May 12 2016 Peer Recognition Reggina Yandila DO Provider EngagementService Excellence Champion Comments We wish there were two of her She is very dependable and works very ID: 681878
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Slide1
Semi Annual Provider Meeting
May 12, 2016Slide2
Peer Recognition
Reggina Yandila, D.O.
Provider Engagement/Service Excellence ChampionSlide3
Comments:
“We
wish there were two of her
.”“She is very dependable and works very hard. We would not be able to function as well if we didn't have her.”“She is an extension of us. Only thing she cannot do is the actual surgery.”Thank you Jennifer Ingham on behalf of your surgeons and Adena as a whole!
Recognition for Advanced Practice Provider!Slide4
Comments:
“She covers providers when they are off even though it is not expected of her.”
“She even covers providers when they are in meetings to make sure that patients are taken care of.”
“She goes above and beyond the call of duty.”“She is an angel.”Thank you Beverly Tolle on behalf of Adena Internal Medicine and Adena as a whole!Recognition for Advanced Practice Provider!Slide5
Recognition of Providers that Drive to Off SitesSlide6
Most Improved Provider 2015!Slide7
Congratulations!
Dr. Michael Jones
Most Improved Provider - 2015
Making a difference with Service ExcellenceSlide8
Most Improved Provider 1
st
Quarter 2016!Slide9
Dr. Jack Berno
Most Improved Provider - Q1 2016
Congratulations
!Slide10
Top Box
Dr. Kathleen Villarreal 100%
Dr. Wayne Beam 98.5%Dr. Robert Violette 98.1%Dr. John Gabis 97.8%
Marsha Ward, CNP 97.4%
Dr. John Boyle 96.9%
Dr. Shane Matheny 93.8%
Dr. James Thompson 93%
Dr. Lindsey Dohse 92.7%
Thank you for making a difference for our patients!
Congrats to our Top Providers 2016!Slide11
Pavilion Surgery
Most Improved Outpatient Service
Congratulations
!
Making a difference with Service
ExcellenceSlide12
Most Improved Provider for Communication!Slide13
Dr. James Fleming, Jr.
Most Improved Provider Communication
Congratulations!Slide14
Thank you for making a difference
!Slide15
Adena Medical Group
New Providers
Q4
2015 & Q1 2016H. Takaji Kittaka, MD, CMO, Primary Care
Anthony Freeman, DO,
CMO, Surgical Services
L. Wayne Coats, DO,
CMO, Medical SpecialtiesSlide16
Family Medicine
Julie Stone, CNPAdena Family Medicine – Greenfield Specialty
: Nurse Practitioner
Education:
Wright State
University;
Dayton,
OH
And
rea
Howard, CNP
Adena
Family Medicine – Hillsboro
Specialty:
Family
Medicine
Education:
Otterbein University;
Westerville
OhioSlide17
Interventional Pain Occupational Health Management
Jetta Sparks, CNP Adena Occupational HealthSpecialty – Occupational Health
Education:
Ohio
University;
Athens, OH
Andrew Porter, DO
Adena
Spine Center
Specialty:
Interventional Pain Management
Medical
School:
Philadelphia
College of Osteopathic Medicine
Internship:
Delaware
County Memorial Hospital
Residency:
University
of Maryland Medical Center
Fellowship:
University
of Maryland Medical CenterSlide18
OB/GYN Endocrinology & Diabetes
Kristin Newkirk, CNP
Adena Endocrinology & Diabetes Care
Specialty: DiabetesEducation: Otterbein
University; Westerville
, Ohio
Natasha Renault
, CNM
Adena
OB/GYN
Specialty:
Nurse Midwife
Education:
University
of Cincinnati; Cincinnati,
OHSlide19
AMG Operational Update
Chuck Gooder
Interim, VP for Adena Medical GroupSlide20
AMG Audit Team concept and implementation
Educational Coordinator position
AMG Compliance Specialist position
Coding Specialist in provider areaAMG Financial OfficerAMG President Interviews – May 17th
AMG Charter for AMG Advisory Council
AMG Operational UpdateSlide21
AMG Advisory Council Update
John Gabis, M.D.
