Bar graph Performance Driven Academy AGENCY EXAMPLE: EVOLUTION OF DATA COLLECTION WITH ROCHESTER REGIONAL HEALTH MAY 18, 2018
Brought to you by the Managed Care Technical Assistance Center Speaking: Briannon O’Connor, PhD Associate Director CCSI’s Center for Collaboration in Community Health
ROCHES OCHESTER TER REGION REGIONAL AL HEAL HEALTH TH BEHA BEHAVIORAL VIORAL HEAL HEALTH TH DEPAR DE ARTME TMENT NT EV EVOLUTIO TION O OF F DATA C A COLLE LLECTI CTION May 18, 2018 3
PRES PRESENT ENTATION TION AGEND GENDA A • RRH Behavioral Health Overview • Data Roadmap • Key Performance Metric – Evolution of Data • Qlikview Demo • Questions 4
B EHAVIORAL H EALTH OVERVIEW
BH O BH OVER VERVIEW: VIEW: LEGAL EN LEGAL ENTIT TITIES IES Rochester Regional Health System Behavioral Health Department Park Ridge Rochester Mental Rochester General Newark-Wayne United Memorial Chemical Clifton Springs Health Center Hospital Community Unity Hospital Medical Center Dependency Inc. Hospital & Clinic Hospital (RMHC ) (RGH) (UMMC) (PRCD Inc.) Young Men’s Chemical BH ACC Psych ED Psych ED-CIU CPEP Psych-ED CR Dependency Inpatient Psychiatric Psych ED Psychiatric Psychiatric Inpatient MH Clinic- Adult Women’s CR Inpatient & Satellite Inpatient Psychiatric MH Clinic – Adults, Inpatient Satellites CD CD Inpatient MH Clinic- C&Y , Inpatient Satellites CD CD Outpatient Clinic Detox CD Clinic MH CD Clinic – Adult Clinic – Adult & & C&Y School-Based Satellite Health Centers MH Clinic-Adult & Acronym Glossary Satellites BH ACC = Behavioral Health Access and Crisis Center ACT = Assertive Community Treatment PROS CD = Chemical Dependency PROS CIU = Crisis Intervention Unit CPEP= Comprehensive Psychiatric Emergency Program CR= Community Residence ACT C&Y = Children & Youth ED= Emergency Department HBCI=Home Based Crisis Intervention Updated: 4/2018 HBCI MH = Mental Health 6 PROS= Personalized Recovery Oriented Services
BEHAVIORAL HEALTH OVERVIEW: KEY SERVICES & STATISTICS $ 75M+ 2,000+ Individuals Enrolled in Home Health 14 Behavioral Annual Revenue Care Management Health Locations; 4 Counties 370,000 4 75 Active Annual Outpatient Psychiatric DSRIP - Clinic Visits Inpatient Beds 2 Mental Health Embedded in Emergency 92 Addiction 13 Primary Department Access Beds Care Practices Points (includes CPEP) Chemical Dependency ~1000 Staff Members Residential Programs 24 Woman’s Beds & 5 School Based 18 Young Men’s Beds Health Centers 7
BH CURR BH C URRENT ENT PR PROFILE OFILE Behavioral Health Statistics Number of Office of Alcoholism & Substance Abuse Services Operating Certificates 11 Number of Office of Mental Health (OMH) Operating Certificates 16 Number of OMH Satellites 15 Number of Department of Health Programs 3 Number of Hospitals 5 Number of Non-Hospital Facilities 17 Number of School Based Health Centers 5 Number of Emergency Access Points 4 Chemical Dependency Licensed Beds / Active Beds 92 / 92 Inpatient Psychiatry Licensed Beds / Active Beds 104 / 75 Medical Staff 94 Team Members (including prescribers) 983 Inpatient Discharges (2017) 4,329 Outpatient Visits (2017) 366,521 8
B EHAVIORAL H EALTH DATA ROADMAP
2017 D 2017 DATA A A ACHIEVEMENT CHIEVEMENTS • Strategic Planning – Data Vision • Bench Strength Development • Clinical Analyst within the business line • Technical Training for clinical staff • Data Inventory Development • Qlikview Licenses Data Leveraged Data Acquired Data Analyzed • Qlik Inpatient • CPT Code • Payer Mix Dashboard Contracted • Service Mix Reimbursements • Qlik ED Dashboard • County Opioid • Average visits per • Demographics Statistics episode of care • Occupancy % • Unique patients • Unique enrolled served • Medicaid capital patients add-ons • Prescriber caseloads • Newly enrolled • Unweighted visits • Clinic Access patients • Follow-up to •Veteran’s Hospitalization Administration 10 10
DASHBO ASHBOARD ARD DEVEL DEVELOPMENT OPMENT DASHBOARD EXECUTIVE CLINIC OPERATIONAL CLINIC ACCESS NAME SCOPE A high level An operational dashboard A snapshot of the poignant data snapshot of the for mental health and points of the care pathways and Behavioral Health chemical dependency trajectories of the episodes of department as a outpatient clinics used to CD and MH clients from referral whole containing monitor key performance scorecard-like metrics measures with targets and current progress METRIC* Occupancy Unique patients Average # of visits before Readmission New patients Scheduled admission ALOS visits Completed visits Days from intake call to first Margin Intakes available appt Visits Visit status Days from intake call to first Unique patients Admissions completed appt New patients Discharges Days from ED visit OP appt Willingness to ALOS (days & visits) Days from IP discharge to OP recommend Top 10 Diagnoses appt Discharge Disposition Days from intake to admission *Includes demographic analysis- race, sex, zip code, payor 11 11
