Care Management v2012 Enhancements. Lois Gillette Vice President, Care Management

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1 Care Management v2012 Enhancements Lois Gillette Vice President, Care Management

2 Comprehensive Overview Care Management v2012 Please note that this presentation includes slides from the General Session Product Overview given on Monday, May 21 st as well as slides presented during the Care Management v2012 Enhancements breakout given on Wednesday, May 23 rd, thus ensuring that this presentation includes all enhancements of interest to Care Management clients planned for delivery in v st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 2

3 Care Management Version 2012 Priorities Secure Comments Mobile Devices System Performance Solutions Integration Caché SQL 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 3

Conversion to Caché SQL Seamless Conversion from KB SQL Improved Security Model Better Connectivity Paves the way for other enhancements Document

4 Conversion to Caché SQL Seamless Conversion from KB SQL Improved Security Model Better Connectivity Paves the way for other enhancements Document Lists/Checklists Reportable Column Collections accessible in Formulas Library 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 4

5 System Performance Interface Processing Improve Interface MPI matching logic Reduces number of suspected duplicates 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 5

6 System Performance SmarTrack Processing Indicator-specific Processor settings for Nightly Summary Job Enable optional Indicator Tuning for Weekly Summary Job 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 6

7 System Performance SmarTrack Processing Run multiple Indicator Summary jobs concurrently Weekly Background Job (SAN required) On Demand Processing 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 7

8 Improving the Efficiency of SmarTrack Processing Standard Report to display Indicator usage Standard Report to reflect the number of entries on a specified Worklist or all Worklists assigned to a specified user Utility that Midas+ can run upon request to identify duplicate Indicators and Worklist Rules Ability to delete Summary Data for Indicators designated as Inactive 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 8

Solutions Integration Care Management and Live Single-click Navigation to Patient Clinical Data Seamless User Authentication SmarTrack Virtual

9 Solutions Integration Care Management and Live Single-click Navigation to Patient Clinical Data Seamless User Authentication SmarTrack Virtual Worklist Target that creates: Custom Launch Pad View Patient Card M + Icon 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 9

10 Patient Detail View 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 10

Interface Global Unique Identifier (GUID) created for each

11 Interfacing Primary Care Physician added to Encounter Provider grid Documents saved to Document List may be included in Outbound Interface Global Unique Identifier (GUID) created for each encounter 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 11

12 Home Page Clients Only link will open an external browser window Automated authentication into Support Center 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 12

13 Enhanced Look & Color Palette 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 13

14 Patient Lookup Option to display & select from list of last 50 encounters accessed 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 14

15 Improved Flow for Secure Comments 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 15

16 Editing Secure Comments is permitted prior to Save 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 16

17 Append a Template using Icon, Button, or Right Click Menu 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 17

18 Secure Comments Edit Permission 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 18

19 System Administrator uses right click to access Edit Secure Comments feature 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 19

20 ReporTrack - Documents Previously unlinked Documents can be linked Existing Documents can have links modified Edit Function Links Button 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 20

21 SmarTrack Indicator Definition Define Display Symbol for Rates Employee-based Access Function & Drill Down 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 21

22 Expose Focus Study grids as Indicator & Worklist Multiples to Monitor 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 22

23 SmarTrack Qualifying Conditions for Encounter: Days Since Previous Encounter: Days Until Next 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 23

24 New in SmarTrack Definition 22 Qualifying Conditions ENCOUNTER:DRG:ALOS ENCOUNTER:DRG:GMLOS INFECTION CONTROL:Surgery:Encounter Procedure INFECTION CONTROL:Surgery:Encounter Procedure Attribution PATIENT:Primary Care Physician:Group 40 Cross-tabs EMPLOYEE HEALTH:ENVIRONMENTAL EXPOSURES:Location EMPLOYEE HEALTH:ENVIRONMENTAL EXPOSURES:Environmental Exposure ENCOUNTER:Admitting Physician:Default Service ENCOUNTER:Admitting Physician:Default Specialty ENCOUNTER:Next Outpatient Encounter:Location ENCOUNTER:Previous Encounter:Location 10 Sum Variables ENCOUNTER:DRG:ALOS ENCOUNTER:DRG:GMLOS 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 24

25 SmarTrack Worklist Display Options Authorization - Date Authorized A/D Days - Appeal Date Due Encounter - Complaint (first occurring) Encounter - Discharge Physician Encounter - Primary Care Physician Encounter - Day of Stay Encounter - Length of Stay Encounter - Current Length of Stay Encounter - DRG Geometric Mean Length Of Stay (GMLOS) 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 25

26 Clinical Documentation Improvement Adding the diagnosis code to the CDI worksheet Adding HCM CDI fields to the Encounter file Last Review Date Last Query Date Response Response Date Type 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 26

Time Tracking Hospital Case Management Concurrent Reviews Add Time field to General tab Create virtual combined Date/Time field Automatically save Date & Time of: First save of review (regardless of

