Alaska Native Tribal Health Consortium Innovations in the 21st Century

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Alaska Native Tribal Health ConsortiumInnovations
in the 21st Century
2008 Annual Self-Governance Conference Riviera
Hotel, Las Vegas 4/29/08 1330 Grand
A/B Self-Governance Innovations in the 21st
Century

• Thomas D. East, Ph.D.
• Chief Information Officer
• ANTHC

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What is innovation?

• 1  the introduction of something new
• 2  a new idea, method, or device
• Innovation is the ability to see change as an
  opportunity - not a threat  Unknown

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ANTHC Innovation Focus Areas

• Patient Safety
• Quality of Care
• Effectiveness of Care
• Revenue Cycle
• Resource Management
• Decision Support
• Compliance
• Process Improvement

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Our existing systems did not meet our needs
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ANMC Revenue Cycle Improvements 2000-2008
Accounts Payable
Accounts Receivable
Payment Posting
M
M/S/A
M/S
Billing
Contracting
M/S/C
Follow Up On Denials/ Payment
M
Expected Reimbursement
M/S/H/A
M/S
Charge Entry
Pricing / Charge Master Maint
M/S/H
Eligibility / Benefits Service
M/S/P/D
M/S
Revenue Cycle Data Capture (RCDC) process
improvement team
P/D
Clinical Data Entry
Scheduling
S
Coding
M-MS4 S-Signature P-PCC H-HDX D-Datalink C-
Claims Mgr A- Accuro AR Mgr
Registration
Clinical and Charge Documentation
M/S/P/D
P/D
M/S/H
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Datalink Records Management and Workflow
Automation

• PCC forms bar coded
• All forms scanned and available immediately for
  clinical use
• Routed electronically to coding, data entry,
  charge entry, billing
• All workflow related to returns is supported
• Full audit logs
• Extensive reports on revenue cycle process
• Modern .NET and SQL server application

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DataLink Records Management and Workflow
Automation
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Missing Documentation Reports by provider
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Improved Accounts Receivable Management /
Improved collections and revenue cycle mgt
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Integrated HIPAA compliant enterprise reports
management / Improve decision support
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• Improved decision support tools
• Point and click modeling
• Simulation
• What if scenarios
• Models risk and uncertainty

www.lumina.com
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Intelligent demand based Nurse Scheduling -Reduce
operating expenses and increase effectiveness
ClairVia Staff Manager ClairVia Staff Manager
facilitates daily scheduling and staffing, and
ensures that staffing resources are managed and
aligned based on the patient-specific tracking,
demand prediction and assessments achieved by
ClairVia Demand Manager and ClairVia
Outcomes-Driven Patient Acuity. ClairVia Staff
Manager incorporates Personalized Dashboard
Technology ClairVia Staff Manager provides
customizable Web portals that give all critical
staff a single, "front-and-center" information
point for scheduling and staffing processes.
Developed in three role-centric versions, the
dashboards offer real-time status indicators and
user-specific, proactive alerts whenever targeted
thresholds are triggered. Employee Dashboard
Manager/Staffing Office Dashboard Centralized
Enterprise Dashboard Enterprise Staff
Scheduling Management ClairVia Staff Manager
offers centralized control for managing
enterprise-wide staffing coverage and resources,
and for delivering advanced, employee-centric
functionality. Flexible, Rules-Based Scheduling
Generation Daily Staffing Real-time
Decision-Support and Conflict-Checking Staffing
Reports Best-Practice Protocols Productivity
Management On-Demand Reports Employee
Self-Service Request Management Self-Scheduling
Shift-Swapping Shift Opportunities
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SoftLab Laboratory SoftMic Microbiology SoftPa
th Pathology SoftWeb Web client SoftBank Blo
od Bank SoftAR Accounts Receivable SoftComplianc
e Compliance Checking
www.softcomputer.com
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CareSuite Perioperative
Delivering total perioperative automation today
Perioperative Information System OR Six Sigma
Process Improvement Improved OR revenue
capture, quality of care, patient safety and
effectiveness
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OR Manager
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Pre Operative Manager
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Smart Track Patient Tracking System
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Anesthesia Manager
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PACU Respiratory Record
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Web Based Interdisciplinary Careplan
Improve care effectiveness and safety Compliance
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Provider web portal provides an integrated suite
of services for clinicians / Increase provider
effectiveness, quality and safety of
care Deployed to 500 providers throughout AK
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Review Dictated Notes
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Alaska eHealth Network and Alaska Tribal Health
System eHealth Trust
Health Information Exchange with a Personal
Health Record (PHR)

• Real time, on demand exchange of data
• No data stays in HIE
• Local control of all data
• Does not require an MPI
• Many to Many exchange
• Subject to real time availability of data from
  local systems

Alaska State Wide
PHR
Data Respository
Integrated Data Repository (e-Health Trust) for
reporting and epidemiology - Alaska Tribal Health
System governed
Alaska Tribal Health System
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AFHCAN Telehealth

• 8 year Operational History
• 14,000 cases / year
• Research and Production Telehealth System
• Manufacturing of Medical Devices
• Whole Product Solution
• Design ? Installation ? Training ? Support ?
  Marketing
• Installed Customer base includes
• Alaska 248 sites, 44 organizations
• 37 Tribal organizations
• US Army sites (6) US Air Force bases (3)
• State of Alaska Public Health Nursing (26)
• US Coast Guard clinics (5)
• US Coast Guard cutters and ice breakers (6)
• Lower 48, Panama, Greenland

