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 Integration of HIT with Selected Clinical Projects PHM Vendor Selection and Implementation Framework IT/Data Governance Next Steps March 19, 2015 Page 1
Level 1 Diagram March 19, 2015 Page 2
HIT Phase 2 Update 5 primary work streams: 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 HealtheConnections – central hub for HIE March 19, 2015 Page 3
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) March 19, 2015 Page 4
EMR Strategy March 19, 2015 Page 5
EMR Burning Platform Meaningful Use certification is a priority for all providers Provider investment equals ownership 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%) March 19, 2015 Page 6
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 of DSRIP without significant investment and collaboration with the CNYC Collaborative and provider network March 19, 2015 Page 7
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 March 19, 2015 Page 8
Provider Readiness Tiers to Achieve Requirements Solutions & Services Test Readiness OR Fully Meets Requirements Services to Achieve Readiness Technology Ready Services Needed OR Sponsored Vendor Technology Does Not Meet Requirements or Provider Partner EMR Not in Place March 19, 2015 Page 9
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 March 19, 2015 Page 10
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 March 19, 2015 Page 11
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 March 19, 2015 Page 12
Partnerships Keys to Success Vendor Partnerships – Industry position – Quality and performance Alignment – Economics (Total Cost of Ownership) – Future direction Quality & Provider Partnerships Economics Performance – Commitment – Quality and performance – Economics (Total Cost of Ownership) – Organizational strategy and alignment March 19, 2015 Page 13
Vendor Partner Selection Process Schedule at a Glance Month 1 Month 2 Month 3 Month 4 Month 5 Define Draft/ Evaluate Vendor Strategy and Distribute RFI Demos & Requirements RFI Response Workshops Evaluations Define Develop Use Narrow Develop Selection Evaluation Case (Demo) Vendors Committee Criteria Scenarios Conduct Findings Develop Reference Performance Calls Metrics Findings Conduct Site Visits Vendor Preliminary Planning, Project Scope, Timing and Phasing Partners Total Cost of Ownership Model Development and Review Application and Technical Review Contract Review Contracting March 19, 2015 Page 14
HIT Integration with Clinical Projects March 19, 2015 Page 15
Integration of HIT into Clinical Projects Project 2.b.iii - ED care triage for at-risk populations 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 March 19, 2015 Page 16
PHM Vendor Selection and Implementation Framework March 19, 2015 Page 17
Population Health Management (PHM) Defined March 19, 2015 Page 18
Organizational vs Community-Wide PHM Clinical Clinical Radiology Radiology Documentation Documentation Images/Results Images/Results Lab Results Demographics Lab Results Demographics Organizational PHM Model Community PHM Model Integrated PHM Infrastructure Pharmacy Data Social Determinants Claims Data March 19, 2015 Page 19
Requirements DSRIP Additional Requirements Member engagement Patient registries Dashboards for performance Cross-continuum care metrics Quality management and Collaborative care planning outcomes reporting Provider-specific security; ability Operational performance to segment population management and business intelligence Transitions of care - real time Risk and revenue management access to information across providers Integration and infrastructure Support of multidisciplinary care plans March 19, 2015 Page 20
PHM Vendor Selection Process Schedule at a Glance Current Month Month 2 Month 3 Month 4 Month 5 Draft/ Define Distribute Evaluate Strategy RFI RFI Evaluations Response Narrow Vendors Online Develop Selection Vendor Committee Demos (if required) Onsite Evaluations Demonstrations Create Demo Scenarios Evaluations Interactive Workshops Findings Conduct Ref Calls Site Findings Visits Preliminary Project Scope and Phasing Vendor Cost Model Development and Review of Choice Application and Technical Review March 19, 2015 Page 21
PHM Vendor Landscape Aspen Vendor DSRIP Experience? Experience Advisory Board Crimson Population Health Covisint To be implemented by City of New York’s Advocate Community eClinicalWorks CCRM Providers (ACP) Epic Healthy Planet Explorys Platform & EPM Suite Forward Health Group PopulationManager In place at San Joaquin General Hospital’s (SJGH) primary care i2i Systems i2iTracks clinics, participating in California DSRIP CareManager in place at Texas Tech University Health Sciences Kryptiq CareManager 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 March 19, 2015 Page 22
IT & Data Governance Strategies March 19, 2015 Page 23
The Role of IT Governance 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 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 operational 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. March 19, 2015 Page 24
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