PTO TRAINING OCTOBER 5, 11:00 AM Call Instructions: Please Mute - - PowerPoint PPT Presentation

PTO TRAINING

OCTOBER 5, 11:00 AM

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Call Instructions:

Please

• Mute your phone, microphone, and speakers on your computer/device
• Turn off the zoom video feature
• Enter your name/organization in the chat box feature for attendance
• Submit questions via the chat box feature
• Questions will be answered following the presentation
• Time to ask questions via audio will be offered for those on the phone

CQM WEBINAR

THURS DA Y , OCOTOBER 5 11:00 AM – 12:00 PM

HIT Assessment Summary Q3 CQM reporting requirements Conflict of Interest Forms

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Q2 CQM data report

AGENDA

Q&A TCPI and ENSW updates

TCPI UPDATE

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TCPi: Please submit all Clinical Quality Measures by 10/ 25/ 17

https:/ / ucdenver.co1.qualtrics.com/ j fe/ form/ S V_eS ccPhX7pT40Fbn

TCPi CHITA Field Note

https:/ / ucdenver.co1.qualtrics.com/ j fe/ form/ S V_6PS duWbmzgZWWEJ

NQF PQRS Description

NQF 0024

PQRS 239

Weight assessment and counseling for nut rition and physical act ivit y for children and adolescent s.

NQF 0421

PQRS 128

Body Mass Index (BMI) screening and follow-up.

NQF 0028

PQRS 226

Tobacco use assessment and t obacco cessat ion int ervention.

NQF 0018

PQRS 236

Blood pressure cont rol.

NQF 0059

PQRS 001

HbA1c cont rol for pat ient s wit h diabetes.

NQF 0418

PQRS 134

S creening for clinical depression and follow-up plan.

NQF 1448

PQRS n/ a

Development al screening in t he first 3 years of life.

TCPI NATIONAL QUALITY MEASURE COLLECTION TOOL

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We will be reporting Quality measures like we have in the past for this Quarter. Beginning in Quarter 4 (reporting in January 2018) we will be using the new national TCPi Reporting tool We have asked all CHITAs in TCPi to document which measures practices will be reporting. We will preload the tool with this information so when you login at the practice level you will only see measures that you are planning to report on. Please submit this survey by October 13th.

ENSW UPDATE

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▪ Please ensure all measures are reported by October 31st, 2017 ▪ 12 month and 15 month CQMs. Please work with practices to collect

and submit 12 month and 15 month CQMs

SIM Q2 CQM DATA

64.0% 93.0% 98.0% 98.9% 90.2% 100.0% 64.0% 90.0% 97.0% 80.0% 77.2% 92.4% 0.0% 25.0% 50.0% 75.0% 100.0% 2016 Q1 (optional) 2016 Q2 2016 Q3 2016 Q4 2017 Q1 2017 Q2

Percentage of active primary care practice sites reporting CQMs each quarter

1 or more CMQs Required number of CQMs

34.30% 38.90% 49.20% 48.80% 48.80% 34.50% 33.80% 38.80% 33.20% 72.20% 76.50% 93.70% 73.50% 84.90% 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00% 100.00% 2016 Q2 2016 Q3 2016 Q4 2017 Q1 2017 Q2

SIM cohort-1 primary care practices progress over time for Depression Screening, Diabetes A1c Poor Control, and Developmental Screening Clinical Quality Measures

Depression S creening Diabet es A1c Poor Control* Development al S creening

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*For Diabetes A1c measure we want to see the values for this measure decrease over time

SIM Q2 CQM DATA REPORT

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▪ Q2 CQM Reporting Breakdown

▪ 53 Adult

94% Req 100% at least 1

▪ 22 Pediat ric

82% Req 100% at least 1

▪ 17 Adult CPC+

100% Req 100% at Least 1

92 Total Practices

1 10 12 15 16 26 26 26 38 47 55 66 69 69 82

10 20 30 40 50 60 70 80 90

S UD: Alcohol S UD: Alcohol and Other Drug Dependence Depression Remission at 12 months* Developmental S creening Maternal Depression S creening Adolescent Obesity S creen Adolescent Obesity S creen (Activity) Adolescent Obesity S creen (Diet) Asthma Medication Management Fall S afety Adult Obesity S creen S UD: Tobacco Use Diabetes: A1c Hypertension Depression S creening and Follow-up

