“ACO & The CIO” A Complimentary Webinar From healthsystemCIO.com Sponsored by Tribridge Your Line Will Be Silent Until Our Event Begins Thank You! Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Housekeeping • Moderator – Anthony Guerra, editor-in-chief, healthsystemCIO.com • Ask A Question • We will be holding a Q&A session after the formal presentations. • You may submit your questions at any time by clicking on the QA panel located in the lower right corner of your screen, type in your questions in the text field and hit send. Please keep the send to default as “All Panelists.” • Download the Deck • Go to: http://healthsystemcio.com/presentation/ACO-Gordon-webinar.pdf • Shortened link below appears on most slides. • View the Archive • You will receive an email when our archive recording is ready. • Separate registration is required. Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Agenda — 45 Minutes • 20 minutes: Tom Gordon, SVP/CIO, Virtua Health System • 5 minutes: A Word From Our Sponsor: Damon Auer, VP of Healthcare, Tribridge • 20 minutes: Q&A w/Tom Gordon Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
ACO & The CIO Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Background Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Virtua – A leader in southern New Jersey 4 Hospitals 4 Major Outpatient Centers 3 Urgent Care Centers 280+ Employed Physicians 308 Skilled Nursing Beds 2 Home Health Agencies 9 Ambulatory Surgery Centers 3 Fitness Centers Sponsor of Regional HIE $1.2 Billion - Revenues 6
Virtua 2013 Plan on a Page Strategic Imperatives Operational Priorities Define outstanding experience across continuum (patients, guests, employees, 1. physicians, customers, families, volunteers) Improve Customer Loyalty Align education and development 2. Mission People With An Engaged Align rewards and recognition 3. Workforce Strengthen talent pool 4. Validate and measure “loyalty” across the continuum Virtua helps you be 5. well, get well and stay Align with clinicians based on quality outcomes and patient experience 6. well. Care re-design (re-distribution of resources to support improved access to patient 7. care with focus on be well, get well and stay well) Achieve Highest Safety & Develop systems to capture, measure, report and improve outcomes for ACO Vision 8. Quality Quality and Ensure Access patients and employees to Services Top decile performance in publicly reported data 9. Virtua will be the Quality structure redesign from siloed to longitudinal across the continuum 10. premier choice in health and wellness. ACO implementation 11. Community health needs assessment 12. Values Align philanthropy and support all functions to leverage integrated approach Community 13. Improve Community Health Integrity Realign health services in the south to meet community needs 14. Health in a Cost Effective Manner Respect Aggressive management of employee wellness/education/cost reduction 15. Caring Commitment Optimize business portfolio Teamwork 16. Expand women's’ health program Excellence Pursue Strategic Growth 17. Opportunities that Support Evaluate and establish collaborative provider networks and partnerships 18. Growth a Comprehensive Redefine and hardwire the strategic and annual planning process 19. Continuum of Care Increase access to care 20.
Virtua Paper-Lite/CIS Transformation Strategy – “technology building blocks to a connected health record” 2013 + 2006 2007 2008 2009 2010 2012 Expanded Fiber-optic Network and Wireless System Installed New Ancillary Systems: Lab, PACS, others New ED System Connected Health CIS – Course Correction: Siemens EMR/McKesson HIM Records for Population New HIM System & Data Center Health Soarian Results Viewing & Meds Administration New Telephone System & “Recovery” Data Center Clinical Documentation, Plans of Care, Device Integration CPOE, Physician Documentation, SSO/Provision,RFID Ambulatory EMR, Health Information Exchange, PHR, MU Program (Amb./Acute) Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
The Back ackdrop to an any y Healt althcare Tal alk: H Healt althcare Reform . . . Ar Are we e on on div diverging or or converging pa paths? “Reformed” Healthcare Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
The Challenge We All Face Today…… Access Cost Quality . . . . Ba Balancing cost, quality ty and acc ccess Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Virtua’s Response to this Challenge Re-design Care Around Accountability and Lower Cost Address Health Preservation, as well as Traditional Disease Management Be Preferred for Quality & Safety Invest Wisely in Technology Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Understanding “Return on Investment” for IT • Don’t measure ROI purely in monetary terms • Real question: “What is the Return on Value?” • What to look for: “Does IT….. Improve the quality of care and patient safety? Support evidence-based care? Support clinical integration? Increase patient engagement and responsibility? Contribute to a culture of continuous improvement and excellence? Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Transforming Care - A Coordinated Effort Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Tran ansformin ing Car are - A Coordin inated Effort • January 2013, Virtua entered into an Accountable Care Organization (ACO) contract with the Federal government (CMS) • ACO is branded as “ VirtuaCare ” • Four implementation teams were formed: • Transition of Care • Quality Metrics • Care Redesign • Patient Engagement • Policies, Procedures, Workflows and IT infrastructure were developed Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Vir irtuaCare Today – Contracts wit ith payers 13,700 lives 17,000 lives Self-Funded Health Plan for Employees & Dependents Care Coordination Services Medicare Advantage 1,600 lives Third-Party Claims Administrator 12,500 lives
Vir irtuaCare: In Infrastructu ture • Community-Based Health Management (CBHM) • 1 Director of Case Management/Clinical Integration • 1 Operations Manager of Clinical Integration • Community-Based Health Managers (CBHMs) • 4 Registered Nurses • 2 Licensed Social Workers • Interviewing for 2 additional CBHMs • 6 more slated to be hired this year Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Co Communit ity-Based Healt lth Manager (C (CBHM) • CBHM caseload is 100 – 150 patients • Patients selected utilizing reports and physician input: • Historical High Cost (from claims history) • High Utilization (from claims history) • Complex Case Management (from medical history) • Current issues – both medical and social • Patients are evaluated, and Plans of Care are developed • Evaluation and continuous monitoring: • Post-Discharge from Acute Care or Emergency Room • During scheduled physician office visits • Visits to patients’ homes • Via the telephone Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Reportin ing - 3-Year Perio iod • Year 1 (2013) Reporting Year • Year 1 baseline attestation started January 27, 2014 • Attestation cohort has 4,000 patients, selected by CMS • Estimated 840 person-hours to complete data-collection activities for the attestation • Year 2 (2014) Shared Savings Begin – 22 Quality Metrics • Year 3 (2015) Shared Savings Begin – 33 Quality Metrics Breakdown of Metrics 7 based on patient experience 4 based on claims data (from Virtua and other providers) 22 based on health metrics (chronic disease + prevention measures) Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
Information Technology Slide Deck: http://goo.gl/e7OiPZ Webex Support 1-866-223-3239 Event #664 627 633
New IT Landscape Sample of information systems for independent health care providers State Registries Physician Office EMRs Diagnostic Imaging Centers Commercial Pharmacy Data Other HIEs Dentist Office EMRs Nursing Home EMRs Commercial Laboratory Data Health Information Exchange Health System’s Data Warehouse Acute Care EMR Physician Office EMR Pharmacy Patient Billing ER EMR Patient Demographics Laboratory Radiology Sample of Virtua information systems
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