Colorado Demonstration Grant for the Testing Experience and Functional Tools (TEFT) The Colorado Department of Health Care Policy and Financing March 18th, 2015 1 Our Mission Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources The Four Domains for Outcomes • Lab Results • Health Risk Assessments • Client Engagement • Satisfaction • Choice and Control • ADLs • Self-Efficacy • Personal Story Clinical Functional Quality of Life Utilization • ED visits • Hospital Visits • PCP 3 TEFT Components Experience of Care Survey e-LTSS Records S&I Framework Continuity Assessment Record & Evaluation Tool Personal Health Record 4 TEFT Timeline Year One – 2014 – Planning Phase Year Two – 2015 – Implementation of Phase One Year Three – 2016 – Implementation of Phase Two Year Four – 2017 – Implementation of Phase Three TEFT Partnerships: National Partnerships 2 Federal Partners – (CMS, ONC) 3 Contractors (Truven, Lewin, RTI) 9 Grantees (CO, AZ, CT, GA, MN, KY, LA, MD, NH) State Partnerships Stakeholders HCPF HIEs – CORHIO & QHN Waiver Populations Elderly Blind Disabled & Supported Living Services 6 State Partnerships CIVHC – Center for Improving Value in Health Care Telligen (formerly CFMC) QHN, Quality Health Network Colorado Department of Human Services, Aging and Adult Services Area Agency on Aging Colorado HealthCare Association State Partnerships – Con’t. Colorado Health Foundation Colorado Gerontological Society State of Colorado Governor’s Office – IT Leading Age Colorado Hospital Association The Alliance Key Achievements Completed Round One - Experience of Care survey Sent surveys - Health Information Technology surveys to stakeholders state-wide Held stakeholder Meetings - throughout Colorado in person and via webinar Created Criteria for PHR vendors Developed implementation work plan 9 Solutions: Criteria for PHR Products 1. Must be able to integrate data coming from a HIE 2. Must be able to take data input from a client, caregiver or provider in the form of other devices 3. Must be customizable to suit the different user needs including non-clinical and clinical data 4. Must be able to display benefits and waiver related information or partner with a vendor who can 5. Must be secure in managing the data including HIPAA compliance 10 Solutions: Criteria for PHR Products Con’t. 6. Must be able to meet the basic Standards and Interoperability (S&I) Framework requirements 7. Must accept data input from secure Direct Messaging 8. Must be able to send alerts to any stakeholder, including providers and physicians 9. Must be customizable or open sourced 10. Must be from a vendor that is financially viable Lessons Learned From Planning Phase Need to facilitate stronger communication for round two EoC & investigate lower response rate in SLS waiver Important to include open brainstorming in stakeholder meetings regarding PHR Going state-wide is challenging but allows us to see trending and patterns with clients in LTSS There is already identifiable criteria important for PHR development Go slow to go fast – stages of implementation will be important 12 Stakeholder Meetings Community meetings held from July, 2014 through December 2014 11 on-site meetings and 3 webinars Attendees included the community centered boards, Single entry points, RCCO’s, ACO’s, HCBS providers and state partners 13 What Our Stakeholders Want… Non-Clinical Clinical • Personal Story • Active Medications/Allergies • Staff Schedules • Lab/Radiology Results • Track Units • Past Visits & Upcoming Appointments • Alerts • Support Plan/Goals • Push Alerts for ED visits & Hospitalizations How Query-Based HIE Works Laboratories Public Health Departments Radiology Centers Hospitals Pharmacy Information CIIS Immunizations Reportable Conditions Immunizations Public Health Alerts Medications lists Newborn Radiology Reports Lab Results Screening Pathology Reports Diagnostic-Quality Results Medical Images Hospital ADT Info Consult Reports Transcription Notes Lab/Rad Community Health Record (with CTN) Data Analytics Immunizations Future CCD Orders CCD Upload 15 The “Perfect State” of HIE Full Integration of Public Health Integration of Behavioral Health Statewide & National Connectivity Increased Interoperability Key Considerations: Security of information User flexibility Opt-Out features Designed to aid Client in managing LTSS Services 17 What This Means for Implementation… 18 Implementation: Three Phases Phase One - Navigation Teach how to navigate the PHR - Non-clinical, clinical (only a couple elements) Phase Two – Data Feeds Added PHRs connect to the state HIEs, add more data Phase Three – Dynamic Phase Clinical enters data, interactive – personal story, answers daily questions, tracks own wellness, interacts with PHR 19 Three Measures of Success Frequency of Use Who is using it and how often Efficient coordination of services Tracking scheduled appointments and units Increase in quality of services Patient engagement impacts services 20 Key Milestones Identified 5 communities in Colorado to be Focus Group settings Demo’d three electronic Personal Health Record (PHR) for LTSS (ManaHealth, Get Real Health and FEI Systems) Developed a state partner advisory committee Developing partnership with HCPF IT Department to design MMIS/PHR solution 21 Upcoming Challenges… HCBS Providers at different levels of Health Information technology Case Managers and Care coordinators utilizing home grown or purchased “EHR” systems that are not certified to be integrated with an HIE Accessibility to internet, laptops and computers at varying levels PHRs must be usable for the elderly, blind, disabled populations PHR usage across the board very limited 22 Next Steps Focus Groups begin March 2015 Pilot Sites to be identified from the Focus Groups PHR Demos to be initiated for clients, caregivers and providers Designed to aid Client in managing LTSS Services Work with HCPF and new MMIS system 23 24 Thank You Tim Cortez Manager, Community Options Search Community Living Office Department of Health Care Policy & Financing [email protected] Pamela A. Russell LTC Program Director CORHIO [email protected] Danielle Culp Department of Health Care Policy & Financing [email protected]
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