© 2015 the verden group wrestling the beast of pcmh your partner in practice op user’s conference...

© 2015 The Verden Group

Wrestling The BeastOf PCMH

Your Partner in Practice

OP User’s ConferenceApril 23-25, 2014


Getting Started


Getting Started – Understand Requirements

First, understand the requirements and concepts

1. Understand the purpose• http://www.youtube.com/embed/ZC4YCLG4h5k

2. Read the Standards thoroughly. Then read them again!

• http://ow.ly/uX6zZ

3. Take the trainings (online or in-person)

• http://ow.ly/uX6KJ

4. Visit practices who are already medical homes and network to learn best practices

• http://recognition.ncqa.org/

http://www.youtube.com/embed/ZC4YCLG4h5k

http://ow.ly/uX6zZ

http://ow.ly/uX6zZ

http://recognition.ncqa.org/


Getting Started – Where Are You Today?

Second, figure out where you are in the process and what points you may already have:

➢ Scan through the Standards and check off -

• What you are you already doing

• What processes you need to adjust

• What you need to build

AND / OR you can take the PCS free survey and we will help you determine your ‘gaps’ . . .


Take the PCS Online Survey

▪ Complete to the best of your ability – keep it simple▪ We will provide feedback to show you where you are

today▪ It will help to set up your project plan by identifying

the areas in which you need to do the least work (quick hits) and the most work

▪ Yes, it is FREE for OP Clients!

https://www.theverdengroup.com/application-process/

PCS Survey

https://www.theverdengroup.com/application-process/


Example of the Survey


Getting Started – Have Points Already?

Third, what points can you get through OP?

➢ OP has applied for ‘pre-validation’ points for 2014

• This means that you will receive credit for certain factors simply by having OP’s EMR . . .

You may be able to get up to 6.375 points just for being an OP Client!


Example of How Pre-Validation Points Work


Getting Started – MU Points?

Fourth, what points do you already have from MU1?

➢ If you are already doing MU, identify all MU related factors for which you already have the data collected

MU1-MU2 PCMH Crosswalk:


Fifth, Build & Train Your Team

➢ Form a PCMH team comprised of at least:

• A physician ‘champion’ for each location

• A nurse / clinical manager

• An office manager

➢ Train the members of your PCMH team

➢ Share information across the practice and keep EVERYONE informed

Get Buy In


• Who should you have on your team?▪ Clinical▪ Administrative▪ Physician Champion

• How frequently should you meet?• How will you stay on track with the project?• Who should receive training?• What training is necessary?

▪ NCQA online webinars▪ NCQA in-person training

The Team and The Plan


Tools & Support

➢ OP has a PMCH module that includes the following features:

➢ PCMH Reports bundle via QIC

➢ Access to the PCMH user roadmap

➢ PCMH reports webinar to review the OP generated reports

➢ OP has great information, including a Roadmap, available here:

PCMH User Roadmap

Utilize Your Resources!

https://docs.google.com/a/connexinsoftware.com/spreadsheet/ccc?key=0AtMoV6rnP_T1dDdzTkN0TTN2Uml1dkxOU25CRWRuY2c&usp=sharing


Setting Up Your Project


Put in place basic project management controls:

• Break down the work that needs to be done

• Start with the most important tasks first (not chronologically!)

• Set a timeline to accomplish each item

• Create an organized process for compiling the data and documentation that will be submitted to NCQA

• Have standing meetings on a weekly basis

• Share regular updates with staff in the form of memos

Apply Project Management Principles


• Walk through every task, in front and behind the scenes, and follow the patient flow through the office

• Look for these key items:▪ Are there formalized policies and procedures ? ▪ Technology utilization beside an EMR, what else does

your practice have that you can leverage for recognitiono Website? o Patient Portal? o Recall system?

Catalogue What You’ve Got


• Keep detailed notes during your assessment▪ Enter it right into your plan. This is your

roadmap to tracking the changes needed to transform

• Keep it simple▪ If you are not sure about something, note

that and keep moving through the ‘assessment’

Catalogue What You’ve Got


Tackle the major pieces first:

➢ Figure out what ‘conditions’ you want to focus on first and set up visit templates for those

• While you work through the rest of the project, those most important pieces of data will already be in the process of being gathered

➢ Figure out the best ways to identify and stratify your ‘high-need’ patients (vulnerable and high risk populations)

➢ Determine what data you can get at readily for items like recalling, tracking preventive care and immunizations and improving quality

Focus On The Important Work First


Zero in on Red first and make decisions about important conditions. Implement Green early – these are the processes that are easiest to adapt. Understand what you need to do for Black and plan accordingly as you work through the project.


Tackle the Conditions and ‘Must Pass’

Elements First


Recap - How the Scoring Works


Focus on Must Pass & High Scores


Processes & Procedures


Set Up Protocols

• Create visit templates for your important conditions

▪ The longer you are collecting data, the more likely you will reach your percentage targets when it comes time to compete the workbook.

• Set up Standing Orders and utilize them▪ Example (2D4): testing protocols, defined triggers

for prescription orders, medication refills, vaccinations, routine preventive services


Processes Preformed But Not Written?

• First, use what you’ve got▪ Job descriptions, meeting notes, training handouts etc.

• Start drafting! ▪ Don’t do an individual policy or procedure for each

factor - group them together, and keep it simple ▪ Have everyone pitch in

• Ask staff to draft what they do and those can be edited / refined from there


No Process At All?

• Start by adding the easy ones first▪ Example – collecting race & ethnicity, PCP

➢ Have your staff begin doing that right away. ➢ The longer you have them collecting data, the

more likely you will reach your percentage targets when it comes time to submit your supporting data and documentation

OR▪ Take a short cut and purchase MGMA’s fully

customizable Policies and Procedures templates if you do not have any of your own- http://www.mgma.com/store/books/electronic/patient-centered-specialty-practice-medical-home-p

http://www.mgma.com/store/books/electronic/patient-centered-specialty-practice-medical-home-p

http://www.mgma.com/store/books/electronic/patient-centered-specialty-practice-medical-home-p


Manage Your Documentation


Capture As You Go▪ Create a ‘Master Copy’ binder / electronic file folder and

have one person manage it▪ Keep working versions and final versions separate to

avoid version control issues▪ Tag documents with the specific factors that each

section is addressing using Word notes, PDF markers, etc.

▪ Consistently name your files specific to the Element and Factor(s) addressed

Use a tool like Basecamp!

Compiling the Material


There Are Resources Available to Help You!


AAP Resources: www.pediatricmedhome.org


PCS PCMH Program Project Management and PCMH Consulting Packages in Conjunction with OP


Contact Information

The Verden Group, IncYour Partner in Practice

www.TheVerdenGroup.com

Susanne Madden, MBA, NCQA [email protected]

Julie Wood, MSc, NCQA [email protected]

Q & A

http://www.theverdengroup.com/

mailto:[email protected]

mailto:[email protected]

© 2015 the verden group wrestling the beast of pcmh your partner in practice op user’s conference...

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