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JULY 5, 2018

facebook.com/MeckEMS @MecklenburgEMS mecklenburg-ems-agency

PROJECT UPDATE: SIREN WHAT ARE WE TRYING TO ACCOMPLISH? Implement Siren version 4.8.x with minimal disruption to critical agency activities by 3/28/18, to include designing and testing an implementation process. GENERAL DESCRIPTION Siren version 4.8.x will provide many advantages to the Agency. IT will be able to model mandatories in house in addition to providing other in house customization. The improved ability to customize and modify the patient care documentation package will prevent costly contractor fees. Medic will also be able to better adapt to future documentation needs as a result of the improved customization capability. Attachment capabilities will be present with the upgraded Siren package, creating an opportunity for better, more accurate patient care documentation. The upgraded Siren version will also alleviate issues that the agency currently experiences with slowness. The Siren team will be charged with designing and testing the process that will be used to upgrade to the modern Siren version. This upgrade will ensure Medic remains in compliance with NEMSIS and PREMIS standards, which are changing in late 2018. Cognos version 10 will also be upgraded to version 11 during this process, creating a need for historical data conversion, and migration and user license structure to be evaluated, and all reports will need to be prioritized and updated to the new system and data source. Additionally, Medic’s current processes rely heavily on several technological interfaces with Siren, all of which will need to be identified and managed to avoid disruption of critical activities. Siren is integral to nearly all aspects of the agency, and the upgrade will require an organized structure. REASON FOR THE EFFORT The current version of Siren will fail to meet NEMSIS and PREMIS data collection standards as of late

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2018. Additionally, the operating systems used by the current version of Siren are out of date and will not be supported much longer. Out of date systems create data vulnerability, putting the agency at risk for security breaches and potential HIPAA noncompliance. The current version of Cognos used throughout the agency to analyze and mine data will not be functional with the upgraded version of Siren and will subsequently require upgrading to version 11. Updating Cognos at the same time as Siren will allow data structures to be mapped and verified at the same time to avoid the need to pay for contractor rework. WHERE ARE THEY NOW??? “There’s a lot of progress with the Siren project”, stated Lester Oliva, Siren Team Lead. “The team is trying to find the balance between keeping historical data and updating the software for the next generation of Siren users. It has been quite a challenge.” Recently, the team submitted nearly 2,000 changes to the software, including minor changes (e.g., grammatical capitalization) and major changes (e.g., adaptation to Medic jargon). Once these changes are complete, the software will be tested and the team will move on to the next phase: incorporating mandatories. Incorporating mandatories create multiple patient report templates and rebuilding internal/external reports. The road to Siren implementation is a long one. There will be a few roadblocks along the way. However, the team is optimistic that once the tablets and the siren software roll out, Medic will have an excellent product for our patients and providers. In the meantime, keep your eye out for more opportunities to provide feedback and interact with the new program. For more information, email Lester Oliva at lestero@medic911.com

PERIOD 3 (3/1/18 - 6/30/18) WEEKLY RESULTS THRU’ 6/29/18

EST. PAYOUT : $1000 FINANCIAL STANDING VS. BUDGET (GOAL: > 0.25%)

QUALIFYING CRITERIA Budget, Patient Satisfaction and Total Task Time goals must be met to turn on Performance Pay. If one of these three goals is not met, Performance Pay will not be paid.

ON TARGET

PATIENT SATISFACTION RATED AS “EXCELLENT” 69%* (GOAL: > 50%; LOW: 50%-59%; MID:60%-64%; HI: > 65%)

TOTAL TASK TIME

66:23

(GOAL: < 70:00; LOW: 69:00-70:00; MID: 68:01-68:59; HI: < 68:00)

$150 $300

AGENCY DRIVER SAFETY SCORING AVERAGE (GOAL: > 8%) 9

PERFORMANCE CRITERIA ($100 EA.)

CMED MPDS HIGH COMPLIANCE (GOAL: > 70%) 78%

RESPONSE TIMES P1: 96.92%/P2: 95.54% (GOAL: P1, P2: > 90%; P3: > 85%) P3: 92.57%

P1 TRAUMA SCENE TIMES (GOAL: < 10:00) 7:59

*Pat Sat through 6/22/18

The latest Performance Pay Tracking Period began on March 1. We are striving to meet the Patient Satisfaction goal of a ≥ 50% rating (experience as “Excellent”). In order to create a comfortable margin of performance, while continuing to improve the patient experience, we would like to share some feedback from recent patient focus groups. The two areas that patients value the most are: 1. Communication from the treating crew: “Explain treatment options and procedures” “Provide reassurance and compassionate communication with the patient” 2. Setting clear expectations: “Set transport length expectation” “Set a triage level expectation before arriving at the hospital”

SEPTEMBER 2014

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VitaMin Vital health information in a minute

When worry turns into anxiety It’s normal to feel worried or anxious from time to time. You might feel nervous about taking a test, starting a new job or mingling at a party. A small dose of worry keeps you alert, focused and ready to do your best under pressure. But too much anxiety can interfere with daily activities and hold you back from living your life. Anxiety can look and feel very different from person to person. Intense anxiety may be triggered by fear of certain places, activities or situations. Or it may feel like a constant worried state where you’re anxious about anything and everything.