Number SIM primary care practice sites that reported on each CQM in Q2 of 2017

**This measure is only available for practices that are in both S IM and CPC+

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48.85% 33.20% 69.34% 45.29% 81.86% 79.28% 0.00% 80.37% 59.22% 60.03% 84.85% 75.24% 47.11% 43.83% 62.59%

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00%

Aggregate values of CQMs reported on by S IM primary care practice sites in Q2 of 2017

63.82% 26.44% 69.55% 42.53% 52.46% 75.87% 55.56% 56.94% 70.86% 37.75% 39.07% 61.19% 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00%

CPC+ reporting group (N=17 practice sites)

47.05% 27.27% 81.12% 60.08% 84.85% 74.96% 46.54% 43.57% 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00% Depression S creening (S IM): Obesit y Adult S creening: Ast hma Med Management : Mat ernal Depression: Development al S creening: Obesit y Adolescent Weight : Obesit y Adolescent Nut rition: Obesit y Adolencest Act ivity:

Pediatric reporting group (N= 22 practice sites)

44.60% 34.70% 69.27% 45.68% 86.73% 80.69% 0.00% 80.69% 56.90% 42.19% 45.83% 88.94% 47.99% 46.01% 64.56% 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00% 100.00%

Adult reporting group (N= 53 practice sites)

CQMS WITH DOCUMENTED ISSUES IN Q2

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Depression S creening, 1 Asthma: Medication Management, 1 Maternal Depression S creening, 1 Adolescent Obesity , 2 Adult Obesity , 1 S UD: Tobacco, 1 S UD: Alcholo and other drugs, 1

Number of practie sites that reported difficulties with different CQMs

Represents 6 practice sites that documented their issues with specific CQMs

Q2 DATA FLAGS

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▪ Focus on Practices that didn’ t report all measures

Less than required Adult:10 Peds:4 CPC+:0 Reported 0 Adult:0 Peds:0 CPC+:0

PRACTICES THAT DON T SUBMIT REQUIRED CQMS

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▪ We are making a concerted effort to identify why practices are not

able to submit the required number of CQMs

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urvey sent to CHITAs with three questions:

▪ Please explain why the practice did not report the required number of measures?

(check all that apply) (Vendor, Workflow or other issue)

▪ Please explain why the practice did not report the required number of measures?

(check all that apply)

▪ Please explain why the practice did not report the required number of measures?

(check all that apply)

Q3 2017 SIM CQM REPORTING REQUIREMENTS

Q3 REPORTING REQUIREMENTS AND SCHEDULE

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SIM Q3 2017 CQM reporting requirements

▪ Practice sites choose: trailing 12 months or year-to-date

▪ Trailing year approach is preferred

▪ Q3 report due October 31st 2017 ▪ CQM reporting will be through Qualtrics

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REPORTING SCHEDULE: ADULTS

2016 Q1 (Jan-Mar 16) 2016 Q2 (Apr-Jun 16) 2016 Q3 (Jul-Sep 16) 2016 Q4 (Oct-Dec 16) Test period, practice sites report whatever they can Choose 3 core CQMs:

• Asthma
• Influenza
• Depression OR Maternal Depression
• Obesity: Adult

Choose 3 core CQMs (same as Q2) Report 4 core CQMs (non-Mathematica):

• Asthma
• Influenza
• Depression OR Maternal Depression
• Obesity: Adult

and 1 non-core CQM (non-Mathematica):

• Diabetes: Hemoglobin A1c
• Fall Safety
• Hypertension

= 5 total CQMs 2017 Q1 (Jan-Mar 17) 2017 Q2 (Apr-Jun 17) 2017 Q3 (Jul-Sep 17) 2017 Q4 (Oct-Dec 17) Choose 5 primary CQMs:

• Depression Screening
• Diabetes: Hemoglobin A1c
• Hypertension
• Obesity: Adult
• SUD: Alcohol & Other Drug