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AFHCAN Products and Services

• Hardware
• AFHCAN Carts
• AFHCAN Portable Briefcase
• Software
• tConsult Cart
• tConsult Web
• tConsult Server
• Services
• Support
• Training
• Design

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A Primary Care Tool

• Ear Disease
• Audiometer, Tympanometer, Video Otoscope
• Heart Disease
• ECG Vital Signs Monitor
• Respiratory Illness
• Spirometer Vital Signs Monitor
• Trauma, Skin Wound
• Digital Camera
• Dental Problems
• Dental Camera
• General
• Scanner Forms

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AFHCAN Cart Peripherals

• Base Cart include
• Metal Frame
• Isolated Power System
• CPU and LCD Touchscreen
• Expansion Ports for USB, RS232, Video In/Out,
  External Display
• Supported Peripherals
• Video Otoscope
• Digital Camera
• Scanner
• Video Conferencing
• ECG
• Spirometer
• Tympanometer
• Audiometer
• Dental Camera
• Vital Signs Monitor
• External Scopes
• Stethoscope (due in 08)

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A User Interface Designed by Clinicians

• Simplicity is key for Case Creation.
• Minimize need for keyboard skills
• Touchscreen
• Color coded
• Rich Web Interface for Specialists

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Training
More than 20 manuals have been developed to
augment the training and support provided by our
staff.

• AFHCAN provides training in many different areas
  such as
• Video Conferencing for Telehealth
• Clinical use of telemedicine software
• Clinical use of biomedical equipment
• Software and Hardware management for IT
  specialists
• Training Offerings
• Didactic classes
• Web based training
• Manuals
• Ongoing monthly basis in Anchorage
• On-site training in the regions
• CMEs and CEUs available for many classes.

• Classes include
• Desktop User
• New User Training
• Training Refresher
• System Administrator
• Train-the-Trainer Workshop
• Non-Clinical Orientation
• Cart Hardware Upgrade Procedure
• Orientation to U.S. Telemedicine, for
  International Doctors

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PATIENT TRAVEL (N10,838)
8 CAUSED travel
68 PREVENTED travel in 2006
6m Potential ANNUAL TRAVEL SAVINGS
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PROVIDER Responses
64 Helped EDUCATE patient (N1,998)
77 Made JOB MORE FUN (N2,341)
78 Improved PATIENT SATISFACTION (N1,998)
86 Improved QUALITY OF CARE (N2,061)
89 Helped COMMUNICATE with doctor (N2,080)
Percentages of cases created to which the
provider Agreed or Strongly Agreed with the
statement.
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Data collected at Norton Sound Regional Hospital
demonstrates annual travel savings in excess of
180,000 from two audiologist practicing
telehealth.
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For More Information

• Lori Eussen
• Director of Sales and Marketting
• [phone]
• leussen_at_afhcan.org

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Alaska Home Telehealth Monitoring Initiative
Bringing Health Care Into Your Home
Village of Togiak Home Telehealth Monitoring
Pilot Location
Blood pressure Heart rate Pulse oximetry Blood
glucose Spirometry Coumadin/PT-INR
www.afhcp.org
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Process ImprovementInnovation

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Adoption of ITIL Best Practice Framework for
Health Information and Technology (HIT)
ITIL is guidance for the wise and rules for the
foolish Brian Johnson
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Incident Management Problem Management Change
Management Financial Management Request
Management Client Management Release Management
(ERM) Policy Management Configuration
Management (CMDB) Human Resources Administration

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Visionovation
Tom Lefebvre, SPAN Deborah Brollini, DCHS Molly
Southworth, ANMC Med Staff Irene Douthit,
CBSS Kalani Parnell, CBSS Kerry Wilson DEHE
(Helen Stafford) Stewart Ferguson, AFHCAN/HIT

• Reaching our Vision through Innovation

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Reaching our Vision through Innovation
Program Overview
Activity Description Launch Date
Innovative Projects Projects submitted and approved by ELT from no cost up to 140,000 max. (excluding other possible matching sources) 9/01/07 140,000
Awards Recognition Establish visibility recognition for innovation within ANTHC such as Innovator of the year other means to acknowledge creativity. 12/01/07 5,000
Marketing IMF Team resources to help deploy innovation across ANTHC (brochures, buttons, etc.) 9/01/07 5,000
Innovation training Innovation training for leadership and staff both on-site and outside (ie innovation boot camp) 11/01/07 30,000
Stewardship positions Dedicated time by ANTHC staff to engage in Natl. International opportunities around ANTHC innovation (funding match with Div.) 1/01/08 10,000
Sabbaticals Exchange programs Opportunities to learn share around innovation with other organizations (ie for periods of a week or a month) FY08/09
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Reaching our Vision through Innovation
Results

• FY07 10 ideas submitted, 4 funded, 2 operational
  improvements
• FY08 175 ideas submitted, 10 funded, 7
  operational improvements 
• Received multiple ideas for Environmental issues
  and  fitness, exercise, health which were bundled
  into 2 managing groups (Sustainable Environment
  Team and Health Wellness) that were provided a
  small amount of seed money.

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 A dream with courage is innovation A dream
without courage is a delusion  Unknown