Centra boosts quality care compliance scores by 24 percent with Microsoft 365 business intelligence tools
Centra, a nonprofit healthcare system, demonstrates its commitment to excellent care through its many health programs—and by its forward-looking adoption of cloud services that empower employees to provide better care. Using Microsoft 365, Centra provides data for clinicians to improve quality-based healthcare practices and increase payor reimbursements. IT staffers help create mobile, highly secure work environments to expedite teamwork. And they’ve established a daily claims audit process and a digital provider directory for patients that boost overall operational efficiency.
Headquartered in Lynchburg, Virginia, Centra is a regional, nonprofit healthcare system that serves more than 380,000 people throughout central and southern Virginia. After a challenging decade of healthcare reform, Centra emerged a larger, more comprehensive network of health service providers that’s winning accolades for quality of care. In January 2018, two flagship facilities within Centra—the Centra Lynchburg General Hospital and Centra Virginia Baptist Hospital—won a five-star rating from the Centers for Medicare and Medicaid Services (CMS).
Data empowers providers to enhance care
Centra uses data to empower its Firstline Workers—the physicians and other clinical staffers who provide patient care throughout Centra—to review their performance against quality benchmarks, so they can improve patient care as the organization moves to a quality-based reimbursement model, pursuant to the Patient Protection and Affordable Care Act, or ACA for short. US Congress signed the ACA into law in 2010 with a goal to encourage health reform through payment reform. But healthcare organizations like Centra found it challenging to collate, analyze, and deliver meaningful data to the providers in their networks so they could assess the quality of care.
“This value-based system is complex and fast-moving,” says Dr. Matthew Johnson, Chief Population Health Officer for Centra. “Today, an increasing portion of the payments from government payors, such as CMS, introduces the concept of risk, whereby providers could potentially face changing reimbursements based on their performance around quality, cost, and patient experience.”
Centra responded to this quality-based model by creating Centra Alliance, a Medicare Shared Savings Program Accountable Care Network, wherein care providers work together to take on the management of Medicare beneficiaries. “Within the narrow network, the engine that drives positive change in care delivery is data,” says Johnson. “We supply real-time, actionable information directly to our 370 Centra Alliance care providers using Microsoft Power BI in Office 365 E5.” Office 365 is a component of Microsoft 365, which also includes Windows 10 and Enterprise Mobility + Security.
“We use our Power BI–based BI Clinical Dashboard to lower the risk of reporting penalties and improve the quality of care we provide,” continues Johnson. “In the nine months since we introduced the Power BI dashboard, our overall quality compliance scores increased from 34 to 58 percent. This represents thousands of new touches of improved care provided to our patients.”
Before Centra introduced the BI Clinical Dashboard in March 2017, it had to find ways to comply with increasingly stringent CMS reporting requirements and avoid a penalty of up to $10 million if the organization failed to correctly track and report on six quality metrics. Centra worked with a partner, Citius Tech, to mine the information in its data warehouse and create a report for providers. “We first attempted a high-level dashboard that aggregated everyone into one group,” says Johnson. “It wasn’t very flexible, and it didn’t allow us to drill down to individual patients.”
When new legislation expanded the 6 quality benchmarks to 15 metrics—such as statin therapy, influenza immunization, and breast cancer screening—pressure grew to provide Centra physicians with more granular information to avoid potential payment reductions from CMS.
“With Power BI, we were finally able to deliver a meaningful dashboard with real-time data on the different quality benchmarks,” says Johnson. “This is a huge advance in actionable, transparent data, where individual physicians can compare their own performance against each benchmark and then drill down to see which patients are driving their scores.”
Improved quality of care increases reimbursement
Using the BI Clinical Dashboard, Centra strengthened its ability to comply with CMS reporting requirements and empowered physicians with meaningful information that’s contributing to lasting improvements in healthcare practices. Better compliance scores are a direct result of the dashboard’s drill-down capabilities.
The dashboard provides a valuable tool for physicians because it includes patient information, which is protected under the Health Insurance Portability and Accountability Act (HIPAA). “We can include patient information that’s protected under HIPPA because Power BI, as part of Office 365, provides the requisite level of data security,” says Johnson. “It is the first time we have been able to give doctors real-time information to make care decisions. With this level of transparent, operational information in a highly secure setting, we are seeing physicians making durable changes to their practice, raising the bar for quality care across our organization.”
And that can translate into improved revenue. In 2017, Centra submitted its quality measurement data to CMS and was awarded a 70 percent quality rating, which will be used to calculate an increase in reimbursement in the future. Physicians can also use the dashboard to improve their scores and risk adjustments to drive reimbursements from patients with Medicare Advantage health plans administered by the Piedmont Community Health Plan, a health insurance company owned by Centra. “The more data we can give physicians to help them do appropriate risk adjustments and accurately measure the severity of illness in a particular population, the better the payments will be from Medicare Advantage,” says Johnson.
Highly secure workplaces drive mobile productivity
Centra chose to align its cloud journey with Microsoft technologies back in 2014. A key reason for choosing Microsoft was the company’s flexible licensing model that aligns with the different digital tool sets required by a diverse workforce that includes executives, administrative staff, and firstline clinical workers.
Another critical factor was the willingness of Microsoft to work with Centra to meet its security requirements. “We needed to keep our data within the continental United States, and Microsoft agreed to that with our tenant,” says Jody Hobbs, Managing Director of Business Applications and Information Security Officer at Centra. “So, we became one of the first healthcare providers to move all employees to Exchange Online.” Today, to protect employees from increasingly sophisticated attacks, Centra uses Office 365 Advanced Threat Protection, an email filtering service that helps protect against malware, viruses, and malicious hyperlinks in emails.
