Date
Dec 2016
Client
Mount Sinai
Role
Product Design
Mount Sinai PPS, or the Mount Sinai Performing Provider System, is part of New York State's Medicaid redesign initiative known as the Delivery System Reform Incentive Payment (DSRIP) program. The DSRIP program aims to fundamentally restructure the health care delivery system by reinvesting in the Medicaid program, with the primary goal of reducing avoidable hospital use by 25% over 5 years. This initiative supports community-level collaborations and focuses on system reform, specifically to achieve a more efficient and patient-centered healthcare system for Medicaid beneficiaries.
The Mount Sinai PPS is a network that includes Mount Sinai Health System's hospitals and a large consortium of other healthcare providers, including community-based organizations, primary care providers, mental health services, substance abuse treatment centers, and other social service agencies.
Community Gateway
Mount Sinai PPS has developed Community Gateway, a state-of-the-art web based platform designed for partners to access innovative tools as a mechanism for clinical transformation. These tools are created to help organizations connect with other health care providers in the MSPPS network, manage clinical performance, review comprehensive data about patients, and access support and training resources.
There are significant barriers to care for Medicaid patients. Mount Sinai PPS providers surveyed indicated that it was “difficult” or “very difficult” for their clients to access primary, specialty, behavioral health, substance abuse, and other basic care needs.
Lack of community health centers and shortage of mental health services. Need for more care coordination. 61% of survey respondents report Medicaid beneficiaries have a difficult time accessing specialty care services.
Reduce avoidable hospital use by 25% over 5 years, concentrating on chronic patients. By providing the technology to connect partners, healthcare providers and government to observe the patients progress.
Projects include the creation of an integrated delivery system, development of care transition services after hospitalization, hospital home care collaboration, and others. In partnership with providers serving over 300,000 patients, MSPPS is working to integrate services across this robust health care system.
Initially, we used quantitative measures available in the state’s data books and other identified data sources that align with the DSRIP metrics for measuring the success of each project. We also used data that PPS stakeholders designated as critical for successful project planning and execution. In addition, existing CNAs conducted by Mount Sinai PPS hospital partners were examined for this analysis.
Once data was gathered from the various data sources and the accompanied survey, we conducted a thorough analysis of the current state of the community, summary of provider organizations, and review of the population’s health care needs. The CNA focused on the health needs in the service area and includes analyses by population for the Medicaid, duals, uninsured and all-payer populations. By comparing the indicators of these payer groups, we can examine the health disparities between those with access to coverage and those without.
A flexible place place with multiple applications, depending on the permissions would have different functionality/applications for the multiple partner categories.
- Functionality to upload the metrics.
- Patient journey
- Easy restructuring of the information.
- Ability for partners to manage their users.
- Define clear on boarding process.
In order to participate in DSRIP, providers must work together to form Performing Provider Systems, or PPSs, which are regional entities responsible for the health of the population in their service area. Each PPS is responsible for selecting between five and 10 projects from a specified menu of DSRIP projects and domains. The project selection process was guided by the results of a comprehensive Community Needs Assessment and informed by PPS members and community partners who were engaged throughout the planning process.
Contextual inquiry
In-depth Interviews
Affinity mapping
Opportunity solution diagramming
Sketching & wire framing
Design prototyping
Usability testing / Design QA
Over tree weeks, I created and led our research plan, conducting in-depth interviews with partners who had previously connected with Mount Sinai on other projects, as well as with IT engineers to validate my assumptions, better understand staff-side pain points, and uncover opportunities for improvement and innovation. I drove our partnership with partner's coordinators for member engagements to plan logistics and collaboratively draw patients journey.
Quantitative data were selected based on their alignment with the DSRIP metrics and milestones for each domain and project category. To the extent possible, data sources with statewide, citywide, borough, and county-level data were selected. Details on the data, including the definition of the indicator, data source, year(s), geography, location, and data type, were compiled in a standardized template. Data were then collected and verified as being accurate and reproducible to their source. Mount Sinai PPS CNA Page12 Qualitative data were derived from Mount Sinai PPS provider partner survey results, which collected on-the-ground insights from providers on key community health needs and barriers to accessing care.
Respondents answered 62 questions divided into six components: Organizational Information, Access to Health Care Services, Care Coordination, Population Health, Health Care Barriers, and Patient Centered Medical Homes. Of the approximately 200 parent organizations and unique standalone organizations in our PPS,190completed and submitted a survey. In addition, the PPS asked providers to complete a comprehensive survey which captured data on provider readiness and gaps in care.
New York State is the third most populated state in the United States and New York City alone is larger than 39 other states’ populations. New York City residents represent 43% of the state population, with more than 8.4 million residents.
Implementing Responsive Design
When I joined Mount Sinai they already made decision on going with desktop first. So my biggest challenge was to rebuild the desktop portal and create the experience for the mobile and tablet devices. I created seamless experience for the partners on diverse digital devices.
Feedback Chanel
Mount Sinai did’t have any feedback channel or communication with users. I had to build the user group that we reach out every month. Test with clinicians, as they are really busy.
Multilevel Permisions
Complications in managing multilevel data and content. Information shown would depends on users permissions, we had 6 roles (admin, partner admin, contributor, partner user, public,...)
Data
Limitations in data collection included the fact that them a majority of data sources that are publicly available are in the aggregate. This type of secondary data can introduce some inconsistencies, though those were reconciled as best as possible. Near the end of the CNA process the PPS did gain access to some Medicaid claims data through Salient, which was incorporated where appropriate.
We had monthly releases of new features using Agile sprints. As being responsible for the UI team I been managing work load, representing design in the leadership meetings.
Achieved all desired internal metrics and shared achievements with the government. The Mount Sinai PPS reflects a significant shift towards value-based care, where the focus is on improving the quality of care, enhancing patient experiences, and reducing costs by preventing avoidable hospital admissions and emergency department visits. Through its comprehensive approach and collaborative network, Mount Sinai PPS aims to achieve a sustainable healthcare system that meets the needs of New York's Medicaid population
We created monthly on boarding process for partners.
The user adaptation had 91% satisfaction rate from the user data and surveys.
Portal achieved its main goal and the program is still in use today.
