DSRIP HIT Phase 2 Update - Central New York Care Collaborative · Collaborative care planning...
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DSRIP HIT Phase 2 Update March 13, 2015
Transcript of DSRIP HIT Phase 2 Update - Central New York Care Collaborative · Collaborative care planning...
DSRIP HIT Phase 2 Update
March 13, 2015
March 19, 2015 Page 1
Agenda
Introductions
HIT Scope Update
– Original Scope of HIT
– Revised Scope
– Roll Played by Aspen Advisors
Phase 2 Update – Current State to Future State
EMR Rollout Strategy
Integration of HIT with Selected Clinical Projects
PHM Vendor Selection and Implementation Framework
IT/Data Governance
Next Steps
March 19, 2015 Page 2
Level 1 Diagram
March 19, 2015 Page 3
HIT Phase 2 Update
5 primary work streams:
HealtheConnections – central hub for HIE
Current state provider readiness assessment
EMR rollout strategies
Integration of HIT into CNYCC selected clinical projects
PHM vendor selection and implementation framework
IT & Data governance strategy formalization
March 19, 2015 Page 4
Current State Provider Assessment
Number of providers in network – 1656
Number of practices – 223
MU participation – 49.5% of those who have an EMR
EMR landscape – over 48 different vendors
Number of no responses – 262 providers (48 organizations)
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EMR Strategy
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EMR Burning Platform
Meaningful Use certification is a priority for all providers
Provider investment equals ownership in the technology
Adoption of EMR allows for community integration with HeC RHIO
Also allows for participation in programs like DSRIP
By waiver year 5 – all MCOs must employ non-fee-for-service payment systems that reward value over volume (>90%)
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Current StateFragmented
~6 % of providers are paper-based (no EMR), 78 % have an EMR and 16 % did not provide responses or responses were unclear
Only 49.5% of providers have achieved MU Over 48 vendor systems across the region This highly fragmented and disparate HIT ecosystem will not support the requirements
of DSRIP without significant investment and collaboration with the CNYC Collaborative and provider network
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Desired Future StateCoordinated and Patient Centered
100% of providers have an approved and certified EMR solution 100% of providers have achieved MU by the end of DY3 100 % compliance (meeting requirements) with providers across the region The future provider ecosystem has strong collaboration, sustainable solutions, highly
integrated and coordinated information flow. Care delivery and information flow is patient centered
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Fully Meets Requirements
Provider ReadinessTiers to Achieve Requirements
Test Readiness
Services to Achieve Readiness
Sponsored Vendor or Provider Partner
Solutions & Services
Technology ReadyServices Needed
Technology Does Not Meet Requirements
OR
OR
EMR Not in Place
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Provider Readiness – Tier 3Fully Ready
Early adopter
Test HIT/HIE infrastructure
– Health Information Exchange
– Population Health
– Data Analytics
– Active and collaborative care management
Review training and communication material
Evaluate and test use cases
Demonstration sites
Super users and advisors
– Assist provider network to reach Tier 3
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Provider Readiness – Tier 2Technology Ready
Technology early adopters
Define gaps (process, people, policy)
– Develop individual plans to address gaps
– Establish checkpoints on remediation activity
Fully integrate into care collaborative
– Health Information Exchange
– Population Health
– Care Plans
– Data Analytics
When requirement are met, move to Tier 3 status
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Provider Readiness – Tier 1 & 0Limited or No Technology
Providers require full service (solution and support)
Establish provider segmentation
Extend services and solutions from:
– Vendor partner
– Provider partner (Tier 3 sites)
– Hybrid (Vendor and Provider partner)
Develop Individual Plans
– Timeframe
– Costs
– Resources
Monitor and test sites
When requirements are met, move to Tier 3
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Partnerships Keys to Success
Vendor Partnerships
– Industry position
