Monthly Update
June 2015
 
  

CCC Board of Directors Meetings:

All CCC Board of Directors meetings are held at 1111 E. Cesar Chavez St., Austin, TX 78702.

  • Next Meeting: August 11, 2015 from 2:00-4:00 pm.

The CCC Board will also meet September 22, 2015 at 2:00 p.m. These dates are subject to change pending Board approval.

  Superhero Award

On Friday, June 5, 2015, mild-mannered Mark Hernandez, M.D. was transformed into his SuperHero alter ego. The occasion was the Friends of Front Steps Luncheon at the First United Methodist Church in downtown Austin. At the luncheon, his SuperHero status was officially recognized with a Community Spirit award that honors individuals who work to make Austin a better place to live. 


Front Steps is a nonprofit organization dedicated to creating real answers and real solutions to the needs of people experiencing homelessness by providing a pathway home through shelter, affordable housing, and community education.

  

CCC IT Update


The CCC-IT team is currently working on multiple key initiatives and has completed significant milestones in each. Below are some of the highlights:

 

One-Button Project:  The project aims to connect the ICC (the community HIE) to the Seton HIE to pull the Discharge Summary for patients that have been in the hospital ER in the past 24 hours. The CCC has engaged the services of a vendor, AEGIS, for this implementation. AEGIS, along with the ICC team, completed a pilot of this project which pulls the patient Discharge Summary and displays it on a secure webpage and staged an informal demo for staff last week.

 

Mini-Nav:  Staff are currently evaluating proposals received to select a vendor for the CCC Navigation System.

 

Patient Portal Project: Vendor selection is also underway for the patient portal project.

 

CCC Website development:  The template for the CCC website has been completed and approved.  CCC Business units are working to create the site content with the end of June as the anticipated "go live" date.

:: 512-978-8164

Contact: Mark Hernandez

CMO Message -

Mark Hernandez, MD


 
We have spent the last several summers in Central Texas adapting to drought. Brown yards, no washing of cars and shrinking lakes have been the norm. But this year, thanks to the emergence of a specific weather pattern in the Pacific, we have seen record rains, flooding in the whole of the state on an unprecedented scale, and a different set of challenges to face in our lives. I am struck by the parallels to our work in healthcare. As we await a decision by the U.S. Supreme Court on the Affordable Care Act's ability to provide subsidies in states with federal exchanges, we watch the Texas Medical Board offer a telemedicine rule which is then halted by the courts. Every day, we seem to face changes in the environment in which we do our work.

 

So how do we transform healthcare in such an environment? How do we know that what we put into place today will work tomorrow, especially given the mutability of the external environment? It is my belief that we do this not by using "state of the art" thinking (what is the best approach today?) but to use "cutting edge" thinking (how will we likely do this in the future?). This introduces more risk into the equation (innovation is favored over established methods) and we seek to mitigate that risk through constant measurement, assessment and performance improvement. Thus, I would like to invite you to learn about how the CCC will develop our ability to be a "learning" organization which is aware of its internal and external environments, how it affects what we are trying to achieve, and how we adjust ourselves to optimize performance.

 

- Mark

IDS Plan Overview


 
The CCC presented its initial IDS Plan to the CCC and CH Boards in April 2015.  The plan was commissioned by the CCC Board in the fall of 2014 to serve as a framework describing the first incremental work to be done over the next 12 - 18 months.  It will be expanded to include plans for future years once implementation of the initial work plan begins. 

 

The IDS work plan focuses on the creation, expansion, and enhancement of the foundational elements required to begin to transform health care safety net services in Travis County into an integrated delivery system (IDS) in which the CCC becomes accountable for the health of a defined population.  This includes increasing access to a range of services that allow each person to be served in the most appropriate setting for their needs as well as creating or enhancing integrators, critical activities that link separate care services to create a networked system of care.  Much of the prioritized work for Year 1 will focus on creating or enhancing these systemic integrators.

 

Prioritized work for the CCC in FY15 and FY16 includes:

  • Develop centralized care coordination services that includes
    • Screening patients upon enrollment for medical needs in addition to financial assistance eligibility
    • Assignment of patients to a medical home
    • Standardization of care coordination services across the IDS
    • Navigation and transition of patients between care settings
    • Closely managing care through case management, utilization management, etc.
  • Enhance and expand select specialty care services through supply management and demand management tactics including:
    • Pilot alternative methods of service delivery
    • Streamline the referral process
    • Account for true cost of care
  • Develop CCC measurement, assessment, and performance improvement capabilities (more information provided later in newsletter)
    • Define measurement process and standards
    • Assess quality of services
    • Improve system performance
  • Continue work on Health Information Technology (HIT)
    • Launch patient navigation software and a patient portal
    • Create access to a centralized community resources directory
    • Finalize the CCC data analytics architecture and launch performance measurement tools
    • Improve timeliness and usability of data that supports other technology initiatives ("One Button")
  • Other key initiatives
    • In conjunction with The University of Texas Dell Medical School, plan for the opening of an ambulatory surgery center
    • Work with FQHCs to analyze changes to federal prospective payment system (PPS), with the goal of outlining new payment methodologies
    • Continue work on a redesigned and expanded MAP benefit plan

IDS Plan Spotlight

Measurement, Assessment, Performance

 

One support function that is critical to the downstream success of the Integrated Delivery System (IDS) is measuring ongoing performance, assessing overall system efficacy, and assisting operational leadership in improving areas where performance gaps are identified. Initially, this work will focus on designing the processes to enable these activities.  The initial design for each work stream will be completed in collaborative workgroups.  Moving forward, Dan Chauncey, Community Care Collaborative (CCC) Chief Performance Officer, will lead the CCC Office of Performance Excellence (OPEx) in support of these work streams.

