Qualifacts Helps Customer Cut Report Building Time by 500%

Recently, Generations/Gaither, a behavioral health service provider and Qualifacts customer, needed to build a particular report in Qualifacts’ report building system and wanted to learn more about the report building process. To address Generations’ reporting needs, a personalized one-on-one training was arranged through a statement of work.

Being so closely located to Qualifacts’ Nashville headquarters, we arranged for Generations to visit our office for the training day. Upon arrival Wayne Greer, Executive VP of Generations/Gaither’s Group, met one-on-one with Qualifacts’ reporting subject matter expert and gained invaluable answers to the questions hindering Generations’ essential reporting abilities.

The training day was tailored to target Generations’ specific needs and included discussion topics around methods of accomplishing a report detail and applying rules, and processes to accomplish reporting goals. In addition to tons of learning, the training also included a bit of fun and laughter for good measure.

Wayne ended the day with a fully functional report that he personally created and completed, and stated that the one-on-one training was well worth his time.

“Being able to sit down with Qualifacts staff in-person, I believe we were able to accomplish, in a very short time, work that would have taken much longer if we had tried to work over any kind of distance medium. Indeed, when I submitted the original request to have my report written, the estimated time to complete the report was 25 hours. Working together in person, we were able to complete the report in about 4 to 5 hours and spend additional time in general training. It was also nice to be able to see where the support staff worked and to meet the folks that I have been working with over the phone. It was a very productive and pleasant visit.”

- Wayne Greer, Executive Vice President of Generations/Gaither’s Group and Qualifacts Customer


Pilot Project Challenges Providers to Create Industry Benchmark

As a leading SaaS provider, Qualifacts is constantly driving innovation and employing user informed data to build solutions to complex healthcare reform needs. One example of this is our recently launched pilot project; through which, the Qualifacts team is encouraging organizations to play a greater role in future improvements to CareLogic IMPACT, our fully integrated outcomes management tool. The project will help leverage comprehensive benchmarking data to gain insight into several key areas including unmet implementation needs, access to outcomes data and much more.

The project includes ten participating organizations and will focus on:

  • Monitoring the implementation and use of CareLogic IMPACT in order to better identify strengths and opportunities for improvement
  • Developing and piloting a benchmarking process that is scalable for the entire CareLogic IMPACT system
  • Evaluating outcomes linked to CareLogic IMPACT for each participating organization

We look forward to sharing the project results with the CareLogic IMPACT family shortly and applying these findings to further streamline clinical outcomes measurement.

Want to learn more about  the pilot project and CareLogic IMPACT? Contact Christy Winter for more information.

Building Integrated Care Readiness through a Culture of Collaboration

As a promise to close the gap between the treatment of our bodies and our minds, Integrated Care seeks to standardize the collaboration of behavioral health and primary care providers. The Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Council for Behavioral Health, along with other leading behavioral health authorities, now suggest that integrated care “produces the best outcomes and is the most effective approach to caring for people with complex healthcare needs.”

Many behavioral health professionals are familiar with the importance of a better integrated healthcare model, but are struggling with the idea of creating a culture of collaboration that would enable a provider to participate in integrated care and therefore, holistically improve the lives and well-being of the clients they serve.

We must remember that, clinicians, social workers, counselors and other human service providers do not enter the behavioral health field because they love collaborative data sharing. They work in this field, because they are passionate about people. People who are too often stigmatized for the behavioral health challenges that they face everyday. To this extent, your staff’s passion and dedication are your greatest assets for truly adopting a culture of collaboration which serves as the backbone of integrated care. You can tap into this passion and use it to help facilitate the cultural shift needed to begin to tackle integrated care head-on by focusing on:

  1. Internal Education
    Ensure that your passionate staff members are fully informed on the importance of systemic integration. This is absolutely key to fostering a culture of collaboration, and internally building momentum and enthusiasm for integrated care.
  2. Investment Creation
    Foster a sense of investment by specifically identifying for staff members the direct link between their day-to-day tasks and care goals, and the vision of integrated care best suited for your agency.
  3. Champion Recruitment
    Often undervalued, is the active transformation of passionate staff members into champions of change internally. The impact of fellow staff members championing the cultural changes required to reinforce the value of integrated care and the role of knowledge sharing in supporting the overall mission of your practice should never be underestimated.

Once your staff understands the direct connection between the work they do and the role of integrated care in improving that work and the overall wellness of their clients, they will create a tangible investment in collaborative culture and become champions of care integration.

