Director of Systems Operations for HealthLinc, Inc.
UDS Changes for 2013
• Clinical Performance Measure
Table 6B – Childhood Immunizations
Table 6B – Cervical Cancer Screening
• Other Measures
Patient Zip Codes
Table 4 – Principal Third Party Medical Insurance Source
Clinical Performance Measures
• Table 6B - Childhood Immunizations
– The age for immunization completion has been changed from
“on or before age 2” to “on or before age 3” (date of birth
between January 1, 2010 – December 31, 2010 for the 2013
period)
▪ Has had first visit prior to their 3rd birthday
▪ CDC/AAP still recommends immunization by age 2
▪ Changed to align with the Healthy People 2020 goals
Clinical Performance Measures
• Table 6B - Childhood Immunizations
– Removing Hepatitis A, Rotavirus and Influenza immunization
categories from the immunization test battery
– 2013 Immunizations:
▪ 4 DTP/DTaP
▪ 3 IPV
▪ 1 MMR
▪ 2 Hib
▪ 3 HepB
▪ 1 VZV (Varicella)
▪ 4 Pneumoccocal conjugate
Clinical Performance Measures
• Table 6B - Cervical Cancer Screening
Compliancy updated to include women age 30 or older at the
time of their visit who received a Pap test accompanied with an
HPV test during the current reporting period or the prior 4 years
▪ Also included: Women 24 – 64 who have had a Pap test
during the current reporting period or prior 2 years
Aligns with the 2012 recommendations for the U.S. Preventive
Services Task Force
Other Measures
• Patient Zip Codes
– Broken out by Insurance Source instead of just patient count and zip
code
▪ Insurance Sources:
• None/Uninsured
• Medicaid/CHIP/Other Public
• Medicare
• Private Insurance
Other Measures
• Table 4 - Principal Third Party Medical Insurance Source
– Updated Age Categories:
▪ Changed to 0 – 17 and 18 and Older
▪ Currently 0 – 19 and 20 and older
Will match the census categories
Intergy and Practice Analytics Overview
• 2013 Software Changes
– Childhood Immunization Clinical Measure Changes
– Cervical Cancer Screening Clinical Measure Changes
– Patient Zip Codes by Insurance Source
– Revised Age Break to Summarize Insurance Source Data
– Practice Analytics UDS Dashboard Updates
Childhood Immunization Clinical Measure Changes
• Changes to Table 6B
The Hepatitis A, Rotavirus, and Influenza immunizations have been
removed from the immunizations required for a child to be counted
as fully immunized
A child is considered as fully immunized if the child has been
vaccinated or there is documented evidence of contraindication for
the vaccine or a history of illness
A child is considered fully immunized prior to or on the third birthday
Childhood Immunization Clinical Measure Changes
• In the following example, the UDS Report Table 6B - Quality of Care
Indicators Section C - Childhood Immunization is displayed
Cervical Cancer Screening Clinical Measure Changes
• The UDS Report Table 6B Pap Tests section reporting has now
been updated to include female patients age 30 to 64 years who
have a 5 year interval for Pap tests when accompanied by an HPV
test on the same lab order.
• The measure counts the female patients based on both of the
following criteria:
Women age 24 to 64 years with a 3 year interval between Pap
tests
Women age 30 to 64 years with 5 year interval between Pap
tests accompanied by an HPV test on the same lab order
Cervical Cancer Screening Clinical Measure Changes
• Patients are now included for an HPV test based on lab results that
correspond to specific LOINC codes for HPV tests.
