Planning for Incentives

Transcription

1 Planning for Incentives Sue Severson, CPEHR, CPHIT Director, Health Information Technology Services July, 2010

2 Stratis Health Nonprofit organization that leads collaboration and innovation in health care quality and safety, and serves as a trusted expert in facilitating improvement for people and communities Serves as Minnesota s Medicare Quality Improvement Organization (QIO) Involved in other state and national projects funded through government contracts, foundation and corporate grants, and health systems Funded in partnership with The Center and CSS to be the HIT Extension Center for MN & ND HIT experience HIT toolkits Education and technical assistance HIT surveys Policy

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4 Building Foundation for HIT Sample tools Overview of Tools How to Use the Toolkit Governance Vision for HIT Communication Plan Total Cost of Ownership and Return on Investment IT Staffing Inventory IT System Inventory HIT Security Analysis Contingency Plan Assessment Application/Interface Inventory Financing Assessment HIT Attitudes Assessment & Computer Skills Survey

5 Total Cost of Ownership Tool

6 Strategic Planning Sample tools HIT Steering Committee Agendas and Minutes Clinical IT Leadership Project Management Job Description HIT Strategy/Migration Path Workflow and Process Mapping Workflow

7 What to Map in Hospitals Admission process Medication reconciliation H&P/results review/differential diagnosis Patient assessment Care planning/pathways Provider orders Consultation management Patient monitoring and charting Medication administration Transfer of care/care coordination, e.g., Clinic Emergency Department Surgery/Recovery Intensive Care Long Term Care/Home Health Care Discharge/patient instructions Charge capture/coding Reporting/quality improvement Departmental operations, e.g., Laboratory Pharmacy Radiology Nutrition & Food Service Materials Management Process EHR Impact Benefits Metrics Expectations/ Goals Process to Evaluate Relate Processes to Goals Medication Reconciliation (Med Rec) EMAR populates a single med list Med list generates relevant alerts at CPOE Communicate med changes in a timely and effective manner Reduce med errors & improve patient safety through relevant alerts from Med Rec process Comply with Joint Commission # Med Rec points; types of potential errors Ave # med changes at each point #/% near misses out of all possible changes #/% errors out of all possible changes Reduce # near misses and errors due to lack of Med Rec by 75% Use Joint Commission tracer methodology to determine all points of Med Rec and alerting needs

8 Select Tools Process diagram Swim lane process chart Flow process chart Systems flow chart Software is available to aid in drawing charts, if desired Copyright , Margret\A Consulting, LLC. Used with permission of the author.

9 Basic Systems Flow Chart Ovals start and end Rectangles process Diamonds decision

10 Critical Success Factors Map processes that will be impacted by HIT, unless other reason for process improvement Engage persons actually performing the process. Leave bias and blame at the door reward those who find the most warts! Avoid getting ahead of mapping current processes, but make sure they are complete and address the information flow remember, information is being automated, not the staff member or the patient Get to the root cause of problems when looking for improvements. Address immediate opportunities; use others as key functional requirements for your HIT Use workflow and process mapping to create Ah ha! moments that initiate the change process. Follow up that changes are adopted and that the changes achieve your goals. Correct course if necessary; celebrate success once change is implemented

11 Importance of Structured, Standardized Data

12 Acquisition Sample tools Code of Conduct Understanding the Marketplace Requirements Analysis Request for Proposal RFP Analysis Key Differentiators Demonstration Plan Site Visit Plan Reference Check Plan Vendor of Choice Contract Checklist

13 Planning for Implementation Sample tools Project Plan Issues Management Workflow and Process Improvement Forms and Reports Analysis Clinical Decision Support Vocabulary Training Plan Testing Plan Roll Out Strategies Space Planning Input Device Planning System Build Dictionary Security Risk Analysis, Access, and Audit Controls

14 Other Spreadsheets Some Example: worksheets Security are Analysis interactive, Tool Application so you may Criticality enter values is defined and get and the Categories column of criticality totals explained Provide a way to collect information for tracking Use a cover sheet with descriptions of column headings Enforce restrictions on what data may be entered into a cell

15 Implementation of System Sample tools Implementation strategies for clinical information systems Registries and registry functionality Implementation strategies for EDMS and hybrid record Risk management Ongoing system maintenance, administration, and data quality management Implementation strategies for CPOE and e-rx Implementation strategies for E-MAR Policy and procedure checklist

16 Achieving Value Sample tools Quality measurement, reporting, and improvement HIT adoption rate Benefits realization HIT user satisfaction HIT patient satisfaction Total cost of ownership and return on investment assessment

17 Re-use Tools Throughout Total Cost of Ownership (TCO) and Return on Investment (ROI) Actual Actual

18 Data Quality Review comment field utilization Too much entry? Too little entry? Repetitious check boxes? Entry field missing? Review compliance with alerts Number of alerts overridden Rationale for overriding alerts Documented Explained Review output Referral letters Recall lists Contracting capability Quality of care results Impact on HIE Source: van der Sijs, et al, Overriding of Drug Safety Alerts in CPOE, JAMA April 2006 Wife

19 Patient Satisfaction Survey

20 User Satisfaction Survey

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22 Questions Sue Severson, CPEHR, CPHIT Director, HIT Services or

23 Stratis Health is a nonprofit organization that leads collaboration and innovation in health care quality and safety, and serves as a trusted expert in facilitating improvement for people and communities.