2014, marks a pivotal year for behavioral health providers to decide where they fit within the service delivery models of healthcare reform and along the integrated care spectrum, decisions that internal champions of change and a culture of collaboration can help guide. If agencies do not determine where they fit within the future of healthcare, it will be decided for them and with quality of service delivery increasingly tied to reimbursement in the form of pay for performance contracts, the stakes are too high to ignore.

By engaging passionate staff members and encouraging a culture of collaboration we can use integrated care to change the healthcare landscape, offer a higher standard of “customer” service and improve the link between the treatment of mind and body.

Mary Givens is a leading expert on healthcare reform, integrated care and meaningful use. She serves as the Product Manager of Healthcare Reform at Qualifacts Systems Inc. and is the primary contributor for the blog MUforBH, a comprehensive healthcare reform knowledge base for behavioral health professionals.

Meaningful Use & The Golden Thread

Who loves audits? We love audits! Why, you ask? Because with CareLogic you never have to fear losing The Golden Thread.

What is The Golden Thread, you ask? Well, let’s discuss….

Most auditors, either from accreditation committees or insurance, want to see documentation that the services you are providing are medically necessary. An example of “not-so-medically necessary” is as follows…

Jane Client is diagnosed with Anxiety Disorder, NOS and has a Treatment Plan that notes goals such as “Attend medication assessment appointment to determine efficacy for hyperactivity.”

Here’s an example of medical necessity…

Christina Client is diagnosed with Dysthymia and has goals such as “Increase satisfaction with quality of life.”

So what can CareLogic do to help you maintain The Golden Thread? CareLogic has a core set of modules; Treatment Diagnosis, Problems, Goals, and Objectives, and the Goals Addressed Module. They all interconnect in the background to ensure that clinicians document and provide effective care. (Note: They cannot make anyone provide effective care, but they can help maintain the guidelines). Once the Treatment Diagnosis is completed and signed, this then limits the choices available for the Problems, Goals, and Objectives. Which makes sense. If you notice the goals that you and your client are looking for are not showing, perhaps the diagnosis needs to be revisited. The structure of the Problems, Goals, and Objectives allows the client to sit with the clinician and choose which items are relevant to what they want to see happen.

And moving onto the Goals Addressed module. Throw this little fella into your therapeutic progress note, and never have to worry again about not including goals, objectives, and interventions into the progress note.

It is almost as if we have made the auditor’s job irrelevant.

Ok, great, so how does this all relate to Meaningful Use, you ask? Well, the government wants to know that you are using your EHR platform to provide the best care possible for your clients. Using the modules mentioned to meet The Golden Thread gets you that much closer to providing a higher level of care as well as making the government happy when they send you that big ol’ check.

Proposed Rule to Change the Meaningful Use State Timeline and CEHRT Definition

Mary-Givens-headshotOn May 20, 2014 CMS and ONC released a notice of proposed rulemaking (NPRM) that would allow providers participating in the EHR Incentive Programs to use the 2011 Edition of certified electronic health record technology (CEHRT) or a combination of 2011 and 2014 CEHRT to Meet the Measures for calendar year and fiscal year 2014.

The proposed rule (if approved) will “change the meaningful use stage timeline and the definition of certified electronic health record technology (CEHRT). It would also change the requirements for the reporting of clinical quality measures for 2014.”

The Center for Medicaid and Medicare Services is accepting comments on this proposed rule up to 60 days after the file date which was May 20, 2014. The addresses for submitting comments are listed within the proposed rule found here.

If this proposal gets approved, it will only be valid for 2014, and the Eligible Professional will be able to use 2011 Edition CEHRT or a combination of 2011 and 2014 CEHRT to attest to the 2013 definition of meaningful use measures for either Stage 1 or Stage 2 in 2014. If approved, this rule would also allow the Eligible Professional to use the 2013 definition CQMs.

Read additional information from CMS about the proposed rule.

Got questions? We thought so. Please email them to Mary Givens.

Welcome to the Qualifacts family, Consolidated Care!

L-R: L to R: Jennie Dempster, Nancy Pennington, Jan Rhoades, Chelsea Baldwin, Karen Oberlies, Talia McMurray, Doug Steiner

L-R: Jennie Dempster, Nancy Pennington, Jan Rhoades, Chelsea Baldwin, Karen Oberlies, Talia McMurray, Doug Steiner

Consolidated Care, a new Ohio customer, recently completed the Train the Trainer milestone!

Consolidated Care provides a variety of mental health and supportive services to Champaign, Logan, and Hardin counties. One of the most valuable services they provide is being the first people on-site to help survivors of suicide. One such incident occurred while Qualifacts was onsite, and served as yet another reminder to our staff, of the ongoing care that our customers provide.

The Consolidated Care Core Team represents all areas of the agency, from billing and admin, to front desk and clinical.  As you can see by the smiles, they enjoyed the on-site presentation and training and are looking forward to their Go-Live.

