MeHI - HIway Implementation Grantee Feedback
- 1. HIway Implementation Grantee Feedback
- 2. Our Grantees and Collaborators Cross the State • • GREEN BLUE grantees collaborators
- 3. Grantees and Collaborators by Organization Type 0 Hospital, Acute Care Group Practice Community Health Center Health System Behavioral Health Clinic Skilled Nursing Facility/Network HIT Vendor Home Care Agency Physician Network Visiting Nurse Network Accountable Care Organization Government Agency, State and Local Health Information Exchange Health Insurance Plan Independent Practice Association (IPA) Sole Proprieter Hospice Care Agency Hospital, Rehabilitation Laboratory Network Ambulance Service 2 4 6 8 10 12 14 16 18
- 4. How do grantees intend to use the HIway? • Use Case ranking by type Send Receive 17 Send Care Summary 9 Send Referral Request Receive Care Summary 13 Receive Referral Request 5 Receive Discharge Summary 5 6 Send Hospital Discharge Summary Send Lab Results 2 Send Hospital Discharge Notification 2 Medication Reconciliation 2 Receive Lab Results Send Lab and Radiology Orders Send Imaging Notifications Receive Imaging Notifications 1 Receive Hospital Discharge Notification 1 Receive ED Visit Summary 1 1 1 1 Send Hospital Admission Notification Receive Lab Orders 1 1 Send enrollment/admission and … 1 Send ED Admission Notification 1 Send CANS Data to MDPH 1 0 10 20 0 2 4 6 8 10 12 14
- 5. What are grantees measuring? • “Reduce readmission of Heart Failure patients with the use of clinical information exchange “ • “Reduce duplication of diagnostic tests” • “Number of re-admissions within 30 days for patients discharged from a Hospital to a Long-term Care facility” • “Number of patient records, or partial patient records, that have been electronically shared with the trading partner using the MA HIway” • “Average turnaround time from receipt of lab result to entry into EMR”
- 7. Top reported issues • • • Vendor Relations – Coordination and cooperation – Active engagement early in the process – HISP charges Connectivity – Clarity about cost, effort and best method – HISP-HISP coordination – Directory – setup, availability Time and resources – Resource dedication to project – Processing time and cost – Tight timeline and budget
- 8. How Grantees rated their experience connecting to The HIway 19 20 17 18 16 14 14 12 10 10 8 4 1 Consistent With Expectation More Than Expected 7 6 6 2 Less Than Expected 2 2 0 Level of Effort Time Resources Available
- 9. How Grantees forecast their efforts We asked Grantees to assess their confidence on two aspects of their grant. 1) 2) to meet the objectives of their grant, and to spend all their funds. This table reflects their feedback. 25 – 49% 50 – 74% 75 – 99% 100% Meet grant objectives 0 5 6 19 Spend all funds 1 5 5 19 Assess confidence to… NOTE: There are many reasons a Grantee may not spend all their funds. For example, on a more positive note, their costs are less than expected. Conversely, they may be unable to move through their milestones for any number of reasons. 9
- 10. Grantees offer feedback & lessons learned • “Flexibility. Plans change and evolve despite pre-planning and discussions. Our route to the highway changed, changed back and then changed again through the course of our developing the best plan for our patients. Also, our original measures, while well-intended, turned out to be not be appropriate when we went to collect the baseline date so we developed all-together new measures that are meaningful and have data available.” • “Have a very specific project team from all areas of your programs that includes a variety of staff - in order to answer all types of processing questions.” • “The project has also been more time consuming in terms of business process development and redesign than anticipated. It will take more resources in terms of training staff and adjusting workflows once implemented. Still very much worthwhile, though.”
- 11. Grantees offer feedback & lessons learned • “Would have appreciated having the spreadsheets for the provider directories early in the process so that they would be completed and ready for connectivity to HIway.” • “We became aware of the complexity of the project, due to the coordination that needs to take place between all the parties involved: – Us, the Health Center – Our EHR vendor – The HIE vendor – Our trading partner”
Editor's Notes
- #3: This is just a re-orientation in prep for the following slides on our Implementation Grantees.
- #4: This slide depicts the types of organizations which are involved in our Grant – grantees or collaborators.
- #5: We identified 20 unique high-level use cases as part of this Grant. We plan to document these use cases (along with the grantee) in a way that they may serve as a blueprint for others to follow.
- #6: Measurements range from compelling outcome-oriented measures to more leading measures that count transactions. We will work with the grantees to support them measuring these throughout the grant period. We do not anticipate much movement during the grant period, but are optimistic that grantees will find value in the measures and continue measuring post-grant. We believe this activity of identifying measures now will become foundational to future impact-oriented efforts and allow us to focus effort on activities that have a real chance to impact cost and quality in other care settings and among other organizations.
- #7: This is a word cloud of some of the most commonly reported challenges – larger words mean that word was used more often in the grantees reports.
- #8: Other questions in the Report aimed at collecting information on specific issues.This provides our project officers with more information and the opportunity to help resolve or mitigate the issue
- #9: This was a survey question in the report aimed at providing us general feedback on how ‘hard’ it was or was not to connect. Most reported that connecting was as they expected. For some, however, it is taking more time to connect than they anticipated. Also, for some, the resources available were less than expected. Again, while not specific, these responses offer directional feedback. Tackling connection efficiency and resource availability are part of our plans going forward.
- #10: This is a forecast slide for us to better predict who is likely to need help and how much funding may remain available at the conclusion of the Grant.NOTE: We have the individual data, so while this table is presented in aggregate form we are going back to each grantee to address their specific issues.