– Quality and performance
– Economics (Total Cost of Ownership)
– Future direction
Provider Partnerships
– Commitment
– Quality and performance
– Economics (Total Cost of Ownership)
– Organizational strategy and alignment
Alignment
Quality &Performance
Economics
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Vendor Partner Selection ProcessSchedule at a Glance
Month 1 Month 2 Month 3 Month 4 Month 5
Total Cost of Ownership Model Development and Review
Evaluations
Preliminary Planning, Project Scope, Timing and Phasing
Findings
ConductSite
Visits
Application and Technical Review
Findings
Vendor Partners
Develop Selection Committee
Draft/Distribute
RFI
Define Evaluation
Criteria
Evaluate RFI
Response
DefineStrategy and
Requirements
Narrow Vendors
Vendor Demos &
Workshops
Conduct Reference
Calls
Develop Use Case (Demo)
Scenarios
Develop Performance
Metrics
ContractingContract Review
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HIT Integration with Clinical Projects
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Integration of HIT into Clinical Projects
HIT requirement – secure global messaging required within the CNYCC infrastructure
– CNYCC HIT solution – enablement of Direct messaging through the Healtheconnection (HEC) RHIO or other HISPs
– CNYCC action – work with HEC to connect all participating providers to Direct messaging through the Mirth email network by end of DY3
Project 2.b.iii - ED care triage for at-risk populations
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PHM Vendor Selection and
Implementation Framework
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Population Health Management(PHM) Defined
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Radiology Images/Results
Lab Results
Clinical Documentation
Demographics
Radiology Images/Results
Lab Results
Clinical Documentation
Demographics
Organizational PHM Model
Community PHM Model
Integrated PHM Infrastructure
Pharmacy Data Claims Data
Organizational vs Community-Wide PHM
Social Determinants
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Requirements
DSRIP
Patient registries
Dashboards for performance metrics
Collaborative care planning
Provider-specific security; ability to segment population
Transitions of care - real time access to information across providers
Support of multidisciplinary care plans
Additional Requirements
Member engagement
Cross-continuum care
Quality management and outcomes reporting
Operational performance management and business intelligence
Risk and revenue management
Integration and infrastructure
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PHM Vendor Selection ProcessSchedule at a Glance
Current Month Month 2 Month 3 Month 4 Month 5
Onsite Demonstrations
Cost Model Development and Review
Evaluations
Preliminary Project Scope and Phasing
Findings
DefineStrategy
Interactive Workshops
Conduct Ref Calls
SiteVisits
Application and Technical Review
Findings
Evaluations
Evaluations
Vendor of
Choice
Draft/Distribute
RFI
Narrow Vendors
Evaluate RFI
Response
Online Vendor
Demos (if required)
Create Demo Scenarios
Develop Selection Committee
March 19, 2015 Page 22
PHM Vendor Landscape
Vendor DSRIP Experience?Aspen
Experience
Advisory Board Crimson Population Health
Covisint
eClinicalWorks CCRMTo be implemented by City of New York’s Advocate Community Providers (ACP)
Epic Healthy Planet
Explorys Platform & EPM Suite
Forward Health Group PopulationManager
i2i Systems i2iTracksIn place at San Joaquin General Hospital’s (SJGH) primary care clinics, participating in California DSRIP
Kryptiq CareManagerCareManager in place at Texas Tech University Health Sciences Center at El Paso, participating in Texas DSRIP
McKesson Population and Risk Manager
Optum One Population Health
Phytel Population Health Management Suite
Verisk Health Population Health Analytics
Wellcentive Advance Outcomes Manager Currently in use by New York and Texas DSRIP programs
March 19, 2015 Page 23
IT & Data Governance Strategies
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The Role of IT Governance
To create accountability for the strategic deployment of IT resources (people, processes, and technology) across the Collaborative.
To develop and communicate IT strategies that are in line with CNYCC strategic goals and objectives
To establish an IT decision-making model that ensures:
– Decisions are in line with the guiding principles of the Collaborative.
