Midas+ Physician Profiles
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1 Midas+ Physician Profiles Jana Darnell, CPMSM, CPCS, Product Manager, Seeker Muffie Gallardo, CPCS, CPMSM, Senior Training Specialist Susan Hamstra, RN, BS, CPHQ, Implementation Consultant Dan Schober, VP, Product Manager, Statit
2 Objectives 1. Examine decisions to be made and the process for creation of provider profiles in Care Management 2. Review how Seeker can be used to track and support the OPPE and FPPE process as well as store physician profiles from Care Management, DataVision, and Statit 3. Learn about the physician profile reports available in DataVision that can be used to evaluate providers 4. Learn how Statit can use data from many different sources including Care Management, Seeker, and DataVision to present a comprehensive provider profile 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 2
3 Clients Only Website User Documentation 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 3
4 User Documentation 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 4
5 Training Self Paced e-learning 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 5
6 Support>Physician Network 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 6
7 Webinars/Education 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 7
8 Resource - Train Environment PROD (LIVE) PROD (LIVE) TEST TEST TRAIN TRAIN 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 8
9 Care Management 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 9
10 New Joint Commission Standards Professional Practice Evaluation Focused FPPE Ongoing OPPE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 10
11 The goal is to OPPE Data Satisfy regulatory Reporting Requirements for reappointment (Joint Commission) Provide physicians with their own data Identify variances in care practices Identify opportunities for improvement Measure success with improvement efforts Monitor ongoing quality, efficiency, and safety 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 11
12 Data is Powerful 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 12
13 Data Organization/Format Attendance Record Activity/volume data Procedural/Cognitive/Clinical/Technical skills Clinical Pertinence/Medical Record Review Clinical Indicators Peer Review Second Level Review Utilization Surgeries/Procedures Infection Control Mortality Blood Review Drug Reactions Medical Record Review Peer Review CQI/RM Medical Staff Meeting Attendance 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 13
14 Ongoing Professional Practice Evaluation Medical Staff Departments define metrics for the six areas of competency Data is collected regularly and stratified by provider to identify opportunities for improvement performance. 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 14
15 Midas+ Care Management Admissions Readmissions AVG LOS Mortality Resource Utilization Process Measures Patient Relations Healthcare Associated Infections Medical Record Completions 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 15
16 Midas+ Care Management Admissions Readmissions AVG LOS Mortality Resource Utilization Process Measures Patient Relations Healthcare Associated Infections Medical Record Completions 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 16
17 MEDICAL/CLINICAL KNOWLEDGE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 17
18 MEDICAL/CLINICAL KNOWLEDGE Total Inpatient Cardiac Arrests Total Inpatients with Rapid Response Event Subsequent transfer to higher Level of Care Total Hospital Incurred Acute MI Total Hospital Incurred Pulmonary Embolus Total Quality Improvement Organization Issues 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 18
19 MEDICAL/CLINICAL KNOWLEDGE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 19
20 MEDICAL/CLINICAL KNOWLEDGE Attribution Another KEY! 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 20
21 MEDICAL/CLINICAL KNOWLEDGE Physician-level Data with Specialty Comparison 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 21
22 PATIENT CARE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 22
23 PATIENT CARE Core Measure - Process measures Pneumonia Vaccination, Blood Cultures, Antibiotic selection Congestive Heart Failure Echo, ACE Inhibitors, Angiotensin Receptor Blockers (ARBs) Acute MI Aspirin on arrival, discharge, Beta Blocker Returns to ED within 48 hours Returns to ED with subsequent admission Inpatients leaving Against Medical Advice 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 23
24 INTERPERSONAL SKILLS & COMMUNICATION 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 24
25 Cases referred to Ethics Committee Medical Record Suspensions Physician Behavior Issues or Concerns H&P content INTERPERSONAL SKILLS & COMMUNICATION Chief Complaint Treatment plan Physical exam Discharge Summary Accuracy 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 25
26 PRACTICE-BASED LEARNING 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 26
27 PRACTICE-BASED LEARNING 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 27
28 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 28
29 Concerning? Dr Xeri Has 10? 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 29
30 Dr Xeri 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 30
31 Dr Xeri 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 31
32 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 32
33 SYSTEMS-BASED PRACTICE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 33
34 SYSTEMS-BASED PRACTICE TOP DRG Analysis (CHF, PN, COPD) ALOS Pharmaceutical Usage By Diagnosis/DRG Those meeting specific indications (Vanco) Operative or other clinical procedures 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 34
35 PROFESSIONALISM Cases referred to Ethics Committee Meeting Attendance Leadership Roles/Positions Compliance with Bylaws 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 35
36 Seeker 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 36
37 Medical Staff Profile Standard Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 37
38 Details View 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 38
39 Summary View 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 39