This checklist can help you identify symptoms of anxiety.

* * * *

I’m always worrying about something.

* * *

My muscles are tensed up, tight or painful.

* *

I have trouble sleeping.

* *

I’m afraid to try new things.

I’m wound up and unable to relax. I’m tired all the time. I have difficulty concentrating on tasks and making decisions.

I have an intense worry about my own safety or the safety of loved ones.

* *

I use alcohol to help me cope with my nerves. I worry every day (sometimes all day).

I’m irritable, on edge and jumpy. I have unexplained physical problems, such as nausea, diarrhea or other digestive issues.

I anticipate the worst even when there’s no clear reason for concern.

I avoid certain people, places and things for fear that something terrible will happen.

Does anxiety have a hold on you? If you’re having panic attacks or bouts of anxiety that disrupt your daily life, it’s time to say, “That’s enough.” Talk to your doctor if anxiety interferes with family, work or other parts of your life. The first step is to decide that you’re ready to do something to feel better, starting today.

This is intended to be general health information and not medical advice or services. You should consult your doctor for medical advice or services, including seeking advice before undertaking a new diet or exercise program.

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Cigna Behavioral Health, Inc., Cigna Health Management, Inc., and HMO or service company subsidiaries of Cigna Health Corporation. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All pictures are used for illustrative purposes only.

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DEPARTMENT OVERVIEW: BILLING Medic’s Billing Department manages revenue collection for ambulance transport services in Mecklenburg County. The department collects over $40M in revenue annually. Within the healthcare industry, the department may also be “coined” Patient Financial Services or Revenue Cycle. Highly regulated within the healthcare industry, one of Billing’s main function is to prevent fraud and abuse. To ensure Medic is compliant with all current federal and state billing requirements, Supervisor Cynthia Jefferson performs monthly internal audits. Business Analyst Chris Williams also audits and monitors billing processes each month to identify developing trends. Attorney group Werfel & Werfel also performs a yearly external audit. Through these audits, Medic develops educational and training content for the department and In-service. BILLING: SUBSECTIONS Medic’s Billing Department is broken down into subsections. Based on the different cycles of an account, one or all of the following subsections reviews a patient’s information daily. Coding & Charge Entry determines the level of service and charges entered on every transport. For example, Medic had over 112,000 last fiscal year. Level of service and charges are determined from documentation within the CAD Dispatch System and the Siren ticket of all 112,000 transports. Six full-time employees are responsible for coding and are divided between 911 and NET. These coders are Shaina Britt, Jeff Franz, Melody Morrison, Deanna Vandeventer, Teresa Rankin and Victoria Hartsell. Submitting claims to the insurance carrier, Claims and Billing resolves any claim edits and attaches all required records and forms. In FY17, this Billing subsection submitted over 112,000+ claims for $112M. Shay Parks maintain this process.

Derek Gray and Abby John maintain Cash Posting and Refunds. The duo posts all payments, adjustments and denials received to the patient accounting system. Last year, there was over 374,000 transactions. It requires knowledge of payer and facility contracts and denial codes. This helps ensure the account moves to the correct cycle. The refunds process requires familiarity with payment methods, individual payer refund timeline requirements and document retrieval options. Followed by Insurance Follow-Up and Denials, this team is responsible for resolving any of the 2,200 insurance carriers’ claim issues. Each carrier has their own rules and billing guidelines. In order to get a claim paid or resolved, the following employees work with following insurance companies: Sherri Steele (VA, Workman’s Comp, Jail, Tricare and Champus), Nicole Tyson (Medicare), Shay Parks (Medicaid), Sterlynn White (Commercial Insurance and Medicare Advantage), and Vonita Ham (BCBS, Hospice and Facility Claims). Last (but certainly not least), Customer Service answers inbound calls to assist patients, attorneys or insurance companies with questions regarding their

accounts. The department averages 120 inbound calls per day with an abandonment rate of less than 1%. Anissa Clayton, Danielle Walcott and SEPTEMBER 2014Brittany Ovid-Martin handle the majority of the calls. For more information, email Shelly Miller at shellym@ medic911.com.

