Annual Wellness Visit Presentation

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Improve the health of your patient population with Annual Wellness Visits while earning additional revenues for your practice

Improve the health of your patient population with Annual Wellness Visits while earning additional revenues for your practice

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  • 1. Managing HealthCare with AWACStm George Marmo Business Development ManagereC ResearchA division of eCast Corporation 1
  • 2. AWACS is a proprietary system known as“Annual Wellness and Care Surveillance” • AWACS takes advantage of new Medicare law • Medicare patients get an Annual Wellness Visit (AWV) • no copay and no deductible • AWACS helps improve the quality of healthcare, reduces the cost of healthcare and rewards the physician eC Research A division of eCast Corporation 2
  • 3. AWACS Reduces Healthcare Costs • Provides long range plan of healthcare • Identifies high-risk chronic illnesses • Identifies patients who are failing in mental acuity • Identifies patients who pose a safety risk • Reduces accident and fall rate • Reduces long term care and nursing home stayseC ResearchA division of eCast Corporation 3
  • 4. eC Research 4A division of eCast Corporation
  • 5. * Performed by PracticeeC Research 5A division of eCast Corporation
  • 6. eC Research * Performed by Practice 6A division of eCast Corporation
  • 7. eCR AWACS Implementation Plan Greetings and welcome to the eC Research Annual Wellness and Care Surveillance (AWACS) program. Under AWACS, you can expect to achieve the following milestones: You will greatly increase your quality of care for your patients You will reduce the overall cost of healthcare for your Medicare patient population You will increase your own revenue base As you may know, the Medicare Annual Wellness Visit, which is the foundation of AWACS, is a program that is strongly encouraged by Medicare for all your Medicare patients every year. Congratulations! As an AWACS provider, you are demonstrating your professional concern for Plan & Implement patient health and cost reduction measures. Now, here is an implementation plan for your AWACS system. Pre-Implementation Steps AWACS Contract Signed Business Associate Contract Signed Date Due Completed/ Notes  Train Staff NP Assigned Define Days of Week and Times for AWACS (See Note 1)  Configure Systems Define Staff Member names and roles (See Note 3) Implementation  Load Data Steps Date Due Due From/ Completed/ Notes Project Manager Assigned ESV Setup Assigned ESV Trainer Assigned Practice Data and Provider Data Captured .mdEmail service order completed and faxed to client .mdEmail service order signed by client and faxed to eCR Ledger of Medicare patients prepared by client and sent to eCR (See Note 2) eCR AWACS Implementation Plan Page 1eC Research 7A division of eCast Corporation
  • 8. eC Research 8A division of eCast Corporation
  • 9. The Wellness Visit consists of: • Past Medical History • List of Current Providers • Medications, Allergies and Immunizations • Social and Family History • Review of Systems (brief) • Physical Exam (brief) • Functional Capacity and Safety Evaluation • MCI/Cognitive Impairment Evaluation • PHQ-9 Potential for Depression EvaluationeC ResearchA division of eCast Corporation 9
  • 10. 10/7/2011 Betty J Pendegrass-56345 New River Medical Center 1640 Bryan Station Road Ste 101 Lexington, KY 40505 P:859-259-0588 F:859-422-4357 Betty J Pendegrass Printed: 10/7/2011 303 Willow Lane Patient Name: Betty J Pendegrass Glendale, KY 07343 SSN: 555-00-2342 Account Number: 56345 DOB: 09/12/1934 MRN: Age: 77 Rendering Provider: Joy Wilburn Physicians DOS: October 6, 2011 Problem(s) The patient reports the following problems: obesity, forgetfulness, depression, sleep disorder, HTN, osteoarthritis and problems with cholesterol. Report Allergy History (Last Reviewed By: ) 10/06/2011 Other Pollen 10/06/2011 Medication penicillin G benzathine 1,200,000 units/2 mL intramuscular suspension Medication History (Last Reviewed By: ) Date Medication Qty Dosage & Frequency Rfl 10/06/2011 hydrochlorothiazide 12.5 mg oral capsule cap 1 cap(s) orally once a day 0 • Summary 10/06/2011 lisinopril 10 mg oral tablet tab 1 tab(s) orally once a day 0 10/06/2011 Synthroid 100 mcg (0.1 mg) oral tablet tab 1 tab(s) orally once a day 0 Constitution Complains of weight gain, fatigue, weakness and insomnia. Denies appetite. Vitals Date Time LMP EDD Height Weight BMI BP Resp. Pulse Temp. O2 Sat. Head Cir. Waist • Risk Factors (in) (lb) (°F) (cm) (in) 10/07/2011 08:36 AM 62 125 22.91 110/90 35 Reason for Visit The purpose of this visit is the Medicare Annual Wellness Visit for the initial (first) annual wellness visit. Current Providers and Suppliers of Medical Care • 5 Year Plan The patients providers and suppliers