iHT² Health IT Summit San Francisco – Case Study “MLK 2.0: Building Value Based Care from the Group Up” with Sajid Ahmed, Chief Information and Innovations Officer, Martin Luther King Jr. Community Hospital
 

iHT² Health IT Summit San Francisco – Case Study “MLK 2.0: Building Value Based Care from the Group Up” with Sajid Ahmed, Chief Information and Innovations Officer, Martin Luther King Jr. Community Hospital

on

  • 302 views

iHT² Health IT Summit San Francisco – Case Study “MLK 2.0: Building Value Based Care from the Group Up” with Sajid Ahmed, Chief Information and Innovations Officer, Martin Luther King Jr. ...

iHT² Health IT Summit San Francisco – Case Study “MLK 2.0: Building Value Based Care from the Group Up” with Sajid Ahmed, Chief Information and Innovations Officer, Martin Luther King Jr. Community Hospital

Statistics

Views

Total Views
302
Views on SlideShare
302
Embed Views
0

Actions

Likes
0
Downloads
10
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

iHT² Health IT Summit San Francisco – Case Study “MLK 2.0: Building Value Based Care from the Group Up” with Sajid Ahmed, Chief Information and Innovations Officer, Martin Luther King Jr. Community Hospital iHT² Health IT Summit San Francisco – Case Study “MLK 2.0: Building Value Based Care from the Group Up” with Sajid Ahmed, Chief Information and Innovations Officer, Martin Luther King Jr. Community Hospital Presentation Transcript

