November Work Session Record of Learning

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Record of Learning

Primary Care Quality Reporting (PCQR) Work Session

November 9, 2012, 8:00-10:30 AM

On November 9th, 62 leaders from diverse organizations (attachment 2) spent time understanding and discussing:

What would it take to improve quality reporting of local patient-centered primary care?

Objectives of the session:

1. Increase shared knowledge on the value of improving quality reporting of patient-centered primary care.

2. Partner with others to shape the design of a local improvement project.

3. Explore potential opportunities and challenges of the local improvement project.

A presentation was made regarding the value of PCQR and what others are doing (attachment 3).

Small group work sessions were held at tables of six to ten to discuss and shape project design around two

important questions. In a third question, participants were asked to provide what they foresaw as opportunities &

challenges with this project. Syntheses of responses are below; the full responses are attached (attachment 1).

Question 1: In determining what to report/measure, where is a good place to start?

Results (# of tables)

a. A few measures of:

Prevention

Chronic Conditions

Both Prevention & Chronic Conditions 8

b. By measuring:

Clinical process 1

Clinical Outcomes

Both Clinical Process & Outcomes 7

Question 2: What are the top conditions that would be a good place to start with Primary Care Quality Reporting

in Central Ohio?

Results

(# of tables)

Diabetes Mellitus 8

Prevention - Immunization Status 6

Hypertension/Elevated Blood Pressure 5

Prevention - Obesity 5

Cardiovascular Diseases 4

Mental Illnesses 4

Asthma 3

Prevention - Cancer Screening 3

Medication - Reconciliation 2

Chronic Obstructive Pulmonary Disease (COPD) 1

Prevention - Pregnant Women Screenings & Supplements 1

2

Question 3: What do you foresee as opportunities & challenges with this project?

Many Opportunities and Challenges were provided, some themes of collaboration, primary care practitioners, what to measure, and data/technology were observed. Opportunities

To get a community consensus rather than outside perspective. Can improve health in central Ohio among many competing systems/stakeholders. Enable providers & payers to better focus time and attention to several conditions. Provides the opportunity for data sharing and networking. Can improve current data. Great deal of data that already exists, but has not been utilized. This project could help start this process. Give providers the information they need to improve care.

Challenges Being able to address top concerns for all stakeholders. Implementing EMR use throughout the community. Lack of single IT platform. Minimizing cost to doctors and practices wanting to participate. Bringing the group to agreement on what measures and outcomes should be used. Realize that context of data will vary based on patients and practice. Practices should be assured that this

will not negatively impact them. Many PCPs already report data to multiple organizations, so they may be reluctant to get involved in

another reporting project.

The next steps were described. They were sending a meeting record, slide link, and asking about interest in inclusion in the next work session. The next work session is planned for February 1, 2013, 8:00-10:30 AM, location to be determined.

Primary Care Quality Reporting 11/9/2012 Attachment 1.1

In determining what to report/measure, where is a good place to start?

a. A few measures of Prevention, Chronic Conditions, or Both Prevention & Chronic Conditions?

Pediatric may be more focused on prevention than chronic. Context varies engagements behavioral health. Employer ??? want both. Outcomes more critical. Take care of chronic conditions first. "Adult vs. childhood measures." Article re: specific populations chronic conditions AHIP. UDS--prevention and chronic lowers diabetes, hypertension. First look at requirements first NQF. High volume high risk diabetes, Ht Dis(sp). Arrid(sp) duplication. Identifying chronic drives prevention steps taken. Identifying within community where to go = prevention or chronic Prevention services easy to measure and easy to focus insurance(sp) pay at 100%. Must focus on one or two conditions such as asthma or diabetes. Pediatrics 80% prevention. Both with larger focus on prevention. Concern--issues out of control of provider. Long-term vs. short-term outcomes (prevention vs. chronic). Can't look at measures in a vacuum. Purchasers--continued emphasis--productivity and wellness. Public health--greater focus on prevention than diagnosis. Has been hard to integrate clinical expertise with those with technology expertise. Critical for the three major systems in Columbus to talk to each other. Not about lowest price point/about best value. Large national plans inferior in ability to report data to providers. How do we focus on/take care of uninsured population(not as easy to get data)? You get what you measure Both Prevention and chronic conditions should be used. Nationwide Children's current information being gathered: asthma, obesity, elevated BP, immunizations, and developmental screenings. Use measures applying to the largest population and easy to identify. Keep separate measures simple. High volume/high risk/ high cost. Both prevention and chronic condition. Start with a few measures and a small focus Focus on chronic conditions makes quality improvement more successful. As a payer, we focus on both. Prevention will save us money going forward, but we have to deal with current chronic patients as well.