of medical care are as follows: Tammy McChord (dentist), Wal Mart (drug store), Winchester (drug store) and Clark Regional (hospital). Diet The patients diet consists of 1-2 servings of nuts or berries per week, 3 or more servings of fruit per week, 1-2 servings of fish per week, 3 or more servings of red meat per week, 3 or more servings of green, leafy vegetables per week, no servings of soda with sugar per week, 3 or more servings of fried food per week, 1-2 servings of saturated fat food per week, no cups of coffee per day, 1-2 cups of tea • Health Advice per day and 1 aspirin each day. Exercise and Activity Level The patients exercise and activity level consists of low exercise level, gardening, crossword or jigsaw puzzles, boating and fishing. Functional Capacity The patient was evaluated for his or her functional capacity. Pass/Fail results are as follows: sitting (passed), standing (failed), lifting (passed), carrying (passed), pushing (passed), pulling (passed), bending (passed), stooping (failed), squatting (failed), kneeling (failed), reaching (failed) and hand use (failed). Safety The patients safety was evaluated. The evaluation shows that the patients safety awareness is as follows: the patient currently uses handrails and understands the need to hold on to a handrail when walking or using stairs, the patient sometimes or frequently walks on slippery surfaces without the ability to stabilize (fails), the patient drives quite a lot even though it may pose a safety threat to him or her (fails), the patient locks his/her doors and windows and keeps lights on at night, the patient maintains steady contact with his/her family and the patient has a number of friends with whom s/he stays in contact. MCI/Cognitive The patient was assessed for MCI/Cognitive responses and the results are as follows: eye movement (passed), walking and balance (failed), sense of touch (passed), draw clock face with hands showing time (passed), name todays date and location (failed), ability to copy a design (failed), ability to follow a 3-step command (failed), remembering a list of 3 words (failed), ability to follow a written instruction (passed), ability to write a complete sentence (failed) and ability to count backwards from 100 by 5 (failed). Mental State and Potential for Depression (PHQ-9) The patient reports that s/he is happy with his/her family life. The patients outlook on life is negative. The patient appears to be moody, Page 1 of 4eC Research 10A division of eCast Corporation
  • 11. 10/7/2011 uneasy, anxious with a depressed state of mind, sad, empty and in a ready state of tears. The patient appears to has a lack of Betty J Pendegrass-56345 interest in activities that used to be enjoyable. The patient reports that s/he has gained or lost weight recently. The patient reports Medicare Mandatory Requirements that s/he has little to no appetite and does not enjoy eating food. The patients sleeping patterns are abnormal and s/he has difficulty sleeping. The patient appears to be normal, calm, not agitated.. The patient reports that s/he is having trouble remembering and thinking things through lately and having difficulty remembering people, places and things and the details surrounding them. The patient is showing a reduction in his or her ability to move normally. The patient reports that he or she feels fatigued frequently and has a constant lack of energy. The patient feels good about him or herself and does not suffer any feelings of guilt. The patients concentation is poor. The patient is able to make decisions freely. The patient does not have thoughts of death or suicide normally. Risk Factors The patients risk factors are shown in the following table. RISK FACTOR LEVEL TREATMENT OPTIONS ASSOCIATED RISKS Diabetes Moderate Continue monitoring lipids, BMI, waist. Retinopathy CVD Severe Continue monitoring BP, cholesterol, BMI. Stroke/TIA Risk Factors Stroke/TIA High Continue monitoring BP, aspirin intake. Counsel patient on fatty red meat, fried food and saturated fat Colorectal Cancer High intake. Consider referral to Registered Dietician if warranted. Continue monitoring bone density. Consider calcium Osteoporosis/Arthritis Moderate Bone Loss supplement. Depression High Continue monitoring early warning signs of depression. Continue monitoring cognitive impairment. Consider referral Cognitive Impairment Severe to neurologist. Functional Capacity and Continue monitoring safety, driving habits, handrails and Severe Safety slippery surfaces. Written screening schedule - 5 year Plan The patients written screening schedule and 5-year plan is as follows. CATEGORY YEAR1 YEAR2 YEAR3 YEAR4 YEAR5 HbA1C Check if HbA1C Check if HbA1C Check if HbA1C Check if HbA1C Check if value GTR 7.0 else 6 value GTR 7.0 else value GTR 7.0 else value GTR 7.0 else value GTR 7.0 else Office Visit months later. Goal 6 months later. 