DFM RESIDENCY CLINIC MANAGERS MEETING June 10 & 11, 2010 Present: Cyndi Moser, Kathy Seymer, Jerry Barton, Mark Shapleigh, Peggy Soehnlein, Deb Sanftleben, Terri Carufel-Wert, Sue Kaletka, Jim Berg Thursday, June 10 Wingra Clinic Conference Room Clinic Updates Wausau – They went live on Monday with Aspirus’s Prelude and Cadence Systems. This was an easy transition as the staff was used to these two Epic pieces through UWMF. The Epic EHR went live yesterday. So far so good, although they are very busy. They went from a completely paper system to Epic. There were a few technology glitches but overall things are going well. Cyndi reported that the UWMF staff has been fantastic to work with through this transition. People like Sue Zimmerman and Sandy Clark spent hours and hours working on this transition. Eau Claire – Jerry shared plans for their new conference room. Their visit numbers are slowly rising. They are getting a couple of more residents than they had this past year so resident reassignment has been a challenge. They worked with Marketing on a campaign called “Present at your Delivery” which features a baby wrapped in a bow. They are also doing radio ads. Augusta – They are getting a new resident. They are recruiting for a new physician. A lot of their equipment is old so they are slowly trying to upgrade. They have a new MA who is working out very well. It will be interesting to see how the patient satisfaction scores look after we change to the new survey vendor. Both Eau Claire and Augusta and working on the NCQA PCMH recognition and plan to get their application submitted by November. Belleville – They continue to be busy with not enough doctors to see all of the patients. Rich Roberts is now the president of WONCA. They are moving forward on a new clinic. Twenty proposals were submitted and they have narrowed them to 3. There are two potential building sites. They plan to break ground by Oct. 1. ITS Updates (Justin) Wireless – Is slowly starting to rollout. Our staff is working with UWMF to put the authentication client on the laptops. Managers will be contacted soon about when the ITS staff will be coming to their clinic to work on this. You should start thinking about who in your clinic will want authentication on a device other than a laptop. Thursday Slow Down Issue – The slowness is due to the virus scanning that is taking place on Thursday. An updated network card drive will need to be installed. This can be pushed out overnight. Epic Server Issue – A new server will be rolled-out in the next 4 weeks and should improve start-up times. Microsoft – UWMF is moving away from Novell to Microsoft. The servers in the clinics will need to be updated and will be done after hours. This should also have a positive impact on the speed of the sign-on process. E-mail – UWMF will be changing from Groupwise to Outlook in FY12. I-Pads – There is a new mobile device policy. Employees with CME money can use their money to purchase an I-Pad. The internet service is $15/month. There is a small pilot group (Mark is a part of this) who are using the I-Pads and finding ways to use them in the clinics. Apps are also being evaluated at this time. The plan is to rollout I-Pads in small groups. The Clinic Managers are interested in getting I-Pads and in the training needed. Dragon – There are efforts to rollout Dragon to interested users across the system. We are going to be having a meeting with UWMF to better figure out how this applies to our clinics. Voalte – This is a communication system that some healthcare facilities are using in place of Vocera. This system is based on using cell phones as the device and has the capabilities of instant messaging, texting, using GPS technology to identify someone’s location in the clinic, voicemail, paging, etc. Based on the high level of interest, Justin will be setting up a demo with this company. Human Resource Services Update (Judy Atkinson and Joanne Looze) Ambulatory Service Standards – Joanne prepared a document outlining the action steps for employees who are not following expected behavior in the clinics. The group discussed the ambulatory service standards and how the behaviors outlined in the standards are consistent with what we expect in the residency clinics. HR should be notified of any issues as soon as possible so they can identify what work rules were potentially violated. For Academic Staff there aren’t the same type of work rules but a similar process should be followed. Northeast Clinic presented the information on the Ambulatory Service Standards which was met very positively. NE is going to focus on wait times during this next year. UWMF is an “at will” employer. This does not mean that staff can be terminated without following any type of process. UWMF employees are entitled to a fair and legal process and UWMF HR needs to be involved in any issues as soon as possible. Preventing Mass Casualties Two officers from the UW Madison Police Department presented a 90 minute seminar on preventing mass casualties. Although primarily geared for a campus setting, they were able to relate this information to healthcare and all other situations. The presentation was very well received. Quality Improvement Updates (Stephanie Berkson) Patient Satisfaction Survey Vendors – Pending final approval, there is a plan to change patient satisfaction survey vendors from Press Ganey to Avatar (ambulatory clinics only). The plan would be to provide quarterly data to the clinics and annual data to individual providers. At this point, NP/PAs and residents are not included but this is being looked at by our department and others. The plan is to end the Press Ganey survey at the end of July – which is the end of a reporting period. We would then start Avatar on Oct. 1. Microsystems – Applications are due July 2. All UW Health Clinics are eligible to apply. Although the upstate clinics would have a coach to support them (and be at their clinic for their weekly meetings) all clinics are expected to participate in-person for the 4 learning sessions. SPICE – This group