Susan Chauvie, R.N., M.P.A./H.A.

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Susan Chauvie, R.N., M.P.A./H.A.

  1. 1. Enhancing Access and Quality of Oral and Mental Health ServicesEnhancing Access and Quality of Oral and Mental Health Services HRSA All-Grantees MeetingHRSA All-Grantees Meeting November 2007November 2007
  2. 2. OCHIN NetworkOCHIN Network Founded in 2001 (501c 3) Mission “ To improve the health of the medically underserved through the best use of information and information technology” HRSA OHIT 07
  3. 3. OCHIN NetworkOCHIN Network  Collaborative of 20 organizations  Washington, Oregon, California  150 clinic sites • County Health Departments, FQHCs & look-alikes; Rural Health Centers, School-based Health Clinics  200,000 annual patients  1,000,000 annual visits  3,500,000 total visits  2,500 users - 800 providers HRSA OHIT 07
  4. 4. OCHIN Network Patients ServedOCHIN Network Patients Served  35% Hispanic  65% children & women of child bearing age  2/3 at or below 100% FPL  50% uninsured in past year  45% on Medicaid in past year  20% rural HRSA OHIT 07
  5. 5. OCHIN NetworkOCHIN Network Organized Healthcare Arrangement (OHCA) An organized system of health care in which otherwise separate “covered entities” as defined in HIPAA, hold themselves out to the public as participating in a joint arrangement and participate in joint activities pertaining to at least one of the following:  Utilization review activities  Quality assessment and improvement activitiesQuality assessment and improvement activities  Payment activities when financial risk is shared Code of Federal Regulations, Public Welfare, Section 164.501HRSA OHIT 07
  6. 6. OCHIN NetworkOCHIN Network Shared Health Record OCHIN uses a single master patient index (MPI) structure:  Increased patient safety & continuity of care  Most cost effective solution  Enhanced research potential HRSA OHIT 07
  7. 7. OCHIN Network – Current ServicesOCHIN Network – Current Services Fully integrated Practice Management suite and Electronic Medical Record system (Epic Systems): HRSA OHIT 07 • Registration • Scheduling • Billing • EMR • Reporting
  8. 8. OCHIN Network – Current ServicesOCHIN Network – Current Services HRSA OHIT 07 Consultation services • Strategic planning • Readiness assessment • Change management • Workflow reengineering • Project management • Strategies to improve AR • Management of clinical content • Financial planning • Grant writing • Training & optimization strategies • Web-based training • Report design
  9. 9. OCHIN Network – Current ServicesOCHIN Network – Current Services HRSA OHIT 07 Interfaces • 11 lab orders/results • 20 payor • Medicare eligibility • Dental eligibility • Dental billing • Document management • Radiology transcription • Pharmacy ADT • EyePacs image processing • Meditracks • Surescripts Rx
  10. 10.  Centralized billing  Televox HouseCalls- appointment reminder HRSA OHIT 07 OCHIN Network – Current ServicesOCHIN Network – Current Services
  11. 11. Improving Access & Quality toImproving Access & Quality to Oral and Mental Health ServicesOral and Mental Health Services Opportunity EMR to EHR  Eliminate artificial segregation of personal health  Create a comprehensive clinically integrated EHR  Clinical integration = Safer & more cost effective care  Reduce racial, ethnic and poverty disparities HRSA OHIT 07
  12. 12. Improving Access & Quality toImproving Access & Quality to Oral and Mental Health ServicesOral and Mental Health Services Opportunity Integrate dental services  Unhealthy oral bacteria can lead to/worsen many other health conditions.  Financial barriers to care cause minority elderly to receive fewer dental services. 1. Stanton, M.W, Rutherford ,M.K.. Dental care: improving access and quality. AHRQ; 2003HRSA OHIT 07 1 1
  13. 13. Improving Access & Quality toImproving Access & Quality to Oral and Mental Health ServicesOral and Mental Health Services Opportunity Integrate dental services  Poor children are 50% less likely to have preventative dental visits than children in middle-high income brackets.  US children ages 2 – 9 with untreated tooth decay: • Mexican-American 70% • Poor (<200% FPL) 20% HRSA OHIT 07 1. Stanton, M.W, Rutherford ,M.K.. Dental care: improving access and quality. AHRQ; 2003 1 1 11 • African-American 68% 1
  14. 14. Improving Access & Quality toImproving Access & Quality to Oral and Mental Health ServicesOral and Mental Health Services Opportunity Integrate mental health services  45% of suicides have seen PCP 1 month prior.  42% CHC patients have 2x depression than ave population.  PCP averages 50% of their time treating mental health issues in 70% if their patients. 2. Luoma et al., 2002; Fact Sheet & Resource Guide, 2005 Assoc of State Health Officials.HRSA OHIT 07 2 2 2
  15. 15. Improving Access & Quality toImproving Access & Quality to Oral and Mental Health ServicesOral and Mental Health Services Opportunity Integrate mental health services  Since 1980, suicide has doubled among young black males in US.  American Indians appear to suffer disproportionately from depression and substance abuse. 3. Satcher, MD., Ph.D., Mental Health: A Report of the Surgeon General, 1999.HRSA OHIT 07 3 3
  16. 16. Improving Access & Quality toImproving Access & Quality to Oral and Mental Health ServicesOral and Mental Health Services OCHIN Strategy  Build on network success, relationships and trust.  Add Incremental mental health portion to PM & EMR.  Continue to move towards integrated primary care HOME.  Capitalize on members’ desire to move to full integration. HRSA OHIT 07
  17. 17. Improving Access & Quality toImproving Access & Quality to Oral and Mental Health ServicesOral and Mental Health Services OCHIN Plan  Continue working with community to move towards PHR.  Continue to collaborate with states on integration initiatives.  Maintain flexibility/openness to evolving integration needs.  Develop strategic vendor partnerships for future needs.  Use HRSA Innovations grant to help get us there. HRSA OHIT 07
  18. 18. Improving Access & Quality toImproving Access & Quality to Oral and Mental Health ServicesOral and Mental Health Services Challenges  New model of care delivery  Potential provider reluctance- integration vs. subsuming  Training for mental & dental health providers & support staff  Billing- health & behavior codes, limited reimbursement for same day appointments, dental billing  Reporting needs  Change is hard, even when it’s the right thing to do! HRSA OHIT 07
  19. 19. Lessons LearnedLessons Learned  Start simple, build on success, dream big.  HIT isn’t magic – it amplifies what is.  Make an investment for the long term – Ford Explorer.  Do not underestimate the need for change management.  You can never over communicate.  Technology is the easy part.  Be realistic.  You don’t have to do this alone.HRSA OHIT 07
  20. 20. QUESTIONS? Thank You!Thank You! Susan ChauvieSusan Chauvie (503) 943-2500(503) 943-2500 chauvies@ochin.orgchauvies@ochin.org

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