Get Better at IT Key Aspects Challenges

Get Better at IT Key Aspects & Challenges?

Interactive Clicker Exchange

What is the balance between your people and systems for analyzing your patient health outcomes? 1. 2. 3. 4. 5. 100% people & 0% systems (no system) 75 % people & 25% systems 50 % people & 50% systems 25 % people & 75% systems 10 % people & 90% systems

Is your Health IT integrated and/or used with Quality Improvement Activities? 1. 2. 3. 4. Yes No maybe Not Sure

Has your Health IT been able to track or document better system’s Usage? 1. 2. 3. 4. Yes No Often Not Often Enough

Which of the following areas has been most difficult for continuous project or quality improvement? 1. 2. 3. 4. Leadership (people) Buy-in (process) Technology (systems capabilities) Capacity to Use Data for continuous improvement (project improvements)

What percentage of the data in your Health IT system do believe is useful for quality improvement tracking? 1. 2. 3. 4. None of it Some of it Most of it All of it

Is your Health IT set up to facilitate or prompt quality patient care? 1. 2. 3. 4. Yes No Often Not Often Enough

Strategy People Process Technology

Getting Better at IT § Strong and continuous leadership in avoiding complacency and striving to take things to the next level is needed. § Little ways and big ways to get better. § PDSA cycles and performance improvement projects. § Draw on power users in your efforts again. § Use of third parties can help as well.

Strategy People Process Technology

Is Customer Support Excellence a key component of success to Getting Better at IT?

Proactive Courtesy Calls and Evaluation 1. Any problems or barriers with using the system? 2. To what degree is the system saving you time? 3. To what degree is the system reporting effective for you? 4. How is technical assistance and support for you? 5. If not a “ 10”, what can we do to make it a “ 10”? – “The fact that someone calls me to make sure that all is well and to see if I have any ideas is just great. ”

Results: Proactive Courtesy Calls and Evaluation

Results: Paterson Medical and SPNS Agencies

NYC Qualitative Responses – – “Really easy to use. ” “It has taken days out of running reports. ” “You guys are wonderful. ” “The fact that we could do the rents is marvelous. The fact that it keeps track of your contracts is just great. ” – “Shaking up a lot of people because now their bosses can see when work isn't done. ” – – – “Very easy to enter information. Only way to make it better is to have it read your mind. ” “It's great! Very very easy, no issues, very straightforward. Issues with username and password in the beginning, but they were resolved. Doesn't think it could get any easier. ” “It’s nice to work with such a responsive group of people. ” “This intensive TA truly makes a difference!” “It’s great to have all this data at our fingertips. ” “You guys are awesome!”

NYC Qualitative Responses cont’d – – “I think it’s easy and practical compared to other systems we used such as <deleted>… This is the max, the best. I think you did a great job. ” “It’s pretty cool. VERY easy to work with. ” “It's easy. No problems. Very simple. Very User friendly. ” “Great, the last changes are wonderful. I am really happy about the last changes that were made that we had requested. ” – “It is going very good. You [RDE/DOHMH] are providing a good service. ” – – – “I love that it's web-based, so I’m not tied to a machine like other systems. I have no complaints. ” “I like it. It is easy for me to work with, because everything is right THERE, I don’t have to look around for certain items; it tells you the next steps, etc. ” “Your support [RDE] is very fast. Very helpful. Efficient. ”

Paterson Ryan White – “I am seeing more clients than before. I was never meeting my internal goals, until now. ” – – – “The reason we chose e. COMPAS was because e. COMPAS adapts to our process, instead of us having to adapt our process to someone else’s system. ” “The web-based platform was amazing. ” “Good problem solvers. Explains the use of the system clearly and effectively. ” “Very competent staff. Knowledgeable and friendly. Great response time. ” “I am very pleased with RDE and its staff. They have and are responsive to address whatever needs that may be in question. Their quality of competence can be rated a number 10 on a scale of 1 to 10 and 10 being excellent. ”

User-Driven Enhancements § Constructive feedback from TA, Proactive Calls, and QA provided to Administration. § Administration decides if worthy and priority. § Enhancements are reviewed, developed, deployed announced. § Users see their feedback is taken seriously and increase their engagement and system compliance. § National shared best practices community. § User Group

Impact § Users feel empowered that their ideas count. § Improvements (time savings, error reduction, etc) that are valuable to the front-line staff that would ordinarily get lost are actually implemented. § Other ideas are encouraged. Users have hope. § Buy-in is reinforced with the process of improvement.