Centra knowledge workers use Office 365 ProPlus, the most productive version of Office that employees can install on up to five devices, including PCs, Macs, tablets, and mobile phones. “ProPlus was one of the major attractions for us, because it lays the foundation for mobility,” says Hobbs. “We encourage everyone to use OneDrive so that no matter where you are, your files are accessible from the cloud.”
Darrell Manning, Director of Project Management at Piedmont Community Health Plan, a health insurance company owned by Centra, experienced the benefits of mobile productivity when the CEO emailed him one evening, asking for a file. “I thought I would have to go and get my laptop, connect to my Wi-Fi, and take 15 minutes to access the corporate network through the VPN and look for the file on a shared drive,” he recalls. “Then I remembered I had uploaded the file to OneDrive. So, I just used my phone to find it in the cloud, hit share, typed in his name, and hit send. I was done in less than a minute.”
Centra will use Microsoft Intune, a component of Enterprise Mobility + Security, in conjunction with Office 365 ProPlus to help ensure that employees are productive on all their devices, while safeguarding the organization’s data. “We are replacing our current mobile device management solution, Citrix XenMobile, with Intune,” says Hobbs. “We’ll be registering approximately 2,500 mobile devices both for our corporate device users and for some employees who bring their own devices to work.”
The company is also increasing the security of clinical data by introducing Microsoft Azure Multi-Factor Authentication for anyone attempting to access clinical applications outside the organization’s firewall. IT staff replaced its RSA key fobs solution with Multi-Factor Authentication within Azure Active Directory Premium P1, an Enterprise Mobility + Security component. “We want clinical workers and knowledge workers alike to have the flexibility of mobile workplaces, and Office 365 is the way to achieve that level of productivity, with the same feature-rich capabilities for everyone,” says Hobbs.
Centra uses Exchange Online Archiving and Legal Hold for compliance and plans to deploy the data loss protection (DLP) functionality within Office 365 Security & Compliance Center to boost its ability to protect patient information and comply with HIPAA. “We’ll be using data loss protection policies for our outbound email encryption to safeguard protected health information, and we are also evaluating Azure Information Protection for the data that’s stored in Office 365 to create more DLP policies,” says Hobbs.
Azure Information Protection is a component of Enterprise Mobility + Security.
Efficient project management expedites claims updates
Many Centra employees use collaborative sites in Microsoft SharePoint Online to facilitate virtual teamwork. And Manning discovered Microsoft Teams, the hub for teamwork in Office 365, using it to work more efficiently on an average of 15 to 20 concurrent projects—ranging from installing a new fax server to building partnerships with other health plans. Until recently, Manning and his colleagues used email, shared drives, and telephone calls to manage action items, document revision, meeting schedules, and deliverable timelines. But when they consolidated everything into a Teams work environment to run a project that involved developing and launching an online provider directory for customers, they completed the project in just four months.
“We used to experience delays when people didn’t have the right device or weren’t in the office. But I explained that they could access Teams and any documents they needed via their computer, tablet, or phone,” says Manning. “This flexibility meant that no one had to wait to take the next step in the project.”
Today, Manning uses Teams for almost every new project. Recently, he set up three Teams work environments to coordinate how Piedmont sets sales goals for a newly expanded product line. “After our initial meeting, I added Microsoft Planner as a tab and assigned tasks,” says Manning. “Even though my colleagues hadn’t used Teams before, the app was intuitive enough that once they got the email notifying them of their tasks, they completed their assignments and uploaded the documents to the files tab stored in the channel in just a few hours.”
Also, compared to the average of several weeks that it used to take to set up a new project, Manning now only requires a few minutes to set up a project, onboard new members, and establish permissions to view and edit documents. Instead of storing files on a shared folder and contacting the IT department with a security request to set permissions, Manning can take care of setup and permissions himself. “Because IT gets so many user access requests, it took up to two weeks to establish the necessary security parameters for a new project with shared resources,” says Manning. “Now I can create a Teams work environment in a few minutes. I’m also really excited about the ability to add non-Centra guests to projects within Teams as many of our projects interface with non-employees. With Teams, version control is significantly enhanced as we all have access to the same documents.”
Centra operational analysts review the company’s Claims Validation Spreadsheet each day, and now they complete this task more efficiently thanks to the coauthoring capabilities within their Teams workspace. Multiple analysts access the spreadsheet in Microsoft Excel Online to simultaneously review the claims and annotate the file, marking each claim as completed, in progress, denied, or requiring more information. “We needed to have multiple people collaborating on the spreadsheet at once, and it just wasn’t possible until I discovered Microsoft Teams,” says Manning. “Now we save hours every day in the claims audit process, with fewer manual errors. Claims are the lifeblood of our business, so being more efficient and effective about how we audit those claims is a huge business benefit.”
Whether it’s providing firstline workers, such as clinical staffers and physicians, with better data or offering highly secure workplaces for creative teamwork, Centra IT staff is enabling a new world of mobility and productivity that factors down to one thing: providing better patient experiences that meet the requirements of today’s healthcare reforms.
In the nine months since we introduced the Power BI dashboard, our overall compliance score increased from 34 to 58 percent. This represents thousands of new touches of improved care provided to our patients. Dr.