Welcome to the Mount Sinai PPS Town Hall

March 19, 20159:00 a.m. to 12:00 p.m.

Centralized IT Services

Kash Patel, Senior Director, Analytics & Innovation March 19, 2015

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Mount Sinai PPSIT Strategy Vision

Implement a set of capabilities that will

enhance seamless care coordination

among all partners through the creation

of an Integrated Delivery System,

focusing on managing population health

and achieving the Triple Aim

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Our IT Objectives

Support transitions of care and clinical/ social care planning

Comprehensive population and patient level

analytics

Enhance data sharing at the point

of care

Capture and manage DSRIP

project goals and partner

performance

Increase patient and caregiver

activation

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Why this Strategy is Important• DSRIP is a means to an end of achieving population health

and delivery transformation• Meeting the DSRIP requirements without transformation will not lead to

long-term success

• DSRIP funds will not offset investments and costs 1:1• DSRIP funds and capital are intended to provide a small incentive to go

where the market (consumers and payers want us to go)

• Partners must transform how they organize and delivery care to be competitive in the future (ability to deliver value, quality and outcomes)

• The long-term value is to have the infrastructure and capabilities to engage in value-based reimbursement models (e.g. capitation or shared-savings)• $200 – 300* million over five years for 200 DSRIP partners vs. being able

to generate savings on $4-5 billion in total Medicaid spending per year*Depending on final award and the dollars the PPS is able to draw down based on performance

Connecting our Partners and Delivering Centralized Services

High-level Strategy

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TIER 1 – State Investments

SHIN-NYState-wide MPIMAPP – Analytics tool (claims based data)Alerts (through RHIO)Secure Messaging (through RHIO)

TIER 2 – PPS (Centralized) Investments*

Data Warehouse & AnalyticsRHIO & HIE ConnectivityPPS Governance & ManagementProvider & Patient Engagement

TIER 3 – Partner Investments

Software investments such as Electronic Medical Records (EMR) or other electronic platformsHardware investments such as PCs, laptops, network, security, and other such devicesOperational Costs such as training and staff

(Draft)

(Draft)

Key Definitions:State MPI = Master Patient Index (the logic that will match the same patient with multiple Medical Record Numbers or other unique identifiers across the stateRHIO = Regional Health Information OrganizationHIE = Health Information Exchange

*All services subject to availability of capital and operating budget

(Draft)

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Centralized IT Services*

• Learning Management• Care Mgmt./

Coordination• Tele-health• Provider-level

dashboards

• DSRIP reporting• Provider performance

management & evaluation

• PPS Partner Management (CRM)

• Enterprise Master Patient Index (eMPI)

• Bidirectional data sharing

• Interoperability• Alerts & Messaging

• Longitudinal records• Patient stratification

by risk• Predictive analytics

and Utilization Management

Data Warehouse & Analytics

Regional Health Information Organization

and Health Info. Exchange

Connectivity

Provider & Patient

Engagement

PPS Governance & Management

*All services subject to availability of capital and operating budget

Partner-level IT Investments(Varies by Clinical vs. non-Clinical Provider)

Partner infrastructure (potential areas of focus):• Software: Electronic Medical Records (upgrades,

expansion, or first time acquisition) or other appropriate electronic platform, health information security software/upgrades, telemedicine, ePrescribing and other electronic ordering systems, clinical quality measures (CQM) or other quality data reporting systems

• Hardware: PC’s, laptops, tablets, printers, servers, routers, network switches, back-up devices, mobile devices, security devices intended to protect against information breaches, remote monitoring equipment

• Operational costs (personnel & maintenance): Training, implementation staff, vendor costs

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High-level Timeline

• Project data collection & reporting design• HIPAA & security for LLC• Partner database (CRM)• Project specific requirements• Detailed partner assessment and education

Short-term (3-6 months)

• Support for PCMH & MU certification achievement• RHIO/SHIN-NY adoption• Build/purchase for Centralized Services

Mid-term (6-18 months)

• Support for PCMH & MU certification achievement• Care Coordination/management platform connectivity• Partners connect to centralized & State-level services• Implementation of analytics & HIE

Long-term (18+ months)

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Key Takeaways & Next Steps

KEY TAKEAWAYS:▶ Diverse IT capabilities of our partners▶ Plan for IT adoption will vary by provider type & role▶ Partners will need to make some IT investments in order

to connect into the State, RHIO & Centralized Services▶ Connecting into centralized services will be crucial to

success of projects and achievement of Population Health goals

NEXT STEPS:▶ IT Committee to work with Clinical & Workforce

Committees to define project-specific requirements▶ IT Committee to develop detailed assessment for

partners▶ Finance Committee to define funds flow to support

Centralized Services

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Questions?