6 months later. 6 months later. 6 months later. 5-year Testing & is: 6.5 Goal is: 6.5 Goal is: 6.5 Goal is: 6.5 Goal is: 6.5 Every visit - goal: Every visit - goal: Every visit - goal: Every visit - goal: Every visit - goal: BP Systolic < 120 Systolic < 120 Systolic < 120 Systolic < 120 Systolic < 120 Diastolic < 80 Diastolic < 80 Diastolic < 80 Diastolic < 80 Diastolic < 80 Every visit - goal: Every visit - goal: Every visit - goal: Every visit - goal: Every visit - goal: Wt/BMI BMI 18-25 BMI 18-25 BMI 18-25 BMI 18-25 BMI 18-25 Screening Plan CBC, CMP, TSH, CBC, CMP, TSH, CBC, CMP, TSH, CBC, CMP, TSH, CBC, CMP, TSH, U/A, Microalbumin, U/A, U/A, U/A, U/A, Standing Lab Orders HbA1C, Lipid Plus Microalbumin, Microalbumin, Microalbumin, Microalbumin, HbA1C, Lipid HbA1C, Lipid HbA1C, Lipid HbA1C, Lipid Plus Plus Plus Plus Seasonal Flu Seasonal Flu Seasonal Flu Seasonal Flu Seasonal Flu Pneumovax (once Immunizations after age 65) Tdap (every 10 years) Gastroenterologist Registered Registered Registered Registered Registered Dietician Dietician Dietician Dietician Dietician Referrals Optometrist or Optometrist or Optometrist or Optometrist or Optometrist or Ophthalmologist Ophthalmologist Ophthalmologist Ophthalmologist Ophthalmologist Podiatrist Podiatrist Podiatrist Podiatrist Podiatrist Personalized Health Advice The patients personalized health advice is as follows. Health Advice CATEGORY RECOMMENDATION ACCOMPLISH BY • Food with saturated fats include meats, milk, eggs, butter and cheese. Talk to your provider about your intake of saturated fats. We suggest you reduce your intake of eggs and butter and order sandwiches without cheese and mayonaise. If you can reduce the saturated fat in your diet, your heart will love you for it and youll lose inches off your waistline. Page 2 of 4eC ResearchA division of eCast Corporation 11
  • 12. The Report includes an assessment of RiskFactors: •Lung Cancer • Diabetes II •Colon Cancer • CHD/CF •Breast Cancer • COPD •Prostate Cancer • Depression • Cognitive Impairment • Functional Capacity • SafetyeC ResearchA division of eCast Corporation 12
  • 13. eC ResearchA division of eCast Corporation 13
  • 14. 10/7/2011 Betty J Pendegrass-56345 • Please let your provider know that you are having difficulty sleeping at night. Remember to avoid large meals and caffeine before bedtime. • You should discuss your fatigue and loss of energy with your provider as soon as possible. • Your age is 65 years or older. As you age your bones become brittle and you have muscle loss. Your provider can discuss ways that you can help strenthen bones and muscles. • Your risk for arthritis is "moderate." Please talk to your provider about this as soon as possible. • You had difficulty using your hands. Your provider will discuss this with you separately. • You had difficulty kneeling. Your provider will discuss this with you separately. • You had difficulty reaching over your head. Your provider will discuss this with you separately. • You had difficulty squatting down. Your provider will discuss this with you separately. As directed by your provider: Physical Strength • You had difficulty standing up. Your provider will discuss this with you separately. ______________ • You had difficulty stooping. Your provider will discuss this with you separately. • Exercises you should do every day include walking around the block twice, lifting 20 pounds 10 times and bending and stretching at the waist. If you are able, consider gardening, walking, bowling, golfing or other recreational activities 3 times per week to keep your muscles and bones strong. • If you feel that your physical movements have become restricted lately, please let your provider know immediately. • Your provider will discuss your reduction in physical movements with you and offer some further advice. • Your risk of osteoporosis is "moderate." Please talk to your provider about ways you can prevent osteoporosis. Your • Your provider will talk with you about your reported high blood pressure As directed by problems and discuss options with you. your provider: Referrals ______________ Electronic Joy Wilburn 10/07/2011 07:25 PM SignatureeC Research Page 4 of 4A division of eCast Corporation 14
  • 15. eC Research 15A division of eCast Corporation
  • 16. Summary • Very innovative strategy that reduces overall cost and increases the quality of healthcare • Addresses the very heart of what CMS wants to provide which is “proactive” healthcare • Rewards physicians and up running in less than 30 days • Comes with certified “starter” EMR, works with any EMR and stores data in a Health Information ExchangeeC ResearchA division of eCast Corporation 16
  • 17. George Marmo eC Research Business Development Manager (973) 524-5048 gmconsultllc@gmail.comeC ResearchA division of eCast Corporation 17