  • Martin Luther King, Jr. Community Hospital Page 1 3/28/2013 The New Martin Luther King Jr. Community Hospital (MLK2.0): Building Value Based Care from the Ground Up by Sajid Ahmed, CIIO IHT2, San Francisco March 25, 2014
  • Martin Luther King, Jr. Community Hospital Page 2 3/28/2013 Martin Luther King, Jr. Community Hospital “Transforming Healthcare Delivery through Care Coordination” A Hospital Overview Sajid Ahmed, Chief Information and Innovations Officer
  • Martin Luther King, Jr. Community Hospital Page 3 3/28/2013 History • August 2007: Martin Luther King, Jr. Harbor (formally MLK/Drew) was closed • April 2010: LA County and UC jointly sponsored Assembly Bill 2599 (AB 2599) to ensure long-term financial viability of the new Hospital • July 2010: County and UC sign Coordination Agreement; UC will assist with: • Hospital’s Graduate Medical Education program • Hospital-based physician services • Hospital’s quality and performance improvement programs • Pre-opening activities that require physician expertise • August 2010: MLK-LA formed as a new nonprofit entity; Board members are appointed by the County and UC • October 2012: CEO, Dr. Batchlor hired. • February 2013: Employee number 2 hired, Sajid Ahmed
  • Martin Luther King, Jr. Community Hospital Page 4 3/28/2013 The New Public/Private Partnership Governance: County Board of Supervisors Governance: Board of Regents MLKCH Foundation Coordination Agreement IGT and Indigent Care Funds MLK, Jr. Community Hospital Governance: Community Board Non-Profit 5013c Building Lease LA County UC, UCLA Fundraising
  • Martin Luther King, Jr. Community Hospital Page 5 3/28/2013 A private, non-profit, safety net hospital providing high quality, collaborative care for South Los Angeles and surrounding communities in partnership with the County of Los Angeles, University of California and other community providers Identity Statement
  • Martin Luther King, Jr. Community Hospital Page 6 3/28/2013 Vision To be a leading model of innovative, collaborative community healthcare Mission To provide compassionate, collaborative, quality care and improve the health of our community Values • Caring • Respect • Collaboration • Excellence • Accountability Vision, Mission and Values
  • Martin Luther King, Jr. Community Hospital Page 7 3/28/2013 Hospital Service Area • Population – 1.2 million residents • Socioeconomic – 67% of household incomes less than $50,000 • Payer Mix – Predominately Medicaid; 14% Medicare • Access to Healthcare – Federally Qualified Health Centers (FQHC) – County multispecialty outpatient center on MLK campus – Private providers and IPAs – Physician shortages across all medical and surgical specialties – High need for adult medicine providers – Lack of organized managed care medical groups
  • Martin Luther King, Jr. Community Hospital Page 8 3/28/2013 Access to Health Care in South Los Angeles • Health Professional Shortage & Medically Underserved Areas • High need for adult medicine providers • Lack of organized medical groups • One hospital • 90% of residents travel outside area for health care
  • Martin Luther King, Jr. Community Hospital Page 9 3/28/2013 Projected Payer Mix – 2015* Medicare 10% Medi-Cal FFS 24% Medi-Cal managed care 39% Medicare dual-eligible 2% Uninsured 23% Commercial 2% *Based on ADC
  • Martin Luther King, Jr. Community Hospital Page 10 3/28/2013 Hospital Service Area • Large portions designated as a Health Professional Shortage Area and/or a Medically Underserved Area • Physician shortages exist across almost all medical and surgical specialties
  • Martin Luther King, Jr. Community Hospital Page 11 3/28/2013 Hospital Service Area • Significant Health Disparities ⁻ Mortality rates for diabetes, coronary heart disease, stroke and lung cancer among the worse ⁻ High incidence rates of AIDS among adolescents and adults ⁻ Low birth rates
  • Martin Luther King, Jr. Community Hospital Page 12 3/28/2013 MLKCH Medical Staff Hospital-Based Specialties Provider Anesthesiology UCLA Emergency Medicine VEP Hospitalists VEP Intensivists VEP Laborists Eisner Pathology UCLA Radiology UCLA Surgery (ENT, Neurosurgery, Oral, Ortho, Plastics) Under discussion Total Estimated FTEs 55 Specialty Consultants Primary Care
  • Martin Luther King, Jr. Community Hospital Page 13 3/28/2013 Dr. Elaine Batchlor, MD. MPH Chief Executive Officer Sajid Ahmed Chief Information and Innovations Officer Dr. John Fisher, MD, MBA Chief Medical Officer Keith Bradkowski, RN, MS Chief Operating Officer/ Nursing Officer Kellie Todd Director, Community Affairs and Marketing Dr. Medell Briggs Malonson, MD, MPH Medical Director, Quality Danielle Sreenivasan Interim Chief of Staff Blair Contratto Interim Vice President, Network and Business Development Rebecca Bales Interim Chief Financial Officer Melayne Yocum Interim Chief Administrative Officer Tim Fyffe Interim Vice President, Facilities Peggy Crabtree Vice President, Ancillary Services Phyllis Nelson Interim Director, General Services Dyan Sublett President, MLK Community Health Foundation Pre-Opening Organization Chart Indicates permanent staff Indicates actively recruiting position; currently filled by consultant Indicates position currently filled by a consultant; recruitment will begin in future when applicable Manager, Community Relations (OPEN) Susan Burrows Vice President, HR
  • Martin Luther King, Jr. Community Hospital Page 14 3/28/2013 • Clinical Excellence – Workforce – Protocols and performance • Care Delivery Innovation – Connected continuum of care – Population health management • Operational Effectiveness and Efficiency – Structure, systems and tools • Stable Financial Position • Collaboration and Community Engagement MLKCH Strategic Objectives
