Charleston SC RHJVAMC/NHCC/628 MDG Joint Venture Review Low Country Federal Healthcare Executive Council FY 10 Review.

Charleston SC RHJVAMC/NHCC/628 MDG Joint Venture Review

Low Country Federal Healthcare Executive Council

FY 10 Review


Low Country Federal Healthcare Executive Council (LFHEC)• Governing Body for management of joint healthcare services • Chartered Oct 06 based on local Navy/Air Force/VA collaboration • Meets monthly • Annual Strategic Planning Off-Site: August 2010

Representation:• Commanding Officer, Naval Health Clinic Charleston (NHCC)-Chair• Director, Ralph H. Johnson VA Medical Center (RHJVAMC) • Commander, 628th Medical Group (628 MDG)• Commanding Officer, Naval Hospital, Beaufort• South Carolina Market TRICARE Director• Healthcare Business, Fiscal, Planning & Clinical/Ancillary Staff• Chiefs of Medical Staff, Senior Nurse Executives


LFHEC Mission:

Enhancing delivery of quality, patient-centered health care through collaborative Federal and community partnerships

LFHEC Vision:

Blazing the trail in seamless Federal healthcare…for you!


2. Quality of Care Committee• Medical Staff Issues/Credentialing, Privileging, Joint Commission Issues• JACC Emergency Response Team & AED standards at VA/DoD clinic• Shared Training

1. Market Opportunities Resource Sharing Committee • Explore sharing opportunities• Develop sharing agreements• Identify/evaluate future Joint Incentive Funds (JIF) Projects• Coordinate Interface with other LFHEC Standing Committees

LFHEC Standing Committees


3. Information Management/Information Technology• Evaluate/assess IM/IT Sharing capabilities for market application i.e. “Single Desktop” and Laboratory Data Sharing Interoperability • Support interoperability components of JIF projects and sharing

agreements• Carolina e-Health Alliance JIF Submission ($2.3M under review)

• partnership between LFHEC and four major health systems

4. Integrated Disability Evaluation System• Newly formed committee to coordinate plans for the nationally mandated VA/DOD Integrated Disability Evaluation System (IDES)

LFHEC Standing Committees


1. Begin the process to establish the Charleston commuting area as a DoD/VA Joint Venture (JV) site

2. Share Best Practices regarding the Implementation of Patient and Family Centered Care/Patient Centered Medical Home

3. Extend Stakeholder Relationships

4. Promote Interoperability of Electronic Medical Records/Information Technology

5. Decrease Costs through Recapture of Fee Basis/TRICARE Network services

FY-11 LFHEC Strategic Goals


New Initiatives – Projects Implemented

IDENTIFY ALL NEW INITIATIVES OVER THE PAST YEAR:

1. Opened the CAPT John G. Feder Joint Ambulatory Care Clinic, Joint Base Charleston (JB-CHS) Sep 2010

a. VA Community Based Outpatient Clinic (CBOC) is co-located, One of Three Wings

b. Shared Phlebotomy Services

c. Waiver – NHCC provides 10 day prescription for VA patients requiring immediate medications

d. NHCC performs Stat laboratory tests for Veterans seen at the CBOC

e. Laboratory Data Sharing Initiative

IDENTIFY ANY PROJECTS OR EFFORTS THAT WERE CLOSED OR FAILED IN THE LAST YEAR:

None


New Initiatives – Projects Implemented

IDENTIFY ALL NEW INITIATIVES OVER THE PAST YEAR:

1. Initiation of Joint Outpatient Orthopedics Services (Resource Sharing Agreement (RSA) - NHCC Nov 09

2. Initiation of Joint Cardiology Clinic (RSA) - NHCC Dec 09

3. Initiation of Consulting Pathology Services (RSA) (RHJVAMC staff) at both NHCC and 628 MDG (3rd & 4th Qtr 2009)

4. Initiation of Market-Wide Education and Training Initiatives – Jun 09

5. 628 MDG/NHCC/RHJVAMC MOU Readiness Skills Verification Training Program - Dec 08 *FY-10 18 Trainees with favorable comments post-completion