– Decisions are made in a timely and definitive manner, and at the right level.
– Decisions and their associated impacts are understood across the Collaborative.
To manage the evaluation, approval, prioritization and budgeting for IT projects.
To establish a data governance model that includes clinical, financial, and operational data standards and requirements across the Collaborative, but based on data captured at the provider level.
To ensure that the expected benefits of IT investments are realized.
IT GOVERNANCE provides a forum for working together, making decisions, and effecting change, and LEADERSHIP to leverage planning and tools to create a data driven organization
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Example IT ResponsibilitiesCNYCC IT will be responsible for overseeing the various IT initiatives that have impact across the network.
Overseeing an initial assessment of IT systems and capabilities
Deploying an EMR to participating providers
Developing and identifying standards for data definitions, data elements, and data exchange
Oversight of the data captured, stored, and used for reporting on behalf of the Collaborative through the HealtheConnections RHIO
Establishing priorities for IT expenditures
Overseeing development of the IT infrastructure for population health management
Assisting partner organizations to evaluate IT systems and vendors
Developing an IT change management strategy
Monitoring IT benchmarks and progress toward achieving IT goals
Developing a data security and confidentiality plan and overseeing the implementation of related policies and procedures
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IT and Data GovernanceSchedule at a Glance
In Process DY1 Q2 DY1 Q3 DY1 Q4 Ongoing
Determine timing for future activities
Develop the IT andData Governance Strategy
Determine scope of responsibility for the IT and Data Governance
Committee Create Board Governance
Committee and hire IT support
Communicate plans and provide education
Develop data management and
reporting standards, processes & workflows
Determine roles and responsibilities for the
RHIO and for CNYCC member organizations
Evaluate project management and DSRIP
reporting tools
Educate, information, and engage key
stakeholders
Create / Approve
governance structures,
subcommittees, decision-making
model
Establish data governance structure,
guiding principles,
priorities, and responsibilities
Hold regular meetings, measure and report on progressEnact ongoing data privacy and security policies & procedures
Develop the IT ChangeManagement Strategy
Determine organizational
vision, capabilities, and future state
Create Change Management
Toolkit
Develop Impact / Risk Assessment
Develop Communication
Strategy, Education, and Training Plan
Implement new processes and
workflows
Measure and report on progress
March 19, 2015 Page 27
CNYCC DSRIP HIT Implementation Timeline
Demonstration Year DY1 DY2 DY3 DY4
Quarters 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1 PPM System Selected & Implemented
2 EMR Selection Process
3 EMR Implementations for Providers
4 HeC Integration with Provider Network - Direct
5 HeC Integration with Provider Network – HL7/CCD
6 PHM System Selection Process
7 PHM System Implementation
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Hardcore DSRIP Requirements
All eligible participating providers in the Performing Provider System’s integrated delivery system will be connected to the local RHIO/SHIN-NY and be actively sharing information across all key clinical partners
Ensure that EMR systems used by participating providers meet Meaningful Use and PCMH Level 3 (where applicable) standards by the end of Demonstration Year 3.
Possess an ability to share relevant patient information in real time so as to ensure that patient needs are met and care is provided efficiently and effectively.
Vendor Selection Process
Creating use cases and employing a standards driven approach – select EMRs for each provider type
Convene providers by type (LTAC, BH, SNF, etc) to determine best practice for EMR adoption
March 19, 2015 Page 29
Next Steps
Finalize Phase 2 deliverables – implementation related plans
CNYCC Call to Action:
– IT support startup work effort to begin
– Begin implementation phase
• PPM tool implementation
• PHM software selection
• EMR software vendor short list
Provider Call to Action
– Self-identify the tier for your practice
– Follow-up with the providers via webinars
– Establishment of groups to help facilitate the implementation phase:
• Board based EMR selection workgroup
• Board based PHM selection workgroup
• De-emphasize IT’s role in selection process