  • Martin Luther King, Jr. Community Hospital Page 15 3/28/2013 MLKCH Clinical Services Licensed Bed Type Total Medical/Surgical 93 Intensive Care 20 Obstetrics 18 Total Licensed Beds 131 Other Total Nursery - Bassinets 11 Emergency Department 21 Fast Track Stations 8 Operating Rooms 4 C-Section Rooms 1 Post-Anesthesia Care Unit 12
  • Martin Luther King, Jr. Community Hospital Page 16 3/28/2013 MLKCH Clinical Services Scope of Inpatient Services to be Provided by the Hospital  Anesthesiology  Cardiology  Emergency Services  Endocrinology  Gastroenterology  General Medicine  General Surgery  Neurology  Obstetrics & Gynecology  Ophthalmology  Orthopedics  Otolaryngology  Pathology  Radiology  Plastic Surgery  Pulmonary Medicine  Urology
  • Martin Luther King, Jr. Community Hospital Page 17 3/28/2013 The MLKCH Brand Values Innovation Caring MLK Community Hospital Key Attributes
  • Martin Luther King, Jr. Community Hospital Page 18 3/28/2013 MLKCH Brand: Caring • Behavioral interviews to employ diverse, multilingual workforce that embraces our values • Family-centered hospital rooms with sleepover beds • Patient interactive systems for education, entertainment, and interaction with staff • Healing art collection • Customer service coordinators • Press Ganey and HCAHPS satisfaction surveys to measure and improve satisfaction
  • Martin Luther King, Jr. Community Hospital Page 19 3/28/2013 MLKCH Brand: Quality • High quality physicians • Evidenced-based medicine and performance transparency • Team-based care • Coordination with care partners across continuum • Patient education and engagement • High quality, high touch, high tech patient centered care
  • Martin Luther King, Jr. Community Hospital Page 20 3/28/2013 MLKCH Brand: New • New hospital leadership and organization • Recruiting and training high caliber staff • New state-of-the-art building • Installing new furniture, fixtures and equipment • State-of-the-art information and biomedical technology
  • Martin Luther King, Jr. Community Hospital Page 21 3/28/2013 MLKCH Brand: Collaboration Area of Collaboration Partner Care Coordination • LAC-DHS • Southside Coalition of Community Health Centers • Referral hospitals • Other community providers Clinical Oversight • UCLA Construction of New Building • Department of Public Works Emergency services • EMS and referral hospitals Funding • Los Angeles County • California DHS • MLK Community Health Foundation Inpatient Providers • UCLA • Valley Emergency Physicians • Eisner Medical Group • Others
  • Martin Luther King, Jr. Community Hospital Page 22 3/28/2013 MLKCH Brand: Innovation • New approaches to care delivery – Telehealth to expand access to specialty care – Patient interactive system and smartphone applications to educate and engage patients – Mobile solutions for providers – Connectivity to care partners – Use of auxiliary health care workers • Community Learning and Resource Center • Innovation Hub
  • Martin Luther King, Jr. Community Hospital Page 23 3/28/2013 Health Care Transformation & Population Health Management
  • Martin Luther King, Jr. Community Hospital Page 24 3/28/2013 The Campus Master Plan Positions MLKCH to be an Innovative Provider of Coordinated Care Innovation center, Medical office space, Urgent care, Mental health, Homeless recuperative care, Assisted living, Skilled nursing facility, Rehabilitative care, Senior housing Source: Initiative for a Competitive Inner City
  • Martin Luther King, Jr. Community Hospital Page 25 3/28/2013 MLKCH Care Partners MLKCH Dignity California Hospital St. Francis Hospital LAC DHS Rancho Harbor LAC USC UCLA Clinical Leadership Quality Telehealth Hospital Partners DMH Hawkins Community Partners Physician Partners Alta Med SSC 8 FQHCs Omnicare IPA IPA Other HCLA IPA Alta Med IPA MedPoint MSO Social Services Home Health, DME, Rx Payor Partners LA Care Health- Net Medi- care Covered CA Comm- erical MediCal Medical Groups SPA 6 MLK Campus Public Health Centinela Hospital Outside SPA 6 Outside SPA 6 LA County Kaiser Indep. Physicians DHS MACC Long-Term Care Other Community Partners1 Associ- ations CBOs Govn’t Agen- cies 1Other Community Partner Examples: • CBOs – Shields for Families, Black Women for Wellness, Urban League, Community Health Council • Associations – American Heart Association, American Diabetes Association • Government Agencies – DMV, 311, Parks and Recs
  • Martin Luther King, Jr. Community Hospital Page 26 3/28/2013 Strategy to Manage Population Health • FQHCs and Community-based Clinics • Community Providers • Affiliated Medical Groups • High Risk Clinic Primary and Specialty Care Partnerships • Multi-Disciplinary Transition Teams • Post-Discharge Clinic Care Coordination • Home Visits • Sub-Acute Care Providers Post Acute Providers
  • Martin Luther King, Jr. Community Hospital Page 27 3/28/2013 Strategy to Manage Population Health • Remote Patient Monitoring • Learning and Resource Center • Smart Phone Apps for Disease Management and Health Promotion • Peer Support Groups Prevention, Education, and Wellness • Shared Risk Payments • Value Based Alignment of Payment Incentives
  • Martin Luther King, Jr. Community Hospital Page 28 3/28/2013 Inpatient Care • EHR secures past visit data & real- time patient info feeding important data into the clinician workflow • Cerner Smart Registries provide top opportunities according to patient information, prioritizing interventions • Patient’s health record issues alerts providers of possible health risks or care gaps based on trends in the patient’s record Pre- Hospitalizatio n • Pre-admit screening via eConsult • Planned admissions using risk profiles • In-home medical monitoring to detect necessary admissions • TCC helps high risk patients avoid unnecessary admissions • Health system navigation education to avoid unnecessary admissions Post- Discharge • Discharge instructions over-the-phone to PCP and/or caretakers • Securing transitional care: TCC, PCMH, Home Health Agency • Assess patient’s needs and connect him or her with resources for continued care: In-home medical monitoring and mobile apps
