CPCA NEXTGEN MEETING
February 28, 2012
Introductions
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• Jason Whiteaker, Product
Management Channel
Kevin Maguire, District VicePartner
President
• Brian Sauers, HIE Business
John Darbani, Sales
Development Executive
Executive
• Michael Cassarino, National
Andy Draa, Sales
Implementation Advisor
Bryce Williams, Sales
• Roy Feague, Vice-President,
Cherie Holmes-Henry,
Development
Director of State
• Mischelle Denison, Sr.
Engagement
Director Specialty Sales
Agenda
9:15-9:30am: State of the Union: Update on Community Health clients in CaliforniaCherie/Mischelle
9:30-10am: UDS/OSHPD Reporting- Jeff Gebhart
10:00-11:00am: Health Quality Measures and Dashboard- Laura Anderson
11:00-11:15: Break
11:15-11:45am: NextGen Implementation- Michael Cassarino
11:45-12:15pm: Insight Reporting: Jason Whiteaker
12:15-1:00pm: Lunch- Provided by NextGen
1:15-2:00pm: NextGen Patient Portal- Brian Sauers
2:00-2:30pm: NextPen- Roy Feague
2:30-2:45pm: Break
2:45-3:30pm: KBM Update, 8.0: Mischelle and Carmen
3:30-4:00pm: ICD10 Update Readiness and Update- Ana Croxton/Billy Parrish
4:00pm: Adjourn
STATE OF THE UNION: COMMUNITY
HEALTH CENTERS IN CALIFORNIA
California CHCs
• 63 CHC Clients
• 4 HCCNs
UDS Update
Agenda
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UDS Reporting Module
Where do I start?
Changes
10 Min Version of Initial Training
Enhancements last few years!
FAQ / Race & Ethnicity and MU
Clinical and OB data – review
Q&A
UDS Reporting Module
Current Release Version 3.2.18msi
Beta Testing in September
October – Limited General Release
November – General Release
Goal is 2 Releases per year
UDS Focus Group
Members
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Henry Piaskowski, PTSO
Dan Royal, PTSO
Chris Vega, Clinicas del Camino Real
Chris Velasco, Clinicas del Camino
Real
Heather Budd, Blackstone Valley CHC
Michele Lambert, Vista Community
Clinic
Ella Meach, Vista Community Clinic
Jo Abraham, HealthPoint
Heather Findlay, FHC
Charter
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Identify
market
needs
and
value
propositions
Assist in prioritizing needs/requirements
Validate requirements, designs, prototypes,
and final solution as needed
Participate in Beta Testing or LGR (must be
on current software release version) as
appropriate
Provide
testimonials/white
papers
supporting the newly developed solutions
Reference site
Make an overall positive contribution to meet
the project objectives (schedules, costs,
quality, etc.)
Changes
•http://www.hrsa.gov/datastatistics/health-centerdata/reporting/
•Go to the training from the BPHC and
Primary Care Associations.
2011 UDS Clinical Measures
Four Clinical Measures in three clinical areas have been
added to the measures which will be used in grant
applications and in the UDS
– Weight assessment and counseling for children and
adolescents
– Adult weight screening and follow-up
– Tobacco use assessment and cessation counseling pair
– Asthma – Pharmacological treatment
2011 UDS Clinical Measures HRSA
Data Strategy
New clinical measures will allow BPHC and health
centers to demonstrate the quality of patient care using
an enhanced set of measures which are part of the CMS
“Meaningful Use” data set
– New measures focus on preventive health care
– Most have AMA CPT-II codes
– All qualify under the Meaningful Use rules
Communication/Training/Help
• Email Blast
• Help Desk
• NextGen
“What’s New”
• NCS Website
• NACHC NG
User Group
• NextGen
Community
Forum for
CHCs
• UGM Sessions
• NCS Website
and
Documentation
• Help – built
within product
Release of new
Version
Training
Other
Communication
Support
• Help Desk
• Weekly Calls
Where do I start?
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BPHC official web site
NextGen’s UDS Web site
http://www.ncslive.com/uds
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UDS tool setup, guides, videos
Install the UDS tool – file a support ticket
for additional help
Training from NextGen Implementation and
Training
Refer to CHC-specific System Configuration
Training (SCT)
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E.g. separate trans codes for Table 9 adj!
Where do I start?
