Healthcare Intelligence Network

A physician practice's measurements reporting efforts will flourish under a "physician champion" to lead the way, notes Linda Davis, a consultant to the Buyers Health Care Action Group (BHCAG) in Minnesota. Once a transparent reporting effort is underway, it can bring about significant cultural change and raise motivation levels in the naturally competitive provider environment, she adds. Aware of the automated vs. manual reporting methods in use, the BHCAG facilitates the reporting effort via its direct data submission process, which accepts data from practices in many formats. Gary Austin, a healthcare industry consultant on corporate/product strategy and program management, Davis, Sue Lewis, senior vice president of health and productivity solutions at IncentOne, and Mark Xistris, director of provider relations and health information for The Alliance, examined how their respective organizations are using these four strategies to stay competitive in the fast-growing consumer-driven movement during a May 30, 2007 audio conference, Value-Driven Healthcare in Action: A Four-Pronged Approach to Meet Consumer Transparency, Quality and Access Demands.

Rewarding members and employees for being savvy medical consumers and shopping is an increasing trend in healthcare, notes Sue Lewis, senior vice president of health and productivity solutions at IncentOne. Companies are leveraging the corporate Intranet, meetings and health fairs to spread the word on incentives to their populations. She has also observed that companies offering consumer-directed health plans are in the best position tax-wise to extend benefits to dependents and retirees. Gary Austin, a healthcare industry consultant on corporate/product strategy and program management, Linda Davis, a consultant to the Buyers Health Care Action Group (BHCAG) in Minnesota,Lewis, and Mark Xistris, director of provider relations and health information for The Alliance, examined how their respective organizations are using these four strategies to stay competitive in the fast-growing consumer-driven movement during a May 30, 2007 audio conference, Value-Driven Healthcare in Action: A Four-Pronged Approach to Meet Consumer Transparency, Quality and Access Demands.

Until patient satisfaction ratings can be evidenced to be linked to outcomes, they should not factor into a provider's quality ratings, says Mark Xistris, director of provider relations and health information for The Alliance, an employer-owned and directed not-for-profit cooperative that helps companies manage the total cost of ensuring the health and well-being of their workforce. His organization, recently named a community leader by the U.S. Department of Health and Human Services, believes that providers and payors have legitimate concerns about releasing cost information to consumers, who may misinterpret the data without proper guidelines. Gary Austin, a healthcare industry consultant on corporate/product strategy and program management, Linda Davis, a consultant to the Buyers Health Care Action Group (BHCAG) in Minnesota,Sue Lewis, senior vice president of health and productivity solutions at IncentOne, and Xistris, examined how their respective organizations are using these four strategies to stay competitive in the fast-growing consumer-driven movement during a May 30, 2007 audio conference, Value-Driven Healthcare in Action: A Four-Pronged Approach to Meet Consumer Transparency, Quality and Access Demands.

Involving physicians and nurses in an initiative that teaches patients how to manage their own care may initially increase the demand on an already overtaxed primary care system, says Christopher Wise, administrative director of the Medical Management Center at the University of Michigan (U-M) Health System. But ultimately, the patient who better understands the intricacies of their disease and available care alternatives will actually have fewer reasons to access primary care physicians, he adds. In U-M's model, he explains, social workers and nurses who know the university's health services best function as health navigators, helping the chronically ill find their way through the system. For optimum efficiency and results, the patient's self-management must be linked to a broader aspect of the physician's office and the medical home it provides. Margaret Brennan, administrator for the Primary Care Access Network with Orange County Government, Maureen Kersmarki, board chair of the Primary Care Access Network for Florida Hospital along with Wise, described how their respective organizations have created sustainable partnerships for increasing access to primary care during a May 16, 2007 audio conference, Strategies to Increase Primary Care Access, Use and Coordination.

Already on a quest to accelerate clinical excellence, Memorial Medical Center in Springfield, Ill. was the first hospital to sign on with the CMS/Premier Hospital Quality Improvement Demonstration in 2003. Jim Bente, Memorial's vice president of quality and organizational development, said the initiative was a natural extension of Memorial's focus on safety, quality and clinical excellence. A top performer in the demonstration project, Memorial initiates employees in its culture of quality from the day they're hired, explains Bente. To emphasize this commitment, department and individual goals in this initiative are prominently displayed throughout the hospital. Bente, Regina Berman, administrative director for performance improvement, and Liz Popwell, Cleveland County Healthcare Systems' vice president of systems management, gave us the inside details on how these hospitals have structured their internal processes to support an environment of performance improvement that has led to quality incentive payments from CMS under the Hospital Quality Improvement program during an April 18, 2007 audio conference, How to Structure a Healthcare Performance Improvement Process That Results in Incentive Payments.