  • Martin Luther King, Jr. Community Hospital Page 29 3/28/2013 Hig h Ris k 5% Mediu m Risk 15-35% Low Risk 60-80% Community Activities E-Letters, Texts, Mailings Awareness/Educati on Campaigns Primary Care Medical Home In Home Medical Monitoring Transitional Care Clinic Group Classes Learni ng Center Targeting Risk Factors eConsult
  • Martin Luther King, Jr. Community Hospital Page 30 3/28/2013 Utilization by Health Status Healthy 50% Stable 20% At Risk for Multiple Chronic onditions PERCENTA GE] Multiple Chronic Conditions 8% Catastrophi c Conditions 2% 0% 5% 10% 15% 20% 25% 30% 35% Health Status Percentage of Costs Healthy: 6% Stable: 10% At Risk for Multiple Chronic Conditions: 24% Multiple Chronic Conditions: 28% Catastrophic Conditions: 32% Percentage of Population
  • Martin Luther King, Jr. Community Hospital Page 31 3/28/2013 1.4 Utilize group classes to educate rising-risk patients on how to manage their condition Low Risk Mediu m Risk Implementation Tactics 1.1 Educate residents about the how to navigate the local healthcare system through the Learning Center 1.3 Refer appropriate patients to existing Primary Care Medical Homes with which MLKCH has direct lines of communications 1.2 Connect local PCPs to MLKCH hospitalists through E-Consult to determine if hospital admission is the appropriate course 1.6 Refer highest risk patients to the Transitional Care Clinic 1.5 Utilize in-home medical monitoring devices to provide 24/7 care and recognize warning signs as they’re occurring
  • Martin Luther King, Jr. Community Hospital Page 32 3/28/2013 1.4 Communicate directly with patient’s Primary Care Medical Homes on admissions as well as with discharge instructions Low Risk Mediu m Risk Implementation Tactics 1.3 Coordinate planned admissions using E-Consult 1.2 Use Electronic Medical Records to standardize and centrally store patient information and share it across the organization 1.6 Refer highest risk patients to the Transitional Care Clinic 1.5 Utilize in-home medical monitoring devices to supervise post-discharge care and plan necessary admissions 1.6 Initiate quality reporting to track clinical performance on key measures and identify weaknesses in care coordination 1.1 Connect patients with telehealth tools including mobile apps
  • Martin Luther King, Jr. Community Hospital Page 33 3/28/2013 1.4 Utilize group classes to educate rising-risk patients on how to manage their condition Low Risk Mediu m Risk Implementation Tactics 1.1 Promote healthy behaviors and increase awareness through e-letters, texts, and mailings 1.3 Institute a series of community activities geared at engaging the community in health promotion 1.2 Provide a series of tools and classes at The Learning Center to increase patient’s ability to manage their health 1.5 Increase patient engagement through e-health tools and platforms
  • Martin Luther King, Jr. Community Hospital Page 34 3/28/2013 MLK Health Transformation Center A program to identify, pilot and adopt new technologies, processes and workforce development initiatives, designed to enhance the care within Martin Luther King, Jr. Community Hospital and the health of the entire South Los Angeles Community.
  • Martin Luther King, Jr. Community Hospital Page 35 3/28/2013 Where are we Today?
  • Martin Luther King, Jr. Community Hospital Page 36 3/28/2013 Key Accomplishments • Completed Environmental, Physician Needs and Clinic Needs Assessments • Created strategic plan, operations plan and 5 year budget/pro forma • Developed physician staffing plan • Hired C-Suite executives • Selected medical equipment and furnishings • Completed IT strategy and selected health information systems • Engaged with South Los Angeles community and other key stakeholders
  • Martin Luther King, Jr. Community Hospital Page 37 3/28/2013 Where We Are Today • Los Angeles County completing construction of new facility • MLKCH will complete the following before opening in 2015 – Install equipment and information technology – Implement electronic health record system – Test all equipment and the new IT system – Develop policies, procedures and work flows – Stock the facility – Hire and train staff (approximately 700 FTEs) – Obtain licensures, certifications, and accreditations
  • Martin Luther King, Jr. Community Hospital Page 38 3/28/2013 Key Activities Underway • Hiring hospital management team • Developing – Community engagement and marketing programs – Human resources infrastructure – Policies and procedures • Selecting key partners for revenue cycle, general services, pharmacy, and clinical technology • Securing hospital equipment • Designing and building health information systems • Developing care coordination protocols and resources
  • Martin Luther King, Jr. Community Hospital Page 39 3/28/2013 Key Challenges • New public-private partnership • Local market dynamics – Poor health status and payer mix – Recruitment and retention of qualified staff • Development of an integrated, coordinated system of patient care • Opening a hospital during an era of healthcare reform and significant market change
  • Martin Luther King, Jr. Community Hospital Page 40 3/28/2013
  • Martin Luther King, Jr. Community Hospital Page 41 3/28/2013
  • Martin Luther King, Jr. Community Hospital Page 42 3/28/2013 Questions?
  • Martin Luther King, Jr. Community Hospital Page 43 3/28/2013 Martin Luther King, Jr. Community Hospital
  • Martin Luther King, Jr. Community Hospital Page 44 3/28/2013
  • Martin Luther King, Jr. Community Hospital Page 45 3/28/2013
  • Martin Luther King, Jr. Community Hospital Page 46 3/28/2013
  • Martin Luther King, Jr. Community Hospital Page 47 3/28/2013
  • Martin Luther King, Jr. Community Hospital Page 48 3/28/2013
  • Martin Luther King, Jr. Community Hospital Page 49 3/28/2013 Thank You!