Creating an IT Strategy that Excites and Unites

Transcription

1 Creating an IT Strategy that Excites and Unites Scott Green SVP/GM, Behavioral Health

2 IT Touches Everything Begin with this reality in mind Establish the wins in the work for everyone Data Analytics: Ability to get data out of the system

3 IT Touches Everything Clinical Leadership Will the system facilitate concurrent/collaborative charting? What are reasonable standards for note completion? Can we integrate currently disparate systems (telehealth, EBP s, Consumer Engagement) in a more efficient way?

4 IT Touches Everything Training and human resources How to we onboard new employees and get them competent with the EHR? How do we train people when updates and improvements are provided from the vendor? How do we keep existing staff current? Role-based Onboarding CareRecord Basics Recommended Practice/ Optimization Continuing Education Billing fundamentals for new hires Introduction to myavatar PM billing for end users Optimizing the use of myavatar PM for end users Billing learning network Troubleshooting claims in myavatar PM

5 IT Touches Everything Finance Can we monitor productivity and billing through go live? Where are the targeted areas of efficiencies and what is the plan to ensure we are achieving them? How will we highlight the success our investment in technology brings in this space?

6 IT Touches Everything Human Resources What policies and procedures need to change as we become fully electronic? Does this have implications for discipline, hiring or firing? Will recruitment and retention be affected by the implementation of technology?

7 IT Touches Everything Marketing Are there the public relations issues associated with this change that are: POSITIVE ( XYZ organization takes next step in technology evolution ) or NEGATIVE ( XYZ organization spending money on software that could be used for patient care )? Should referrers and other stakeholders be informed about these changes personally e.g. by direct communication? Does the change allow for a win for partners?

8 It Touches Everything Board of Directors How will the organization be better as a result of this project? How will we know if we are successful? How will the communities we serve benefit? What business case can we make to justify the investment? Mission Driven Economic Reality Market Competitiveness Service Expansion

9 Unique Role of Leadership Technology and Project Management Technology answers what? Project Management answers how? and the when? Only Leadership Can Answer the Why? Set the strategic imperatives Communicate how the organization will be better for doing this Communicate to the organization the cost of not acting Drive collaboration and a common goal with wins for all

10 Leadership If management is the art of getting things done through others, leadership is about creating a compelling vision of the future and helping others adopt that vision as their own. The responsibility for painting such a vision falls largely to the executive sponsors of the technology initiative. How does your organizations vision get shaped? What role does your vendor partner play in this conversation?

11 HIMSS Analytics EMR Adoption Model Stage Stage 7 Stage 6 Stage 5 Stage 4 Stage 3 Stage 2 Stage 1 Stage 0 US EMR Adoption Model SM Cumulative Capabilities Complete EMR; CDD transaction to share data; Data warehousing; Data continuity with ED, ambulatory, OP Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS Closed loop medication administration CPOE, Clinical Decision Support (clinical protocols) Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capabilities Ancillaries Lab, Rad, Pharmacy All Installed All Three Ancillaries Not Installed

12 EMR Adoption Model SM Limitations Physical Health Focused In-patient Focused EMR and EMR/Clinical Elements, Not HIT Linear Measures Adoption with Minimal Thresholds Limitations in Extensibility; Static Limitations in Comparisons

13 Aligning IT with corporate strategy for sustainability and success

14 PROVIDING CARE Planning, delivering and documenting care given. INFORMING CARE Bringing information to the professional clinical, financial or operational at the most valuable point in time. ACCOUNTING FOR CARE Managing claims, processing payments and generating revenue from intake to remittance. INTEGRATING CARE Creating a coordinated, integrated and comprehensive care process across all providers of care, while maintaining responsibility for the health status of a person. ENGAGING IN CARE Empowering the person to participate directly in the care process.

15 Accounting for Care IT Capability Threshold X Codified Demographics Capture 100% capture pre- or at admission X Consent Management 80% of consents captured and tracked X Charge Capture and Coding 98% coding audit substantiated Eligibility & Medical Necessity Verification (270/271) 70% of encounters verified X Claims Scrubbing 90% of claims accepted on initial submission X Claims Submission 90% of claims submitted X Integrated Appointment Scheduling 100% of appointments X Contract Management 100% payor rates known for 80% of services X Remittance Management 95% collection rate Authorization Management (278) 90% of authorizations

16 Informing Care IT Capability Threshold X Track Consumer-related Health Incidents 100% of consumer-related health incidents documented X X X X X Data-driven Workflows and Alerting Data-driven Care Planning Evidence-based Content at the Point of Action Consumer Progress Evaluation External Benchmarking Practice-based Evidence/Predictive Modeling Clinical Decision Support Based on End-user Input End-user Use of Real-time Business Analytics 80% of users access data-driven workflows and alerting 80% of treatment plans with data-driven evaluation of needs/level of care 80% of users have access to evidence-based (best practice) content 80% of progress notes populated with client-entered progress data 15 external benchmarking metrics (5 each of financial, operational, and clinical) Standards of care based on historical analytic trends & use models to predict future state Immediate access to electronic clinical decision support based on end-user input Real-time end-user access to dynamic data/analytics for rapid ask & answer capabilities (not static reports) X Org-wide KPI Tracking with Defined Performance Goals Organizational KPI performance is tracked in real time

17 Client Example

18 Netsmart Client #1 Netsmart Client Averages Netsmart Client High Scores Netsmart Clients

19 IMPLEMENTERS Technology Vendors HIEs Service Providers Personal Health Record

20 Plugging in the EHR How does it work? Hosted Environment Third Party APPs

21 ED Alert Notifications x Patient presents at an ED Home Care Agency Alert is received by care team and discharge planning begins Upon discharge all appropriate care team members are aware

