Midas+ Physician Profiles

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

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

Clients Only Website User Documentation 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 3

User Documentation 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 4

Training Self Paced e-learning 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 5

Support>Physician Network 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 6

Webinars/Education 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 7

Resource - Train Environment PROD (LIVE) PROD (LIVE) TEST TEST TRAIN TRAIN 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 8

Care Management 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 9

New Joint Commission Standards Professional Practice Evaluation Focused FPPE Ongoing OPPE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 10

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

Data is Powerful 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 12

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

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

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

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

MEDICAL/CLINICAL KNOWLEDGE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 17

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

MEDICAL/CLINICAL KNOWLEDGE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 19

MEDICAL/CLINICAL KNOWLEDGE Attribution Another KEY! 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 20

MEDICAL/CLINICAL KNOWLEDGE Physician-level Data with Specialty Comparison 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 21

PATIENT CARE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 22

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

INTERPERSONAL SKILLS & COMMUNICATION 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 24

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

PRACTICE-BASED LEARNING 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 26

PRACTICE-BASED LEARNING 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 27

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Concerning? Dr Xeri Has 10? 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 29

Dr Xeri 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 30

Dr Xeri 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 31

21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 32

SYSTEMS-BASED PRACTICE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 33

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

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

Seeker 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 36

Medical Staff Profile Standard Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 37

Details View 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 38

Summary View 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 39

Monitoring Grid for OPPE and FPPE 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 40

Attachments 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 41

Comment Templates 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 42

Focus Studies Proctoring Checklists 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 43

Proctoring Review Form 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 44

Compile Care Management Profiles in Seeker 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 45

Compile DataVision Profiles in Seeker 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 46

Compile Indicator Profiles in Seeker and Link to Provider 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 47

Profiles Stored on Staff Membership Grid 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 48

Historical Profiles No Drill Down 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 49

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

Statit PPR Button 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 51

PPR Profile 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 52

DataVision 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 53

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

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

Physician Profiles 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 56

Quality Profile 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 57

Patient Safety CMS Hospital Acquired Conditions 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 58

Standard Report DataVision Provider Profile 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 59

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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

Accessing APR-DRG Reports 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 62

Single APR-DRG Comparison Profile 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 63

APR-DRG ALOS Detail Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 64

APR-DRG Mortality Detail Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 65

APR-DRG Specialty Comparison Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 66

Provider APR-DRG Detail Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 67

All APR-DRG Detail Report 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 68

Statit 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 69

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

21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona

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

Automatic E-mail Sent to Physicians Prior to Their OPPE Review 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona

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

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

Who is Different? The Standard Approach 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 76

Who is Different? You Must Consider Volume! 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 77

Keeping My Finger on the Pulse of My Team 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 78

OPPE Chiefs Experience Chiefs receive an e-mail 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

Automatic E-mail Sent to Chiefs Each Month 21st Annual Midas+ User Symposium May 20 23, 2012 Tucson, Arizona 80

Thank you for attending. Questions, anyone? Jana Darnell, CPMSM, CPCS Midas+ Seeker Product Manager jana.darnell@acs-inc.com Muffie Gallardo, CPCS, CPMSM Midas+ Senior Training Specialist muffie.gallardo@acs-inc.com Susan Hamstra, RN, BS, CPHQ Midas+ Implementation Consultant susan.hamstra@acs-inc.com Dan Schober Midas+ Statit, VP Engineering dan.schober@acs-inc.com