 

MeasurementClearly define a set of metrics and associated goals for the IDS.

 

An agreed-upon set of measures and standards will allow the IDS to align its work across all participating organizations.  In addition, CCC will prioritize the selection of nationally-endorsed measures and standards, as appropriate, to allow for comparison of IDS performance with national best practices.

Key Deliverables:  Project Portfolio, Metrics Library, Training Plan


AssessmentDefine clear systems for tracking and assessment of system performance.

 

With measures established, the CCC will have a structure for program/service assessment.  The regular tracking and reporting of performance data will demonstrate the value of IDS programs by providing accurate, transparent, and consistent methodologies for the prioritization and/or continuation of system programs as well as assessment of system performance/effectiveness.

This work stream consists of three key outputs -

 

  • Performance dashboards to measure program, provider or system performance against agreed-upon standards;
  • A CCC Assessment Framework in the review of new services or programs or to determine whether the ongoing viability of an existing program; 
  • A structured approach to evaluating research opportunities for the CCC to lead or participate in.

 

Performance ImprovementImprove system performance and optimize processes.

 

Most critical, will be the development of capacity within the CCC to continuously drive improvement across the IDS.  This work will be managed by the CCC Office of Performance Excellence (OPEx).  The mission of the OPEx is to ensure that participating provider organizations have the capacity, technical skills, technical support, and information necessary to continuously drive improvements across the Triple Aim of cost, quality, and patient experience.  Specifically, the OPEx will provide support to apply performance improvement tools and methods to mitigate any identified performance gaps. This support will range from providing training to increase performance improvement capacity within the respective organizations, through providing direct support from OPEx team members-Performance Improvement Consultants-skilled in facilitating and leading performance improvement activities.

 

The OPEx team includes certified Lean and Six Sigma practitioners (known as Black Belts and Master Black Belts), Certified Professionals in Healthcare Quality (CPHQ), a content expert in Patient Centered Medical Home (CCE PCMH), and a Fellow of the College of Healthcare Executives (FACHE). This collection of expertise and hands-on experience will contribute to the long term success of the Integrated Delivery System and the participating organizations.

 

Key Deliverables:  Completed performance improvement projects.

 
Leader Spotlight 

 

Dan Chauncey, Chief Performance Officer, has over 25 years of performance improvement experience and leads the Community Care Collaborative Office of Performance Excellence (OPEx). He is a Lean Six Sigma Master Black Belt and Theory of Constraints Jonah who has led the development and application of process improvement methodologies and training for more than twenty-five years. Mr. Chauncey is a Fellow of the American College of Healthcare Executives (FACHE) and a Certified Professional in Healthcare Quality (CPHQ). He holds a B.S. degree in Criminal Justice and Behavioral Science from Wilmington College, an M.A. in Human Resource Development and an MBA from Webster University.

 

He has authored three books on performance improvement and instruction design: Performance Improvement for Healthcare: Leading Change with Lean, Six Sigma, and Constraints Management (McGraw-Hill), Instructional Design for the Corporate Trainer: A Handbook on the Science of Training (Writers Club Press) and the Process Management chapter in Rath & Strong's Six Sigma Leadership Handbook (John Wiley & Sons).

University of Texas Dell Medical School

   

The future of medical education in Austin continues to evolve. . .  Another important milestone: Dell Medical School's total tuition and fees have been approved. Learn how the medical school's tuition stacks up against peer institutions across Texas and nationwide.

 

The school's groundbreaking curriculum and signature approach to medical education continues to receive national attention. A JAMA commentary on the changing role of physicians highlights how the school "...will include population sciences as well as biological sciences and will train other health professionals alongside physicians."

 

Texas Health Catalyst, a program of the Dell Medical School in collaboration with other UT Austin colleges and units, will accelerate the translation of research to health products.

Congratulations to residents and fellows who presented their work at Seton and Dell Medical School's first co-hosted Research Day.

 

The team continues to grow, and the inaugural chairs have been sharing their visions with the community. If you missed it, watch Dr. Amy Young present: "Healthy Mothers, Healthy Women and a Healthier Community." And Seton highlights Dr. Kevin Bozic's take on the medical school's decidedly different approach to education

University of Texas Dell Medical School

   

Construction continues on the new hospital, as does both clinical planning and operational work to transform local healthcare delivery...

 

On the clinical side, Dr. Kevin Bozic, inaugural chair of Dell Medical School at the University of Texas at Austin's Department of Surgery and Perioperative Care, discusses the creation of a learning health system dedicated to continuous measurement and improvement. Read the article here

 

Operationally, University Medical Center Brackenridge staff are already preparing for their big move to the new hospital. In order to make the move as easy as possible, UMCB is holding a series of clean-up days as part of Project Cleanup!

 

The first Project Cleanup! was held May 19-20. For this session, the Education and Training Transition team for Dell Seton Medical Center at The University of Texas challenged the UMCB staff to clean out all old holiday/party supplies.

 

Rules: 

Every floor and department had 15 minutes to load up stretchers with unwanted holiday/party supplies.

 

Outcome:  

A total of 67 square feet of old supplies were removed, including four Christmas trees, numerous pumpkins, multiple bunnies, yards of garland, a plethora of ornaments and several (fake) skeletons.

 

Winners:    

Respiratory Therapy won the Grand Prize for clearing the most square footage: 20 sq ft gained!

 

Runner ups:

Surgical Services - for the funniest hat

Acute Care Education - for the funniest item uncovered, a blinged-out walking cane

Radiology - for having the most unique storage area

 

All the collected holiday and party supplies were donated to The Salvation Army.  More clean-up dates are planned... Stay tuned.