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http://www.NextGen.com
Client resources -> Downloads ->
Documentation -> EPM
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Client resources -> Downloads ->
Documentation -> HQM
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CHC-specific SCT & CGT guides
Full set of MU docs, including workflows
and values
There is a high-level video posted
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Client resources -> Downloads ->
Where do I start?
• This year there is training for clients
who already use the UDS Reporting
tool.
• We do free weekly Tues 3PM EST
Web-exes 12/06/11 – 3/27/12 (not
a general training call)
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Half-hour to an hour, cover FAQ,
changes
See www.ncslive.com/UDS for details
Where do I start?
• Monthly CHC billing calls with Claims
Analyst
• “I need more help – where do I go?”
• File a support ticket
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Allows us to allocate resources
Provides an escalation path for faster
response times
Where do I start?
Licensing – A Review
• One UDS module license needed per
database and server.
• As many as needed per legal entity.
• Resellers / hosts also licensed per
practice.
• Request your initial license in the
tool – it knows the connections!
• It must be activated by NCS after
the request.
Licensing – A Review
• Changes to license (new server or
DB) must be requested through
support tickets.
• Mappings & setup entered before
license applied
• The calcs won’t run & reports can’t
be viewed until the license is
applied.
How does UDS
Reporting work with
NextGen?
• Set up your NextGen system with File
Maintenance
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Covered in CHC-specific SCT
• Enter the data in EPM / EHR
• E.g. primary med coverage on
demographics.
• Qualifying Encounter flag gets set /
auto marked on encounters by EPM
billing (even self pay)
How does UDS
Reporting work with
NextGen?
• Set up the NCS UDS reporting tool
• E.g. map the NG providers to UDS
staffing categories
• Run the report via the UDS tool.
• View the last reports without having
to re-calc.
• Report server will be copied over
every day. UDS tool schedules job.
Items NextGen covers
• Patients by Zip
• Table 3
• Table 4
• We have a separate field to track the
medical coverage
• We don’t just pull the last insurance, e.g.
a dental patient
• We don’t cover member months – EPM /
EHR only knows about those patients
having encounters
Items NextGen covers
• Table 5
• The UDS report tool for NextGen covers
users and encounters, but can not track
FTE’s. This must be submitted through
HR.
• Table 6A (selected diagnoses)
• Again, these primary diagnoses are those
from the visits and charges; those with
the EHR product can also pull services
from the EHR modules
Items NextGen covers
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OB & prenatal info (Table 6 & 7)
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Table 6B, Section A, age
Table 6B, Section B – EHR (standard KBM)
only
Table 7, Section A header (“Pregnant women
w/ HIV/AIDS”) - by mapping CPT4 and
diagnosis codes
Table 7, Section A & Section D line 1 & 2:
(“Deliveries and babies by birth weight”) by
mapping CPT4 and diagnosis codes
Table 7, Section A & Section D lines 3 – 5:
EHR (standard KBM) only
Items NextGen covers
• Table 6B (Quality)
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Section C & D by mapping diag & procedures
and other info (age, etc)
Paps referred out can be stored in the order_
table in the EHR
Hysterectomies by mapping (when
performed) or in KBM standard fields
(history)
Section E, F, G, G2 & H by standard
Meaningful Use fields in the KBM
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Documentation mentioned previously – client
resources (HQM) on NextGen.com
Items NextGen covers
• Table 7 (Disparities)
• Section B & E, hypertension, lines 6 &
7 by mapping diag
• Section B & E, hypertension, line 8:
AEHR KBM (standard) only
• Section C & F, diabetes, lines 9 & 10
by mapping diag
• Section C & F, diabetes, lines 11 – 13:
AEHR KBM (standard) only
Items NextGen covers
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Not Table 8
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These expenses normally don’t come from EPM
Table 9D
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Only columns a, b, d, e and f (Full Charges This
Period, Amount Collected This Period, Allowances,
Sliding Discounts, and Bad Debt Write Off)
• Allowances column D must be combined with items in GL like
paybacks and penalties!
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Not Table 9E
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But you can use transaction codes to separate
state/local indigent programs (line 6a) and pull that
from the NextGen UDS tool in the 9D details.
Qualifying Encounters
Select your SIM
Check the 3 Qualifying
Encounter indicators if the
SIM requires this setting.
Check these 3 boxes
only if the SIM meets
the federal definition
of a qualifying
encounter.
