Patient Engagement Primary Care Webinar for DY4 Agenda - - PowerPoint PPT Presentation

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Patient Engagement Primary Care Webinar for DY4 Agenda - - PowerPoint PPT Presentation

Oct 18, 2022 22 likes •407 views

Patient Engagement Primary Care Webinar for DY4 Agenda Housekeeping DSRIP Timeline DY3 and DY4 Targets and Performance Audits Changes to Reporting Templates Engagement Criteria Refresher Training o 3ai Model 1: Integration of Behavioral

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Patient Engagement

Primary Care Webinar for DY4

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Agenda

Housekeeping DSRIP Timeline DY3 and DY4 Targets and Performance Audits Changes to Reporting Templates Engagement Criteria Refresher Training

  • 3ai Model 1: Integration of Behavioral Health into Primary Care
  • 3bi: Cardiovascular Disease Management

WatchDox Refresher Training Q&A 2

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Housekeeping

Please DO NOT place your phone on “HOLD” Please keep your phone lines muted We have planned time for questions At any time feel free to submit questions using the chat feature and we will be sure to answer your questions 3

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DSRIP Calendar

4 DY4

April 1, 2018– March 30, 2019

Next MPA Period:

MY5

July 1, 2018– June 30, 2019

Demonstration Year (DY) Measurement Year (MY)

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DY3 and DY4 Targets and Performance

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DY3 Patient Engagement Performance

Project DY3 Target (80%) DY3 Actual 2biii ED Care Triage 5,400 5,749 2bvii INTERACT 460 4,349 2bviii Hospital/Home Care Collaboration 720 1,402 2di Patient Activation Measures 47,200 15,783 3ai Behavioral Health Integration 13,620 52,970 3aii Crisis Stabilization 8,721 15,743 3bi Cardiovascular Disease Management 19,680 21,394 3fi Maternal & Child Health 600 812 TOTAL 96,401 118,202

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DY4 Targets

Project DY4 Target (80%) 3ai Behavioral Health Integration 13,620 3bi Cardiovascular Disease Management 19,680 TOTAL 33,300

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For these two projects, the DY4 target is the same as the DY3 target.

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Audits

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Past Audits

November 2017: DY3Q2 sample request

  • 60 patients for 3ai Model 1 only

March 2018: Patient engagement audit and IA onsite visit

  • 398 patients across all 8 projects

Results:

  • Partners were incredibly responsive in providing satisfactory substantiating

documentation on a tight deadline—THANK YOU!

  • We did encounter several errors (approximately 4%)
  • Reporting issues (bad data)
  • Misunderstandings of “actively engaged” criteria
  • Process issues (inability to retrieve patient records)
  • To avoid these issues in DY4, we are conducting a series of re-education

webinars for all partners

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We Will Be Audited Again

We expect to be audited in late 2018 or early 2019 (for DY3), and a year after that (for DY4) When the state asks Millennium for substantiation, we will in turn ask you to provide it

  • Typical substantiation = screenshots of patients’ EMR records

Ensure documentation is available should an audit take place

  • Consider the delay—save records for at least a year

Millennium may also conduct its own audits at any time to monitor data quality and effectiveness of re-education 10

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Errors

Consider doing your own audits internally You may discover a patient who was reported as engaged when they were not actually engaged If you discover an error, please notify Millennium immediately

  • If we have not yet reported your data to NYS, we will work with you to

correct the error

  • Do not simply upload a new file—we will have to manually delete

the erroneous data from the old file

  • If your data was already submitted to NYS and the error is substantial,

we will notify NYS to mitigate issues in case of future audit

  • The state does not provide any mechanism for a PPS to correct a report or delete

patients erroneously reported

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Changes to Reporting Templates

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New Reporting Templates for DY4

Projects 3ai Model 1 (Integration of Behavioral Health into Primary Care) 3bi (Cardiovascular Disease Management) 13

New blank templates are in WatchDox: Patient Engagement > DY4 Templates

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Updated timeframes and instructions Added clarification about reporting engaged patients Removed columns for provider name and NPI—not needed

Changes to Templates

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Example: project 3bi

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Do not alter the template Files must be in Excel format

(not .csv)

Use the Template Correctly

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This is where the latest templates are stored

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Engagement Criteria Refresher Training

Primary Care: 3ai Model 1: Integration of Behavioral Health into Primary Care 3bi: Cardiovascular Disease Management

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Valid Patient IDs

The state allows two types of patient IDs: CIN: 8-digit alphanumeric Medicaid patient ID

  • 2 alpha, 5 numeric, 1 alpha
  • Example: AB12345C

—OR— Managed Care Organization (MCO) ID: Member ID number from patient's insurer/payer/MCO

  • May be in various formats
  • Examples:
  • WNH771234567
  • DAU12345C00
  • 74212345600
  • YJP8812345701

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Invalid Patient IDs

We omit any patient with the following suspicious/invalid IDs:

  • Blank (no ID)
  • 4 characters or shorter (e.g., “+”)
  • All alphabetical characters (e.g., “TEST”)
  • Obviously invalid (e.g., “12345”)

If your report includes a “TOTAL” or other extraneous rows, please remove them (otherwise your report will be rejected) 18

Please: Filter these out before submitting your file.

