Michelle Currie Ms, Rn, Cphq, Cphims Email & Phone Number

San Francisco, Ca, Us

Hands-on development of Fast Healthcare Interoperability Resources (FHIR) Apps. I am building the following five FHIR Apps before the end of 2024:1. Patient Management Application on HAPI FHIR Server2. SMART on FHIR/Patient Access API on EPIC3. SMART Provider App on Cerner4. SMART backend app on EPIC5. FHIR facades on a Postgres Database#JavaScript, #HTML, #CCS, #EDI

San Francisco, Ca, Us

As the founder and Principal Value Realization/Solution Engineer at SavantSolutions4HIT, LLC, I utilize my expertise in clinical informatics to design, integrate, and manage Healthcare Information Systems (HIT) to support clinical processes, improve usability/reusability, and enhance clinical quality. I excel at aligning stakeholders, gaining buy-in, and guiding the development and implementation of healthcare policy, regulations, data standards, and innovative business solutions at both state and federal levels. My contributions are instrumental in shaping comprehensive clinical quality improvement and value-based care programs and initiatives.

San Francisco, Ca, Us

San Francisco, Ca, Us

Served as the subject matter expert for quality measurement-related infrastructure, data standards, and federal ONC policies/regulations for the National Quality Forum (NQF). • Conceived and developed a Diagnostic Excellence grant proposal securing two years of funding from the Gordon and Betty Moore Foundation to remediate electronic medical record (EMR) clinical data gaps, preventing research on missed and delayed diagnoses. • Laid the groundwork for a strategic partnership between NQF, The Joint Commission (TJC), and the American Medical Association (AMA) to improve the quality of EMR clinical data through the HL7 standards development process, ensuring structured and unstructured clinical data meet the level of precision and data quality required for effective research and analysis of patient symptoms.

San Francisco, Ca, Us

In my role as a FHIR Engineer at SavantSolutions4HIT, LLC, I provided subject matter expertise on HL7 FHIR data standards and US Core Data for Interoperability (USCDI+ Population Health) requirements to support the core data set for interoperability of chronic and infectious disease surveillance at CDC. I translated complex FHIR data standards/models into Domain Analysis Models and visual diagrams using UML standards to improve communication across diverse stakeholders. By fostering alignment of understanding among CDC stakeholders using UML visual diagrams, I enabled accelerated prioritization of agency comments and submission requests to ONC for USCDI+ Public Health.

San Francisco, Ca, Us

The California Advancing and Innovating Medi-Cal (CalAIM) is a multi-year initiative by the California Department of Health Care Services (DHCS) to enhance care coordination and improve the quality of care provided to Medi-Cal members by implementing broad delivery system, program, and payment reforms. • Identified metrics and built strategic reporting capabilities for (CalAIM) Enhanced Care Management (ECM), Community Support (CS), and Population Health Management (PHM) Programs, establishing the necessary infrastructure to address food and housing insecurity, care coordination and county health disparities for Medi-Cal members in San Bernadino County. • Identified critical information gaps and spearheaded an initiative to implement standardized protocols and data validation processes, ensuring data availability for CalAIM's continuous quality improvement initiatives in San Bernadino County.

San Francisco, Ca, Us

Provided Clinical Informatics and FHIR subject matter expertise for the (MIDS) Development, Reevaluation, and Continued Implementation of Outcome/Efficiency Measures for Hospital and Eligible Clinicians Task Order for the Centers for Medicare and Medicaid Services (CMS) public reporting and payment programs. • Synthesized complex Health IT regulatory and technical regulations providing a clear vision and roadmap for USCDI+Quality for the Center for Medicare and Medicaid Services (CMS) aimed at modernizing Medicare Advantage (STARS), Merit-Based Incentive Payment System (MIPS), Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs), Bundled Payments for Care Improvement (BPCI) Value-Based Payment Initiatives.• Identified the list of “must support” data elements for CMS, the Office of the National Coordinator (ONC), and United States Cored Data for Interoperability (USCDI) regulations that define the minimum data EMR vendors must support and make available through FHIR enabled Application Program Interfaces (APIs) for quality measurement.

San Francisco, Ca, Us

San Francisco, Ca, Us

• Developed and implemented performance improvement plans to reduce unsustainable variability in monthly medical claims costs for self-insured employers. Initiatives focused on improving analytic capabilities to identify and prioritize initiatives to improve poor performance. • Used Statistical Process Control (SPC) reports to identify root causes of avoidable utilization including lack of culturally sensitive care options, low health literacy, and care navigation barriers (SDoH). • Recommended Benefit Plan design changes to reward employees for establishing relationships with primary care providers and enrolling in behavior modification programs like the Diabetes Prevention Program (DPP). Reduced avoidable costs by $1.2M for a mid-size, self-insured employer within two years.

