Dfm Residency Clinic Managers Meeting

DFM RESIDENCY CLINIC MANAGERS MEETING April 7 & 8, 2010 Wisconsin Room Alumni Hall

Present: Present: Cyndi Moser, Kathy Seymer, Jerry Barton, Mark Shapleigh, Peggy Soehnlein, Deb Sanftleben (Wednesday only), Sue Kaletka, Jim Berg

Wednesday, April 7

The group participated in the HealthLink 10 minute tip.

Data Reports (Chuck Illingworth)

Resident Reassignment – The spreadsheets are out to the clinics. Chuck is still waiting for the codes for the new residents.

Supervising Schedule – The clinics reported that they are all using the scheduling department (ends in a 2) that is for supervising residents. Chuck is running the reports electronically but is still using the paper schedules for quality checks.

Documentation of Nursing Home and Home Visits –

 If a faculty member is at a Nursing Home visit or Home Visit with a resident, the faculty member must open the note in order to get production credit.

 If a faculty goes on one of these visits, they should create an off-site encounter. There is a process for doing this so that this does not create two encounter numbers. The process is on the DFM website as well as U-Connect.

 New Innovations is the official way to track these visits for the residents.

Vocera Communications A representative of the Vocera Communications Company presented information on their system that would allow hands free communication throughout the clinic. Physicians and employees would wear a communication device around their neck and would be able to communicate with others throughout (and outside) of the clinic. Justin Knupp listened to the presentation and has concerns about our wireless system being able to work with this system. If enough clinics are interested, we could make a case to UWMF who manages that system to give us an upgrade. The next steps are to find out what types of communication systems are needed by the physicians and others and to talk to the medical directors to see if there is support in exploring this further.

Clinic Updates

Wausau – very focused on implementing the Aspirus Epic system on June 7th. Most in the clinic are excited.

Verona – Marguerite Elliott passed away in Feb. Her Celebration of Life Ceremony will be held this Saturday. The items that they are focusing on for physician satisfaction are: paperwork efficiency, prescription renewal process and triaging phone calls. They have an opening for a new physician. Their immunization rates have continued to be very high and are crediting the nursing staff for their wonderful work with this. They want to put up a box to collect patient comments in the clinic. They are redoing their templates to limit how many new patient visits they have in one session for faculty. They have been working with their local nursing home for develop more standing orders for admissions and continuing care.

Northeast – They have had some personnel changes – most of which have made people very happy! They are busy, busy, busy.

Operational Updates Infoview – Managers continue to work on learning how to get information through Infoview. There are many reports that managers may find helpful, once they have the comfort level of using the system. Connecting with Jim for individual training has been very helpful.

Students in Clinics – Jim continues to work with Risk Management to get the legal agreements in-place.

HIPAA Misdirected Communication – The Managers were reminded to submit an Incident Report Form if there is misdirected communication (i.e. fax containing PHI is sent to the wrong location). One of our clinics has already submitted a form for this reason. There is concern that staff will not want to report any type of HIPAA violations.

Reference Lab Billing – There still continue to be issues with the billing of reference lab charges based on a change made by PBS. Jim continues to work on this.

Coding Updates (Tina Childs)

Consult Requests – there are still a lot of questions about the changes to requests for consults. The electronic consults can be found under the Orders Tab in HealthLink.

ICD-10 – this is coming in 2013 and will be a huge change for our physicians. More information to come.

Clinician Review – the reviews are starting again. The managers asked if they could get a copy of the feedback when it is sent to the clinicians. Tina will start doing that.

OB List – Tina asked for questions or feedback about the list. Jerry had questions about billable charges for GHC-EC patients.

Thursday, April 8 Finance Updates (Barb Stransky, Tom Hankins, Michelle Riley, Teri Ott)

Barb Stransky was introduced as the new CFO.

Forms – Teri reviewed information on common forms. She reminded everyone where they can be found on the DFM website. The Request for Travel or Employee Development Authorization form no longer needs to be sent to the Finance Dept. Clinics/budget units may want to continue to use this form as an approval and cost estimation tool. If you’d like an advance payment for a conference, you can use the green form. A draft of the green reimbursement form was reviewed.

Reimbursement – the managers were reminded to check the CME ledger balances prior to approving requests for travel or employee development. This can be found on the J drive.

The rules regarding reimbursement timelines were reviewed. The group was also reminded that direct deposit is available for reimbursements. A list of the UW DFM Licenses, Dues and Memberships was distributed.

Teri reviewed the meal per diem information and used British Columbia as an example since that is where STFM is being held.

Michelle reported that the Peoplesoft conversion will be happening in the several weeks. The fund and product numbers will be changing. There will be about 60 new accounts and a new chart of accounts will be distributed. A “behind the scene” mapping process will convert current account numbers. Everyone will need to be trained. We will see if this training can happen during the next manager’s meeting in June.

