Practice Transformation Readiness Assessment

Transcription

1 Practice Transformation Readiness Assessment Patients, payers, and government agencies are requiring all medical professionals to improve their patients' health and experience of care while reducing costs. Improving patient care requires practices to accomplish more while being reimbursed less. Practice Transformation gives you the ability and confidence to adapt and thrive in this evolving environment while improving patient care. This requires a concentrated focus on three key areas: Management o Broad organizational support o Strong leadership with vision for change at all organizational levels o Financial stability o Focus, commitment, and clear strategy Technology and Analytics o Optimize structural capacity (electronic health records, operations management, and resources [i.e. time, staffing]) o Data-driven measurement and feedback Processes o Experience with teams o Approach to transformation We will provide you with a feedback report that presents the findings, your score and readiness for change, and some recommended changes to assist you in your practice transformation efforts. We are also available for consultation to help you establish a formal transformation plan, accompanied by individualized services to meet your goals. Please complete the assessment according to the directions found below. If you have any questions as you progress through the assessment you may write your thoughts in the space provided on the last page. Also, feel free to contact us with any questions or concerns at or PracticeTransformation@healthinsight.org. You can also take this assessment online at

2 Practice Transformation Readiness Assessment Practice Transformation Readiness Assessment Please complete the following information about you and your organization. This information will not be disclosed to anyone besides the HealthInsight team. We recommend that your Quality Improvement Team members complete the assessment together to ensure a well-balanced, non-biased, assessment. Please list the names of others who complete the assessment with you. When completed, please this assessment to PracticeTransformation@healthinsight.org or fax to (801) Your name and job title: Organization & Address: Date: / _/ Month Day Year Names and job titles of other persons completing the survey with you: 1. Please select your practice type: Primary Care Specialty Both Your phone number: ( ) - Your address: To which healthcare network/system does your facility belong, if any? How many providers are employed at your practice site (MD/DO, DDS, DMD, DC, CNM, NP, PA, etc.)? How many providers are working towards Meaningful Use? When was the first year you attested for Meaningful Use? Does your organization use an electronic health record (EHR)? (Check only one) _Yes, all electronic; no paper charts _Yes, although we still have some paper charts _No, but we plan to implement _No, and we have no plan to implement Can you run reports (data) from your EHR for Quality Improvement needs? Yes No We need help with this Is your clinic willing to measure and assess progress and continuously improve processes? Yes No Have you clearly defined the need to transform your clinic to reflect the changing environment? Yes, we want to transform because: No, we cannot transform because: If applicable, what EHR system, and version are you using? Is it 2014 ONC-certified? Yes No I don t know If no, when do you plan to have the 2014 certified update? How does your organization host the EHR? (Check one) _In-house, on internal servers _Hosted externally, not internet/web based _Hosted external to organization, Internet/web based _Don t know How experienced is your staff with Quality Improvement efforts? Highly we have a QI Team, meetings, and clinic plans Fairly we know about QI, but don t really formally work on it Not very experienced we don t know much about QI, and do not really work on it Is now the right time to implement significant culture change (e.g., will it compete with other major changes currently being instituted in your clinic)? Yes No

3 Practice Transformation Readiness Assessment What are the top priorities for your clinic this year? _ What do you need assistance with to ensure your clinic meets current and future changes? What are your top sources of information about practice transformation? (Please list applicable Journals, Websites, Associations, Other) Directions for Completing the Assessment This assessment is designed to help systems and provider practices consider and rate the important components required for comprehensive transformation and system redesign. The results will help identify opportunities for improvement. Instructions are as follows: 1. Answer each question from the perspective of one physical site (e.g., one clinic). It is best to have a multidisciplinary team answer the questions together to ensure all perspectives are captured. 2. For each row, mark the point value that best describes your current organization. The rows present key elements of clinic redesign. Each aspect is divided into levels showing various stages in improving processes. The stages are represented by points that range from 1 to 9. The higher point values indicate that the actions described in that box are more fully implemented. You will only check one box per row, i.e., Executive Leadership Commitment: you may mark a 2 under Level 1. Please contact HealthInsight at (801) regarding questions about this assessment. completed assessment form to PracticeTransformation@healthinsight.org or fax to (801)

4 Part 1: Management Leadership, Teamwork, Practice Management, Financial Components Level 1 Level 2 Level 3 Executive Leadership Commitment Provider Commitment We focus on Business as usual with limited capacity or interest to strategize for future needs. We focus on patient care and avoid new initiatives and improvement projects due to lack of time and resources. We support clinic transformation/improvement initiatives, but are constrained and unable to commit sufficient resources. We support transformation/improvement initiatives, but lack time to attend meetings and get involved. We completely support transformation and improvement efforts, including resource allocation (i.e., carving out staff time to attend meetings). We completely support transformation and improvement initiatives by attending meetings and promoting positive changes. Staff Commitment We focus on patient care and avoid new initiatives and improvement projects due to lack of time and resources. We like to be involved in transformation and improvement projects, but don t always have time. We completely support transformation and improvement initiatives by attending meetings and being involved. Organizational Priorities We have too many competing priorities to focus on practice re-design efforts. We have a variety of priorities, and limited time and resources to focus on many quality improvement efforts. We fully embrace quality improvement efforts and want to be known as innovators and leaders in our community. Teamwork We do not have defined team member roles and tasks, and do not maximize all staff members skills and abilities. We do not have defined team member roles, but many staff members skills and abilities are maximized for team performance. We fully promote team-based care practices all team members have defined roles; their skills and abilities are maximized for team performance. Practice Management We have some practice management components, but we do not formally track issues such as net revenue per provider. We do not have a strategy for financial improvement. We have some practice management components, we track some financial elements, but not consistently, and results are not used to improve processes, if needed. We have a comprehensive, formalized financial management strategy; processes and policies reflect standardized accounting practices.

