advancing team-based care:data driven dashboards to support team based care
TRANSCRIPT
WelcomeThe National Cooperative Agreement on
Advancing Team-Based Care
WEBINAR 4: Data Driven Dashboards to Support Team-Based Care
April 7th, 2016
Presented by the the Community Health Center, Inc. & the MacColl Center for Health Care
Innovation
SpeakersFrom MacColl Center for Health Care Innovation, Group Health Research Institute:Ed Wagner, MD, MPH, Director Emeritus Brian Austin, Deputy DirectorKatie Coleman, MSPH, Research Associate
From Community Health Center, Inc.:Margaret Flinter, APRN, PhD, Senior Vice President & Clinical Director Kerry Bamrick, MBA, Senior Program Manager Veena Channamsetty, MD, Chief Medical OfficerNicholas Ciaburri, BS, Director of Business IntelligenceTierney Giannotti, MPA, Quality Improvement Data AnalystLori Clavette, RDH, Mobile Dental Program ManagerRamon Clark, Medical Assistant
From Community Health Partners:Lander Cooney, MS, Chief Executive OfficerHannah Pulaski, MSN, RN, Nursing DirectorAmber Traxinger, Data Analyst
Community Health Center, Inc.
Foundational Pillars1. Clinical Excellence- fully Integrated teams,
fully integrated EMR, PCMH Level 3
2. Research & Development- CHC’s Weitzman Institute is the home of formal research, quality improvement, and R&D 3. Training the Next Generation: Postgraduate training programs for nurse practitioners and postdoctoral clinical psychologists as well as training for all health professions students
CHC Profile:•Founding Year - 1972•200+ delivery sites•130k patients
The Community Health Center, Inc. and its Weitzman Institute will provide education, information, and training
to interested health centers in: Transforming Teams• National Webinars on advancing team based care• Invited participation in Learning Collaboratives to advance team
based care at your health center
Training the Next Generation• Two National Webinar series on developing Nurse Practitioner
and Clinical Psychology residency programs and successfully hosting health professions students within health centers
• Invited participation in Learning Collaboratives to implement these programs at your health center
Email your contact information to [email protected] and visit www.chc1.com/NCA.
Learning Objectives:1. Participants will be able to identify how two different
members of the team can utilize data driven dashboards.
2. Participants will be able to identify two potential impacts of using clinical dashboards on UDS outcomes.
Get the Most Out of Your Zoom Experience• Send your questions using Q&A function in Zoom• Look for our polling questions• Live tweet us at @CHCworkforceNCA and #primarycareteams and
#HRSAnca • Recording and slides are available after the presentation on our
website within one week• CME approved activity; requires survey completion • Upcoming webinars: Register at www.chc1.com/nca
CHC’s Timeline in Using Data-Driven Dashboards• 1970s: Participated in
initiatives around data collection using computers
• 2006: First fully integrated electronic health record system• eClinicalWorks
• 2010: Built our own data warehouse, for reporting and data analysis• Covers clinical, financial,
and Human Resources• Currently: Integrating data and
process involvement with the goal of better patient outcomes
Creating Effective Dashboards and Reports• Team Based approach
• Each team member uses different sets of data, and gets a different dashboard
• Work with clinical leadership to identify the goal of the dashboard• Work with care teams and clinical microsystems to determine what data is
useful to them and how it best fits in with their workflows• Work with EHR staff to determine the best way to input the data
• Actionable Data• Distributing the data to the team members that can take action on it• Only include the data that is actionable – Too much data can be a bad thing!
Why develop my own reporting environment?• Control
• Buying vs. Renting• More transparent access to your
data• Flexibility
• Customize your dashboards and reports as you see fit
• Combine your data with data from other sources (payers, EHX’s, finance, HR, etc.)
• Workflows• Design your dashboards around
your workflows rather than your workflows around your reporting tools
BI Data Environment• Having Useful data starts with the EHR
• Structured Data• Reformat the data to make reporting
easier• Include business rules• Connect to data from other sources• Format for easier reporting
• EHR’s are designed for inputting data, not reporting
• Clean the data• Exclude non-valid values • Map data to categories
• Analytics Cube allows for drag-and-drop high level data analytics
Utilizing Data Starts on the Front LinesOur phone script
includes data on which appointments the patient is due for so that we can schedule all of their appointments at once.
