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 Health into Primary Care o 3bi: Cardiovascular Disease Management WatchDox Refresher Training Q&A 2
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
DSRIP Calendar DY4 April 1, 2018– March 30, 2019 Demonstration Year (DY) Measurement Year (MY) Next MPA Period: MY5 July 1, 2018– June 30, 2019 4
DY3 and DY4 Targets and Performance 5
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 6
DY4 Targets DY4 Target Project (80%) 3ai Behavioral Health Integration 13,620 3bi Cardiovascular Disease Management 19,680 TOTAL 33,300 For these two projects, the DY4 target is the same as the DY3 target. 7
Audits 8
Past Audits November 2017 : DY3Q2 sample request o 60 patients for 3ai Model 1 only March 2018 : Patient engagement audit and IA onsite visit o 398 patients across all 8 projects Results : o Partners were incredibly responsive in providing satisfactory substantiating documentation on a tight deadline— THANK YOU! o We did encounter several errors (approximately 4%) • Reporting issues (bad data) • Misunderstandings of “actively engaged” criteria • Process issues (inability to retrieve patient records) o To avoid these issues in DY4, we are conducting a series of re-education webinars for all partners 9
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 o Typical substantiation = screenshots of patients’ EMR records Ensure documentation is available should an audit take place o 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
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 o If we have not yet reported your data to NYS, we will work with you to correct the error o Do not simply upload a new file—we will have to manually delete the erroneous data from the old file o 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 11
Changes to Reporting Templates 12
New Reporting Templates for DY4 Projects 3ai Model 1 (Integration of Behavioral Health into Primary Care) 3bi (Cardiovascular Disease Management) New blank templates are in WatchDox: Patient Engagement > DY4 Templates 13
Changes to Example: project 3bi Templates Updated timeframes and instructions Added clarification about reporting engaged patients Removed columns for provider name and NPI—not needed 14
Use the Template Correctly Do not alter the template Files must be in Excel format This is where the latest templates (not .csv) are stored 15
Engagement Criteria Refresher Training Primary Care: 3ai Model 1: Integration of Behavioral Health into Primary Care 3bi: Cardiovascular Disease Management 16
Valid Patient IDs The state allows two types of patient IDs: CIN: 8-digit alphanumeric Medicaid patient ID o 2 alpha, 5 numeric, 1 alpha o Example: AB12345C —OR— Managed Care Organization (MCO) ID: Member ID number from patient's insurer/payer/MCO o May be in various formats o Examples: • WNH771234567 • DAU12345C00 • 74212345600 • YJP8812345701 17
Invalid Patient IDs We omit any patient with the following suspicious/invalid IDs: o Blank (no ID) o 4 characters or shorter (e.g., “+”) o All alphabetical characters (e.g., “TEST”) o Obviously invalid (e.g., “12345”) If your report includes a “TOTAL” or other extraneous rows, please remove them (otherwise your report will be rejected) Please: Filter these out before submitting your file. 18
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 o 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
3ai Model 1: Behavioral Health Integration Engagement criteria: o 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
3bi: Cardiovascular Disease Management Currently for non-pediatric practices only (possible future opportunity) Engagement criteria: o Patients receiving services from participating providers with documented self- management goals in medical record (diet, exercise, medication management, nutrition, etc.) o 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 21
3bi: Frequently Asked Questions Question Answer What CVD None. There is no diagnosis requirement for this project. Patients may or diagnosis codes are may not have CVD. required? Any type. Examples: Patient wants to quit smoking; commits to call NYS QuitLine • What type of self- Diabetic patient has a goal to improve A1C; commits to better diet • management goals Depressed patient commits to reach out to support system when needed • Pediatric asthma patient has a goal to improve use of inhaler are allowed? • A patient commits to eat healthier, lose weight, or exercise more • Patient has a goal to follow safe sex practices • How is the goal The goal must be clearly shown in the patient’s record, so that an auditor can documented in the find it. EMR? 22
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
Example Screenshots: Where are the goals? Patient 1 Patient 2 (Allscripts) 24
Example Screenshots: Where are the goals?, cont. Patient 3 (eClinicalWorks) Patient 4 (eClinicalWorks) 25
Example Screenshots: These might be goals . . . Patient 5 (eCW) Patient 6 (Allscripts) 26
Example Screenshots: Aha! Goals!! Patient 7 (Allscripts) Patient 8 (Allscripts Enterprise) 27
Example Screenshots: Aha! Goals!! cont. Patient 9 (Medent) Patient 10 (Medent) 28
EMR Demonstrations/Tips Allscripts Pro eClinicalWorks 29
EMR Users Allscripts Cerner: Medent: Professional: o Child and Family o Evergreen Health Services o Chautauqua Center o GBUACO o Kaleida clinics o ECMC clinics o Jericho Road o Elmwood Health eClinicalWorks: o Main Buffalo Pediatrics o Neighborhood o CHCB o Northtown Medical o Resource Center o Foothills o Omega Family Allscripts o NFMMC clinics Medicine Enterprise: o Summit Pediatrics o TLC clinics o Olean Medical Group o UPC o UB Family Medicine 30
WatchDox Refresher Training 31
WatchDox Basics Link: http://ecmc.watchdox.com If someone at your organization needs WatchDox access, just let us know! o Email reporting@millenniumcc.org and include the person’s email address o 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
Upload Patient Engagement Files to the Correct Location in WatchDox Navigate to your Patient Engagement folder Make sure you’re in the correct folder! 33
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