Committee Chair/Senior Medical Director, Primary CareSlide22
To be a Forum
for
Discussion and Recommendations
to AMG AdministrationAdvance the mission and goals of AMG to ensure high patient satisfaction, provider quality of life, and the ongoing success and growth of AMG by:Maximizing AMG operationsContinuous Quality Improvement
Delivery of AMG clinical services and patient access
ChargeSlide23
Council Composition represents make-up
of
Adena
Medical GroupMedical Specialists (1)Primary Care (3) Surgical
Specialists
(3)
Advanced-practice
Providers
(2)
9 representatives, selected by AMG members
Staggered terms of 1 – 3 years
MembershipSlide24
Members
Dr. Emiley Blake
Adena
OB/GYN
Surgical Services; 1-yr
Dr
.
Brian
Cohen
Adena
Bone & Joint
Surgical Services; 3-yrs
Dr. Adam Esham
Adena
Urology
Surgical Services; 2-yrs
Dr. John Gabis
Pickaway-Ross Family
Primary Care; 1
-yr
Dr. Richard Mizer
Adena
Family-
G’field
Primary Care; 2-yrs
Dr. Collins Okolie
Adena
Internal Med
Primary Care; 3-yrs
Dr. Tom Lewis
Adena
Dermatology
Specialty Svc; 2-yrs
Beverly Tolle, CNP
Adena
Internal Med
Adv. Practice; 3-yrs
Deb Wolf, CNP
Adena
Family-
G’field
Adv. Practice; 2-yrs
Chair
Vice ChairSlide25
To ensure
communication is being
provided
and discussed with AMG physicians and advanced-practice providers on projects and initiatives before they happen.Members to be liaisons to their peers in their respective departments/services on topics discussed, and to bring peer input back to the Council.
Role of Council/MembersSlide26
Inaugural Meeting held
Apr. 12, 2016
Meets the
2nd and 4th Tuesday of each month at 7:30 a.m.3 meetings to dateRamping up and developing a healthy RAIL of items for future discussion and recommendations
Meeting FrequencySlide27
Current RAIL
AMG Advisory Council Agenda Item (RAIL)
ACTION
1
Physician Compensation Policy
2
Medical Director payments
3
GME Resident payments
4
Process and Capability of the Central Authorization department for AMG
5
AMG vision
6
Strategic Plans
7
Provider Communication Plan Overview (draft could be ready by May 10 meeting)
8
Patient Advisory Council Input
9
AMG Requirement for MA certification
10
IHS
provider score card
11
Service Line Modeling and update for consideration
12
Budget reporting
13
President, Adena Medical Group job description
14
Legal Support for AMG
15
Provider Contracts - What should we be including in the contracts? Citizenship?
16
Provider Engagement Committee
17
Discussion regarding evaluations for Advanced Practice Providers
18
eRX - Meaningful UseSlide28
Council Charter and Responsibilities
AMG Leadership Recruitment
Job Description for President for AMG
Recruiter on site May 17AMG Administration StructureEducation, Compliance
Compensation Policy Update
Draft
to be presented to Council in a few weeks
Initial Discussion ItemsSlide29
Audit Process
Model Clinic Audits
How data will be used
What is the routine audit process?Provider ScorecardRole of scorecard
Not intended for evaluation purposes
Ease of access to data and benchmarking info
Recognize under and over performance
Initial Discussion ItemsSlide30
Prior-Authorization/Denials
Service to providers
Free-up office staff to service patients/providers
Assure patient coverage/benefitsBulk calls to major payers – time savingsAvg. timeline for prior-authorizations/denial
Stat = 45 min
High priority = 1-3 business days
Average rate = 3-5 business
days
Documents
common denial issues for further action/research
ie
:
breach of contract by payer
Initial Discussion ItemsSlide31
MA Certification
Requirements for hiring certified MAs
Certification expectation of current MAs
Meet Meaningful Use Requirements – order entryCommunication Plan OverviewPlans for effective two-way communicationRequest for input into what providers need/prefer in terms of communication
Pt Portal/CLPP Recommendations
Timeliness to get patient data on portal
Inpatient = 36
hrs
post discharge/Outpatient = 4 days
Initial Discussion ItemsSlide32
Make regular contact with your representative
Ask questions
To your AMG Advisory Council representative(s) re: items of concern and/or for inclusion on Council agenda
To your clinic leadershipTo AMG LeadershipEmail questions/concerns to physician@adena.org
Physician HR Liaison (Faitha Shelton)
fshelton@adena.org
Be involved
Making Your Council Work for YouSlide33
QuestionsSlide34
Acute Care Update
L. Wayne Coats, D.O.
Chief Medical Officer – Medical SpecialtiesSlide35
“I would like to thank
Dr.
