August 2010 Issue

Safety Net Providers assess patient satisfaction with expanded hours

In 2009, five safety net clinics joined together to create a collaborative proposal to expand evening and weekend hours at safety net clinics in the Kansas City region. The project received funding from the Health Care Foundation of Greater Kansas City and the REACH Healthcare Foundation. Two of the clinics, Quindaro Family Health Care and Health Partnership of Johnson County, began offering additional evening and weekend hours last October. KC Free Health Clinic expanded its hours in November, followed by Swope Health Services in January. Northland Health Care Access partnered with Samuel U. Rodgers to begin providing evening and weekend care in March.

The National Opinion Research Center (NORC), in conjunction with the participating clinics, developed a patient survey to gather information about patients’ health care access, sources of care, health-seeking behaviors and clinic experiences. The survey was distributed to patients who received health care at the clinics during the new evening and weekend hours. Preliminary aggregate results show the following:

• 66 percent of patients would not have received care if safety net clinics were not open in the evening.
• 27 percent would have visited an emergency room if the clinic had not been available.
• 68 percent of the patients said this was the first time they had attended an evening clinic.
• 44 percent of the patients said they have no regular place of care for medical concerns.
• 48 percent of the patients indicated that the clinic was where they went for medical care.
• 100 percent of the patients said they were extremely likely or very likely to return to the clinic for treatment in the future.

For more information about evening and weekend clinic hours, please contact Traci Rowland. 

Sign up for KCBHIE monthly updates

To keep stakeholders apprised of the progress of the Kansas City Bi-State Health Information Exchange, a monthly update will be sent to any interested individuals on the first Friday of each month. This update will take the place of the monthly conference call. The update will include a synopsis of the KCBHIE Formational Board meeting, an overview of the work of KCBHIE committees that has taken place over the last month and any other relevant information that may be of interest to stakeholders. The August update is available now. To receive future monthly updates via e-mail, please contact Jody Denson.

KCBHIE joins effort to develop statewide health information exchange

In July, the Kansas Medical Society, the Kansas Hospital Association, the Kansas City Bi-State Health Information Exchange and the Wichita Health Information Exchange announced that they will join together to create a statewide health information exchange, the early phases of which are expected to be operational in the state's two largest metropolitan areas by year's end.

The collaboration arose out of a shared belief that a statewide health information exchange, developed through the combined efforts of the provider community and the leading health information organizations in Wichita and Kansas City, will put the state in the best possible position to:

• Ensure that the core focus of the HIE is on protecting patient privacy while improving patient care coordination and quality;
• Ensure that the costs of operating the HIE are fairly and appropriately shared by all stakeholders, and structured to minimize barriers to participation by all providers;
• Ensure that the health information exchange is available to and serves the needs of providers and patients in rural and medically underserved areas of the state;
• Achieve efficiencies of scale in the purchase and implementation of the core technology infrastructure required by a health information exchange; and
• Capitalize on the unique strengths that local communities and regions bring to the health information exchange and ensure that individual regions or communities have the decision-making authority to address local or regional health care initiatives.

The four health care groups have all been active participants in the year-long process led by the Kansas Department of Health and Environment through the eHealth Advisory Council to create an overarching framework that will establish standards for approval, operation and oversight of health information exchanges. The groups intend to continue to support and work closely with the KDHE-led planning effort, which is expected to submit its strategic and operational plans to the federal government for approval by the end of August.

Children’s Enhancement Project continues to grow

The Children’s Enhancement Project (CEP) is now providing direct services to children in Missouri with significant behavioral health needs. Children receive services in Professional Parent Homes and in their own homes. The goal of the project is to provide intensive services to children in the community to reduce hospitalizations. Five Enhanced Behavior Specialists have been hired by community mental health centers to work directly with the children, and interest in becoming a Professional Parent Home is growing. There are three licensed Professional Parent Homes and four more families have expressed interest in becoming licensed.

