integrating our community partners for a more accountable organization presented by: jon holmes,...
TRANSCRIPT
Integrating our community partners for a more accountable
organization
Presented By:Jon Holmes, Christopher Kelly & Himabindu Moram
Accountable Care Organization
• VisionWe will be a clinically integrated health care delivery system that is the health provider of choice in Phoenix and recognized nationally for quality, service and community programs.
2011 AT A GLANCE
600,000 patient visits to our hospitals, physician and specialty practices.
36,391 emergency food boxes for the community.
9,749 visits to Adult Day Health Care.
3,849 employees in the Network.
3,100 children served at the Children’s Dental Clinic.
1,902 volunteers with 194,491 hours of service.
1,111 physicians on our combined medical staffs.
69 new homeowners created through Neighborhood Renewal.
Accountable Care Organization
The 203-bed hospital with all private rooms excels in emergency heart care, pediatricemergency and inpatient care, orthopedics, and many other specialties.
48,125 inpatient days and outpatient days.25,946 patient visits to the 24/7 Children’s Emergency Center, Mendy’s Place, part of the Virginia G. Piper Pediatric Center for Excellence.
48,950 patient visits to the Emergency Department.
John C Lincoln Deer Valley Hospital
The 266-bed hospital is a two-time recipient of the prestigious Magnet designation for excellence in nursing care from the American Nurses Association as well as the home of two nursing units honored with the Beacon Award for Critical Care Excellence.
71,917 inpatient days and outpatient days.
50,393 patient visits to the Emergency Department.
3,098 individual patients who needed Level 1 Trauma care.
John C Lincoln North Mountain Hospital
ACO ParticipantsJohn C. Lincoln Health Network – North Mountain HospitalJohn C. Lincoln Health Network – Deer Valley HospitalJohn C. Lincoln Health Network – Desert Mission, LLCJohn C. Lincoln, LLCJohn C. Lincoln Comprehensive Women's Center, LLCJCL Gastroenterology, LLCNorth Valley Internal Medicine, LLCJCL Neurology, LLCJCL Urgent Care, LLCBreast Imaging Specialists of Arizona, LLC
Accountable Care Organization
With 1,111 physicians on our combined medical staffs, are we maximizing our core beliefs and vision C.A.R.E. service standards
Are any physician practices or critical services a broken link?
• Incorporate the remaining JCL network practices JCLMyChart
• Work with other physician practices to build an EDW
• Integrate transfer center for EDW (trauma, cardiovascular, stroke)
• Capture data from our pre-hospital service providers
• Values– Quality, Safety and Efficiency: We measure
ourselves against the highest benchmarks of quality and safety while maintaining and continuously improving our efficiency, effectiveness and our capacity to heal and to help.
– Community Benefit: We anticipate community needs and find new ways to meet them. We do this through increasing community access to health services, and by providing service programs that foster sustainability.
– Growth and Regional Collaboration: Positive, well-managed growth and collaboration to integrate care allows us to impact and positively influence more lives.
– Clinical Integration: We believe that patients can be best served through a collaborative and integrated partnership of hospitals, physicians and payers; along with other providers and care facilities.
How can we accomplish better C.A.R.E Service Standard?
JCLMyChart Personal Electronic Health Record
For patients of John C. Lincoln Physician Network Practices
JCL’s initial response to connecting partners…
Utilizing JCLMyChart:
Arcadia Family ClinicBeatitudes CampusNorth Phoenix Medical ClinicSquaw Peak Family MedicineSun Valley Family MedicineCalavar Family MedicineDearing Family MedicineDeer Valley Family PracticeNorth Valley Internal MedicineSaguaro Family PracticeDel Lago Family MedicineDynamite Creek Medical CenterGavilan Peak Family PracticeJohn C. Lincoln Urgent Care at AnthemNew River Medical OfficeTramonto Crossing Family MedicineDeer Valley MedicalHarbor Pointe Internal MedicineNorth Valley Audiology*
Not Participating:
John C. Lincoln LifeStream at ThunderbirdJohn C. Lincoln Your Family MedicineJohn C. Lincoln Wellness ElementsJohn C. Lincoln LifeStream at YoungtownCare for Women Deer ValleyCare for Women North MountainNorth Mountain Radiology GroupNorth Phoenix PulmonologyNorth Valley GastroenterologySpecialists in Natural Medicine
*only 1 specialty practice utilizing system
JCLMyChart Personal Electronic Health Record
• Trauma• Medical• EMS
• Aneurism
• CVA & TIA• Seizure
• STEMI• NSTEMI• EP studies
Cardiology Neurology
TransferVascular
Community Partners & Vital Data
• Security• Information Sharing• Variation of technology
among service providers• Budget limitations• Providers seeing this as a
priority• Resources• Change
• Create a central depository for outside information
• JCL houses the EDW • Partners can use existing
systems• Improves Quality Data
Reporting• Creates opportunities for
improvement
Key Challenges
You are only as strong as your weakest link…
Moving Patient Care and Assuring Quality Patient Outcomes
A Path to Connectivity…
OutpatientJohn C. Lincoln
Physician Network
Outpatient and Inpatient John C Lincoln North Mountain Hospital
Inpatient , ED, and OrthopedicsJohn C. Lincoln
Deer Valley Hospital
• Three institutions:• Separate
administrations• Separate IT
infrastructures• Must collaborate!!!• Quality metrics• Coordination of Care
• Sharing of data facilitates collaboration
John C Lincoln ACO
John C. Lincoln Physician Network
eClincalWorks
John C Lincoln North Mountain Hospital
EPIC
John C. Lincoln Deer Valley
HospitalCerner
• Three institutions• Three EHRs• Problems “talking”
between systems• Is patient X in Cerner the
same patient in EPIC?