40 Monitoring Grid for OPPE and FPPE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 40
41 Attachments 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 41
42 Comment Templates 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 42
43 Focus Studies Proctoring Checklists 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 43
44 Proctoring Review Form 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 44
45 Compile Care Management Profiles in Seeker 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 45
46 Compile DataVision Profiles in Seeker 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 46
47 Compile Indicator Profiles in Seeker and Link to Provider 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 47
48 Profiles Stored on Staff Membership Grid 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 48
49 Historical Profiles No Drill Down 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 49
50 Upcoming Statit Integration Button added to Provider Organization record Review History links added to Staff Membership grid Profiles tab 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 50
51 Statit PPR Button 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 51
52 PPR Profile 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 52
53 DataVision 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 53
54 DataVision Provider Profiles Navigator Physician Profiles Indicator & Detail Report Profile Types Standard Report Provider Profiles Provider Profiles SmartReport APR-DRG Provider Reports 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 54
55 Server Application (Navigator) Facility-specific data with drilldown Physician Profiles Quality Profile Peer Review Profile Acute Care Medical Profile Acute Care Surgical Profile Patient Safety CMS Hospital Acquired Conditions 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 55
56 Physician Profiles 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 56
57 Quality Profile 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 57
58 Patient Safety CMS Hospital Acquired Conditions 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 58
59 Standard Report DataVision Provider Profile 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 59
60 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 60
61 Web Application (SmartReport) Comparative Data Single APR-DRG Comparison Profile APR-DRG ALOS Detail Report APR-DRG Mortality Detail Report APR-DRG Specialty Comparison Report Provider APR-DRG Detail Report All APR-DRG Detail Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 61
62 Accessing APR-DRG Reports 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 62
63 Single APR-DRG Comparison Profile 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 63
64 APR-DRG ALOS Detail Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 64
65 APR-DRG Mortality Detail Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 65
66 APR-DRG Specialty Comparison Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 66
67 Provider APR-DRG Detail Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 67
68 All APR-DRG Detail Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 68
69 Statit 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 69
70 Physician Profiling: The Challenges Physician data is located in many different sources Physicians are skeptical of the data Integrity is compromised when: - Multiple copies of the same data exist - Data is manually extracted and manipulated - Profile is created manually in Microsoft Word or Excel Measures used to assess performance will change 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 70
71 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona
72 OPPE Physician Experience Automatic notification 45 days (default) prior to OPPE review Automatic notification when review is started, changed, or completed Details for individual measures are easily accessible Data concerns can be reported with the click of a button Performance on measures can be assessed and/or explained 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 72
73 Automatic Sent to Physicians Prior to Their OPPE Review 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona
74 Managing the Physician Team Which physicians are truly performing differently? How do I understand physician performance when volumes differ so much? How can I tell if changes to a process truly have the desired effect? How is my physician team performing on various performance measures? How can I easily slice and dice performance data in different ways to identify underlying performance issues? Who on my team currently has unusual performance for any measure? How can mangers be informed when a provider gets a really bad review or a really good review? How do I keep my finger on the pulse of my team s performance? 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 74
75 Which Physicians are Truly Performing Differently? Identify physicians performing better or worse than their peers How to account for low volume physicians? 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 75
76 Who is Different? The Standard Approach 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 76
77 Who is Different? You Must Consider Volume! 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 77
78 Keeping My Finger on the Pulse of My Team 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 78
79 OPPE Chiefs Experience Chiefs receive an on 1st of the month with upcoming review tasks Chiefs can add comments, action plans, or process changes to specific measures for providers Chiefs select a Review Outcome Chiefs select predefined review phrases or enter their own 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 79
80 Automatic Sent to Chiefs Each Month 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 80
81 Thank you for attending. Questions, anyone? Jana Darnell, CPMSM, CPCS Midas+ Seeker Product Manager Muffie Gallardo, CPCS, CPMSM Midas+ Senior Training Specialist Susan Hamstra, RN, BS, CPHQ Midas+ Implementation Consultant Dan Schober Midas+ Statit, VP Engineering
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