I would be interested to see these two broken down by age. Prevention is good in looking at someone from age

18. Chronic is good because we can't control what chronic conditions people already have.

Prevention is more doable in today’s primary care world.


Data up to date/actionable

Depends on the population that is being served. The ideal would be both.

Focus on both prevention and chronic conditions because each may focus on one of the other. So focusing on

both would be a good idea. Must understand the context of these measures.

Present the context of the practice (medicaid, medicare, etc.) Mental health/behavioral health. PEDs aren't

concerned with chronic conditions so that needs to kept in mind. Facilitated by control of hypertension what

you ??? by managing chronic condition. Integrate both prevention and chronic. Doesn't matter where you start

but that you show improvement.

Start with chronic and prevention would flow out of this especially for DM, HTN, HLN, obesity, and cig abuse.

Keep it simple walk before you run

For any decided measures it is important to ??? practice context is % uninsured vs. insured, educational levels of

patient mix, income, ???. A measure of patient engagement may be important too.

Preventative visits 1st? BOTH! Prevention = long-term quality. Chronic conditions more immediate.

Over next five-ten years, measure is both. The shift should be toward prevention. The question is where and

when the intersection takes place.

PCMH requires both

Hard to separate these as cost and quality are both dependent upon tracking these.

Both are important.

chronic--->prevention focus

What do employers want? More long-term benefit for prevention, lower cost and focus on chronic conditions.

Chronic conditions will involve more non-primary care involvement.

100% table report(sp)--both needed. Manage what gov(sp) measures. 80% prevention 20% chronic, but chronic

conditions ??? Diabetes. Measurement drives behavior, shown in other industries.

Focus on prevention and chronic. Informational context is important ????.


b. By measuring Clinical Process, Clinical Outcomes, or Both Clinical Process & Outcomes

Critical to set the context of the info relative to the overall outcome. Use what's available today. Need to be consistent. All behind both--but preference(sp) with starting with #1--clinical process. Go for both--don't take baby steps. Need to catch up. Used RX example. Free meds at pharmacy no record of RX being processed via insurer, etc. Depends on what measuring. Not focus on processes go(sp) ultimately get to outcome. Outcomes years out. Depends on conditions. Not one without other. Focused on prevention and chronic--limited to focus on one or two such as asthma or diabetes. Emphases in either process of outcome is condition dependent. Patient engagement needs to be one of the processes measured. Needs to get to compliance reporting/including patients. Prevention can be process oriented. Need to move beyond process for chronic conditions. Physician perspective. Make measures sensitive enough that it makes a difference. For example, if I have to check a box that I gave the patient education, who cares? What does that matter? This issue of management sensitivity and unit of analysis is key to designing scorecard. Both process and outcomes are important. Process should be the beginning. EMR is epic we are developing smart sets so providers will note information in same area across the board. RX data has measurement issues due to $4 generics that aren't being billed for by retailers. Prevention measures are easier to identify. Measure both process and outcome measures. Industry is changing rapidly--we don't have time to take baby steps--let's push the envelope (to the extent providers, payers, employers have capability to play) Identify outcomes, and then develop the process. Process is where you have to start. If the process is not right the outcomes won't be. impt-->prevention this is where it's at especially for chronic conditions I think outcomes will drive process. Process insufficient without results, but absolutely critical as ??? step toward long-term and difficult to measure outcomes. Both clinical process and outcomes. Focusing on context of the outcomes. Need one to have the other.


Need to prioritize and focus on a few. Huge numbers of measures are overwhelming. Trying to do too many. Need to work process before you can work on outcomes. Outcomes is a good place to start. Process more down the road. Example is clinical quality measures as reported in UDS Determining outcome measures may help to identify and allow for adjustments in the process. Where are we now, where are we over time? Both are important and where to start. Need to define "clinical outcomes". Can't control patient but why measure patient engagement. Must measure process before outcome. Diversity to build necessary(sp). Physician perspective--make measures sensitive e.g. did you provide patient education? Need a goal to bring consensus.