Qualifying Encounters
In charge entry, all it
takes is one SIM
that is flagged as
qualifying to trigger
the encounter level
qualifying flag
If at least one charged
SIM is flagged as
qualifying, when the
encounter is billed the
encounter level
indicator is checked
automatically.
The encounter level
flag can be overridden
manually if necessary.
This encounter level
flag is what the UDS
report uses to count
qualifying encounters
Qualifying Encounters
• Use the “Detail Possible
Encounters” report in the UDS tool
to identify encounters with charges
having flags marked with UDS
flags.
E.g. unbilled encounters
Setting Up the UDS Tool
• Refer to the SCT guide for EPM setup
• Use the UDS tool wizard to go through
the configuration and setup workflow
• Assign a set of filters to the report
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Each “filter set” stores one set of results
that day on report server.
• Check any missing mappings
• Run the Report!
This provider is set
to map by provider
type and is missing
something.
Missing provider
type means it
must be set in
the EPM.
This provider type on the practice tab must be set.
We can’t use the multiple provider types on the
“provider types” tab because we
must have only one mapping.
Enhancements in 2011
• Prior years:
• Create separate filters to store separate
results for different dates / ent / practice
/ location / exclusion combinations.
• Import a list of persons to exclude
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This will help new clients unduplicate if
they get a list from old system.
NG login
Reporting Services instead of Crystal
Wizard-like setup with better validation
Better install & performance
Enhancements in 2011
• Bureau requirements
• New clinical measures
• ~150 fields pulled from KBM
• Added OB Table 7 line 2 all
deliveries
Filter by “all”:
10 prac, 15 loc
Filter by “1 loc”:
1 prac, 1 loc
Last run by “1 loc”
for 2009: expand
to see results
Prior run by “1 loc”
for 2000 – 2010
was erased to make
room
Last run by “All”
for 2000 – 2010
is still kept
All practices
checked will be
included in the
Report.
Exceptions: Any
items listed will not
be included.
There are exceptions
for patients, providers
& procedures.
Match these
EPM items up
with their UDS
mapping.
Follow through these
steps under “Setup”
first.
FAQ
• What if I have part of the year on
my old system?
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If you can get a list of UDS patients
from old system,
Use the new method to import that list
into the “exclude persons” option for a
separate “unduplicated” filter.
FAQ (Partial Year con’t)
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Encounters, Financials – take old system
+ NextGen (normal).
Patients – take old system + NextGen
(“unduplicated” filter set)
You must tell the conversion team to
import your prior system id into the
“other_id_number” field in the person
table.
Some calculations like vacc. still require
manual effort, e.g. two medical visits
FAQ (Partial Year con’t)
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If you can’t get a list of patients by an
ID, you must resolve this using the
detail reports (e.g. below)
FAQ (Partial Year con’t)
• Install tips
• Watch the pre-recorded Web-exes
http://www.ncslive.com/UDS/releases
• Especially the “New Client” presentation
This is the best “monthly new client”
training I have done lately.
• If you don’t have a Report Server, get
one.
FAQ (Partial Year con’t)
• Install tips
• Watch the pre-recorded Web-exes
http://www.ncslive.com/UDS/releases
• Especially the “New Client” presentation
This is the best “monthly new client”
training I have done lately.
• If you don’t have a Report Server, get
one.
FAQ (Partial Year con’t)
• The UDS report will not let you run
it if any of the people in the period
with a qualifying encounter is
missing age or sex.
• This is to protect you from
submitting with lower numbers than
you should, or with Table 3 totals
that don’t match – and you don’t
waste an hour.
FAQ (Partial Year con’t)
• “My numbers are off”
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Check the Troubleshooting Guide!
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http://www.ncslive.com/UDS
Support reps are trained on it.
• Tickets will be escalated to the
technical consulting services dept
Race / Ethnicity
• History
• Prior to 2007, the Bureau required one
set of race descriptions including
“Hispanic / Latino”
• In late 2007, the Bureau required
ethnicity (i.e. of Spanish descent) as a
separate table.
• NextGen had just one field, so we
crammed it in together – “White, nonHispanic”.
Race / Ethnicity
• History
• Prior to 2007, the Bureau required one
set of race descriptions including
“Hispanic / Latino”
• In late 2007, the Bureau required
ethnicity (i.e. of Spanish descent) as a
separate table.
• NextGen had just one field, so we
crammed it in together – “White, nonHispanic”.
Race / Ethnicity
• History
• In NextGen 5.5.27.12, we added
separate race & eth fields on UDS tab.
