ToC+-+Success+Metrics+Meeting+Minutes+07-05-2011

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 * Date:** 07/05/11
 * Name:** Transition of Care (ToC) Success Metrics


 * Agenda/ Objectives:**
 * **Topic** || **Time Allotted** ||
 * Welcome and recap of last week || 5 minutes ||
 * Review of ONC Proposed Metrics || 10 minutes ||
 * Review of Success Metrics Category Spreadsheet
 * Additions/deletions to the table
 * Brainstorm how the categories will actually be measured (fill in the measurement type/unit column)
 * Clearly define the metrics (ex. Live in Production, Live in Test, etc.) || 40 minutes ||
 * Wrap Up / Next Steps || 5 minutes ||

__Panelist Attendees:__ John Donnelly, Holly Miller, MD, Amy Berk, Smriti Singal, Brandy Hays __Sub-Workgroup Attendees:__ Allen Hobbs, Andriy Selivenonky, Chris Andreou, Ed Larsen, Emily Mitchell, John Williams, Mayuri Patel, Sandy Stewart, Susan Campbell
 * Attendees:**

Can we establish a baseline in Year 0? What might we survey to build that baseline? || In Progress || SWG Members || Smriti Singal || 07/12/11 ||
 * Action Items:**
 * **Action Item** || **Next Steps / Status** || **Lead** || **Contributors** || **Due Date** ||
 * Update the ToC Metrics Matrix per discussion as documented below || Completed || Smriti Singal || Amy Berk || 07/05/11 ||
 * Review and Comment on the ToC Metrics Matrix as posted to the Wiki;
 * Explore the research and come back with prioritization and then come back with the timelines || In Progress || SWG Members || N/A || Ongoing ||
 * Draft Definitions of ToC Success Metrics that have been identified || In Progress || Dr. Miller/John Donnelly || SWG || 07/12/11 ||
 * Follow up with outputs of PD WG || In Progress || Amy Berk || N/A || 07/12/11 ||
 * Update Initiative List on Wiki || In Progress || Smriti Singal || N/A || ASAP ||
 * Attend ToC Success Metrics Call for 07/12/11 || In Progress || Dr. Miller/John Donnelly || SWG || 07/12/11 ||


 * Statement of Purpose:** To assess the success of the ToC Initiative through measureable improvements in quality, clinical workflow and adoption for patients undergoing clinical care transitions

Review of ToC Success Metrics Matrix; asked the WG to review and make comments-No comments posted at this time > Categorize of Metrics to measure Success;
 * Notes from Discussion:**
 * Today, we intend to take a “deeper dive” into these metrics
 * Overview of Proposed ONC ToC Metrics
 * Recap from last week
 * Adoption, Uptake
 * Process; reduce workflows and cycle times
 * Outcomes
 * There is no “Direct” Project as one of our current six ---Direct Project will facilitate ToC more easily
 * The Use of Certified directories is obligatory
 * The Push Model could be used officially for ToC; the number directly in use would give us a handle on the ToC for adoption
 * The Use of Certificates and Provider Directories are separate
 * The Recognized data model is around the core data sets
 * User Certificates that is used today in current Information Exchange Model; use of the Work product that comes out of that group
 * Certified Provider Directories coming out of that group? –They changed the scope, but still going on
 * Focused one of the projects to support Direct
 * The work of discovery providers addresses has been deferred into next steps
 * If these are all pre-conditions of ToC, why are you trying to take economic credit as compared to the document itself? Depending on what infrastructure is in place, the economics may be different.
 * It is a reflection of; they are used to support a ToC [kind] of transaction; in terms of adoption; the more in use, the more success we have in care providers doing ToC.---underlying Information Technology metric and validates the work done by the ONC sub-committees
 * This project has established it as a pre-condition; we are hoping that this is an underpinning of the ToC that is deployed
 * Action: Add a line; Adoption of HER/PHR vendors by the CIM/Vocab Standards (Recognized Data Model by Edge vendors)
 * Use of PD and Certificates by the HIST
 * Action: Add a line: Use of Certificate Authorities---Follow up with outputs of this group; per Amy
 * Action: Data Overload; express this in terms of “Avoidance of Data Overload” ---may be hard to quantify; may want to figure some concrete indicator ---may get creative in how we measure this; selection of data elements vs. data dump (both on the vendor and recipient side)
 * Need to get baseline data; we are only in the proposition phase of metrics; collect some for year 0 and then onward
 * Satisfaction Levels to be put together
 * Clinical Outcomes: Improvement in Clinical Quality-For Meaningful Use this is what we need to do
 * Difficulties with Clinical Qualities; difficult to obtain in the ambulatory world (adverse events voluntarily developed)
 * MU; Stage I; Electronic Data Exchange---Can this be categorized as adoption? ---Care Providers live in production? Hodge podge of how providers are meeting this; we can get much more specific around MU; if providers and how providers are using Direct to meet this---How does this fall into Outcomes rather than Adoption? Have you satisfied the MU criteria for both?
 * MU; Stage II; System exchange minimum of Core Data Elements
 * Reduction of admissions or readmissions; PCMH; embedded care managers; of interest in studies regarding both of these areas; there is data out to look upon; examination of utilization data
 * Perhaps we can differentiate between process and outcome?
 * ACTION: MU should go into ADOPTION; MU is all about Adoption
 * ACTION: Care Providers live in test and Care Providers live in Production; Need to include “ToC” -Maybe testing other functionality without actually exchanging ToC information
 * Distinguish between process and clinical outcomes
 * Add two Rows:
 * Reduction in Cycle Time (on the receiving side)-for creation of ToC documents
 * Reduction in Cycle Time of receiving old information about a patient for ToC
 * Need to be very cautious and strike the right balance between send and receive
 * ACTION: Add to replace “Goal” in Year Zero; “Method to Establish Baseline”


 * Next Steps:**
 * Comments should be posted to the Wiki and start thinking how we might measure
 * Can we establish a baseline in Year 0?
 * What might we survey to build that baseline?
 * Add ToC Success Metrics WG to the Initiative Meeting List

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