Get Better at IT Key Aspects & Challenges?

1. Get Better at IT Key Aspects & Challenges?

2. Interactive Clicker Exchange

3. :00 What is the balance between your people and systems for analyzing your patient health outcomes? • 100% people & 0% systems (no system) • 75 % people & 25% systems • 50 % people & 50% systems • 25 % people & 75% systems • 10 % people & 90% systems

4. :00 Is your Health IT integrated and/or used with Quality Improvement Activities? • Yes • No • maybe • Not Sure

5. :00 Has your Health IT been able to track or document better system’s Usage? • Yes • No • Often • Not Often Enough

6. :00 Which of the following areas has been most difficult for continuous project or quality improvement? • Leadership (people) • Buy-in (process) • Technology (systems capabilities) • Capacity to Use Data for continuous improvement (project improvements)

7. :00 What percentage of the data in your Health IT system do believe is useful for quality improvement tracking? • None of it • Some of it • Most of it • All of it

8. :00 Is your Health IT set up to facilitate or prompt quality patient care? • Yes • No • Often • Not Often Enough

9. Strategy People Process Technology

10. Getting Better at IT • Strong and continuous leadership in avoiding complacency and striving to take things to the next level is needed. • Little ways and big ways to get better. • PDSA cycles and performance improvement projects. • Draw on power users in your efforts again. • Use of third parties can help as well.

11. Strategy People Process Technology

12. Is Customer Support Excellence a key component of success to Getting Better at IT?

13. Proactive Courtesy Calls and Evaluation • Any problems or barriers with using the system? • To what degree is the system saving you time? • To what degree is the system reporting effective for you? • How is technical assistance and support for you? • If not a “10”, what can we do to make it a “10”? • “The fact that someone calls me to make sure that all is well and to see if I have any ideas is just great.”

14. Results: Proactive Courtesy Calls and Evaluation

15. Results: Proactive Courtesy Calls and Evaluation

16. Results: Proactive Courtesy Calls and Evaluation

17. Results: Paterson Medical and SPNS Agencies

18. NYC Qualitative Responses • “Really easy to use.” • “It has taken days out of running reports.” • “You guys are wonderful.” • “The fact that we could do the rents is marvelous. Thefact that it keeps track of your contracts is just great.” • “Shaking up a lot of people because now their bosses can see when work isn't done.” • “Very easy to enter information. Only way to make it better is to have it read your mind.” • “It's great! Very very easy, no issues, very straightforward. Issues with username and password in the beginning, but they were resolved. Doesn't think it could get any easier.” • “It’s nice to work with such a responsive group of people.” • “This intensive TA truly makes a difference!” • “It’s great to have all this data at our fingertips.” • “You guys are awesome!”

19. NYC Qualitative Responses cont’d • “I think it’s easy and practical compared to other systems we used such as <deleted>… This is the max, the best. I think you did a great job.” • “It’s pretty cool. VERY easy to work with.” • “It's easy. No problems. Very simple. Very User friendly.” • “Great, the last changes are wonderful. I am really happy about the last changes that were made that we had requested.” • “It is going very good. You [RDE/DOHMH] are providing a good service.” • “I love that it's web-based, so I’m not tied to a machine like other systems. I have no complaints.” • “I like it. It is easy for me to work with, because everything is right THERE, I don’t have to look around for certain items; it tells you the next steps, etc.” • “Your support [RDE] is very fast. Very helpful. Efficient.”

20. Paterson Ryan White • “I am seeing more clients than before. I was never meeting my internal goals, until now.” • “The reason we chose eCOMPAS was because eCOMPAS adapts to our process, instead of us having to adapt our process to someone else’s system.” • “The web-based platform was amazing.” • “Good problem solvers. Explains the use of the system clearly and effectively.” • “Very competent staff. Knowledgeable and friendly. Great response time.” • “I am very pleased with RDE and its staff. They have and are responsive to address whatever needs that may be in question. Their quality of competence can be rated a number 10 on a scale of 1 to 10 and 10 being excellent.”

21. User-Driven Enhancements • Constructive feedback from TA, Proactive Calls, and QA provided to Administration. • Administration decides if worthy and priority. • Enhancements are reviewed, developed, deployed and announced. • Users see their feedback is taken seriously and increase their engagement and system compliance. • National shared best practices community. • User Group

22. Impact • Users feel empowered that their ideas count. • Improvements (time savings, error reduction, etc) that are valuable to the front-line staff that would ordinarily get lost are actually implemented. • Other ideas are encouraged. Users have hope. • Buy-in is reinforced with the process of improvement.