Dependence

• SUD: Tobacco

Secondary CQMs (if needed):

• Asthma (new)
• Fall Safety
• Maternal Depression Screening
• SUD: Alcohol

= 5 total CQMs required Report all 6 primary CQMs:

• Depression Screening
• Diabetes: Hemoglobin A1c
• Hypertension
• Obesity: Adult
• SUD: Alcohol & Other Drug

Dependence

• SUD: Tobacco

Secondary CQMs (if needed):

• Asthma (new)
• Fall Safety
• Maternal Depression Screening
• SUD: Alcohol

= 6 total CQMs required Same as Y2Q2

• Phase in additional secondary CQMs

as appropriate = 6 total CQMs required Same as Y2Q2

• Phase in additional secondary CQMs

as appropriate = 6 total CQMs required Cohort 1 SIM CQM Reporting Schedules: http://www.practiceinnovationco.org/wp-content/uploads/2017/02/SIM-Clinical-Quality-Measures-CQM-Reporting-Schedules-Cohort-1.pdf

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REPORTING SCHEDULE: PEDS

2016 Q1 (Jan-Mar 16) 2016 Q2 (Apr-Jun 16) 2016 Q3 (Jul-Sep 16) 2016 Q4 (Oct-Dec 16) Test period, practice sites report whatever they can choose 3 core CQMs:

• Asthma
• Depression
• Influenza
• Maternal Depression
• Obesity: Adolescent

choose 3 core CQMs (same as Q2) Report 5 core CQMs (non-Mathematica):

• Asthma
• Depression
• Influenza
• Maternal Depression
• Obesity: Adolescent

2017 Q1 (Jan-Mar 17) 2017 Q2 (Apr-Jun 17) 2017 Q3 (Jul-Sep 17) 2017 Q4 (Oct-Dec 17) Report all 4 primary CQMs:

• Depression Screening
• Developmental Screening
• Maternal Depression Screening
• Obesity: Adolescent

Secondary CQMs (if needed):

• Asthma (new)

= 4 total CQMs required Same as Y2Q1

• Phase in additional secondary CQMs

as appropriate = 4 total CQMs required Same as Y2Q1

• Phase in additional secondary CQMs

as appropriate = 4 total CQMs required Same as Y2Q1

• Phase in additional secondary CQMs

as appropriate = 4 total CQMs required Cohort 1 SIM CQM Reporting Schedules: http://www.practiceinnovationco.org/wp-content/uploads/2017/02/SIM-Clinical-Quality-Measures-CQM-Reporting-Schedules-Cohort-1.pdf

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REPORTING SCHEDULE: CPC+

2016 Q1 (Jan-Mar 16) 2016 Q2 (Apr-Jun 16) 2016 Q3 (Jul-Sep 16) 2016 Q4 (Oct-Dec 16) Same as Cohort 1 SIM Only (see above) Same as Cohort 1 SIM Only (see above) Same as Cohort 1 SIM Only (see above) Same as Cohort 1 SIM Only (see above) 2017 Q1 (Jan-Mar 17) 2017 Q2 (Apr-Jun 17) 2017 Q3 (Jul-Sep 17) 2017 Q4 (Oct-Dec 17) Choose 4 primary CQMs:

• Depression:

a) Depression Screening (SIM/QPP) OR b) Depression Remission at 12 months (CPC+ group 1)

• Diabetes: Hemoglobin A1c (CPC+

group 1 & SIM/QPP)

• Hypertension (CPC+ group 1 &

SIM/QPP)

• SUD: Alcohol & Other Drug

Dependence (CPC+ group 2 & SIM/QPP)

• SUD: Tobacco (CPC+ group 3 &

SIM/QPP) Secondary CQMs (if needed):

• Asthma (SIM/QPP)
• Fall Safety (CPC+ group 2 &

SIM/QPP)

• Maternal Depression Screening

(SIM/QPP)

• SUD: Alcohol (SIM/QPP)

= 4 total CQMs required Report all 5 primary CQMs:

• Depression:

a) Depression Screening OR b) Depression Remission at 12 months

• Diabetes: Hemoglobin A1c
• Hypertension
• SUD: Alcohol & Other Drug

Dependence

• SUD: Tobacco

Secondary CQMs (if needed):

• Asthma
• Fall Safety
• Maternal Depression Screening
• SUD: Alcohol

= 5 total CQMs required Same as Y2Q2

• Phase in additional secondary CQMs

as appropriate = 5 total CQMs required Same as Y2Q2

• Phase in additional secondary CQMs

as appropriate = 5 total CQMs required Cohort 1 SIM CQM Reporting Schedules: http://www.practiceinnovationco.org/wp-content/uploads/2017/02/SIM-Clinical-Quality-Measures-CQM-Reporting-Schedules-Cohort-1.pdf

SIM HIT ASSESS MENT RESULTS

S LIDE TITLE

DETAILS OF DATA COLLECTION

▪ Assessment released on May 5, 2017 to all CHITAs/ RCCOs for 92 Cohort 1

S IM practices (CMHCs excluded)

▪ S

urvey administered through S urveyMonkey

▪ Data collection until late July, 2017 ▪ 34 questions about practice, electronic health record (EHR), electronic

clinical quality measures (eCQM), health information exchange (HIE), telehealth, broadband and health information technology (HIT) related barriers

▪ Average time to complete 20 minutes ▪ Analytic S

ections- ▪ Pat ient panel and payer mix; Incent ive programs; EHR; eCQM; HIE; Telehealt h;

Broadband; HIT concerns

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S LIDE TITLE

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COMPLETION RATE

Total number

• f cohort 1

SIM practices SIM HIT assessment submitted Assessment submission rate RCCO1 37 34 92% RCCO2 7 7 100% RCCO3 11 11 100% RCCO4 7 6 86% RCCO5 10 10 100% RCCO6 14 14 100% RCCO7 6 4 67% Grand Total 92 86 94%

S LIDE TITLE

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TOTAL NUMBER OF P ATIENT ENCOUNTERS ANNUALLY

Total # of patient encounters per year Number of practices Practices Missing Data RCCO1 455,608 28 7 RCCO2 187,233 7 RCCO3 81,320 7 5 RCCO4 172,514 6 RCCO5 158,241 9 1 RCCO6 227,528 14 RCCO7 359,426 4 Total 1,641,870 75 12

S LIDE TITLE

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P AYER MIX

37% 14% 36% 12%

SIM Cohort 1 Payer Mix

Medicaid Medicare Commercial Ot her

S LIDE TITLE

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EHRS AND INCENTIVE PROGRAM P ARTICIP ATION

8% 10% 17% 5% 19% 12% 5% 14% 1% 1%5% 2%1%

Elect ronic Healt h Record S yst em

Allscripts Athenahealth eClinicalWorks eMD Epic EpicCare GE Centricity Greenway Kareo Medt ech NextGen Office Practicum Pract ice Partner

No APM APM Total responses Total practices in survey RCCO1 3 31 34 34 RCCO2 7 7 7 RCCO3 1 7 8 11 RCCO4 2 4 6 6 RCCO5 9 9 10 RCCO6 2 11 13 14 RCCO7 2 2 4 4 Total responses 10 71 81 86

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PRACTICE EHR IS S UES BY VENDOR

Practices faces EHR issues with: EHRs Training staff for data entry Training staff for security protocols Training staff for role-based workflow Training staff for HIE use Developing, running and fine- tuning reports eCQM quality reporting Total practices Allscripts 14% 14% 14% 7 Athenahealth 11% 11% 67% 67% 9 eClinicalWorks 13% 7% 7% 13% 13% 13% 15 eMD 25% 25% 25% 25% 4 Epic 6% 6% 6% 13% 6% 13% 16 EpicCare 10 GE Centricity 25% 50% 50% 4 Greenway 8% 17% 8% 25% 33% 25% 12 Kareo 1 Medtech 100% 1 NextGen 25% 4 Office Practicum 2 Practice Partner 1 Total 5 7 3 11 17 17 86