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COMPLIANCE CLASS TRAINING In order to successfully complete this LMS training, please be aware of the following: Passwords and Login It is your responsibility to ensure that you have access to the Success Factors Learning Management System (LMS). You will need to log into the LMS to complete your compliance training and to set up your fit testing/TB test, if applicable. If you have never logged into the LMS then you will do the following: • Go to: https://medic911.plateau.com • User ID: Employee ID number with preceding zeros if applicable • Default Temporary Password is: ‘medic911’ If you have forgotten your password please use the “forgot password” function. If that fails then contact Medical Services at eqs@medic911,.com. Password resets will only occur during business hours. • You must be sure that you have your correct login information before attempting to complete work in the lab

For complete instructions, visit https://www.medic911.com/extranet/my-medic/corporate-compliance.If you have Corporate Compliance content questions, contact Pam Jackson at pamelaj@medic911.com. For technical questions, contact Medical Services at eqs@medic911.com ATTENDEES Elizabeth Ansley-Fisona, Anna Baldwin, Scott Bodien, Tabitha Byers, Brent Cail, Michael Carter, Nicholas Chase, Ed Clay, Hunter Cromwell, Janine Curlee, Jeffrey Davidson, David Dombo, Kyesha Dula, Jim Emerson, Marisa Epps, Michael George, Robert Harford, Shaun Heptinstall, Matthew Hestwood, Nicole Hogan, Aaron Hopping, Kelleigh Jackson, Cathy Jordan, Jeffrey Karll, Irina Kerusenko, Eric Koelbl, Jackson Langevoort, Shellye Ledbetter, Kaitlin Lewis, Ron Martin, Casey Miller, Jacob Miller, Rebecca Mullis, Beth Pethel, Patrick Pfund, Ian Priola, Gary Rizzo, Tyler Smith, Matthew Soria, Jason Swick, Claudia Tetenbaum, Benjamin Thackston, Christopher Weber and Sterlynn White.

August 2018

• Calendar week starts on Monday. Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday 4

SAFE TEEN 0700 - 1300

NO IN-SERVICE IN AUGUST – SIMULATION ONLY. IN-SERVICE WILL RESUME IN SEPTEMBER.

24 ASSESSMENT CENTER 0800 - 1700

SCOPE OF PRACTICE

SAFETY MEETING

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1300 - 1500

UPDATE: MEDICAL SERVICES For more information, email EQS@medic911.com

More sim information is coming soon as well as registration opportunities.

DOPAMINE PARAMEDIC INCENTIVE PROGRAM 1. Secondary to the continued uncertainties with 1. Slots are filling quickly. If you are planning to medication supply chains, dopamine is still beenroll or have enrolled into a paramedic proing stocked as a “kit” which contains four (4) gram this year, please reach out to Trevor Tayvials of dopamine. All 4 vials (200mg each) lor for more information on the benefits you should be combined into a 500cc bag in order may be eligible to receive. to achieve the correct concentration of 1600 2. If you have already enrolled in the incentive mcg/mL. program, be sure you have reached out to n (800 mg in 500 mL which is also 800,000 Bryan Runyan to discuss any scheduling needs mcg in 500 mL = 1600 mcg/mL) you may have. CODE STROKE 1. Please continue to make every effort to document FAST-ED scores. There should be one recorded FAST-ED score in the comments section for all suspected stroke patients. Paper forms are no longer required. 2. As a reminder, the FAST-ED score consists of the following categories: n Facial Palsy; Arm Weakness; Speech Changes; Eye Deviation; Denial/Neglect n All categories are scored on a 0 – 2 scale IN-SERVICE TRAINING 1. July in-service is scheduled to begin on July 3rd. If you have not already, please take a moment to register for the session you plan to attend. 2. Simulation is back!!! Fall simulation will begin August 2018 and run through the end of October 2018. The training schedule during this period of time will be as follows: n August – Simulation only, no lectures. Online content will be available n September – Simulation + on-site lecture (in-service). Online content will be available n October – Simulation only, no lectures. Online content will be available

PRONOUNCED AFTER DISPATCH BILLING 1. The billing department will go live with billing for outcomes of “DOA-10-67” and “PronouncedNo Transport” on July 1, 2018. 2. Remember that crews are not being asked to “seek out” insurance information; however, if a SSN is available, please be sure to document it. 3. Please be diligent with documenting the correct times and dates in the A/P section – especially when completing a chart for a call that was dispatched before midnight. We have seen several charts where these times are off in excess of 24 hours secondary to the date not being corrected. CARDIAC ARREST/CARDIAC MONITORING 1. Crews are reminded to review/implement the post-resuscitation care protocol in all ROSC cases. 2. Crews should utilize first responder AEDs for first shock if the AED has been applied prior to arrival. Defibrillation should not be delayed in order to exchange the MRxSEPTEMBER for the FR3. 2014 3. Please remember to always attach the 1st acquired 12-lead to all reports.

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Questions? Please contact PR at PR@medic911.com.