23. Strategy People Process Technology

24. After Action Reviews (AARs) • What did we do well, that we would do again? • What could we do better? • If we had to do it over again, what would we do differently?

25. Not All HIT Challenges Have Technology Solutions • Policies, procedures, protocols may need to be created or amended. • Realignment of expectations may need to occur. Communication is the solution. • User capacities (including non-technical capacities) may need to be upgraded.

26. Other Methods of Engagement • Integrated into QM committees • Quarterly Provider Meetings • User Group • National Quality Centers / outside parties • Presentations / Conferences

27. August 2008 HRSA All Grantees Meeting • "Application of Innovative Technology for Planning Bodies: Web-based Needs Assessment, real-time Graphic Data for Priority Setting, and Web-based Client Satisfaction Surveys."

28. Client SatisfactionGetting Better at IT • Client Satisfaction filled out by clients using Provider Access Points, at home, library, and community college. • Unique Identifier eliminates the need for client entry of demographic data, reducing overall survey burden. • Survey data available in real-time. Tens of thousands of pages of paper savings. No delay, no need for central data entry of paper. • eCOMPAS performs initial analysisand graphical data presentation, freeing up analysts to concentrate on drawing meaningful conclusions.

29. Client SatisfactionGetting Better at IT • eCOMPAS reporting facilitates data drill-down for multiple layers of analysis. • Data integrity is improved through the reduction of human error in data entry. • Data are available immediately to all stakeholders. This is useful feedback for providers who are now able to make midcourse corrections immediately, not 12+ months later. • Reports provided in an easy-to-use dynamic and visual format, allowing for instantaneous drilldown.

30. Consumer Participation: Existing Tools • Instruction Sheets • Access Cards • Access Point Signs • Consumer Training Sessions and Locations • On-line Help • Provider Assistance: Train the Helper

31. Provider Kiosks St. Paul’s CDC

33. Comparison of Number of Observations We were expecting response rates to drop in moving from paper-based to web-based surveys. Instead going web-based produced a surprising increase in response rates for a primarily urban, disadvantaged population, making internet access barriers a myth.

35. Needs AssessmentGetting Better at IT • In-Care survey filled out by clients using Provider Access Points. • Out-of-care surveys administered via field teams. • In-Care Survey data available in real-time. No delay, no need for central data entry of paper. • Out-of-care surveys data entered into same central, integrated web-based database by field teams. • eCOMPAS performs initial analysis and graphical data presentation on both in-care and out-of-care, freeing up analysts to concentrate on drawing meaningful conclusions. • Data available immediately to all stakeholders. • Reports provided in an easy-to-use dynamic and visual format.

37. Complex Data Collection

38. Next Question Next Question Getting Better at IT- The System does all the work behind the scenes.

41. Selected Outcomes • Reduction / elimination of duplicate data entry. • 50% reduction of time in fee-for-service billing and other activities for providers, enabling more clients to be seen each day (and more quality time with clients) • Real-time feedback and improved data quality. • Federal reporting went from being a “nightmare” to a tool used for real-time data quality improvement. • Providers engaged in data analysis seeing its value for quality improvement.

42. Practical Lessons for Replication • Stakeholder engagement at all stages is key. • Incremental development allows for absorptions and refinement. • A web-based architecture reduces cost and maintenance headaches. • Being data rich does not means using the data to its fullest extent. A regular, structure process to leverage data analysis is a large commitment. • Quick feedback loops with real-time analysis are important to make midcourse corrections. • Be creative. Transforming a challenge (federal reporting) into a data quality improvement tool helped turn lemons into lemonade.

43. Be Flexible

44. Teamwork Makes a Difference

45. Strategy People Process Technology

46. SPNS Module Use

47. Appointment Adherence Has an Impact

48. Strategy People Process Technology

49. Conclusion • Implementing and sustaining HIT is challenging. • The costs of doing HIT wrong are significant. • HIT, done right, is worth time, energy, and investment. • Techniques, strategies, peers, and resources exist to help you. • The HIT Lifecycle Adoption Framework can help you touch the key bases in a structured way. • Focus on the process over the product, and choose your strategic partners and vendors wisely.

50. Workshop Evaluation