Van Dyke
for his excellent comprehensive care of our patients, and also for his communication about his findings/treatment plans.”Dr. Kirk Tucker for his role as Chief Quality Officer and our continued “A”
grade
in the Leapfrog
Hospital
Survey
RecognitionSlide36
Pulmonary/ Critical Care
Dr.
Nickolus
Floudapor begins in the FallRecruiting NP DermatologyRecruiting APP
Internal Medicine
APP/ Physician
Cardiology
Contract negotiations with Lead Provider
Nephrology
Site visits/ Interview Provider #3
Endocrinology
Recruiting 2
Providers
Gastroenterolgy
Recruiting 1 ProviderRecruitmentSlide37
19 Change Control
documents
since Winter 2015
Red Shirt Rounding Monthly12/17 requests done/being workedOn hold for the near futureSome Meditech
tasks still incomplete
ICD-10,
problem lists
,
admit order
issues,
cover
function
Priority
PaksMay 26 and June 23rdBuild FreezeMedication Reconciliation gaps
Adena One/ INPATIENTSlide38
Denominator #
can include ED
and/or
InpatientSGRP 103Stage 2 Final rule>10% Discharge meds are e-scribed2% Medicare payment at risk in 2016
3% Medicare payment at risk in 2017
E-Scribing/ MUSlide39
E-prescribing Controlled SubstancesSlide40
Meditech Ambulatory
EHR
Update
Justin Smith, M.D.Adena Family & Internal Medicine – Waverly/ CLPP Committee MemberSlide41
Ambulatory Platform
Web-based
(HTML)
Integrated
Designed for touch screen
Providers, schedulers, codersSlide42
Overview of Build Team
Components of the Build
Physician Training/Education
Roll-out ScheduleOpportunities for FeedbackPresentation OutlineSlide43
Subject Matter Experts (SMEs)
Esham
, Dana
AllergyBauml,
Michael
Cardiology
Gallina
,
Kelly
Derm
-Gen
Lewis,
Thomas
Derm-SurgSchuster, RebeccaENTGabis, John
FamilyMizer, RichardFamilyBrooks, Kathy
Gastro
Haidar
,
Wael
Inf
Disease
Coats, Wayne
Int
Med
Smith,
Justin
Int
Med
Villarreal, Kathy
IM/
Peds
Pargeter
, Kevin
Nephrology
Jones, Michael
Neurology
Blake,
Emiley
OB/
Gyn
Malinowski, Mark
Pain
Mgmt
Fortney, John
Pediatrics
Maranzana
, Alex
Pediatrics
Chamberlain,
Casey
PMR
Boyle, John
Podiatry
Johnson, Courtney
Pre-
AdmTank,
KunalPsychSaadla,
HavalPulmVan Dyke, Kenneth
RheumStrauch, BradleySports/Ortho
Spahn, ChristinSurgery
Johnson, StephenUrologyJepsen, Stephen
VascularSlide44
Clinical Core T
eam
Last Name
First Name
Type
Position
Practice/Role
Kennedy
Candice
S
Director (RN)
CTL
Burns
Brooke
P
Director
Primary Care
Taylor
Niki
P
Office
Mgr.
Piketon
Family
Agnew
Tina
S
Office
Mgr.
Surgery
Thornsberry
Penny
S
Office
Mgr.
