Center of Excellence for Health Systems Improvement for a Tobacco-Free New York: Advisory Committee Meeting Minutes December 15 th, 2015 11:30am 2:30pm Hilton Albany, 40 Lodge Street, Albany, NY Attendees - Patricia Bax, Marketing Coordinator, NYS Smokers Quitline - Dorothy Farley (call-in), Vice President, Social Services, Community Healthcare Network - Patricia Folan, Director, Center for Tobacco Control and Health Systems Change Contractor for the Long Island Region - Ryan McCormack (call-in), Assistant Professor, Emergency Medicine, Bellevue Hospital, NYU School of Medicine - Scott McIntosh, Director, Health Systems Change Contractor for the Finger Lakes Region - Sara Phelps, Community Programs Manager, Bureau of Tobacco Control, New York State Department of Health - Erin Sinisgalli, Director, Seton Health/St. Peter s Health Partners and Health Systems Change Contractor for the Capital Region - Maxine Smalling, Acting Director, Coordinated Nursing Services, New York State Office of Mental Health - Julie Wright, Program Manager, Health Systems, Bureau of Tobacco Control, New York State Department of Health - Daren Wu, Chief Medical Officer, Open Door Family Medical Centers, Inc. CAI - Elizabeth Jones, Director, Health Systems Improvement, CAI - Marcy Hager, Project Director, COE for HSI, CAI - Kameron Wells (call-in), Consultant, CAI Members not present - Colleen Foreman, Chief Nursing Officer, Community Health Center of Buffalo - Catherine Guzman, Orange County PROS Program Director, Access: Supports for Living Meeting Minutes I. COE for HSI Resource and Workgroup Updates o Electronic Health Record (EHR) Super User Workgroups
The COE for HSI has convened eclinicalworks (ecw) and Allscripts Super User Workgroups to identify those electronic health record (EHR) system template changes and enhancements needed to most effectively support the integration of evidence-based tobacco dependence treatment into standard care delivery. Super User Workgroups ultimately will make recommendations for modifications to templates to EHR vendors, negotiate a reduced fee for modifications for participating federally qualified health centers (FQHC), and support the roll-out of the revised templates. o Four ecw Super User Workgroup Webinars have been completed, two of which were supported by Angela Langdon, Quality Improvement Director, Southern Tier Community Health Center, who created a demonstration of the minimal data set for 5 A s data set and created a demonstration for ecw workgroup. o The COE for HSI held call with representatives from ecw to discuss updating its smart form and template to incorporate the Workgroup s recommended changes. Representatives informed workgroup that they would not be able to update the tobacco control smart form because that would affect all ecw users worldwide, but said they would be able to create a tobacco dependence smart form using the minimal data set for the 5 A s. o The Allscripts Super User Workgroup has two Webinars, and currently is looking for a health system to volunteer to create the 5 A s data set demonstration and test workflow. o Regional contractors have been leveraging the EHR Super User Workgroup with several DSRIP Performing Provider Systems (PPS) by inviting the COE for HSI to present. To date, the COE for HSI has presented on the products of the Super User Workgroups at two PPS meetings. o The Advisory Committee agreed that expanding current membership to include DSRIP project representatives would expand the reach of the EHR Super User Workgroup and create more opportunities for collaborative negotiations. o The Advisory Committee agreed that creating Fax-to-Quit versus Opt-to-Quit talking points to clear-up misunderstandings between the two different programs would be beneficial. o One Advisory Committee member suggested that the COE for HSI create an EHR Super User Workgroup timeline to assist with updating current workgroup members and to assist with the recruitment of new health systems into the workgroups. o Advisory Committee members expressed support for the EHR Super User Workgroup next steps, which include: 2