22 Integrated Care The Justice System + Care Coordination Admission (proactive care) An individual is admitted into a Health Home program (HHUNY) 80% Approximately 80% of Dept. of Corrections (DOC) data is available through Appriss Information is included in the Care Plan (CareManager) Arrest Watch alerts for arrests of your target population Ongoing Care Tracking through CareManager (reactive care) Any new arrests will send alerts to CareManager in real-time

23 Prescription Drug Monitoring Program Physician (Prescriber) uses OrderConnect to e-prescribe Appriss Database checks medications to indicate drug seeking behavior or potential overdose concerns Presents the information back to prescriber through OrderConnect Appriss connects to all state databases except the states of: CareConnect checks against State DB; Direct connection through CC to the different state registries

24 Creating a Virtual Storefront Enabling Shared Capacity Via a Virtual Network Choose Your Practice Choose Your Provider Choose Your Pharmacy

25 Telemonitoring and Cloud Technology Secure and Compliant Built on the same trusted platform (Plexus Cloud) as our CareRecord solutions Healthcare-centric, HIPAA-compliant, BAA Assures secure data exchange; no data on client device Provides clear actionable security guidelines Evolves according to the healthcare landscape and regulatory environment Meets the American Telemedicine Association (ATA) Guidelines

26 ThinkDay Process Slide explaining the process of a ThinkDay Include info on the high caliber of people from Netsmart leadership who are spending time with them Include a photo of MGV with people in the Imaginarium if available

27 The value of a Think Day Stay Aligned Update Mutual Strategy Shape Strategy So thankful for the level of expertise brought to the table. It s like getting expert advice on so many topicsfor free. Clinical Nursing Medical/Lea dership Device/IOT Expertise in integration Innovation Cloud/Security Experts in all aspects Updates on trends Solution Development Latest trends in Dev Guidance on new solutions Legislation/Advocacy Ability to coordinate efforts Shape agendas Interoperability Data Exchange Founding members of national networks FOAK experience Support/Managed Services Former COO of $80M organization Founder of Managed Services Consulitng compny Behavioral Health Leadership Former CEO of large CMHC and Research Institute Experience with hundres of clients Healthcare Market Expertise Acute Care and Post Acute experience Experts across all segments of Human Services

28 Partnership Strategy Focus on Expertise Management, Finance & Administration Comprehensive Support Services People Process Market Leading Solutions Technology 28

29 BH ALIGNMENT MATTERS PREDICTABILITY MATTERS OBLIGATIONS MATTER Social Services Pharma MCO COMMUNITIES Delivery / Efficiency PLEXUS CLOUD 1:X Ratio CLIENT GOALS NETSMART GOALS SA Health Homes IP/OP Public Health Develop Trusted Relationships Vision Mission Imperative Shared Objectives VALUE = OUTCOMES Contractual Policy Phone Support WORKGROUPS COST REGIONAL EXCHANGES CONNECTIONS YOURS Theme Partners Usability NetsmartCares Innovation Client Health Inspection OURS Guardiant Searchable Go live Knowledge Support base User Groups 24x7 Client SLA Help Desk Support COLLABORATION MATTERS EXPERIENCE MATTERS RESPONSIVENESS MATTERS

30 Client Perspective of Value It s amazing what wonderful things can be accomplished when we work together. The alliance between Netsmart and Kansas City-based Cornerstones of Care is an example of two organizations that are achieving positive outcomes through collaboration and by rethinking traditional client-vendor relationship roles. Cornerstones of Care s Electronic Health Record Director Justin Horton says that by redefining these roles with Netsmart: We were able to move our EHR foundation forward 10 years in only 10 months time. As part of this partnership, Metrocare and Netsmart will fully integrate its teams to optimize clinical, financial and operational aspects of Metrocare; including IT outsourcing, hosting and managed services, advanced application support, revenue cycle management and strategic technology sourcing. We have a long history of investing and innovating with technologies of our own and this partnership with Netsmart will allow us to accelerate toward the goal of advancing our care models across Dallas County, said Metrocare CEO Dr. John Burruss.

31 Workflow Whether going from paper to electronic or old EHR to new EHR: Identify key workflows Do NOT try to replicate old workflow in the new system I want THAT piece of paper on THAT screen No, you really don t Using the 80/20 rule, pick a few key workflows and flowchart them in excruciating detail Use this opportunity to reengineer the way the organization works, not just to implement the EHR

32 An EHR Implementation is a Change Management Process Initial excitement about the new direction Confusion, doubt and uncertainty during the actual change Relief and satisfaction and arriving at the new destination

33 The Balancing Act Make the workflows match what clinicians want Change the clinical workflows to improve processes

34 Questions for Clinical Leadership Domain Clinical Workflow Productivity Leadership Quality Customer Service Human Resources Training Questions How can we implement concurrent charting? What are reasonable standards for note completion? What activities and work processes can we/should we stop doing because of improved workflows? How can we demonstrate improved quality with this technology? How will we assure that the customer experience is improved or at least not negatively affected as a result of this technology? What policies and procedures need to change as we become fully electronic? Does this have implications for discipline, hiring or firing? How will we train new and existing clinical staff and assure their competency at using the EHR now and in the future?

35 Clinical Management Clinical leadership must help develop policies and procedures that will affect the clinical staff directly. Reengineering workflows: Clinical Outcomes Productivity/Efficiency Customer Satisfaction Ethical concerns Resistance to change

36 Remember: A Living System