5 Part 2: Technology and Analytics Analytics, Reporting, Tracking, Interoperability Components Level 1 Level 2 Level 3 Meaningful Use Although we have heard about the Meaningful Use requirements, we do not feel that it applies to our practice and have no plans to pursue it. We have attested for Meaningful Use in the past and/or desire to pursue Meaningful Use going forward but are unsure of our resources to do so. We have attested for Meaningful Use in the past and plan to continue to dedicate resources towards meeting the requirements going forward. Interoperability We currently fax referrals and/or requests for patient records. We also receive records by fax, either through a fax machine or directly to . We have used or tested electronic technology to exchange data with other offices, although it is not part of our regular processes. We plan to do more in the future to exchange data with other clinics. We use Direct or HIE functionality to exchange records with other clinics and perform referrals or transitions of care. Reporting from HIT on Quality We haven t reviewed quality on standardized measures through our EHR; we get occasional quality reports from the payers with whom we work. We can generate quality reports from our EHR on a few measures that are important to us, or we regularly receive and review reports from an external source. We generate standard and customized reports from our EHR, and use them to improve our workflow and preventive and chronic care patient outcomes. Patient Portal Use We do not have a patient portal, are unsure of the benefits, and/or have no plans to implement one unless required to do so. We have a patient portal but have not fully promoted its use with our patients and still need to learn more about it. We provide a patient portal and have fully implemented and promoted it to increase engagement and support for our patients. Patient and Population Management We use our EHR to manage individual patient care, but have not really used it to monitor specific populations, such as patients with diabetes. We use our EHR to manage individual patient care, and use it to ensure specific patient populations are current with all required tests. We use our EHR comprehensively for individual patient and all population health care. We run lists of specific patient populations at regular intervals and call patients who are overdue for testing. Privacy and Security of HIT Our vendor has assured us our system is secure and records are private; we are not totally confident we would pass an audit. We have conducted basic reviews of our technology to confirm security and privacy of information. We feel fairly confident we would pass an audit. We have gone through a thorough process to assure our systems are secure including but not limited to environmental, inventory and system reviews. We have made corrections; we have an ongoing process to address risk and vulnerabilities in this area.

6 Part 3: Processes Resources, Redesign, Coordination, Collaboration Components Level 1 Level 2 Level 3 Access and Continuity Care Coordination Referral Management Patient Engagement Quality Improvement Our patients have access to care during traditional office hours only; we rarely have same day appointments available; our patients do not have much choice into which provider they see. Our patients have intermittent access to care immediately or same day; we do not offer after hours or weekend appointments; patients typically see the same provider each visit but oftenhey are seen by the first available provider. Our patients have access to care during alternative hours, such as night and weekends, or can their providers or leave messages on our webportal; we provide same day appointments; our patients typically see the same provider each visit. We offer little or no care coordination or care management services; we do not see patients immediately after hospital discharge. We offer some care coordination and management services, but do not have a formalized program or dedicated staff member to provide services. We offer comprehensive care coordination or care management services; we have a dedicated staff member to provide services, and support efforts to reduce hospital readmissions. We do not track referral appointments and results in an organized fashion; we get a few referral results back from specialists and sometimes when the patient comes in again. We loosely track our referral results and appointments; we have developed some processes but many referrals remain untracked. We have a formal referral management process to ensure patients appointments are made, kept, and results received. We want to engage patients in their care but do not have capacity to do so, and are unsure of how to do this; we do not have many resources to assist patients. We only engage patients in their care when they show initiative or are high-risk for non-compliance; we have some resources to assist patients. We actively engage patients in their care by using methods such as Motivational Interviewing to determine care barriers, helping them set up selfmanagement goals, and tracking their progress in our EHR. We understand the need, but do not undertake continuous Quality Improvement initiatives or projects. We have some informal processes for quality improvement; more reactive than proactive. We are actively engaged in continuous quality improvement with measurable goals and objectives; we meet regularly to discuss and achieve our established QI goals. Workflow Analysis and Redesign We have never conducted workflow analysis or undertaken any significant redesign efforts to improve clinic quality and efficiency. Roles not clearly defined. We have participated in some minor workflow redesign efforts, we lack knowledge and experience to undertake comprehensive transformation. Some, but not all staff roles are clearly defined. We have participated in significant clinic redesign efforts to improve quality and efficiency, including workflow analysis, to implement major system improvements.

7 Is there any additional information you would like us to consider for your Readiness Assessment? Please see the following articles for additional information regarding practice transformation McNellis RJ, Genevro JL, Meyers DS. Lessons learned from the study of primary care transformation Annals of Family Medicine. 2013;11(S1): S1-S5. Crabtree BF, Miller WL, McDaniel RR, Stange KC, Nutting PA, Jaén CR. A survivor s guide for primary care physicians. Journal of Family Practice. 2009;58:E1