Technology that allows Cleveland Regional Medical Center (CRMC) to conduct concurrent chart reviews also generates reports that guide nurses and physicians in improving the patient experience, explained Liz Popwell, Cleveland County Healthcare Systems' vice president of systems management. A holistic approach to outpatient care -- including proper discharge instructions, disease-specific survival kits, and outpatient care analysis -- has resulted in a 37 percent drop in hospital readmissions. The challenge to maintaining CRMC's top rating in the Premier Hospital Quality Incentive Demonstration Project, she said, is ensuring that new staff members are adequately trained in core measures and processes. Jim Bente, Memorial's vice president of quality and organizational development, Regina Berman, administrative director for performance improvement, and Popwell gave us the inside details on how these hospitals have structured their internal processes to support an environment of performance improvement that has led to quality incentive payments from CMS under the Hospital Quality Improvement program during an April 18, 2007 audio conference, How to Structure a Healthcare Performance Improvement Process That Results in Incentive Payments.

Robots -- dispensing meds in the pharmacy, assisting in the operating room, and even facilitating remote doctors' rounds -- is just one example of the technology supporting quality initiatives at Hackensack University Medical Center (HUMC), explained Regina Berman, administrative director for performance improvement. As the top earner in the CMS/Premier Pay for Performance project for two years running, HUMC has seen a "reverse migration" of patients who used to head to New York for medical care, said Ms. Berman. Its bariatric surgery program draws patients from around the nation, and its cancer center 100 attracts new patients each week. Just 10 miles from the Big Apple, HUMC has been cited by Business Week magazine for its technology initiatives and by New York magazine as one of the top 10 hospitals where physicians would go for their own care. She attributes the success of HUMC to involvement and commitment of front-line staff. Jim Bente, Memorial's vice president of quality and organizational development, Berman, and Liz Popwell, Cleveland County Healthcare Systems' vice president of systems management gave us the inside details on how these hospitals have structured their internal processes to support an environment of performance improvement that has led to quality incentive payments from CMS under the Hospital Quality Improvement program during an April 18, 2007 audio conference, How to Structure a Healthcare Performance Improvement Process That Results in Incentive Payments.

The hands-on approach of Enhanced Care Initiatives' "Easy Care" program for the frail elderly is built on human interaction, communication and reinforcement. Nurses act as health advocates, pulling together all aspects of a patient's care and supporting the patient by working for them in the healthcare system. However, technology has its place: a tablet PC is a communication hub for nurses, a web-based patient data collection tool is an information repository, and in-home monitoring tracks meds intake. Dr John Charde, Enhanced Care Initiatives' vice president of strategic development, described how Enhanced Care Initiatives varied programs "touch" the frail elderly. Charde and Laurie Russell, XLHealth's senior director of health solutions, explored how to create effective care management approaches for the frail elderly during an April 26, 2007 audio conference, Managing Transitions to Care for the Frail Elderly.

Fall risk assessment is built into XLHealth's health risk assessments for the elderly, explained Laurie Russell, its senior director of health solutions. Members' caregivers and pharmacists also play key roles in XLHealth's fall prevention efforts. More than a year into CMS' Medicare Health Support Program, Russell detailed how her organization's "Ask Your Doctor" report empowers members with the language to address medical conditions during a doctor visit. Dr John Charde, Enhanced Care Initiatives' vice president of strategic development and Russell explored how to create effective care management approaches for the frail elderly during an April 26, 2007 audio conference, Managing Transitions to Care for the Frail Elderly.

