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Patient-Centered Medical Home NCQA’s PCMH 2011 Standards Training Webinar # 8 David Halpern, MD, MPH March 28, 2012 Legal Disclaimer © Copyright 2011 North Carolina Community Care Networks, Inc. All rights reserved. The content set forth herein is made available on an “as is” basis without representation or warranty of any kind and solely for use and distribution by primary care physicians, without modification and only so long as the content of this footer is reproduced on every copy thereof, in connection with the internal activities of their respective not-for-profit organizations to secure NCQA recognition as patient-centered medical homes. All other uses of or modifications to the content set forth herein without the prior express written approval of North Carolina Community Care Networks, Inc. are strictly prohibited. Works copyrighted by third parties and included herein are used with the permission of the respective copyright owners in each case. Acknowledgements Let’s Review • Standard 3 – Plan & Manage Care – PCMH3A: Implement Evidence-Based Guidelines – PCMH3B: Identify High-Risk Patients – PCMH3C: Care Management - MUST PASS – PCMH3D: Medication Management – PCMH3E: Use Electronic Prescribing Let’s Track Our Progress • • • • • • Standard 1 – Enhance Access/Continuity Standard 2 – Identify/Manage Populations Standard 3 – Plan/Manage Care Standard 4 – Self-Care Support/Resources Standard 5 – Track/Coordinate Care Standard 6 – Measure/Improve Performance Today’s Agenda • Interactive Survey System (ISS) • Record Review Workbook (revisited) • Questions Interactive Survey System (ISS) What Is the ISS? • The ISS is the web-based PCMH practice selfassessment or survey. • The practice uses the ISS (also called the “Survey Tool”) for: – Entering responses for each item (Standards/Elements/Factors) – Attaching documents and providing text to support their responses Using the ISS For each Element, you MUST: • Add/Upload a Document • Link the Document to an element • Add Supporting Text (if necessary) Using the ISS – Demonstration Cautions • In order to finalize your survey, you must first complete and submit your PCMH APPLICATION (different from the Survey Tool). This was “purchased” when you obtained your Survey Tool. There is a separate log-in process. If you forgot to order one of these free applications when you got your survey (or can’t find the email with your log-in info), you MUST contact NCQA and get one ASAP. Cautions (continued) • After you have added/uploaded and linked your supporting documents AND completed your application, you must submit your survey. The application process is not complete until you’ve submitted: 1. Your completed APPLICATION (demographic practice info) 2. Your completed SURVEY (PCMH answers & supporting documentation) Application Fee Discount • All CCNC practices are eligible for a 20% discount on their final NCQA application fee. • To get this discount, you must identify yourself to NCQA as a practice affiliated with CCNC and you must provide them with a discount code. • To obtain the CCNC discount code, please email me at [email protected] and provide your name, practice name, and CCNC network Record Review Workbook (revisited) What Is the “Record Review Workbook”? • Elements 3C, 3D, 4A – Require medical record abstraction of data – Need % of patients meeting the element (based on a numerator and a denominator) • Two methods to collect and submit patient data – Method #1 - report from the electronic system – Method #2 - Record Review Workbook • Excel workbook in the Survey Tool • Tool to identify a sample of patients and abstract data needed for Elements 3C, 3D, 4A Using The Workbook 1. Find Workbook in Survey Tool 2. Download and save file to computer 3. Review instructions and data needed from patient records 4. Select patient records to review 5. Review patient records for data 6. Enter data in Workbook 7. Enter numerical result in Survey Tool 8. Link Workbook to Survey Tool Selecting Patients for Workbook ~ Use same 48 patients for EACH Workbook Element ~ STEP #3. • Use appointment or billing system to identify patients with visit on June 5th • Choose every patient with any of 3 clinically important conditions who had a visit on this date that was related to the important condition STEP #1. START DATE = Today’s date February 15th STEP #4. Continue choosing patients going back on consecutive dates until you have selected 48 patients STEP #2. Go back 30 days = January 15th RRWB = Supplemental Worksheet Click here RRWB Tabs Three tabs Instructions Patient Conditions Record Review RRWB – Enter Important Conditions Enter three important conditions here including an unhealthy behavior/mental health or substance abuse AND high-risk or complex patients, IF you are including them. RRWB – Enter Conditions Enter conditions from drop down menu, for example: Diabetes Hypertension Depression High Risk/Complex RRWB – Enter Data Entering NOT USED in row 1 “grays” out the column Response Options Yes No Not Used Not applicable RRWB – automatically calculates the % of Patients that met factor Patients that Met Factor Number (33/48) Percent (69%) Result for ISS Enter RRWB Responses in Survey Tool Enter responses From RRWB Yes or No AND Percent Questions? Community Care PCMH Team • David Halpern, MD, MPH Community Care of North Carolina (CCNC) • R.W. “Chip” Watkins, MD, MPH, FAAFP Community Care of North Carolina (CCNC) • Brent Hazelett, MPA North Carolina Academy of Family Physicians (NCAFP) • Elizabeth Walker Kasper, MSPH North Carolina Healthcare Quality Alliance (NCHQA) Questions? Feel free to contact me: David Halpern, MD, MPH (215) 498-4648 [email protected]