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AGENDA

MiPCT/CCM Spotlight ADT Alert and workflow Training for Care Managers and PO/CCM Leads January, 2014. AGENDA. Brief Spotlight Overview of “Phase One” Member List Functionality “Phase Two” ADT Alert Briefing Care Management Workflows Prompt action on Transitions of Care

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AGENDA

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  1. MiPCT/CCM Spotlight ADT Alert and workflow Training for Care Managers and PO/CCM LeadsJanuary, 2014

  2. AGENDA • Brief Spotlight Overview of “Phase One” Member List Functionality • “Phase Two” ADT Alert Briefing • Care Management Workflows • Prompt action on Transitions of Care • How ADT alerts can be used to prioritize and manage your caseload

  3. Spotlight Overview

  4. What is the MiPCT Spotlight Offering? A way for Care Managers to receive web-basedaccess to MiPCT member lists with near real-time alerts when patients are hospitalized or discharged where available. .

  5. Spotlight Data Security • External security audit review performed in 2012 with CynergisTek and subsequent review planned for 2013 upon CCM Version 2 rollout completion • Annually CTC undertakes: • Risk analysis of the company, our processes, assets, applications, data (under a NIST 800-30 based risk management program) • Review of all our policies and BAAs internally and with lawyers • Disaster recovery test • External network/application security tests • Worked with Healthcare Law Consultancy (CCM) to address new HIPAA omnibus regulations (September 2013) • Policies in place and updated as HIPAA regulations change to address things such as security breaches including notification to affected parties.

  6. Phase 1: MiPCT Member Lists via CTC Spotlight

  7. Phase 1: New Member Alerts via CTC Spotlight

  8. ADT Availability

  9. Spotlight Leverages ADT Access • Through partnership with MiHIN, MSMS, and others • Leverages MiHIN/CareBridge ADT work • Expands ADT availability with additional feeds with prioritization of ADT feeds of greatest value to MiPCT practices

  10. ADTs Available Q1 2014 Facilities included in the first set of ADT feeds for MiPCT patients with hospitalizations or ED visits: • Beaumont • Working on identifying individual facilities • Henry Ford Health System • Macomb to start • Wyandotte and Main campus to follow • Trinity

  11. Admission, Discharge, Transfer MiPCT Data Flow and Progress • Over half of our POs participate in the Crimson Care Management (CCM)/MiPCT partnership • Care managers now receive member lists electronically via a web interface • ADT notifications being added

  12. Phase 2: Admission/Discharge AlertingPatient Admitted Email Alert

  13. Phase 2: Admission/Discharge AlertingPatient Discharged Email Alert

  14. Phase 2: Admission/Discharge AlertingPatient ER Visit Email Alert

  15. Phase 2: Admission/Discharge Alerting

  16. Alerting – Acknowledge via emailLogin to Spotlight

  17. Alerting – Acknowledge via emailClose Alert

  18. Admission/ER Visit Information

  19. Discharge Dispositions:

  20. Care Management Workflows

  21. CTC/ADT alert only process flowdeveloped by: St. John Providence, Partners in Care MiPCT-P.O.- Soft launch Partner

  22. Transitions of Care Best Practice Workflows Care Manager (CM) ADT alert workflows: • Associated with corresponding faxed patient information. • Associated with CM electronic access to patient record.

  23. CM Workflow for Inpatient Alert

  24. CM Workflow for Discharge Alert

  25. CM Workflow for ED Alert

  26. ADT AlertsBest Practice Process • The following steps are completed by the CM 24-48 hrs. after alert notice. • Acknowledge receipt of admission, discharge or ER alert from CCM. • Investigate patient change in status and determine care management intervention. • Document receipt of alert, intervention(review of EMR and follow up with facility contact, patient and physician) and planned follow up with patient in EMR.

  27. Transitions of Care Integrated Workflow (displays inpatient, discharge and ED flows in one screen)

  28. ADT/CTC Summary of Key Points • Alerts need to be acknowledged on a timely basis throughout the day to minimize multiple alerts on the same patient. (i.e. admission alert that is not acknowledged by the time of discharge will generate another alert -> discharge alert) • When acknowledging an alert by email, click on “view care plan” button once logged in CTC. Clicking “close” will remove alert from your home page and require you to look up patient by name. ( Patient hospitalization report is being developed via CTC website to see patient TOC activity.) • It is recommended that review of the discharge disposition code be incorporated into your process.

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