Please contact us for any questions:▶ Kumar Chatani (Co-Chair)

– Kumar.Chatani@mountsinai.org ▶ Barbara Hood (Co-Chair)

– barbara.hood@ryancenter.org▶ Kash Patel

– Kash.patel@mountsinai.org▶ Evan King

– eking@copehealthsolutions.org▶ Ragini Sarma

– rsarma@copehealthsolutions.org

IT Update

Evan King March 19, 2015

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Current State Analysis

MilestoneTarget

Completion DateSummary Requirements

1) Conduct data collection for assessment

DY1, Q2

Detailed IT current state assessment. Relevant QEs (RHIOs/HIEs) should be involved in performing this assessment.

Comprehensive analysis of partners across continuum to inform current state capabilities. Needs to assess partner data collection, management and ability to engage in reporting and data sharing.

Implementation Plan: Key Requirements

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Implementation Plan: Key Requirements

Data Sharing

MilestoneTarget

Completion DateSummary Requirements

1) Develop roadmap to achieving clinical data sharing and interoperable systems across PPS network

DY2, Q1

A governance framework with overarching rules of the road for interoperability and clinical data sharing;

A training plan to support the successful implementation of new platforms and processes; and

Detailed plans for establishing data exchange agreements between all providers within the PPS, including care management records (completed subcontractor DEAAs with all Medicaid providers within the PPS; contracts with all relevant CBOs including a BAA documenting the level of PHI to be shared and the purpose of this sharing).

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Implementation Plan: Major Risks & Mitigation Strategies

▶ Risk 1: PPS partners not fully comprehending the IT requirements

▶ Mitigation Strategy: Engage in comprehensive community-based partner education through workshops, web-based learning tools and 1:1 interaction at partner sites; development of education materials by provider type to clearly state expectations and requirements.

▶ Risk 4: Consent process may inhibit ability to access and share pertinent patient data

▶ Mitigation Strategy: Continue to coordinate with GNYHA, other PPSs, RHIOs and stakeholders to drive policy change and consent education for patients through providers to continually improve level of consent and mitigate policy barriers.

▶ Risk 6: State proposed solutions and services do not meet PPS needs or adhere to proposed timelines and standards

▶ Mitigation Strategy: Continue to closely engage with State, KPMG, RHIOs and directly with Salient to understand performance risks and detailed plans to continually re-evaluate top risks; continue to drive “Plan B” strategy until demonstrable/tangible performance of State solutions is evident and consistent

APPENDIX for IT

Connecting PartnersMount Sinai PPS

TELEHEALTH

DISEASE REGISTRIES

INFORMATION SECURITY

CENTRALIZED REPORTING

CRM

CONSENT MANAGEMENT

EMPI

Patient

Hospice

Pharmacy

Clinics

All Other

Non-PCPCBO

Nursing Homes

PCP

Behavioral Health

Care Mgmt/ Health Homes

HospitalsSubstance

Abuse

HIE

SHIN-NY

DATA MANAGEMENT

ADVANCED ANALYTICS

CONTACT CENTER

PATIENT PORTAL

RHIO

ALERT MANAGEMENT

DSRIP - NY STATE DEPARTMENT OF HEALTH SUPPORTING PLATFORM

ACHIEVING POPULATION HEALTH

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Our Assumptions and Knowledge Gaps

Our Assumptions What we need to Understand or Clarify

IT strategy is designed around the Integrated Delivery System (2.a.i) project, which all partners must participate in

Input from partner committees, project leads and PPS partners to inform detailed project requirements and current gaps