Planned Care Dashboard
Complex Care Management Dashboard
Behavioral Health Dashboard
Dental Dashboard
Dental Dashboard (continued)
Strategies for Success:Using Measurement to Guide
Improvement
Chronic Opioid Dashboard: Background• One example of using data to improve quality
of care• Developed to support care teams in
management of patients using chronic opioids• November 2015: Grand Rounds on the
management of patients on chronic opioid therapy (COT)• New and improved Opioid Dashboard unveiled• Didactic information about managing COT
patients• Provider-specific report distributed• Panel management time to review cases on
the Opioid Dashboard
Chronic Opioid Dashboard
Control Charts: ExplanationLines on graphs:• Solid line = average
• Dashed lines = 3 std dev limits
Patterns to Look For:• Point(s) outside limits
• Shift (8 or more consecutive points on same side of average)
• Trend (7 or more points with consecutive increase or decrease)
Interpretation:• Pattern absent = random
variation• Pattern present = significant
∆
Mar-15 Jun-15 Jul-15 Aug-15 Sep-15 Nov-15 Dec-15 Jan-16 Feb-160
102030405060708090
100Urine Toxicology Screening (past 6 months)
Mar-15 Jun-15 Jul-15 Aug-15 Sep-15 Nov-15 Dec-15 Jan-16 Feb-160
20
40
60
80
100
Pain Assessment (past 3 months)
statistically significant increase for one month
Opioid Measures: % Patients Meeting Measure
Mar-15 Jun-15 Jul-15 Aug-15 Sep-15 Nov-15 Dec-15 Jan-16 Feb-160
102030405060708090
100Opioid Agreement (ever)
Mar-15 Jun-15 Jul-15 Aug-15 Sep-15 Nov-15 Dec-15 Jan-16 Feb-160
20
40
60
80
100Urine Toxicology Screening (past 6 months)
Mar-15 Jun-15 Jul-15 Aug-15 Sep-15 Nov-15 Dec-15 Jan-16 Feb-160
20
40
60
80
100Patients Receiving Behavioral Health
(past 3 months)
Mar-15 Jun-15 Jul-15 Aug-15 Sep-15 Nov-15 Dec-15 Jan-16 Feb-160
20
40
60
80
100Pain Assessment (past 3 months)
statistically significant increase for one month
Mar-15 Jun-15 Jul-15 Aug-15 Sep-15 Nov-15 Dec-15 Jan-16 Feb-160
20
40
60
80
100 Prescription Monitoring Drug Website Queried (12 months)
statistically significant increase for two months
p Chart: Checking Rx Drug Monitoring Website – Site I
Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-160%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
UCLpPercentp-barLCLp
Month
% o
f pati
ents
on
COT
who
se p
rovi
der c
heck
ed
the
CT P
MP
in th
e la
st 1
2 m
onth
s
statistically significant increase for one month
p Chart: Checking Rx Drug Monitoring Website – Provider I
Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-160%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
UCLpPercentp-barLCLp
Month
% o
f pati
ents
on
COT
who
se p
rovi
der c
heck
ed th
e CT
PM
P in
the
last
12
mon
ths
Resource Spotlight #1
Resource Spotlight #1
Resource Spotlight #2
www.improvingprimarycare.org
Community Health Partners, Inc.• FQHC started in 1997, rural/frontier, ~130
employees, 6 sites• Medical, dental, behavioral health, pharmacy,
and educational programming• 12,000 patients during 45,000 visits in 2015• NCQA-recognized Level 3 PCMH since 2012• Live on NextGen EHR since April 2009, added
integrated EDR June 2012
Open Space for Discussion
RemindersSign up for our next webinar in this series:
A Team Approach to Prevention and Chronic Illness Management
Thurs., April 21st, 3–4 p.m. EST
Complete our survey!
Sign up at www.chc1.com/NCA