DASHBO ASHBOARD ARD DEVEL DEVELOPMENT OPMENT DASHBOARD INPATIENT SERVICE GAPS NAME SCOPE A dashboard displaying key inpatient An analytical tool used to evaluate gaps measures and analyzing in services (both geographically and readmissions back to BH as well as programmatically) that are possible any inpatient facility within RRH growth opportunities in our communities METRIC* Discharges Location of Service All Cause Readmissions Patient Location BH Readmissions Readmission % Waitlist (Demand) Population Density Overall ALOS CBO Mapping First ALOS, Readmit ALOS, Patient demographics Restraint/Seclusion *Includes demographic analysis- race, sex, zip code, payor 12 12
K EY PERFORMANCE METRIC
KEY PE KEY PERFORM RFORMANCE ME ANCE METRIC TRIC Follow Up to Hospitalization (FUH): # patients attending a behavioral health appointment within 7 or 30 days post day of discharge from a behavioral health inpatient program # patients discharged from a behavioral health inpatient program Behavioral Health= mental health or chemical dependency unit 14 14
FUH R FUH ROLL OUT OLL OUT: 2015 : 2015-2016 2016 Key Program Identification: • 1 Psych Inpt • 1 CD Inpt • 2 CD Outpatient Clinics • 2 MH Outpatient Clinics Level Setting Meeting: Review of metrics and definitions, goal overview, identification of email/paper process for tracking metrics Data Collection- Paper/Emails : Paper data sheets identifying numerator/denominator information to be emailed to point person each month 15 15
FUH ST FUH STAND ANDARD ARDIZA IZATION TION Key Program Identification: ALL RRH BH Programs Level Setting Meetings: Multiple meetings with various stakeholder groups across levels of care to level set regarding: • “So What” of the metric & RRH BH vision • Patient continuity of care • Identified best practices to support patient care • Identified workflows to support patient care • Defined roles & responsibilities of staff at various levels of care Data Collection- Excel : • Monthly excel files tracking patients discharged from inpatient unit and linked to outpatient • Monthly RRH BH dashboard populated from excel files • Review of monthly dashboard data to inform areas of excellence and opportunities for improvement 16 16
FUH W FUH WORKFL ORKFLOW W 17 17
FUH PR FUH PROGRAM TRA OGRAM TRACKING CKING • Included drop downs for as many fields as possible • Manual Process • Potential for error • Transfer from individual programs to dashboard • Provided Opportunity to do the work & work out kinks 18 18
FUH PR FUH PROGRA OGRAM D M DASHB ASHBOAR ARD 19 19
CQI FR CQI FRAM AMEW EWORK ORK • All stakeholders review RRH BH department performance • Share best practices • Target supports & intervention to underperforming program • Identify key process metrics to track and metrics to cease tracking • Update workflows to support patient care • Goal- work towards automation of data collection 20 20
FUH D FUH DATA A A AUT UTOMA OMATION TION Key Program Identification: All RRH BH Programs & all BH Programs within RHIO Level Setting Meeting: • Identify key workgroup members to inform data specifications document • Engage EMR Personnel to identify ability to capture data in EPIC/CareConnect • Identify Scheduled Frequency of Report • Report Validation Data Collection- Qlikview Application : Utilization of Data Visualization Software & Care Connect Data to compile data and populate dashboard 21 21
FUH QLIKVIEW DEMO FUH QLIKVIEW DEMO 22 22
Q UESTIONS
THANK Y THANK YOU OU Contact Information: Mandy Teeter, MBA, MSW, Director, Operational Excellence & Adult Mental Health Mandy.Teeter@rochesterregional.org Liz Schreiber, MA, LMFT, Manager, Quality & Operational Excellence Elizabeth.Schreiber@rochesterregional.org Frankie Tangredi, Clinical Analyst Francesca.Tangredi@rochesterregional.org 24 24
Mark your calendars and register Webinar (Wednesday, 12-1pm): Practice Development and Management, 5/23/18 In-person events in late June (10am-2pm) Register individually, not by agency Rochester, 6/18 Albany, 6/19 NYC, 6/29
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