San Francisco, Ca, Us

Streamlined operations and established standard deliverable timelines for the cross-functional quality measure development processes. Provided subject matter expertise to evaluate the strength of the company product, identify functional gaps, and provide guidance and strategic recommendations on product development.• Secured executive buy-in to acquire and integrate Atlassian Project Management into Confluence and JIRA, streamlining and automating business processes and expediting analytic deliverables to clients. • Initiated project plans, routine reporting, and governance infrastructure to mitigate risks, ensuring the delivery of measurable results to clients and alignment with strategic objectives.• Conducted competitive landscape analyses to identify strategic gaps in measurement products. • Recommended adding CMS performance-based program measures to increase product breadth and expand potential client base.• Identified and delineated quality measurement requirements and conducted comparative analyses between Motive's Practice Wisley, AHRQ's CDS Connect, and CMS's Measurement Authoring Tool (MAT).

Chicago, Il, Us

Oversaw, orchestrated, and ensured the attainment of internal goals and objectives across executive leadership, business development, sales and marketing, engineering, product development, measurement ideation, design and development, and data acquisition to drive the successful execution of pilot initiatives across diverse clients.• Established processes for data acquisition and mapping, quality measurement design, and development of off-the-shelf reports for the population health product. • Leveraging the Unified Modeling Language (UML), led the translation and conversion of data standards (X12, FHIR, HL7 V2/v3, CDA, OMOP), CMS and commercial insurance claims data, business rules, and population health reporting requirements into Extract, Transform, and Load (ETL) processes, ensuring semantic data quality that is "fit for purpose" for ingestion into analytical products.

Nashville, Tn, Us

• Maximized CMS reimbursement rates by improving hospital performance in the Inpatient Prospective Payment System (IPPS) and the Hospital Inpatient Quality Reporting Programs (IQR).• Led the identification of compliance gaps related to CMS condition-based treatment (Core Measures) timelines by thoroughly analyzing regulatory standards, quality metrics, workflow inefficiencies, and clinical user requirements. • Collaborated with the IT department to design and develop the "Care Traffic Control" analytics dashboard, closing workflow and information gaps for Frontline clinicians. This clinical decision support initiative improved hospital reimbursement through the Hospital Value-Based Purchasing (VBP) Program, enhancing patient outcomes and financial performance.• Led performance improvement initiatives that increased compliance with evidence-based care recommendations for Community-Acquired Pneumonia (CAP) by 65% within two months. Used human-centered design principles to gather requirements from clinical users and lab technicians to design and implement a Clinical Decision Support (CDS) alert for emergency department nursing staff. This alert provided proactive verification of blood culture collection status before administering antibiotic orders. • • Remediated high-risk, non-compliant Focused Professional Practice Evaluations (FPPEs), Ongoing Professional Practice Evaluations (OPPE), and privileging-related medical staff operations and established continuous readiness for the Joint Commission through routine monitoring.• Coached and mentored six quality department staff, preparing them to assume greater responsibility and decision-making.

Oakland, California, Us

Led teams of subject matter experts with diverse functional and technical backgrounds to ideate, design, develop, and implement clinical, business, and technology transformations for the Northern California Region, improving care for 8.1M members. Partnered with the Northern California physician Quality Chiefs and Member Services to develop and execute a DMHC corrective action plan (CAP) for health plan oversight of delegated quality-of-care complaint investigation and remediation operations. • Analyzed and interpreted complex state health plan regulations delineating the requirements to satisfy DMHC conditions of compliant delegation and oversight of quality-of-care investigation operations.• Redesigned data collection in MIDAS, revised peer review policies and procedures, conducted mock audits, and established region-wide case closure reporting in StatIT, enabling Health Plan executive oversight, proactive monitoring of case closure rates, and the ability to centralize quality of care investigative operations for the Northern California region leveraging economies of scale and reducing Health Plan administrative costs.Analyzed and documented comprehensive requirements for Continuum of Care operations, including Utilization, Case, and Transition Management. • Conducted staff and leadership interviews and documented current state data flows, business processes, business rules, use cases, applicable regulatory and compliance standards, and transition management/post-acute placement processes. • Organized findings into user, business, clinical, functional, and non-functional requirements.• Identified and validated solution functionality across Epic/KP HealthConnect Ambulatory, Inpatient, Home Health/Hospice, Revenue Cycle, and Tapestry modules that fulfilled 75% of the Continuum of Care requirements.• Designed a strategic plan for technically integrated and enabled future state operations for Utilization, Case, and Transition Management.