IDENTIFY ANY PROJECTS OR EFFORTS THAT WERE CLOSED OR FAILED IN THE LAST YEAR:

None


Joint Venture Performance Measures

PMs USED TO TRACK JV SUCCESS:

1. Quarterly workload statistics for MRI, Orthopedics & Cardiology 2. Man-Hours Worked (DMHRSi used for “DoD” days in Joint Clinics, and in VISTA for VA Days)

DATA SOURCES USED FOR THE PMs:

1. CHCS/M2/DMHRSi

2. VISTA/DSS/VSSC

OUTCOMES FOR EACH PM LISTED: 1. MRI – JIF Funds $2,467,890 – Value of Services provided

exceeded JIF investment in two years FY10 Orthopedics: 689 encounters; 36 surgeries FY10 Outpatient Cardiology: 641 encounters; DoD TRICARE Outpatient Cardiology network costs decreased 45% Dec 09 – Jul 10 ($79,000)

2. DMHRSi Data: Orthopedics: 558 hours Cardiology: 344 hours


Access to Military Installation Procedures

REQUIRED ACCESS PROCESS and POLICIES FOR VA BENEFICIARIES and/or EMPLOYEES

TYPE OF VISITORID BADGE*

PRIOR COORDINATION VA APPOINTMENT

DOCUMENTATION / VERIFICATIONVISITOR CENTER

VA EMPLOYEE DVA MOU with JB-CHS

RHJVAMC conducts National Agency Check with Inquiries – Sends

letter to JBC

If outside of normal

criteria

VA PATIENT Base1 Year

First visit allowed with VIC or Appt Letter or on Daily

Appointment list

JB-CHS conducts SLED/ NCIC Checks. VA

Security Clerks at JACC assist in

processing requests

“

VA PATIENT FAMILY MEMBER

Spouse, Children or Parents (> age 16)

Base 1 Year

First visit allowed with VIC or Appt Letter

Must accompany Veteran Same as Above “

VA PATIENT GUEST/ESCORT

Drives and or Assist Veteran (> age 16)

Base 1 Year

First visit allowed with VIC or Appt Letter

Must accompany Veteran

Same as above after being issued a letter

from RHJVAMC – only two escorts allowed

“


Access to Care and Referral Management

ISSUES RELATED TO ACCESS TO CARE & REFERRAL MANAGEMENT:

1. Durable Equipment approval for Orthopedics Patients 2. 628 Access to Care/Continuity of Care/Patient Satisfaction

RESOLUTIONS TO ISSUES RELATED TO ACCESS TO CARE & REFERRAL MANAGEMENT:

1. All DME processed through NHCC Referral Management Center for DoD beneficiaries

2. The recent implementation of the Air Force Family Health Initiative at the 628 MDG, modeled on the Patient-Centered Medical Home concept, has enhanced access to care, continuity of care and quality of care


Future Initiatives and/or Proposals

NEAR TERM (1-2 YEARS) INITIATIVES:

1. Joint Optometry Clinic – Joint Incentive Fund Project

2. Stakeholder Relations Program – Educational seminars regarding Patient and Family Centered Care- Medical Home Implementation

3. Obtain Authority and Implement Sharing of Radiological Images 4. Awaiting Results of Carolina E-Health Alliance JIF Submission for FY11

5. Five FY11 LFHEC Strategic Goals

6. Co-Located IDES services and resources on JB-CHS


Future Initiatives and/or Proposals

LONG TERM (>2 YEARS) GOALS / INITIATIVES / STRATEGIES:

1. Participation of all LFHEC members in the Carolina e-Health Alliance, a local health information exchange

2. Mobile Pharmacy (Sharing or possible JIF project)

3. Additional VA/DOD Initiatives (JIF and/or Sharing Agreements) with Naval Hospital Beaufort and/or Winn Army Community Hospital, in Ft. Stewart, GA

14

Charleston SC RHJVAMC/NHCC/628 MDG Joint Venture Review Low Country Federal Healthcare Executive Council FY 10 Review.

Documents

dodva joint venture

sharing opportunities

joint base charleston

mdg commanding officer

medical group

committees lfhec

medical home

patientcentered health