Sarah Dawson, Population Health Director NYS PCMH IBM Watson VBP - - PowerPoint PPT Presentation

Sarah Dawson, Population Health Director

NYS PCMH IBM Watson VBP

 Recognition Program through NCQA that began

April 1, 2018

 Innovative advanced primary care approach to

improving the health of our patients by a systematic focus on high quality primary care, population health, and integrated behavioral health

 NYS is paying for technical assistance provided to

practices for 12-18 months, we will be working with Common Ground Health

 Utilize IBM Watson Engagement Manager as a

vehicle to close care gaps

 Population health platform that will be

utilized as our analytics tool for identifying and closing care gaps

 Comprehensive view of our patients by

pulling patient information from Medent, Paragon, billing codes, and claims data

 Identifying and closing documentation gaps;

efficiency and effectiveness of the EMR

 Perfor

• rman

ance M e Manag ager er

• Measure and manage quality performance
• Identify care opportunities
• Create and view reports

 Engag

agem ement M t Manager er

• Identifies patient care opportunities and notifies then

about recommended visits, test, procedures, or follow-up

• Evidence-based protocols that reflect the most up-to-

date standards of care, including published guidelines from organizations such as NCQA, HEDIS, AAFP, and NQF

• Strengthens both preventive care and chronic disease

management, and encourages patients to be more actively engaged in their health care

 Ca

Care M e Manager er

All Fidelis UHC Empire Plan Excellus RPE3 Medicare MIPS Medicaid PCMH Breast Cancer Screening X Cervical Cancer Screening X Colorectal Cancer Screening X Influenza X X X Pneumococcal Immunization X X HPV Immunization X X X Medicare Wellness X Wellness Annual X Bone Mineral Density Scan (DXA) Attention Deficit Hyperactive Disorder X Pediatric Asthma X X Well Child Exam X X X X Annual Visit OB-GYN Annual Visit OB-GYN - Established Patient Diabetes Diabetes (Enhanced) X Obesity Obesity Management (Enhanced) X X X Heart Failure Coronary Artery Disease (CAD) Hypertension Hypertension (Enhanced) X X X COPD Chronic Obstructive Pulmonary Disease (COPD) Behavioral Depression X X Asthma Asthma Thyroid Disorder Severe Thyroid Disorder High Cholesterol Hypercholesterolemia Management Heart Failure Thyroid Disorders Hypercholesterolemia Potential Revenue Condition Measure / Protocol Preventive Peds OB/GYN

 Executive Team - for approval and support with NYS PCMH and IBM

Watson Engagement Manager (5/15)

 Reviewed IBM Watson Engagement Manager Protocols with AMMS FM

(5/17) – Pilot

 Met with leadership & Bill Brien from Common Ground Health (5/18)  Primary Care Provider Meeting w/ leadership and Bill Brien (5/21)  IBM Watson Protocol Review and Workshop (6/20-6/21)  Office visits w/ leadership and IT to learn workflow & EMR use  Primary Care office meetings (7/17, 7/23, 8/1)  AMMS Practice Manager Meeting