Healthcare R.E.F.O.R.M. = Major Changes to Behavioral Health

R.E.F.O.R.MA few weeks ago, our healthcare expert Mary Givens, presented a webinar entitled, “The Affordable Care Act Means Major Changes to Behavioral Health.” If you missed it don’t worry, you can see the presentation in its entirety here.

Mary simplified Healthcare Reform with a simple acronym:

     Revise and Refine

     Evidence Based

     Follow Through and Follow Up

     Outcomes and Data

     Real, Quantifiable Results

     Manage Risk

Simple enough, but what exactly does it all mean? And more importantly, how can you apply this to your organization? Use the below tips to get started:

Revise and Refine - Any time that you want to introduce a new process at your organization, you should follow the Plan-Do-Check-Act Model.

Plan – A model that encourages high quality care. You can do this by finding current processes that can be made more efficient. How is your organization spending their time and how can it be better optimized?

Do – Take action on the plan! By educating and training our team, sharing goals, and addressing concerns. Keep in mind, with any major changes to your business there will be objections and people will resist the change.

Check – By running reports frequently and retraining as necessary. Expect to have to retrain staff on specific aspects of an EHR as problems arise.

Lastly, act by using data you have collected over a specific period of time to gauge success. Identify the problem areas and make changes accordingly. Most importantly – don’t forget to celebrate the successes!

Evidence Based
Next, make sure you’re making evidence-based decisions, both clinically and operationally. A 2014 Certified EHR can help you make these decisions by providing CDSR’s, assessment tools and screening tools, helping you maximize capacity while maintaining quality. You should also use evidence to demonstrate your quality of customer service.  A way to do this is to measure customer engagement such as the use of a customer portal.

Follow Through and Follow Up
Once you’ve made an evidence-based decision, provide specific actions carried out in a specific amount of time. A provider should carry out the action and then assign other actions to care team members. ALL actions must be completed, or there must be documentation provided to support why they were not completed. With the use of an EHR, you can easily track all actions to make sure they are being completed, which ultimately improves the quality of care for your customers.

Outcomes and Data
Reform means objective (no comma needed) data based evidence, to demonstrate quality and efficiency (cost saving) service delivery. Some examples of outcomes that demonstrate quality and efficiency are:

Patient Engagement –You should be helping them self-manage their health, wellness, and recovery. Some ways to do this are: by using customer portals, involving their care team (family and friends), using concurrent documentation, and more significantly – involve the customer in all decisions.

Prevention – In addition, your data should help you be proactive. You can reduce the need for emergent, high cost services by encouraging customers to use natural support networks and community support. You should use CDSR to identify early indicators of an illness.

Clinical – Lastly, assess regularly to demonstrate change in assessment score over time (greater level of functioning)

Real, Quantifiable Results
You should be able to demonstrate quantifiable results both operationally and clinically.

When it comes to operations, know your costs first: averages billed for key services vs. net revenue vs. cost. Second, focus on no show rates per type of service, backfill rates, and a centralized schedule. One point of improvement for most organizations is the daily backfilling of cancelled appointments.

From a clinical standpoint, you should be focusing on episodic care needs and measuring a level of care by considering symptoms and functions. To start: focus on a small number of goals centered on moving to a higher level of functioning and lower service utilization. Finally, you should be tracking the ‘ordered’ service mix. Are the services scheduled and are they actually happening?

Manage Risks
Now that payers pay on quality and not just on volume, the risk is now shared, and in some cases there is a greater risk for the provider. You’re now wondering if you’re going to get paid for a service and how much. Some ways to manage these shared risks are to measure and manage based on what your own data is telling you, maximize your capacity and maximize the valued outcomes.

On a pay for performance model, you should know how much you are being paid for each service and how much it costs. It is important to know your mix of risk tiers so you can manage them and stay solvent. You need to identify episodes and levels of care in order to access data per episode to move customers through levels of care as assessment, screening, symptoms and diagnosis warrant.

As far as patient engagement and capacity, make sure you are actively working patients who are not attending appointments or adhering to their treatment, and make changes. You can do this through customer portals or reminder calls. You should be aiming to be at capacity while still delivering a high quality of care at all times. Also, don’t forget that if any symptoms are outside of your specialty area, they must be addressed.

We hope these tips helped simplify Healthcare Reform for you. When it comes to major changes, don’t wait until 2016. Use this time to make changes, tweak your processes and collect data on how well you are doing as an organization. If you don’t define how well you are doing or what high quality services you provide –a payer is going to define it for you.

For more information regarding Healthcare Reform, check out MUforBH.com.



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