3 1. Developing a manual for health systems to build the 5 A s data set into EHR and test workflows updates 2. Convene IT Super User Workgroup to provide technical assistance to support the adoption of revised templates and smart forms at participating FQHCs. 3. Engage additional FQHCs and Super Users to gain further influence with current and other EHR vendors 4. Due to the fact many DSRIP projects work with EPIC (another EHR vendor), consider creating EPIC Super User Workgroup as a next step. o Behavioral Health Regulation Crosswalk Workgroup The COE for HSI has convened stakeholders across New York State to develop a set of guidelines for behavioral health providers to implement best practices in accordance with their regulations and/or standards of care. The Workgroup has developed a crosswalk of the different governing body requirements to examine overlap and what supersedes what. o The Behavioral Health Regulation Crosswalk Workgroup found that further guidance is needed to ensure regulations are met and exceeded to meet best practices for tobacco dependence treatment, and regional office interpretation of regulations often guides what happens on the ground. o Potential resources to compliment crosswalk include: 1. A reference document on incorporating tobacco dependence treatment into co-occurring disorder treatment. 2. Guidance on integrating tobacco use into individual recovery plan to ensure continuously re-assessment. 3. Providing an implementation framework that ensures best practices for tobacco dependence treatment for longer and more intensive treatment are included in guidance document. 4. Relapse prevention and discharge follow-up guideline templates. o The Advisory Committee agreed that the Behavioral Health Crosswalk presents an opportunity for regional contractors to engage behavioral health systems and sites to integrate best practices for tobacco dependence treatment into co-occurring disorder treatment. o The Advisory Committee suggested providing regional trainings or a Statewide Webinar advising regional contractors on how to utilize and interpret the Behavioral Health Regulation Crosswalk.
4 o Maxine Smalling updated Advisory Committee that Office of Mental Health (OMH) licensed clinics and PROS clinics regulations will be updated and offered to work with COE for HSI to incorporate the changes. She also suggested including Article 31 regulations, since OMH licensed clinics and PROS clinics are required to meet both Article 31, and OMH licensed clinic or PROS clinic regulations. II. COE for HSI Year Three Priorities o The COE for HSI updated the Advisory Committee on the resources and tools that would be finalized and created during the next six months, including: o The Supporting Evidence-Based Tobacco Dependence Screening & Treatment Training Toolkit, which will be disseminated at the beginning of 2016 o Next steps for finalizing the Behavioral Health Regulation Crosswalk with input from OMH and OASAS o The plan for creating FQHC Tobacco Dependence Treatment Case Studies o The development of a Behavioral Health Tobacco Dependence Screening & Treatment Training Toolkit. o Advisory Committee members agreed that these resources will be beneficial and will require further technical assistance on utilization of the tools once disseminated to regional contractors. o The Advisory Committee agreed that the COE for HSI should continue to leverage the EHR Super User Workgroup to advance regional contractors collaboration with DSRIP PPS partners that have included a tobacco project, in addition to leveraging the EHR Super User Workgroup to incorporate DSRIP PPS partners that are not currently actively working with regional contractors. o In order to increase health systems Advisory Committee membership, the Advisory Committee suggested inviting more health systems champions to join the Advisory Committee. o One Advisory Committee members suggested inviting a DSRIP lead to join Advisory Committee. o Advisory Committee suggested the COE for HSI annually update Mental Health Literature Review to incorporate new findings to disseminate to regional contractors that would assist in their work with behavioral health sites. o Advisory Committee members agreed that in-person meetings were more productive and conducive to discussion and suggested having more inperson meetings in the future.
Next Steps 1. COE for HSI and Pat Bax: Develop Fax-to-Quit vs Opt-to-Quit talking points. 2. Pat Bax: Send Allscripts contact details from Texas to assist the template build for the Allscripts Super User Workgroup in 5 A s data set. 3. COE for HSI: Send summary EHR Super User Workgroup progress and communications strategy. 4. Maxine Smalling: Provide edits/updates to the Behavioral Health Regulations Crosswalk on behalf of OMH. 5. COE for HSI: Reach-out to potential health systems champions to join the COE for HSI Advisory Committee. 5