Estimated 200 partner (parent) organizations Distribution of partners by provider type; number of sites per parent organization and providers per site

Partner organizations span a broad continuum (e.g. coordinated health systems to paper-based, stand-alone community organizations)

Current IT capabilities by provider type for 2.a.i and per project; management of patient consent (particularly for HIV, Behavioral Health, Substance Abuse, Family Planning/Minors)

Need to have an incremental and tiered strategy based on partners’ level of IT adoption

Additional necessary centralized services and/or technical support (how much of what, and when)

Achieve our IT functional goals and capabilities by end of 2017

Incremental IT adoption expectations by provider type for the next 3 years

There are many unknowns (e.g. role, capabilities and timing of State-driven solutions)

How best to integrate and align with State solutions while timelines and details are still in development – we’re ultimately accountable

Health IT Capabilities – Partners & PPS

Information Security

PPS level Patient Portal

CRM

Data Management

Platform

Contact Center/

IT Support

partner performance

tracking

AnalyticsPlatform

PARTNER CAPABILITIES

HIE/RHIO/SHIN-NY(Partner & PPS)

PPS CAPABILITIES

Level 1: Partners will support patient care through the implementation of

these IT services/capabilities to ensure patients receive appropriate quality, while reporting on individual

partner metrics

Level 2: Mount Sinai PPS will support partners and patients with this array of services to help ensure the entire PPS is

able to successfully report on and achieve DSRIP metrics

Care Coordination

Patient Portal

Consent Management

IT Infrastructure

EMR

HIPAA C OMPLIANC E

*All services subject to availability of capital and operating budget

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MSPPS Web Tool MSPPS eMPI MSPPS CRM Learning Mgmt System Security/Identity Mgmt Care Coordination Telemedicine

Mount Sinai PPS HIE

Mount Sinai PPS Data Analytics Core

Bronx RHIO Healthix Interboro

MSPPS HIE

Community Partners

Statewide Health Informmation Network of New York (SHIN-NY)

A B C

HIE Adaptors

Deepesh Chandra, v2, 02/03/2015

Mount Sinai PPS DSRIP IT Centralized Services

...State-wide

RHIOs

Other Analytics Services Project Specific Services Other Infrastructure Services

Mount Sinai PPS Centralized Services

EMPI

State-wide eMPI PHI Data Care Coordination Data Patient Query/Lookup Alert/Messaging (Future)

Statewide Health Information Network of New York (SHIN-NY)

*All services subject to availability of capital and operating budget

Mount Sinai PPS Data Sharing Pathways

Registries Patient Portal Provider Portal Score Cards Cohort Analytics Attribution Modeling Care Coordination Risk Stratification Patient Navigator Gaps in Care

Local HIE/RHIOs

Community Partners

READACCESS

Pathway A

PerformanceMeasures

· Has EMR and HIE (preferably bi-directional)

· Patient Lookup / Query· Alerts· Messaging

Local HIE/RHIOs

Community Partners

READACCESS

Pathway B

PerformanceMeasures

· Has EMR or HIE capable of sending data

· Patient Lookup / Query

Clinical Data

Care Coordination

Care Plan

Clinical Data

Care Coordination

Care Plan

Care Plan

PatientLookup

Community Partners

READACCESS

Pathway C

PerformanceMeasures

· Has EMR, but no HIE or HIE not capable of sending data

· Patient Lookup / Query· Alert· Messaging

Clinical Data

Care Coordination

Care Plan

Care Plan

PatientLookup

Alert

Messaging

Community Partners

Pathway D

· Manual data entry via PPS supported Web Tool

· Patient Lookup / Query

PPS Web ToolREAD

ACCESS

Perf.Measures

Care Plan

1-800-MSPPS

Deepesh Chandra, v2, 02/03/2015

MSPPS Web Tool MSPPS eMPI MSPPS CRM Learning Mgmt System Contact Center Care Coordination Telemedicine

Mount Sinai PPS HIE

Mount Sinai PPS Data Analytics Core

EMPI

Mount Sinai PPS Security & Identity Management

*All services subject to availability of capital and operating budget