Tom updated everyone on the budget status. New budgets were sent out yesterday but does not include SIF and PIF. UWMF did not intend for SIF and PIF to be allocated the way we have been doing it so we will have a new method this year. The UW fringe benefits have not been updated yet. Also the Admin. Allocations have not been reviewed yet so changes will be happening with that piece. Since all of the worksheets are currently linked, all changes should go through Tom.

Patient Experience (Margo Bida)

Congratulations to the Star Clinics – Augusta and Eau Claire. Jerry feels that the clinic staff strives for common goals (currently PCMH) which helps with patient satisfaction.

Margo is touring the clinics giving a “Power of the Moment” presentation. She customizes the presentation by site. The current plan is to schedule this presentation when the AMGA data is shared. The data piece would only be a few minutes with the rest being Margo’s presentation. A minimum of 45 minutes is needed but at least an hour is ideal.

The new Service Standards are being rolled-out. There is a special presentation for family medicine which is May 25th during our Clinical Care meeting time. Stephanie, Judy and Sue met with Elizabeth Bolt to discuss the impact of the standards. Elizabeth is going to be informing the unions of these standards.

There is interest in changing patient satisfaction survey vendors. Several pilots are currently going on with different vendors. A decision will be made in mid-May.

Quality Improvement (Stephanie Berkson)

Stephanie shared the QI goals that were submitted to Dean Golden by Val last September.

The dashboard is being revised. Stephanie distributed a draft. Feedback should be directed to her. She is working with a group called SPICE – that is working on practice improvement education – which will fold into practice management.

Strategic Planning – Stephanie is working with UWMF and UWHC to integrate and align QI services. She asked for feedback on what is important for the managers and their clinics. Any other thoughts should be sent to Stephanie.

Health Information Management (Sandy Schumacher & Sara L’Herault)

Verbal Disclosure – there was a law change around the permission needed for verbal disclosure to a family member. If a family member poses a question that leads you to believe they already know something (i.e. what time is my Mom’s ortho appointment?) then information can be shared without written permission. However, test results cannot be given out without written permission.

HEDIS audits – the HMOs in the Madison area should work through Sandy’s office to obtain access to HealthLink and to conduct the audits.

Medical Records Ownership – Our records (with the exception of Wingra) are owned by UW. Occupational Health records are owned by the company.

Advanced Directives – These are scanned into the medical record after UWHC looks it over to make sure it has been activated.

Partial Diction – Clinicians can begin using partial diction which means part of the note can be dictated and the other can be typed or brought in by the use of smart sets, etc.

Care Everywhere – There is currently a pilot going on in Madison around Care Everywhere. If all goes well, it will be implemented across the state in the next few months. Care Everywhere means that any facility using Epic can get a record from any other Epic facility if the patient consents. Transcription Turnaround – The turnaround for our DFM clinics is 24-48 hours. This is quite a bit longer than the UWMF clinics have but our clinicians seem happy getting information back that quickly so it is felt that nothing needs to be done at this time. We continue to use our internal transcription pool but use UWMF as our back-up. It seems to be a win-win situation.

ITS Updates

HR Database – Jacob Duffy and Glenn Childs were introduced. They will be working on development of a new HR Database (along with Sandy Rindy who is now part of the ITS Team). They are meeting with several groups to do a needs assessment about what is needed from a HR Database. They spent time with the group discussing our needs.

Virus Scanning – In order to address the Thursday computer slow down issue, there is a plan to move the virus scanning to a different time (middle of the night). This is being tried in a few clinics and will be rolled-out to everyone.

I-Pods – There is some discussion about giving I-Pods to the incoming residents as a learning tool. If anyone knows of any faculty physicians who would be interested in piloting the use of I-Pods, let Justin know.

PC Replacements – there was a question about the funding for the PC Replacements since the money continues to come out of the clinic budgets even though there was a hold on replacing PCs. Tom explained that even though the money is charged monthly to the clinics, in June there will be an adjustment to reflect the actual expenses.

The widescreen monitors in the exam and procedure rooms are being paid for by UWMF. Any other requests (i.e. faculty offices) will go to the Exec. Team for approval.

Wireless Implementation - the implementation for the upstate clinics is hung up in the legal department and working with Charter. Justin will check on the status. HelpDesk Support – Starting April 12th our helpdesk support will be handled by UWMF. A memo was sent out about the change. Let Justin know of issues.

Videoconferencing – Plans to purchase our own bridge so we will no longer need to use the Pyle Center are underway. This should be a cost-savings to us.

Next Meeting

The next manager’s meeting is scheduled for June 10 and 11.