• The following LOINC codes indicate HPV tests:
69358-0
71432-9
59263-4
14503-7
59420-0
69002-4
30167-1
21440-3
59264-2
71431-1
38372-9
21441-1
42481-2
14499-8
44550-2
42770-8
11083-3
Cervical Cancer Screening and LOINC Codes
• LOINC Codes help identify laboratory and clinical observations
In iEHR map the LOINC codes as they point to the new HPV Clinical
Measurement
Clinical>Labs>Information>utilities>LOINC X-Ref
If you need additional help mapping LOINC codes please call Vitera
Support
Use Audit Reports in Intergy if your practice does not utilize iEHR
Patient Zip Codes by Insurance Source
• The UDS Report Patients by Zip Code section has been updated to
report counts of patient zip codes in categories of insurance sources,
such as Medicare to comply with the HRSA 2013 reporting requirements
• The number of patients by Zip code is counted for each of the following
insurance sources:
– None/Uninsured (Column b)
– Medicaid/CHIP/Other Public (Column c)
– Medicare
– Private Insurance
• The UDS Zip Code Analysis Report output in the Intergy system have
been updated for the reporting changes
Patient Zip Codes by Insurance Source
• The following example shows the UDS Report Patients by Zip Code
section
Patient Zip Codes by Insurance Source
• The following example shows the UDS Zip Code Analysis Report
Revised Age Break to Summarize Insurance Source Data
• UDS Report Table 4 - Selected Patient Characteristics
• Updates include changes to age categories that comply with HRSA
reporting requirements for 2013
• The patient age ranges for Table 4 count includes patients from age 0-
17 for Column(a) and patients age 18 and older for Column(b)
Revised Age Break to Summarize Insurance Source Data
• In the UDS Table 4 - 3rd Party Ins Source Analysis Report window, the Age Group radio buttons have been changed from “All, 0-19, and 20 and Older” to “All, 0-17, and 18 and Older”
Revised Age Break to Summarize Insurance Source Data
• The UDS Table 4 - 3rd Party Ins Source Analysis Report output in the
Intergy system has been updated for the reporting changes. In the
following example, the 18 and Older age group is reported
Revised Age Break to Summarize Insurance Source Data
• The UDS Report Table 4 - Selected Patient Characteristics section
output in the Intergy system has been updated for the reporting changes
Practice Analytics UDS Dashboard Updates
• Practice Analytics includes an updated dashboard that displays
reporting updates for HPV
Summary of UDS Proposed Changes for 2014
• Clinical Performance Measures
– Table 6B - Quality of Care Measures
▪ Combine Tobacco Screening and Cessation Intervention into
a single measure
• Aligns with the NQF measure and MU
– New Measure: New HIV Cases with Timely Follow Up
▪ Patients whose first ever HIV diagnosis was made by health
center staff between Oct 1, 2013 and Sept 30, 2014 and who
were seen for a follow up within 90 days of that first ever
diagnosis
Summary of UDS Proposed Changes for 2014
• Clinical Performance Measures
– New Measure: Behavioral Health Measure for Clinical Depression
Screening and Follow Up
▪ Patients ages 12 and over who were
• Screened for depression with a standardized tool AND
• Had a follow up plan documented if patients were considered
depressed
▪ Aligns with NQF and MU – importance of behavioral health
quality measurement
Summary of UDS Proposed Changes for 2014
• Clinical Performance Measures
Table 7 - Health Outcomes and Disparities Measures
▪ Revising the Diabetes Control measure to no longer require
reporting HbA1c levels that are less than 7
• Categories: less than 8%, 8% through 9%, and greater than
9%
▪ Aligns with NQF and MU which reduces health center reporting
burdens
Summary of UDS Proposed Changes for 2014
• Other Measures:
– Table 4: Characteristics Special Populations
▪ Line 26 will be added to report the number of public housing
patient
– Table 6A: Selected Diagnoses and Services Rendered
▪ Line 1-2(a) will be added to report the number of patients with a
first time diagnosis of HIV being reported
Summary of UDS Proposed Changes for 2014
• Other Measures:
– Table 6B and Table 7 Prenatal and Perinatal Services – Changes
▪ All Health Centers will report the services and outcomes for ALL
pregnant medical patients who were either provided prenatal
services (some or all) OR received no prenatal services but were
referred for prenatal care and delivery
▪ The program expectation is that the patients will be tracked in
order to assure continuity of care – especially if they are referred
out for these services
Summary of Ryan White Changes
• RSR Instruction Manual Guideline changes
– Updated on July 15, 2013
– Located in the What’s New section of the RSR Instruction
Manual (page 2)
• Program Reporting Requirement changes
– No reporting requirement changes for 2013
• RSR Data Changes
– No data changes for 2013 reporting
Summary of Ryan White Changes
• RSR Instruction Manual Guideline changes:
Page 9: Expanded the designation of who may recommend medical nutrition therapy from ‘physician’ to health care professional.