• Cannot add on the fly
• Cannot change the label or master list
• Used the UDS tool to migrate.
Race / Ethnicity
• Now
• In NextGen 5.6 SP1 (MU), meaningful
use means all clients need separate
fields!
• Race will be now stored in the original
DB field, and a new ethnicity DB field
will be added.
• They can be viewed on either demo
tab or UDS tab.
Race / Ethnicity
• Now
• Are locked against add-on-fly.
• Can be required.
• Pull from the original master list, but
any values besides meaningful use are
hidden during the upgrade.
• You must unhide “more than one race”.
• Use the NCS utility to migrate values.
CY 2011 Clinical
• The bureau is asking grantees to track new
clinical measures in 2011 including:
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Patients from 2 to 17 with a BMI percentile
recorded AND counseling on nutrition and
physical activity for the current year.
Patients 18+ with (1) BMI charted and (2)
follow-up plan documented if patients are
overweight or underweight.
CY 2011 Clinical
• % of patients 18+ queried about tobacco in
current or prior year
• % of tobacco users 18+ who received
cessation advice or medication
• % of Patients aged 5 – 40 diagnosed with
persistent asthma who have an acceptable
pharmacological treatment plan
• Changes to % of 2 year olds with req’d
vacc.
CY 2012 Proposed
• 3 new proposed clinical MU requirements:
• Coronary Artery Disease (CAD): Lipid Therapy
• Ischemic Vascular Disease (IVD): Aspirin
Therapy
• Colorectal Cancer Screening
• These are already part of MU and should
be captured 2012 in EHR
CY 2012 Proposed
• Staff Tenure – not covered by UDS tool /
NextGen
• Change 6A diagnoses from primary to all
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This will be changed in the 11/1/2012 release of
the UDS tool.
• Questions about Grantee Electronic Health Record
(EHR) Reporting Capabilities and National Quality
Recognition
‘Meaningful Use’
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Please follow the workflow laid out by KBM /
HQM in their white papers
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http://www.nextgen.com/clientMU
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NQF 0024, NQF 0421, NQF 0028a, NQF 0028b,
NQF 0047, NQF 0038
Pedes BMI, Adult BMI, tobacco assessment,
tobacco cessation, asthma pharm therapy
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• Alt: use BPHC listed CPT II codes in
charges (1039F – persistent asthma)
• Where BPHC is diff we follow BPHC (office visit
vs qual enc)
OSHPD Reporting
Any Questions?
KBM UPDATE V8
Transforming Quality at NextGen
• Quality Assurance
Marketing
• Implementation
• Sales
• Product Management • Training
• Product Development • Customer Support
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Doubled QA
department staff
Significant
investment in load
and automation
testing
Implementing more
formal Product
Management
Hired Director of
Quality with QMS
experience
Implemented Agile
Methodologies
2011-2012 Quality Goals
• Improved usability of 5.8 EPM/EHR User
Manuals
• Target specialty content through the strategy
• Add large customer’s data to system test data
base
• Continue client, development, QA
organization collaboration
KBM Customer Participation
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Roles & Responsibilities:
– Identify market needs and value
propositions
– Assist in prioritizing needs/requirements
– Provide customized content as a
foundation for design
– Validate requirements, designs,
prototypes, and final solutions as needed
– Participate in Limited General Release
(must be on current software release
version)
– Provide testimonials/white papers
supporting the newly developed solutions
– Act as a reference site to support new
sales opportunities
– Make an overall positive contribution to
meet the project objectives (schedules,
quality, etc.)
KBM - Clinical Content Update
Strategy
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KBM Version 8
– State of the Art User Interface Experience (UIX)
– Intuitive and easy to use
– Improved usability and high-speed workflow
Clinical Content Update Strategy
– Capitalize off of the new v8 UIX
– Systematically update and maintain all specialties based on the new UIX
– Assist clients getting out of the “custom maintenance business” – can’t keep
up with the regulations, quality measure reporting, and ongoing clinical
content requirements.
– Goal - Rank 1st in each respective clinical specialty market
KBM Release Timeline
(estimated)
• V8.0.1 – General Release in January
• V8.1 (formerly V8.0.2) – targeted for
May-June release (LGR then GR)
• V8.2 – targeted for late 2012 release
Version 8.0.1 Overview
Carmen McGraw
Thank You for your time.
nextgen.com