ORYX Health Check Agenda - PowerPoint Presentation

ORYX Health Check

Agenda Time Topic 0815 - 0830 Introduction and Overview 0830 - 1000 Review of Quality Measures Tools 1000 - 1200 Reporting Portal Navigation 1200 - 1300 Lunch 1300 - 1500 Data Validation 1500 - 1600 Value Check 1600 - 1630 2019 ORYX Updates Discussion 1630 - 1700 Wrap-Up Day 2 Spill-Over Day

Review of Quality Measures Tools 3

Quality Measure Tracking Orders Perinatal Care Quality Measures tracking order embedded within OB Labor and Delivery Admission powerplan Immunizations, Substance Use, and Tobacco Treatment Quality Measures tracking orders are placed automatically by system because these are global ORYX measures

Quality Measures MPage Component

Quality Measures MPage Component Incomplete documentation (Blue) – offers direct link to documentation Complete documentation (Gray/dithered) – pulls snapshot of documentation into component Smart logic – some venues stay under Complete until applicable to patient. Description reflects documentation needed before venue is applicable and moves to Incomplete

Quality Measures Summary MPage Access the Quality Measures Summary dashboard from the upper toolbar

Quality Measures Summary MPage

Quality Measures Summary MPage

Daily Report Tab Access the eQuality Check abstraction tool from the upper toolbar. The abstraction tool is embedded within the EHR.

Concurrent Tab The Concurrent tab lists patients who are in the process of abstraction while still in the hospital and have not yet been discharged.

Abstractor View 1:49 PM

Abstractor View

Abstractor View Attribution Overview:

Discharged Tab

Completed Abstraction Tab Displays patients for which abstraction has been completed Abstractors able to edit a case after it has been completed by going back into abstractor view, making the necessary changes, then marking the case as Completed from the Check Status form

Patients discharged during the month of July August 15 th : First Global sample pull for July September 15 th : First Global sample pull for August October 15 th : First Global sample pull for September November 15 th : First Global sample pull for October September 14 th : Last Global sample pull for July* October 14 th : Last Global sample pull for August* November 14 th : Last Global sample pull for September* August 18 th : First Non-Global sample pull for July September 18 th : First Non-Global sample pull for August October 18 th : First Non-Global sample pull for September November 18 th : First Non-Global sample pull for October *Once the sample population has been captured, the system does not reduce the number of cases below this initial point. If data updates to remove prior cases from a measure new qualifying cases are added to the Discharged tab daily to make up the difference in sample size. September 30 th : Last Non-Global sample pull for July* October 31 st : Last Non-Global sample pull for August November 30 th : Last Non-Global sample pull for September*

Cerner’s Quality Clearinghouse 18

Reporting Portal Navigation 19

Reporting Portal

Core Measures – ORYX v5.2 and After Once you are in the Reporting Portal select the Categories drop down on the left side of the screen (left) Then navigate to the ORYX check box and select it (right) This filter displays measure-specific reports for the different ORYX versions

Opening a Core Measures Report To open and run a report select the measure and version that you would like to run Once you have selected the measure, click the Run Report button

Running a Core Measures Report Now that the Report has been opened, refresh the report to determine a specific timeframe Highlighted in the screenshot to the left is the refresh button that will prompt for a date and time period of data After selecting refresh, enter desired begin and end date and time. Then choose Aggregation Method by HCO and run report for your associated facility

Navigate and Review Report Select a tab to see desired view of measure data (see notes for description of each)

eCQM – eMeasures 2017 and After Once you are in the Reporting Portal select the Categories drop down on the left side of the screen (left) Then navigate to the eMeasures check box and select it (right) This filter displays measure-specific reports for the different eCQM versions

Opening an eMeasures Summary Report To open and run a summary report select the measure and version (reporting year) of report you would like to run Once you have selected the measure, click the Run Report button

Running an eCQM Summary Report Now that the Report has been opened, refresh the report to determine a specific timeframe Highlighted in the screenshot to the left is the refresh button that will prompt for a date and time period of data After selecting refresh, enter desired begin and end date and time. Then choose Aggregation Method by HCO and run report for your associated facility

Navigate and Review Report Select a tab to see desired view of measure data (see notes for description of each)

Opening an eMeasures Audit Report To open and run an audit report, select the measure and version (reporting year) of report ending in “Audit” Once you have selected the measure, click the Run Report button

Running an eCQM Audit Report Now that the Report has been opened, refresh the report to determine a specific timeframe Highlighted in the screenshot to the left is the refresh button that will prompt for a date and time period of data After selecting refresh, enter desired begin and end date and time. Then choose Aggregation Method by HCO and run report for your associated facility

Navigate and Review Report Select a tab to see desired view of measure data (see notes for description of each)