John C Lincoln ACO
JCL Deer Valley
JCL Physician Network
JCL North Mountain Hospital
Cerner Report
EPIC Report
eClincialWorksReport
Reporting Today
JCL Deer Valley
JCL Physician Network
JCL North Mountain Hospital
JCL EDW
JCL ACO Report
Reporting with EDW
• Ability to create performance dashboards
• Physician dashboards that summarizes patient condition across all JCL institutions.
• Patient portals to their own information
Benefits of an EDW
Benefits of an EDW
• Ability to create performance dashboards
• Physician dashboards that summarizes patient condition across all JCL institutions.
• Patient portals to their own information
• Ability to create performance dashboards
• Physician dashboards
that summarizes patient condition across all JCL institutions.
• Patient portals to their own information
Benefits of an EDW
• Agreement from each institution.
• Financial support for a three year pilot of the EDW. – Hardware– Personnel
Year 1 Year 2 Year 3 Total
Hardware $500k 0 0 $500k
Maintenance $54k $54k $54k $162k
Personnel $600k $600k $600k $1,800k
Total $1,154 $654 $654 $2,462k
Requirements for EDW
Information is power… Sun Tzu
Next steps in connecting the network
ESTABLISH– Steering Committee– Guidelines– Workflows– Policy and Procedures– Rules and Regulations
Process Change– Imbed meaningful use
into culture today– Align with ACO measures– Lean Six Sigma– Leverage best practices– Use of specialized
consulting firms– Potential for revenue
generation with successful changes
Operational Transition
Communications
• E-mail distribution groups• On-line Survey• Web-based questionnaires• Alternative electronic multi-media • blogs, website, etc
• Formal presentations • “Lunch and learn” education
sessions (offer CMEs)• Attend BoD meetings
Stakeholder Analysis• Essential stakeholders must be
identified and engaged
• Physician’s and nurses input should be proactively sought early in the decision making process
• Active involvement of stakeholders will facilitate end user to accept new system
• Engaging provider participation may be challenging
• Hospital will need to put in place special initiatives in order to engage partners early
Quality - Becoming an organization that emphasizes and adopts cooperation, savings, quality, more use of evidence-based medicine, more use of data and information technology (Harolds, 2010)
Improved
cooperation
EHR,
Screenings, EBM
Web based information
made available
Group educational sessions on diagnosis
Decision-aided support
in orderingexams
UtilizingNurse
Practitioners&
PhysicianAssistants
“e-visits”
Quality Care
• Beacon Award for Excellence in Critical Care
• Magnet Nursing Hospital• Chest Pain Center Accreditation• Heart Failure Center Accreditation• Primary Stroke Center Accreditation• Breast Imaging Center of Excellence• Blue Distinction Center for Knee and Hip
Replacement• Best Workplaces for Women Awards• Best Places to Work - Valley of the Sun• Business Woman of the Year• Arizona Pioneer Award for Quality
• U.S. News and World Report's Best Hospitals• Premier QUEST Award for High-Value
Healthcare• Premier QUEST Award for Top Performing
Hospitals• Outstanding Trauma Center and Outstanding
Trauma Surgeon Awards• Gold Medal of Honor for Organ Donations• Volunteer Heart of Business Award• Health Leadership Award• Lifetime Achievement Award Finalists• JCL.com: One of the World's Top 25
Healthcare Provider Websites
Awards & Honors: 2008 - 2011
Conclusion