has been charged by Bill Schwab to determine how everyone has the same basic knowledge and language for process improvement. There are core learning modules being developed and Stephanie asked for feedback on how best to do the training in the clinics. There was general support for CBTs being developed and used. Operational Updates Students in Clinics – Dave Deci is working on students not enrolled in a formal program and Jim Berg is working on those that are enrolled in a formal educational program. There will be a form to complete but other than that not much movement on this issue. Jim did state that technical colleges are not part of the state system and therefore each one needs a separate agreement. Telephone Data Systems – Each clinic should have budgeted for a telephone data system. The exception to this is Belleville who will be purchasing a new phone system for their new clinic. Deb believes that Northeast will also be purchasing a new phone system in FY11 has thinks she has put in a capital expense request. Sue will check with Tom regarding this. Jerry is ordering a generic phone system (half of the cost of the one specifically designed for his phone system). He will let us know how it works. UW Health Umbrellas – Kathy has researched getting UW Health umbrellas at the clinic so the staff can walk patients out when it is raining. They would need an order of 25 which is more than one clinic needs. Let Kathy know if you are interested. Downtime Policy – Sue distributed the Epic Downtime Policy that was revised last Fall. It was distributed at that time but the group never discussed it. Sue will send it out electronically and then each site should review with their staff. Please let Sue know if there are questions. Cancellation Policy – A draft of a new cancellation policy was distributed. If anyone has comments they should send them to Ellen Johnson or to Sue. Resident Reassignment – The clinics are still working on the resident reassignment. It is a very time consuming endeavor. The Managers discussed various approaches for getting the reassignment done. Chuck is still able to do the electronic algorithm if requested. Julie Wieser from Marketing will send out the patient letters. Staffing Grid – Chuck sent out the staffing grid containing the faculty staffing FTEs and what they actually worked. Any issues should be sent to Chuck. Faculty Recertification – Laura Clement is working on recertification. Jim Berg will touch base with her. Friday, June 11 AOB Infoview Training- The managers, Jim and Sue attended Infoview training. Finance Updates (Barb, Tom, Michelle and Teri) Infoview and People Soft Conversion – The conversion will take place in early July. Clinic Managers are encouraged to work with the Infoview reports. If there are a lot of questions we will schedule another training. Handouts that should help in the transition were distributed. Clinic Deposits - Barb reminded the group of the rules around making deposits – make deposits at least weekly, or if over $500 and always on the last day of the month. Checks should be endorsed daily with the “For Deposit Only” stamps. There was a question as to why the Madison clinics do not need to do cash journals. Starting in July, Barb would like each Madison clinic to begin a cash journal process. Cyndi will send a copy of the form she uses to Barb as an example. Debit Cards – There was a question as to why the debit card process is so cumbersome. Tom is going to check into this. Reimbursement: If signatures are missing or someone is over their CME limit, the forms are being sent back to the clinic managers for follow-up. If someone goes above their $2000 limit there is chance that it will be paid for but that decision is not made until the end of the fiscal year. Having different resident reimbursement rules for each program makes it difficult. Jerry will take this back to Rick McClaflin and ask that Rick take this to the Program Directors. The new green form was reviewed – this will start to be used on July 1. Cost Center 2013 will no longer be used for CME. All CME will be charged to the appropriate budget unit. Check CME ledger balances before approving requests. Reminders were given about the dates for FY10 reimbursement requests. Gift Policy – Tom reviewed the new UWMF Gift Policy. The biggest change is that monogramming of initials is not considered de minimis. Any questions should be directed to Tom. FY11 Budget – Information about the budgets and next steps will be coming out in the next 1-2 weeks. Variance analysis will be done by the budget unit managers starting with July’s close. Refund Requests (Liz Schoeknecht) Liz introduced the new Manager of Billing Services – Trish Figueroa. There is a new process for refund requests. This should make it easier for the clinics. There was a question about the collections process. It was decided that Mary Dodd should be asked to attend our next meeting. Diabetes Project (Mike McGrew and Travis Dollak) Mike and Travis reviewed the diabetes initiative and stated that we are now in the process of identifying clinics to participate in the next rollout. Eau Claire, Augusta and Belleville are all interested. Northeast may want to wait to until the next wave since they are not going to have a clinic manager when the rollout will be occurring. Operational Updates, cont. Manager Performance Evaluations – All UW Health Family Medicine Managers will be on the same performance evaluation/work planning schedule and will be using the same tools. This is in development. Sue will share the information and tools after everything is all put together. Health Maintenance Alerts – Sue reminded the clinics that all staff members have a part in making the Health Maintenance Alerts successful. There is concern about the receptionists having time and the confidential space to really do their piece. This is understandable and clinics need to do their best and realize that there are circumstances when it is not feasible for receptionists to get involved. Next Meeting – September 9 & 10. Possibly in Eau Claire.