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DSRIP HIT Phase 2 Update
March 13, 2015
March 19, 2015 Page 1
DSRIP HIT Phase 2 Update March 13, 2015 Agenda Introductions HIT - - PowerPoint PPT Presentation
DSRIP HIT Phase 2 Update March 13, 2015 Agenda Introductions HIT - - PowerPoint PPT Presentation
DSRIP HIT Phase 2 Update March 13, 2015 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
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Level 1 Diagram
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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
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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
- wnership 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 State
Fragmented
- ~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
- f DSRIP without significant investment and collaboration with the CNYC Collaborative
and provider network
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Desired Future State
Coordinated 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 Readiness
Tiers to Achieve Requirements
Test Readiness Services to Achieve Readiness Sponsored Vendor
- r Provider Partner
Solutions & Services
Technology Ready Services Needed Technology Does Not Meet Requirements OR OR EMR Not in Place
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Provider Readiness – Tier 3
Fully 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 2
Technology 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 & 0
Limited 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 Process
Schedule 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 Conduct Site
Visits
Application and Technical Review Findings
Vendor Partners
Develop Selection Committee Draft/ Distribute RFI Define Evaluation Criteria Evaluate RFI Response Define Strategy and Requirements Narrow Vendors Vendor Demos & Workshops Conduct Reference Calls Develop Use Case (Demo) Scenarios Develop Performance Metrics Contracting Contract 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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March 19, 2015 Page 19 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
- utcomes reporting
Operational performance
management and business intelligence
Risk and revenue management Integration and infrastructure
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PHM Vendor Selection Process
Schedule 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 Define Strategy
Interactive Workshops
Conduct Ref Calls
Site
Visits
Application and Technical Review Findings Evaluations Evaluations
Vendor
- f
Choice
Draft/ Distribute RFI
Narrow Vendors
Evaluate RFI Response
Online Vendor Demos (if required)
Create Demo Scenarios Develop Selection Committee
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PHM Vendor Landscape
Vendor DSRIP Experience? Aspen Experience
Advisory Board Crimson Population Health Covisint eClinicalWorks CCRM To 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 i2iTracks In place at San Joaquin General Hospital’s (SJGH) primary care clinics, participating in California DSRIP Kryptiq CareManager CareManager 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
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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
- perational 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 Responsibilities
CNYCC 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 Governance
Schedule at a Glance
In Process DY1 Q2 DY1 Q3 DY1 Q4 Ongoing
Determine timing for future activities Develop the IT and Data 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 progress Enact ongoing data privacy and security policies & procedures Develop the IT Change Management Strategy Determine
- rganizational
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
- n progress
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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
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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