Oakland, California, Us

Oakland, California, Us

Remediated fraudulent Medicare billing for professional, laboratory, and pharmacy services provided to Kaiser members across Northern California in non-Kaiser/contracted dialysis centers. • Identified, analyzed, and interpreted complex CMS Medicare consolidated billing requirements, comprehensive Conditions of Coverage and professional standards for coding accuracy, Place of Service coding, and EPIC EMR functionality to identify necessary changes to operational processes, EPIC EMR configurations, modifications of documentation and order templates in EPIC, and amendments to the rules and business logic for automated claims generation in Revenue Cycle. • Designed, developed, and implemented a Medicare-compliant technical solution to address existing non-compliance with finance, business, and clinical operations. • The solution remediated the risk of fraudulent Medicare billing, enabling 18 months of back billing for professional dialysis services.• Designed and implemented a compliant national/corporate interoperability solution to integrate post-acute care physician notes into EPIC ambulatory module/KP HeatlhConnect.

Oakland, California, Us

Managed and mentored 20 remote Business Application Coordinators assigned across 19 Northern California outpatient medical office "geographies" on strategies and tactics to build relationships and establish influence with 2,100 Northern California Permanente Medical Group physicians to execute a successful MyChart big-bang Go-Live.

Oakland, California, Us

Remediated fraudulent Medicare billing for professional, laboratory, and pharmacy services provided to Northern California Kaiser members in non-Kaiser/contracted dialysis facilities.• Identified, analyzed, and interpreted complex CMS Medicare consolidated billing requirements, comprehensive Conditions of Coverage, professional standards for coding accuracy, Place of Service Coding requirements, and EPIC EHR functionality to identify necessary changes to operational processes, EPIC EMR configurations, modification of documentation and order templates in EPIC, and amendments to the rules and business logic for automated generation of claims in Revenue Cycle.• Designed, developed, and implemented a Medicare-compliant technical solution to address non-compliant business and clinical operations.• The solution remediated the risk of fraudulent Medicare billing and enabled back billing for 18 months of professional dialysis services.

Oakland, California, Us

Part of the nursing leadership team that established the inpatient Labor and Delivery Service Line at the Oakland Medical Center and managed the relocation of Labor and Delivery operations and nursing staff from the Alta Bates Medical Center to the Oakland Medical Center. Worked closely with the TPMG leadership team to ensure a seamless transition of care delivery operations while maintaining quality patient care.

Sacramento, California, Us

CALIFORNIA PACIFIC MEDICAL CENTERRedesigned the Nurse Residency Program. Prepared seven nurses for independent practice in Labor and Delivery. Designed and delivered continuing education for nursing staff across antepartum, labor & delivery, postpartum, newborn nursery, and the Neonatal Intensive Care Unit (NICU).

Sacramento, California, Us

PALO ALTO MEDICAL FOUNDATIONDeveloped product vision, marketing strategy, implementation plan, and execution tactics with executive leadership for the first EPIC MyChart Go-Live in the United States.• Developed the business plan for EPIC MyChart, including the first-of-its-kind $5/month paid subscription model for "Email your Doctor." • Designed and implemented cross-functional EPIC Ambulatory/MyChart workflows for "Email your Doctor," prescription refill, electronic lab release, nurse triage/medical advice, appointment scheduling, release of information, member services, and billing features for primary care and all specialty practices.• Partnered with the lead EPIC engineer/programmer and the IT department to develop and execute cross-module and cross-functional test scripts and user acceptance testing (UAT) for EPIC Ambulatory/MyChart functionality and workflows. • Developed both in-person, hands-on, scenario-based, and asynchronous, on-demand, and self-paced EPIC Ambulatory/MyChart training curriculum based on Adult Learning Theory for physicians, registered nurses, and administrative staff for cross-functional, multi-specialty MyChart functionality and workflows.• Delivered scenario-based EPIC Ambulatory/MyChart training classes for business, clinical, and administrative staff on Ambulatory/MyChart functionality and workflows for multiple cross-functional departments and medical specialties.• Designed an Access database, executive dashboards, and operational reports, enabling oversight, management, and monitoring of all MyChart operations. • Established foundational research capabilities to study MyChart's impact on operational efficiency, cost savings, patient engagement/activation, quality of care outcomes, and physician satisfaction.• Provided end-user training and support to the first 1,000 patients in the United States who used the EPIC MyChart product.

Oakland, Ca, Us

• Provided high-quality, efficient, and safe direct patient care to high-risk antepartum, intrapartum, newborn, postoperative, and postpartum patients.• Responsible for advancing professional nursing practice through unit-based initiatives that improved the efficiency and quality of patient care and the continued professional development of perinatal nursing unit staff.

Palo Alto, California, Us

• Provided high-quality, efficient, and safe patient care to high-risk antepartum, intrapartum, postoperative, and postpartum patients.• Committee member responsible for establishing a new antepartum unit, including developing policies & procedures, paper-based physician order sets, nursing documentation spreadsheets, workflows, and related processes for caring for and transferring patients between antepartum and labor& delivery units.

Master'S Degree, Healthcare Informatics

Bachelor Of Science - Bs, Nursing