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E-CQM REPORTING

PTO CHITA No Yes Total CCMCN 4 4 CORHIO 1 34 35 CRHC 2 2 DHHA 4 4 HTW 6 6 PHP 1 3 4 RMHP 1 13 14 Telligen 1 4 5 UC Health 1 11 12 Total 5 81 86 RCCO No answer Manual EHR export Formatted Don’t know Total RCCO1 2 26 4 2 34 RCCO2 7 7 RCCO3 3 7 1 11 RCCO4 3 2 1 6 RCCO5 1 4 2 3 10 RCCO6 2 4 8 14 RCCO7 4 4 Total 5 51 15 12 3 86

S LIDE TITLE

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E-CQM NEEDS & S OLUTIONS

22% 78% 28% 87% 79% 50% 69% 71% 41% 78% 44% 0% 20% 40% 60% 80% 100%

Need help wit h eCQM report ing? Use an eCQM regist ry/ ot her t ools t o aggregate & track quality efforts? Use a solut ion developed by your organization t o export eCQM data? Confident about the accuracy of t he dat a in input s? Confident about the accuracy of t he dat a it ext ract s and export s? Int erested in addit ional support for improving data input, extract ion or export ? Use eCQMs, beyond reporting, t o guide improvement activit ies & chart progress? Built registries of patient s based on t he denominat or of t he CQM measures to t rack & t reat? Faced significant costs associated with building a new CQM measure int o their EHR? Underst and the clinical guidelines from which the CQMs are derived? Int erested in part icipat ing in a Statewide eCQM regist ry solut ion?

Is the practice.../ Does the practice...

Yes No Don't know/ No answer

S LIDE TITLE

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HIT CONCERNS AND IS S UES

7.76 5.99 6.14 7.06 6.73 3.64 7.39 6.46 7.61 7.64 8.83 6.39 Producing & validating new eCQMs Reporting eCQMs to out side entities Acquiring & using telehealth technology Using cost-quality data for payer cont racts Internal business planning & clinic operations Connect ing t o an HIE Coordinating care with other subspecialt ies Building & using regist ries to manage patients Risk strat ifying patient population Accessing cost & ut ilization data Optimizing documentation in EHR workflows Managing EHR vendor problem 1 2 3 4 5 6 7 8 9 10

UPCOMING WEBINARS

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▪

10/10 –TCPi PTO Touch base-Medical Neighborhood & Consult model pitch

▪

10/12 – SIM Field Note Training 9-10 am

▪

10/12 – SIM Office Hours

▪

10/17-- CHES Quarterly Mtg

▪

10/18 – MGMA Practice Webinar -- "Debt Recovery" Collection Techniques for Every Practice. Point

• f S

ervice Best Practices, the 3 C’s of Compassionate Care Conversations. The 3 C’s allow practices to identify several types of S elf-Pay Patients and Patients with High Deductibles. Tim Wiebold

▪

10/19 – Learning Features Call – Medicaid APMs

▪

10/24 – Medical Neighborhood Training #3 9-10 am

▪

10/24 -- Colorado QPP Coalition Office Hours webinar- Quality Resource & Utilization Report (QRUR) Education and Training

▪

10/25 – SIM PTO Training BB

UPCOMING PRACTICE WEBINARS

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▪ 10/11 – SIM Cohort 2 Introductory Webinar 7:45 to 8:30 am ▪ 10/16 - SIM Cohort 2 Introductory Webinar 12:15 to 1 pm

QUESTIONS?

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What challenges are practices & CHITAs encountering related to pulling CQM data from EHRs?

THANK YOU!

University Practice Innovation Team Contact Information

Practice Transformation – S tephanie.Kirchner@ ucdenver.edu Learning Community - Kellyn.Pearson@ ucdenver.edu CQMs – Andrew.Bienstock@ ucdenver.edu SPLIT/Data Related – Lauren.S hviraga@ ucdenver.edu ENSW – Daniel.Pacheco@ ucdenver.edu TCPi - Kristin.Crispe@ ucdenver.edu or Allyson.Gottsman@ ucdenver.edu SIM – Taryn.Bogdewiecz@ ucdenver.edu or Heather.S tocker@ ucdenver.edu Invoicing – Natalie.Buys@ ucdenver.edu

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