Strategy People Process Technology

After Action Reviews (AARs) § What did we do well, that we would do again? § What could we do better? § If we had to do it over again, what would we do differently?

Not All HIT Challenges Have Technology Solutions § Policies, procedures, protocols may need to be created or amended. § Realignment of expectations may need to occur. Communication is the solution. § User capacities (including non-technical capacities) may need to be upgraded.

Other Methods of Engagement § Integrated into QM committees § Quarterly Provider Meetings § User Group § National Quality Centers / outside parties § Presentations / Conferences

August 2008 HRSA All Grantees Meeting "Application of Innovative Technology for Planning Bodies: Webbased Needs Assessment, real-time Graphic Data for Priority Setting, and Web-based Client Satisfaction Surveys. "

Client Satisfaction Getting Better at IT 1. Client Satisfaction filled out by clients using Provider Access Points, at home, library, and community college. 2. Unique Identifier eliminates the need for client entry of demographic data, reducing overall survey burden. 3. Survey data available in real-time. Tens of thousands of pages of paper savings. No delay, no need for central data entry of paper. 4. e. COMPAS performs initial analysis and graphical data presentation, freeing up analysts to concentrate on drawing meaningful conclusions.

Client Satisfaction Getting Better at IT 5. e. COMPAS reporting facilitates data drill-down for multiple layers of analysis. 6. Data integrity is improved through the reduction of human error in data entry. 7. Data are available immediately to all stakeholders. This is useful feedback for providers who are now able to make midcourse corrections immediately, not 12+ months later. 8. Reports provided in an easy-to-use dynamic and visual format, allowing for instantaneous drilldown.

Consumer Participation: Existing Tools • Instruction Sheets • Access Cards • Access Point Signs • Consumer Training Sessions and Locations • On-line Help • Provider Assistance: Train the Helper

Provider Kiosks St. Paul’s CDC

Comparison of Number of Observations Year 2004 Year 2005 1511 13145 We were expecting response rates to drop in moving from paper-based to web-based surveys. Instead going web-based produced a surprising increase in response rates for a primarily urban, disadvantaged population, making internet access barriers a myth.

Needs Assessment Getting Better at IT 1. In-Care survey filled out by clients using Provider Access Points. 2. Out-of-care surveys administered via field teams. 3. In-Care Survey data available in real-time. No delay, no need for central data entry of paper. 4. Out-of-care surveys data entered into same central, integrated webbased database by field teams. 5. e. COMPAS performs initial analysis and graphical data presentation on both in-care and out-of-care, freeing up analysts to concentrate on drawing meaningful conclusions. 6. Data available immediately to all stakeholders. 7. Reports provided in an easy-to-use dynamic and visual format.

ata x. D ple n m Co lectio ol C

Next Question Getting Better at IT - The System does all the work behind the scenes.

Selected Outcomes • Reduction / elimination of duplicate data entry. • 50% reduction of time in fee-for-service billing and other activities for providers, enabling more clients to be seen each day (and more quality time with clients) • Real-time feedback and improved data quality. • Federal reporting went from being a “nightmare” to a tool used for realtime data quality improvement. • Providers engaged in data analysis seeing its value for quality improvement.

Practical Lessons for Replication 1. Stakeholder engagement at all stages is key. 2. Incremental development allows for absorptions and refinement. 3. A web-based architecture reduces cost and maintenance headaches. 4. Being data rich does not means using the data to its fullest extent. A regular, structure process to leverage data analysis is a large commitment. 5. Quick feedback loops with real-time analysis are important to make midcourse corrections. 6. Be creative. Transforming a challenge (federal reporting) into a data quality improvement tool helped turn lemons into lemonade.

Be Flexible

Teamwork Makes a Difference

Strategy People Process Technology

SPNS Module Use

Appointment Adherence Has an Impact

Strategy People Process Technology

Conclusion § Implementing and sustaining HIT is challenging. § The costs of doing HIT wrong are significant. § HIT, done right, is worth time, energy, and investment. § Techniques, strategies, peers, and resources exist to help you. § The HIT Lifecycle Adoption Framework can help you touch the key bases in a structured way. § Focus on the process over the product, and choose your strategic partners and vendors wisely.

Workshop Evaluation

Final word of hope…

How can you accomplish ambitious goals? One bite at a time.

Thank you for your time!