The consulting members of the Intensive Staffing Team are also growing. The intensive staffing team works together to identify the services and supports children will need to remain in the community. New members include Andrea Buford, Swope Child and Youth CPR program director; Jamie Wehmeyer, Tri-County director of intake and support services; and Jamie Henderson, associate psychologist and case management assessment supervisor, KCRO. Kathleen Featherstone, acting director of KCRO, has joined the CEP Steering Committee. The addition of these new members increases community awareness of the project and broadens professional input necessary to ensure needed services will be identified and provided from a collective community approach.

Final rules published for meaningful use of health information technology

In July, the Centers for Medicare and Medicaid Services (CMS) announced final rules that specify the initial criteria that eligible professionals, eligible hospitals and critical access hospitals must meet to demonstrate the meaningful use of health information technology and qualify for incentive payments. The new regulations, incentives and assistance programs seek to improve the health of Americans through “meaningful use” of electronic health records (EHR) in five key areas:

• Improving the quality, safety and efficiency of care while reducing disparities;
• Engaging patients and their families in their health care;
• Promoting public and population health;
• Improving care coordination; and
• Promoting the privacy and security of electronic health records.

For hospitals and eligible professionals, “demonstrating meaningful use” is the key to receiving incentive payments. Key steps in the implementation timeline include:

• The Office of the National Coordinator projects that certified EHR software will be available for purchase by hospitals and eligible professionals by fall 2010.
• Registration for the EHR incentive program will begin in January 2011.
• Medicare attestations may be made in April 2011 by eligible professionals and hospitals.
• Medicare incentive payments will begin in May 2011.
• States will initiate their Medicaid incentive programs on a rolling basis, subject to CMS approval of the state Medicaid HIT plan, which will define how each state will implement and oversee the incentive program.

For Stage 1, which begins in 2011, the criteria for meaningful use focus is on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating the information for care coordination purposes, and initiating the reporting of clinical quality measures and public health information. For more information on the objectives that must be achieved by eligible professionals and hospitals see the handout from the Kansas Foundation for Medical Care. 

Technology assessments underway for area safety net clinics

The Kansas Association for the Medically Underserved (KAMU) and KC CareLink will assist KCBHIE in completing technology assessments of safety net clinics in Kansas and Missouri. KAMU will work with the safety net clinics in Kansas and KC CareLink will work with the safety net clinics in Missouri. Determining how clinics could connect to the health information exchange is of critical importance. In general, clinics can choose one of three ways to participate:

• Clinics that do not want to digitize patient health records can still have access to community health data through a web-based provider portal. 
• Providers may choose to share data across the exchange by utilizing an electronic medical record "lite" that integrates seamlessly into the HIE.
• Safety net clinics may choose to share data directly though their own electronic medical record. 

The technology assessments will be completed as soon as possible. 

Metropolitan Mental Health Stakeholders seek nominations for System Change Committee

The Metropolitan Mental Health Stakeholders are seeking nominations from Missouri stakeholders who are interested in participating in a committee designed to address systemic issues associated with children’s mental health services. The committee is part of the original design of the Children’s Enhancement Project (see related article above). The committee will meet monthly at the Mid-America Regional Council. Examples of some of the issues the committee will address include the development of stronger links between public schools and mental health services, increased use of tele-psychiatry to provide psychiatric services in rural Missouri, improved care coordination, and stronger linkages between Kansas and Missouri children’s mental health services. If you are interested in participating in this committee please complete the nomination form and return it to Laura McCrary by Sept. 2, 2010. 

Presentation to focus on worry-free lobbying for nonprofits

The Health Care Foundation of Greater Kansas City and the REACH Healthcare Foundation will bring the Alliance for Justice to Kansas City on Oct. 21, 2010, from 1–3:30 p.m. at the Pioneer College Auditorium. The Alliance will discuss how nonprofit organizations and foundations can take advantage of clear and generous provisions in federal law that encourage lobbying activity.