27 Time Tracking Hospital Case Management Concurrent Reviews Add Time field to General tab Create virtual combined Date/Time field Automatically save Date & Time of: First save of review (regardless of Status) First save of review with a Status of Complete Compute Elapsed time from Admit to Save Referral Tracking Add PA Time field Create virtual combined Date/Time field Add a grid for Status and associated Date & Time 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 27

28 Hospital Case Management InterQual Version 11 Integration 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 28

29 Concurrent Review InterQual Integration Display entire text of the InterQual review Hide discrete fields Eliminate Display Review Results Button Maintain current discrete fields for reporting Change label for Criteria Set to Product Add 5 new discrete fields for reporting InterQual Episode Day (numeric) InterQual Criteria Subset (dictionary) InterQual Priority (dictionary) InterQual Review Status (dictionary) InterQual Outcome (dictionary) 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 29

30 InterQual Launch Default Parameters Products LOC: Acute Adult Content Versions current Categories All 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 30

Hospital Case Management Concurrent Review Milliman CWQI Integration Content of Milliman Episode Summary will be saved in the Care Management database

31 Hospital Case Management Concurrent Review Milliman CWQI Integration Content of Milliman Episode Summary will be saved in the Care Management database for display and reporting Enable Milliman content to be included in the HCM Worksheet 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 31

Remote Data Entry for Focus Studies, Risk Events and Patient Relations Stand-alone data Entry & Inquiry using ipad Authenticated and non-authenticated users Patient Lookup for non-authenticated

32 Remote Data Entry for Focus Studies, Risk Events and Patient Relations Stand-alone data Entry & Inquiry using ipad Authenticated and non-authenticated users Patient Lookup for non-authenticated users will include Encounters from associated Facilities sharing a single database Encounter Facility: MMC Event Facility: MGH 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 32

33 Focus Studies and User Fields Encounter Admitting, Attending & Discharge Physician Variables added to Focus and User Field Rules Designate Comments as Secure in Focus Studies & User Fields 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 33

34 Focus Studies and User Fields Combined Date/Time variables added to Surgery User Fields for Elapsed Days/Time calculation Surgery: Patient In & Out Surgery: Anesthesia Start & Stop Surgery: Surgery Start & Stop Expanded Dictionary Lookup & Is Like Search 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 34

35 New Version Testing Process Focus Study Distributed in Test area Reflects major enhancements that affect both functional users and System Managers Should be modified to match unique workflow 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 35

36 Data Collection and Extraction Toolkits Data collection using standards specified by 3 rd party Data extraction in format suitable for electronic submission to 3 rd party Care Management v8.0 or higher Ongoing updates outside of Care Management release cycle Incremental Annual Fees Apply 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 36

37 Toolkits Update American Hospital Association RACTrac Survey RACTrac-Compatible Updated content New CSV file format Executive Health Resources Appeals Tracking EHR Integrated Designate attached Files to include in outbound transaction In addition to RAC, Other Denial types such as Medicaid and Commercial will be supported 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 37

Physician Advisor Referrals Vendor Bidirectional exchange Integration Executive Health Resources Accretive Health Real-time Referral status updates

38 Physician Advisor Referrals Vendor Bidirectional exchange Integration Executive Health Resources Accretive Health Real-time Referral status updates viewable in the Disposition field Determination Letters automatically attached as Files 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 38

39 Physician Advisor Automated Updates 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 39

40 NHSN CAUTI Reporting added to CLABSI Toolkit Distributed Focus for Infections (numerator) Distributed Focus for Device Days (denominator) Mapper Process Focus Study shared with other NHSN Toolkits (SSI) Distributed Dictionaries that honor NHSN nomenclature Standard Report to generate data extract file CDA format Suitable for upload to NHSN on-line tool 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 40

41 NHSN SSI Toolkits User Fields in Surgery (denominator) User Fields in Infection Control (numerator) Mapper Process Focus Study shared with other NHSN Toolkits (CLABSI, CAUTI) Distributed Dictionaries that honor NHSN nomenclature Standard Report to generate data extract file CDA format Suitable for upload to NHSN on-line tool Surgery interface modification recommended 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 41

42 NHSN Surgical Site Infection Toolkit 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 42

43 Patient Safety Event Reporting to PSO using AHRQ Common Formats Toolkit Process Focus Study for Unsafe Conditions Update to Common Formats Hospital v1.2 Venous Thromboembolism (VTE) Device or Medical/Surgical Supply including HIT SmarTrack Virtual Worklist Target From Risk to PSO Focus From PSO Focus to Risk Standard Report which displays the original data at first save of the PSO Focus Study 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 43

44 Care Management V2012 General Release November 2012

Midas+ Hospital Case Management and RAC Denial Management

Midas+ Hospital Case Management and RAC Denial Management Cindy McCollum and Dan Parker Midas+ Product Management Specialists Liz Barnes RN, MS, CPHM Midas+ Solutions Consultant Objectives 1. Describe