Reporting Education References Chart-Abstracted ORYX Measures eMeasures

Data Validation 33

Chart Abstracted Measure Validation

eMeasure Validation Process* * Recommend validating only quarter selected for submission and validation each month within quarter after month ends. (since algorithm runs the same way throughout the measurement year for all patients per eMeasure can validate sooner even though selected validation cases may be skued toward beginning of month)

Value Check 36

Value Driven Consulting Framework

Value Priorities 38

Understanding DoD’s Priorities 39 Maximize the full capabilities of MHS Genesis (proactively monitoring ORYX) Meet or exceed national average for all ORYX measures Focus on PC and IMM enterprise-wide

IOC 2017 Successes All IOC sites’ PC-01 at 0%; national average 2% IOC sites’ cumulative PC-05 average at 78%; national average 52% Madigan PC-03 at 100%; national average 98% Bremerton IMM-2 at 96%; national average 94% Oak Harbor SUB-1 at 93%; national average 90%

Guiding Principles 41 Aligned with your organizational imperatives Focused list (3-4 recommended) Understand outcome vs. process Actionable Measurable Examples: IOC sites will improve the number of patients diagnosed with Ischemic Stroke who receive all applicable discharge medications by 10% by the end of Quarter 1, 2019 Madigan will demonstrate a consistent downward trend in ED decision to admit to ED Discharge time (measure monthly and averaged quarterly) by the end of Calendar year

Core Measure Opportunity – IMM-2 IOC Q1 2018 Average: 69.2% National Average 2017 : 94% State Average 2017: 92% Root Cause Discussion:Majority due to no action taken after “unknown” or “not received” documented on admissionNot all patients concurrently tracked for Immunizations Quality Measures Few instances of documentation to meet measure missed during abstractionOutcome/Goal: Ensure all patients are being concurrently tracked for IMM-2 during flu season Educate clinicians against workflow to either provide vaccine or document contraindicationEducate abstractors about where documentation is found Meet national average for 2018-2019 flu season Immunization rule allowing concurrent monitoring of all inpatients > 6 months for flu vaccination status during flu season Influenza Vaccine Screening PowerForm as part of the Admission Process

eMeasure Opportunity – ePC-05 IOC Q1 2018 Average: 56.3% National Average 2017 : 52% State Average 2017: 74% Root Cause Discussion:Newborn feeding documented before newborn admission date/timeNewborn feeding not documented within patient chart Outcome/Goal: Investigate and educate against appropriate newborn admission workflowEnsure clinicians are documenting newborn feeding during patient stay Ensure all newborns are tracked for PC-05 and clinicians are reviewing component before newborn dischargeMeet state average by end of calendar year Perinatal Care Quality Measures tracking embedded within newborn admission ordersets Discrete Infant Feeding documentation within recommended clinical workflow

2019 ORYX Updates 44

ORYX 2018 Requirements Review 45

ORYX 2018 Requirements Review 46

Chart Abstraction 2018 47

eMeasures 2018 48

TJC Updates Waiting for 2019 Final ORYX requirements to be released mid-September New PC-06 Measure New CSTK-01 and STK-OP-1 stroke measures New CQL eCQM formatting in 2019 49

Chart Abstraction 2019 50

eMeasures 2019 51

OQR 2018 vs 2019 52

CQL eCQM Formatting 53 2018 2019 Code Language HQMF CQL Specification Human Readable Human Readable

Apr 30 TJC Q4 2018 submission deadline Jan 31 TJC Q3 2018 submission deadline Submission Deadlines 54 2018 2019 Q1 Q2 Q3 Q4 Q1 Q2 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May June 15 Cerner Q1 2018 lock date July 31 TJC Q1 2018 submission deadline Oct 31 Cerner Q1-Q3 2018 lock date Jan 15 Cerner Q4 2018 lock date Mar 15 TJC 2018 eCQM submission deadline Sept 15 Cerner Q2 2018 lock date Oct 31 TJC Q2 2018 submission deadline Dec 15 Cerner Q3 2018 lock date Mar 15 Cerner Q4 2018 lock date

Quality Reporting uCern Resources 55 Hospital Quality Measures – Meaningful Use and Core Measures uCern Provides both eMeasure & chart-abstracted ORYX updates. Includes Cerner content/solution changes, specification updates, and other relevant information surrounding ORYX Cerner Quality Clearinghouse uCern Messaging about submission and dashboards Reporting and Outcomes Ideas uCern Forum for enhancement suggestions/ideas from clients to ORYX development team Illuminations for Clients uCern Provides web-based presentations that focus on functionality and regulatory landscape updates. Illuminations are not ORYX specific and may include functionality enhancements that DoD is not adopting.

Quality Reporting Wiki Resources 56 Core Measures and eQualityCheck Reference Pages Education around chart-abstraction ORYX support and functionality Meaningful Use Hospital eCQMs Reference Pages Education around eMeasure /eCQM ORYX support and functionality