Page 26 and 40: Added guidance that HAB expects all service providers to complete their own RSR Provider reports and upload client-level data. Grantees may only submit data for providers who are exempt from reporting.
Page 53 and 54: Clarified the reporting guidance related to high-risk insurance pool clients. If RWHAP funds are used to pay the client’s insurance premium, report the client in the “No insurance” category.
Page 54: Clarified when to report a client in the “No Insurance” category.
Summary of Ryan White Changes
• RSR Instruction Manual Guideline changes:
Page 54: Clarified the guidance on when to report a service visit
as a RWHAP-funded service visit.
Page 56 and 57: Updated the response options for reporting
essential support services and core medical services, Local
AIDS Pharmaceutical Assistance services and Health Insurance
Premium & Cost Sharing Assistance services.
Page 66: Added guidance that Substance use screening, Item
61, may be administered by a substance abuse treatment
professional or by a trained health care professional in another
medical/clinical discipline.
Summary of Proposed Ryan White Changes
• RSR Instruction Manual Guideline changes:
– Pending release for 2014 changes
• Program Reporting Requirement changes (for grantees):
– Changes to reporting frequency by 35%
• RSR Data Changes:
– Changes to data elements for data collected beginning January 1st, 2014
▪ Reduce reported data elements by 37%
▪ Data changes (additions) to support implementation of proposed HIV Core Indicators
▪ Retiring data elements that are ineffective
▪ Consistent language across HHS
Summary of Proposed Ryan White Changes
• RSR Instruction Manual Guideline changes:
– Eliminating Duplicate Reports
▪ RSR grantee report will be revised so that it provides the
information needed for both:
• Service Provider Contracts (from RSR)
• Consolidated List of Contractor
▪ Integrating these two reports eliminates the Allocations for
the Allocations and Expenditures report for grantees
Summary of Proposed Ryan White Changes
• Program Reporting Requirement changes (for grantees):
Reducing Reporting Frequency
▪ ADAP Data Report (ADR) will be changed from semi-annual
to annual reporting
• Client-level data for 1/1/2013-12/31/2013 will need to be
in report
• Calendar year 2013 data will be due on 4/28/2014 (not
12/16/2013)
▪ ADR will be annual from that point forward (representing
budget period of 4/1/2013-3/31/2014)
▪ Eventually eliminate Minority AIDS Initiative Reports
Summary of Proposed Ryan White Changes
• HIV core indicators (from Ryan White data collection)
– In July 2012, the Secretary approved the seven core HIV indicators
developed by the HAIIG, which were aligned with Institute of
Medicine recommendations for monitoring federally-funded HIV
prevention programs and consistent with a framework used by the
CDC, HRSA, and others to enhance the continuum of care needed
to achieve durable viral suppression in persons living with HIV
▪ HIV Positivity
▪ Linkage to HIV Medical Care
▪ Retention in HIV Medical Care
▪ Antiretroviral Therapy (ART) among Persons in HIV Medical Care
▪ Viral Load Suppression among Persons in HIV Medical Care
▪ Housing Status
Summary of Proposed Ryan White Changes
• RSR Data Changes:
– Eliminating Data Elements (due to poor quality or redundant)
▪ First Service Date
▪ Date of Death
▪ Number of visits per quarter
▪ Clarify Viral Load
▪ Screened for TB/Hepatitis B/Hepatitis C during reporting
period
Summary of Proposed Ryan White Changes
• RSR Data Changes:
– Changed existing Demographic Data Elements
▪ Federal Poverty Level (FPG) will
be changed to match Affordable
Care Act (ACA) groupings:
• <100% FPG
• 100% - 138% FPG
• 139% - 200% FPG
• 201% - 250% FPG
• 251% - 400% FPG
• 401% - 500% FPG
• >500% FPG
▪ *Coverage Categories will be changed to match ACA categories:
• Private- Employer
• Private- Individual
• Medicare
• Medicaid, CHIP, or other public plan
• VA, IHS, Tricare, and other military health care
• Other Plan
• No Insurance/uninsured
Summary of Proposed Ryan White Changes
• RSR Data Changes:
Added Race/Ethnicity Data Elements
▪ Hispanic Ethnicity sub-
groups
• Mexican, Mexican
American, Chicano/a
• Puerto Rican
• Cuban
• Another Hispanic,
Latino/a or Spanish
origin
▪ Native Hawaiian/Pacific
Islander Race
subgroups
• Native Hawaiian
• Guamanian or
Chamorro
• Samoan
• Other Pacific
Islander
▪ Asian Race subgroups
• Asian
• Asian Indian
• Chinese
• Filipino
• Japanese
• Korean
• Vietnamese
• Other Asian
Summary of Proposed Ryan White Changes
• RSR Data Changes:
Added Demographic Data Elements
▪ Sex at Birth (this is in addition to current gender identification-will not replace it)
▪ *Primary Language at Home
▪ Assessment of Disabilities from a functional perspective
• Deaf or serious difficulty hearing
• Blind or serious difficulty seeing, even with glasses
• Serious difficulty concentrating remembering, or making decisions due
to physical, mental, or emotional condition
• Serious difficulty walking or climbing stairs
• Difficulty dressing or bathing
• Difficulty doing errands alone due to physical, mental, or emotional
condition
*Primary Language and Coverage Categories are still under development as of 12/16/2013
Summary of Proposed Ryan White Changes
• HAB expects all programs to use the new data set during calendar
year 2014
Data collected after January 1, 2014 must include any new variables
and does not need to include variables that have been deleted. In
addition, required schema changes will need to be implemented prior to
reporting in 2014.
• Timeline for Implementation
Department of Health and Human Services expects that federal
programs will implement these new data requirements for fiscal year
2014, (Beginning on October 1, 2013)
RSR manual addenda to be added in November 2013 (?)
Data Dictionary & Schema to be release in late Spring 2014
Additional webcasts in February 2014 and after
UDS Resources
• PAL for UDS Calendar Year (CY) 2013:
http://bphc.hrsa.gov/policiesregulations/policies/pal201302.html
• PAL for UDS CY 2014:
http://bphc.hrsa.gov/policiesregulations/policies/pal201307.html
Ryan White Resources
• HRSA HIV/AIDS Program: http://hab.hrsa.gov/reauthorization/
• 2013 RSR Instruction Manual:https://careacttarget.org/sites/default/files/file-upload/resources/2013RSRInstructionManual508b_0.pdf
• 2014 Data changes to RSR: https://careacttarget.org/library/data-changes-2014
• HIV Core Indicators: http://blog.aids.gov/2012/08/secretary-sebelius-approves-indicators-for-monitoring-hhs-funded-hiv-services.html
• 2013 Submission Timeline: https://careacttarget.org/library/ryan-white-hivaids-program-services-report-submission-timeline
• RSR Data Dictionary/XML Schema: https://careacttarget.org/sites/default/files/file-upload/resources/RSR%20Data%20Dictionary%20Version%202.5.pdf
• Streamlining data collection: http://blog.aids.gov/2013/07/secretary-sebelius-approves-plans-to-standardize-and-streamline-data-collection-for-hhs-hiv-grantees.html
• TARGET Center: https://careacttarget.org/
• Blog.AIDS.gov: http://blog.aids.gov/