ABJ
Jury
Stephanie
P
Office
Mgr. (
RN)
Pediatrics
Costlow
Jessica
P
Office
Mgr. (
RN)
Circleville
Family
Haynes
Sara
S
RN
Infectious Disease
Weaver
Melissa
S
LPN
OB/GYN
Elkins
Chris
S
MA
ABJ
Chandler
Jules
P
MA
Pickaway-Ross Family
Douglas
Tom
IT
IT Clinical Info Mgr
IT Acute Care Liaison
Schlick
Liz
IT
IT Systems Analyst
IT TechnicalSlide45
Documentation
History, ROS, Exam, A/P, procedures
Type, Dragon, point & click,
normals, quick texts, canned textOrder entryFavorites, order sets, standing orders, future orders
Tracking and capturing quality measures
Meditech
“protocols” are similar to
eCW
CDSS
ACO, PCMH, Meaningful Use,
AdenaCare
E-prescribing
First Data Bank, SurescriptsControlled substancesFaxing
Components of the BuildSlide46
Data Migration
Clinical continuity document (CCD)
Medispan
-linked medicationsStructured allergiesProblem list Vaccinations (in development)
Manual abstraction
Addition of 10 Med Assistants to facilitate go-live implementation
Provider verification
Components of the BuildSlide47
CCD Screenshot – MedicationsSlide48
CCD Screenshot – Problem ListSlide49
Components of the Build
Transition plan from
eCW
eCW tasks (labs, e-prescription requests, actions, telephone notes, etc.)Staggered Go-Live
Patient portal
New workflow analysis
Scheduling, chart-prep, check-in, encounter, check-out
Parallel testing
Impact of integration with current acute care EMR
Positives/negatives
Hardware/Equipment
Laptops, badge taps, printers, Dragon mics, POC testingSlide50
Session
I
e-Learning
Lesson via web in-serviceOverview of navigation of the Ambulatory Application Session II
Navigation
& Documentation and EMR
“Do’s & Do Not’s”
4 Hour Session: Classroom or e-learning options
E-learning
option is available for this session for
providers
Session
III
Clinical Scenario Simulation, Transition Planning, Set-Up in Live, E-prescribing Controlled Substances 4-hour session: classroom training only
Provider Training/EducationSlide51
Timeline: Go-Live ScheduleSlide52
Measure
:
For the entirety of 2016, 50% of all permissible prescriptions are:
Transmitted electronicallyQueried for drug formularyDoes not apply to controlled substances & DME
Purpose
:
To determine if a prescribed medication is covered under the patient's prescription plan
Allows the provider to more quickly identify formulary alternatives
Reduces patient/pharmacy calls to office for non-covered medications
Decreases non-adherence to pharmacologic therapy secondary to cost
Outpatient -
eRX
& Formulary VerificationSlide53
Current State
:
41 providers not meeting YTD goal as of
AprilRepresents approximately $350k loss of incentives3% Medicare provider penalty in 2018 if unable to meetProcess:
Scheduled visits
Same-day
visits
Telephone encounters
Electronic refill requests direct from pharmacy
Next Steps:
Work with your
manager
to ensure competency
Improve patient careeRX and Formulary VerificationSlide54
Meeting the eRX Measure
1. Select Rx Eligibility (eRX or Telephone Encounter)
2. Click on “Check RX Eligibility”
3. Close the pop up window
Slide55
New Prescriptions- Benefits of formulary checks
Formulary prescribing guides are available, when selecting a new prescription, if the eRX formulary has been run on the patient.
Green- Preferred Medication
Yellow- Higher Tier on patient’s plan
Red- Not Covered
Question Mark- Unknown Coverage Slide56
Work with your SME
Upcoming interactive demos
Post Go-Live Optimization
E-mail at jsmith5@adena.org or adenaone@adena.org Join a
Meditech
Focus
Group
Opportunities for Feedback/InvolvementSlide57
Questions?Slide58
Open Forum
Reggina Yandila, D.O.
Provider Engagement/Service Excellence ChampionSlide59
#1.
"
I am concerned about the appropriateness of having primary care providers follow-up on post-operative patients after major surgeries. Not just following up but having to manage the post-operative complications. After identifying what would be considered a post-operative complication I have tried to call the office of the surgeon only to get resistance to trying to get the patient in quickly to be seen. Also is there a standard to when a post-op patient should be seen by the surgeon that has done the procedure in particular more complicated surgeries? Also some patients who have had follow with the PA or NP still want to see the surgeon yet even after requesting this they are told to follow-up with primary care if they have questions. Have evaluated the liability with this practice and also the possible impact on patient satisfaction
?"Open Forum QuestionsSlide60
#2. “Can someone update us on what is going on with the ACO? It seemed at first that we were doing well as a system and then the follow-up reports were negative. Where does it stand now? What things are coming down the pipeline to make it better
?”
Open Forum QuestionsSlide61
#3. “Are there any updates on the Modifiers/Coding
?”
Open Forum QuestionsSlide62
#4. “Is there anything new that the Health System is aware of that will eventually affect provider compensation
?”
Open Forum QuestionsSlide63
Thank you!