Lee Aase, Mayo clinic's manager of national media and new media is a self-described borderline Baby Boomer/GenX-er charged with tapping new media channels such as podcasts and streaming video to deliver Mayo's health information to increasingly younger consumers. Experience has shown that it takes a life event such as the birth of a child or a parent's illness to get young people thinking about health coverage and care. But sometimes an emergency can be a defining moment. When an uninsured family member suddenly took ill, Lee pressed his organization's newly launched cell phone health tool into action and averted a costly ER visit. Aase and Scott Schroeder, president and CEO of Cohorts, Inc., along with Aric Hooverson, account director, Grey Worldwide San Francisco and Shelley Patchin, director of advertising, Wellpoint, provided an overview of the media preferences of these generations and the impact these preferences are having on healthcare marketing, products and services during a March 28, 2007 audio conference, Healthcare for the New Generations: Understanding and Engaging Generation "Xers" and "Yers" Through Tailored Products and Channels.

Scott Schroeder, president and CEO of Cohorts, Inc., defines the segments of Generation X and Generation Y and how marketing channels and messages should be influenced by these segments. Lee Aase, Mayo clinic's manager of national media and new media, and Schroeder, along with Aric Hooverson, account director, Grey Worldwide San Francisco and Shelley Patchin, director of advertising, Wellpoint, provided an overview of the media preferences of these generations and the impact these preferences are having on healthcare marketing, products and services during a March 28, 2007 audio conference, Healthcare for the New Generations: Understanding and Engaging Generation "Xers" and "Yers" Through Tailored Products and Channels.

In the patient-centered "medical home" model, patients' families and communities have clear-cut responsibilities, explained Elizabeth Reardon, a consultant with Commonwealth Medicine in Massachusetts. Healthcare organizations can draw parallels from Ed Wagner's chronic care model and learn from the groundbreaking work pediatricians have done to assure continuity of care for children with special healthcare needs. She suggested tactics and resources for drawing families and communities into the medical home model.Reardon, along with Anne Hernandez, director of operations of APS Healthcare and Dr. George Rust, senior consultant for APS Healthcare and Interim Director of the National Center for Primary Care, Morehouse School of Medicine, shared strategies on building an effective medical home project and the impact these programs can have on patient outcomes and satisfaction during a March 7, 2007 audio conference, Utilizing Medical Homes to Create a Patient-Centered Approach to Managing Chronic Conditions.

Implementing an electronic health record (EHR) in 1998 has transformed the way the four-location North Fulton Family Practice in Georgia does business. Dr. Jim Morrow, North Fulton's vice president and chief information officer, described how the EHR has enhanced physician-patient "face time"and care management and improved efficiency, productivity and profitability at the 20-provider practice. He even said that having an EHR has made him a better physician. Dr. Morrow and Dr. Joel Diamond, medical director of Diamond, Fera and Associates, provided physician practices with the key factors to consider when deciding to implement an EHR, along with the critical steps to a successful EHR implementation during a March 21, 2007 audio conference, Essential Elements for Physician Practice PFP Success: Key Steps in EHR Selection and Implementation.

Dr. Joel Diamond, medical director of Diamond, Fera and Associates, explained how concentrating on people rather than IT and engaging the medical leadership and the rest of the staff at the University of Pittsburgh Medical Center for successful hospital implementation of an electronic health record and how these lessons can be applied to a physician practice. Diamond also described how his practice achieved a one-year ROI turnaround from its EHR implementation. Dr. Jim Morrow, North Fulton's vice president and chief information officer and Dr. Diamond provided physician practices with the key factors to consider when deciding to implement an EHR, along with the critical steps to a successful EHR implementation during a March 21, 2007 audio conference, Essential Elements for Physician Practice PFP Success: Key Steps in EHR Selection and Implementation.

Beyond the issues one might expect from serving the dual eligible population, the Minnesota Senior Health Options' (MSHO) program also addresses the service barriers that occur in a rural setting. Sarah Keenan, clinical liaison with Medica, described how MSHO responds to these service issues and how the inevitable breakdowns during care transitions are managed through MSHO's "care coordination" efforts, which ensure communication between providers and follow a patient seamlessly through transitions of care. The flexibility inherent in MassHealth's Senior Care Options model empowers providers to offer on-site and community-based care to enrollees, improves the level of service offered to diverse populations and offers participants a seamless transition to the Medicare part D pharmacy benefits. Keenan and Diane Flanders, director of coordinated care systems for MassHealth, described how to create a coordinated care management approach for dual eligibles during a February 14th audio conference, Managing Transitions to Care for the Dually Eligible Medicare and Medicaid Patient.