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A Report from the Alliance Clinical Practice Improvement Network January 30, 2013. Today. Briefly review highlights from the Alliance’s 2012 Community Checkup Share results from the Alliance’s 2012 Medical Group Survey Presenting: Susie Dade, Puget Sound Health Alliance Commentary:

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Presentation Transcript
today
Today
  • Briefly review highlights from the Alliance’s 2012 Community Checkup
  • Share results from the Alliance’s 2012 Medical Group Survey

Presenting:

    • Susie Dade, Puget Sound Health Alliance

Commentary:

    • Peter McGough, MD, Chief Medical Officer, UW Neighborhood Clinics
    • Scott Kronlund, MD Chief Medical Officer, Northwest Physicians Network
community checkup 2012 ambulatory highlights
Community Checkup 2012: Ambulatory Highlights
  • Sixth Community Checkup
  • Includes results for:
    • 81 medical groups with 4 or more clinicians in more than 300 locations
    • Claims covering 2 million lives
    • Measurement year: July 2010 - June 2011
  • 30+ performance measures
  • New: Generics reporting @ individual provider level
  • New: Generic anti-hypertensives measure
  • Medicaid data back in!
  • Comparison of results over time

www.WAcommunitycheckup.org

data suppliers
Aetna

The Boeing Company

Carpenters’ Trust

CIGNA

City of Seattle

Community Health Plan of Washington

First Choice

Group Health

King County

Molina Healthcare of Washington

Premera Blue Cross

Recreational Equipment Inc. (REI)

Regence Blue Shield

Sound Health and Wellness Trust

Snohomish County

UnitedHealthcare

Washington State Health Care Authority – Public Employees

Washington State Health Care Authority – Medicaid

Washington Teamsters Welfare Trust

Alliance’s data repository includes

approximately 2 million covered lives!

Data Suppliers
alliance vision
Alliance Vision

Physicians, other providers and hospitals will achieve top 10% performance in the nation in the delivery of equitable, high quality, evidence-based care and in the reduction of unwarranted variation, resulting in a significant reduction in the rate of medical cost trend.

progress in achieving top 10 performance

2012 Community Checkup Results

Progress in Achieving Top 10% Performance

At or Above NCQA 90th Percentile, Commercial

  • Screening for Colon Cancer** (but still only at 61%)
  • Screening for Cervical Cancer
  • Antidepressant Medication Adherence (12 weeks)
  • Diabetes – HbA1c Testing
  • Diabetes – Kidney Disease Screening
  • Avoidance of Antibiotics for the Common Cold
  • Avoidance of Imaging for Low Back Pain
  • Use of Spirometry – COPD

**Measures the newly eligible

progress in achieving top 10 performance1

2012 Community Checkup Results

Progress in Achieving Top 10% Performance

Below NCQA 90th Percentile, Commercial

  • Antidepressant Medication Adherence (6 months)
  • Diabetes – Cholesterol Testing
  • Heart Disease – Cholesterol Testing
  • Heart Disease – Use of Beta Blockers
  • Avoidance of Antibiotics for Bronchitis
  • Appropriate Use of Medication – Asthma

Way Below NCQA 90th Percentile, Commercial

  • Adolescent Well Child Visits
  • Screening for Chlamydia
bottom line
Bottom Line . . .
  • Significant variation persists in our region
  • Some medical groups perform among the best in the nation on some measures; others have significant room for improvement
  • No one medical group excels at everything, so opportunities for all to learn
  • While Medicaid results are generally lower, some clinics do as well as high performing clinics in commercial population
  • Low rates translate into thousands of people not getting the right care or having a good experience

“…the gap between what we know works and what is actually done is substantial enough to warrant attention. These deficits, which pose serious threats to the health and well-being of the U.S. public, persist despite initiatives …” Elizabeth McGlynn, NEJM, 2003

slide13

Comments from Drs. McGough and Kronlund

To see detailed Community Checkup results, go to:

www.WAcommunitycheckup.org

slide14

Adoption of Processes

and Tools to Advance

Effective Patient Care

Medical Group

Survey Results

October 2012

background and purpose of the survey
Background and Purpose of the Survey
  • Collect and share information that describes whether or not activities and tools are being implemented in the practice setting
    • Survey developed with physician guidance
    • Focuses on activities and tools that have been shown to positively impact performance and support the delivery of evidence-based care
  • Provide community-wide scan of progress being made (compared results to 2010)
  • Share results to (1) provide broad view of overall clinic management and care coordination, and (2) identify opportunities for improvement
survey overview
Survey Overview
  • Sent to 53 Medical groups
    • 5-county region, included in Community Checkup
  • 42 respondents, up from 33 in 2010 (62% response rate to 79%)
    • 32 medical groups with multiple locations
    • 10 individual clinics
    • 7 medical groups declined to respond
    • 4 medical groups declined to participate
  • Survey assessed practice activity in several domains:
    • Understanding Healthcare Disparities
    • Access and Communication
    • Chronic Conditions Management
    • Care Coordination
    • Data Management
    • Improving Quality and Patient Experience
use of ehrs to manage and improve care
Use of EHRs to Manage and Improve Care

Not surprisingly, EHR adoption is improving in the region and the number of capabilities being used is increasing compared to 2010 (55% to 69%)

Strengths:

  • Patient appointment scheduling
  • Clinical documentation of each visit
  • Documentation of current medical list
  • Lab results reporting

Moderate Improvement:

  • Complete, standardized problem lists
  • RX ordering w/ability to highlight drug interactions/correct dosing
  • Lab/radiology order entry
  • Alerts re: abnormal values
slide26

Use of EHRs to Manage and Improve Care

Uses Lagging Behind:

  • Point-of-care clinician alerts based on evidence
  • Decision support tools (easy access to clinical guidelines or protocols)
  • EHR-linked patient registries
  • Access to clinical documentation from ED and inpatient stays
  • Secure patient portal
    • On line appointment scheduling
    • Patient reminders for needed tests or follow-up care
    • Secure email
    • Access to clinical information (e.g.,lab/radiology/biometric results, medication lists and ordering, visit summaries, immunization records)
community progress high performers
Community Progress – High Performers
  • Implemented majority of tools and resources:
    • Group Health Cooperative
    • The Everett Clinic
    • Virginia Mason
  • Implemented or in the process of implementing majority of tools and resources:
    • MultiCare Medical Associates
    • Pacific Medical Centers
    • Swedish Medical Group
    • UW Medicine Neighborhood Clinics
what s ahead
What’s Ahead?
  • 2013 Community Checkup
    • Beginning statewide-expansion, starting at county level first
  • Fielding 2nd Ambulatory Patient Experience Survey
  • Updated “Resource Use Report” on Common Hospitalizations, to include utilization/service intensity, quality and pricing
  • Potentially Avoidable ED Visits by Hospital & Medical Group
  • 30-day All Cause Readmissions without an MD Visit
slide29

Comments from Drs. McGough and KronlundQuestions?

For more information:

Susie Dade

Deputy Director

Puget Sound Health Alliance

sdade@pugetsoundhealthalliance.org

Please visit our new website:

www.wacommunitycheckup.org