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Duplicate Patients

For projects 3ai and 3bi, a patient can be engaged only once per DSRIP year—duplicate patients are not allowed Check your file: remove all duplicate patient IDs before uploading From quarter to quarter, please include new data only

  • In other words, remove any patients you reported in previous quarters

in the same DSRIP year—these are duplicates and will be omitted

Patients can be engaged under multiple projects within the year 19

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3ai Model 1: Behavioral Health Integration

Engagement criteria:

  • Patients receiving appropriate preventive care screenings that include

mental health/substance abuse

Any industry-standard behavioral health or substance abuse screening is acceptable (e.g., PHQ-2/9, SBIRT, PSC-17, etc.) The screening must be documented in the patient’s health record If a patient is considered ineligible to be screened for some reason, they should not be reported 20

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3bi: Cardiovascular Disease Management

Currently for non-pediatric practices only (possible future

  • pportunity)

Engagement criteria:

  • Patients receiving services from participating providers with documented self-

management goals in medical record (diet, exercise, medication management, nutrition, etc.)

  • Core components require documentation of patient-driven self-management

goals in the medical record which are reviewed at every appointment

We struggled to meet our DY3 target; DY4 target is the same Audit results showed wide variation in how partners document self- management goals Engagement criteria were interpreted differently by different partners

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3bi: Frequently Asked Questions

Question Answer

What CVD diagnosis codes are required?

  • None. There is no diagnosis requirement for this project. Patients may or

may not have CVD.

What type of self- management goals are allowed?

Any type. Examples:

  • Patient wants to quit smoking; commits to call NYS QuitLine
  • Diabetic patient has a goal to improve A1C; commits to better diet
  • Depressed patient commits to reach out to support system when needed
  • Pediatric asthma patient has a goal to improve use of inhaler
  • A patient commits to eat healthier, lose weight, or exercise more
  • Patient has a goal to follow safe sex practices

How is the goal documented in the EMR?

The goal must be clearly shown in the patient’s record, so that an auditor can find it.

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Self-Management Goals: Required Under PCMH

NYS PCMH Standards and Guidelines: Care Management and Support (CM) PCMH-recognized practices should already meet this requirement 23

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Example Screenshots: Where are the goals?

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Patient 1 Patient 2 (Allscripts)

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Example Screenshots: Where are the goals?, cont.

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Patient 3 (eClinicalWorks) Patient 4 (eClinicalWorks)

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Example Screenshots: These might be goals . . .

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Patient 5 (eCW) Patient 6 (Allscripts)

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Example Screenshots: Aha! Goals!!

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Patient 7 (Allscripts) Patient 8 (Allscripts Enterprise)

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Example Screenshots: Aha! Goals!! cont.

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Patient 9 (Medent) Patient 10 (Medent)

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EMR Demonstrations/Tips

Allscripts Pro eClinicalWorks 29

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EMR Users

Allscripts Professional:

  • Chautauqua Center
  • ECMC clinics
  • Elmwood Health
  • Neighborhood
  • Resource Center

Allscripts Enterprise:

  • Olean Medical

Group

  • UB Family Medicine

Cerner:

  • Child and Family

Services

  • Kaleida clinics

eClinicalWorks:

  • CHCB
  • Foothills
  • NFMMC clinics
  • Summit Pediatrics
  • TLC clinics
  • UPC

Medent:

  • Evergreen Health
  • GBUACO
  • Jericho Road
  • Main Buffalo

Pediatrics

  • Northtown Medical
  • Omega Family

Medicine

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WatchDox Refresher Training

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WatchDox Basics

Link: http://ecmc.watchdox.com If someone at your organization needs WatchDox access, just let us know!

  • Email reporting@millenniumcc.org and include the person’s email

address

  • If someone leaves your organization, let us know so we can deactivate

their account

Blank templates are in your “DY4 Templates” folder Old files have been moved to “DY2_Archive” and “DY3_Archive” “Processed” and “Rejected” folders are now hidden 32

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Upload Patient Engagement Files to the Correct Location in WatchDox

33 Make sure you’re in the correct folder!

Navigate to your Patient Engagement folder

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Upload Patient Engagement Files to the Correct Location in WatchDox, cont.

What happens if I’m in the wrong folder?

  • Your file will not be detected by our system—it only searches for files in

Patient Engagement

  • Your patients will not be counted and you will not get credit for

reporting

How do I know I’m in the right place?

  • If you are in the Patient Engagement folder, you will see this at the top
  • f WatchDox:

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To Upload a File

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  • 1. Click on the Upload

button, then navigate to the file you want to upload

  • 2. Click “Next”
  • 3. Click “Done”
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Double-Check the Location of Your Files

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Correct! Files are saved at the top level of Patient Engagement (not in a subfolder)

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Processing Files

Millennium developed a program that checks patient engagement files every hour This system will either process or reject each file received You should receive notifications within a few hours of uploading your file

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New file in correct folder

File is valid

WatchDox user receives an email stating that their file has been processed File is renamed and moved

New file in correct folder

File is invalid

Wrong format (does not match template), not in Excel, invalid dates

WatchDox user receives an email stating that their file cannot be used and explaining why File is moved

New file is uploaded into another folder:

File not found

If you’re not receiving notifications, check your Spam or Junk folder!

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www.millenniumcc.org

Find Millennium on social media:

Questions?

For questions about patient engagement or WatchDox, contact Liz Thelen: (716) 898-1960 ethelen@millenniumcc.org