What are the top 2-3 conditions that would be a good place to start with Primary Care Quality Reporting in Central Ohio? Different population age groups. PEDs asthma and immunization. Reduction in utilization for more immediate ROI--focus on ER. Commercial plans have more short-term focus/cost savings now. Caught between effective and cost-effective. Have to take both long-term and short-term approach. Important?? Is the intent to start something new or to build on what's already being measured as required by other institutions/initiatives--alphabet soup on Jeff's slides. Prevalence in community. Most modifiable. Data driven process to id conditions. What cost most that is modifiable? Efficiencies = specific measurements, dollars saved. Blur between process and outcomes. ER utilization. Geared toward primary care. When(sp) do(sp) all 3Y(sp) medical conditions. The medical office has to do the work of measuring. So much work. How can we choose something already gathered and use it locally? Difference could be a good bet to drive local behavior. Symptom--What about the differentials associated with backpain? Medicine mgmt and RX drug abuse. I don't think we start with backpain but it is an interesting thought. Obesity doesn't have an outcome that is unique(sp)--however as we move forward obesity should have measures developed that drive the intersection between chronic/prevention focus. Children vs. adults? PCP vs. specialty? Good, but has RX(referring to 19) Adults--COPD/asthma, DM,HTN, prevention cancer, flu vaccine. PEDS--asthma, vaccination/immunization Different populations children vs. adults. My answers are focused on children. Diabetes is handled more by endo than primary care. Other possibilities: elevated BP, newborn screenings, diabetes. Some issues must be identified by age group. Choices vary by population. Cardiovasvular diseases can include #8,12, &15. PEDS=1,26,28. Adults= 3,10,24 represent high cost, prevalent conditions. Many of the top conditions overlap for example CAD would have subset ??? the condition. Measure those item that be reported to provide timely feedback. Goal: impact highest number of patients, all ages. Many patients big impact on prevention of morbidity and lowering costs. Effective RX will raise compliance and raise ??? depression, especially. PCPs would not like being measured on 28 because "out of my control". Can we truly prevent obesity?


Asthma is more of a children's issue. #3=HTN,CAD,CHF. Depression screening process measure? Are PCPs expected to impact obesity--behavior? Diabetes is first, second is 3 which includes 8,15,28,31, third is mental illness, and 4 is asthma. Depends on scope and size of the population. 10=DM, HTN, hyperlipidemia, obesity. 21 = depression (too early) don't want to rule out strict emphasis on depression. 26=follow up Clinical correct data. Adult measure: mental health defined as depression, hypertension/obesity, diabetes, tobacco use. Pediatric measures need to be different. Asthma as a PEDs measure, obesity, immunizations. Public health perspective is different than provider perspective. For Children: obesity, asthma, immunizations Cost reduction/expense(sp) maintenance. Improving quality care outcomes. Need data for the process of prioritizing which conditions are most prevalent and which have most evidence for modifiable outcomes. Combine asthma and COPD, impacts both children and adults. Leads to hospitalizations/ER visits. Hospital follow up not on list--medical misunderstanding can be a big cause of readmission. #21 is important but how do you report and measure? Review of all hospitalizations within 2 weeks would help with med , and readmission. #20 it all starts here Noebler(sp) reps at table. Mental illness = depression? 26?, 28?, 29?, 31? Dental?


What do you foresee as opportunities & challenges with this project? Opportunities

Collaboration Community is working together to improve healthcare. Learn from each other what works and what doesn’t. Overall community consensus of general goals

Continued work with a diverse group to discover best practices in community. Group/community focus on condition(s). Work as a community on consistent plan for improving health. Educating the community on what items we want to focus on. Improve health in central Ohio among many competing systems/stake-holders. Share best practices, information among various stakeholders and improve understanding of top issues with each group. Collaboration win-win opportunity for all stakeholders. To truly impact people aim objectives in central Ohio. Organizing as a community is attractive to employer. Good opportunity to work with payers, and other health systems. Great to see so many different perspectives come together to create a comprehensive QI system. Lower costs while improving access to care. Collectively raise the standard of health in central Ohio by "pressuring" ourselves to meet/expand agreed upon community care standards. Address current reporting--helping streamline it--and use reporting as an "advocacy" tool for additional funding down the road. Clarity of project purpose communication to a growing # of stakeholders to establish trusting relationships across the stakeholder landscape. More collaboration between payer, provider, and employer groups. Looking at other area's successes and failures. Reveal community wide weaknesses/areas for improvement in community health. Measures taken could make a local impact. Cost-reduction could follow. Great opportunity to improve communication/collaboration of health care individuals in our community. Lots of great opinions based on the diversity of this group to make sure this project is successful. To get a community consensus rather than outside perspective. Will be easier to implement due to that consensus. Experience a local community "mandate" for measures is powerful. Lower cost while improving outcome/quality of care. Improved payment.


What to report/measure Internal & external benchmarking. Sharing best practices to drive improvements.

Chance to use this project to make an impact in overall outcomes of the population by enabling providers & payers to better focus time and attention to several conditions. Engaging the community could allow us to focus on obesity which is harder to do at provider or practice level. Lumping certain measures together into one. Identify where to go based on conditions already known/present--maybe not known--within community. Why get outcome without process--cause if outcome isn't desired have to look at process. Identifying the conditions without looking at community data was possibly not route to go--look at community issues first. Large amount of available population data to identify preventative measures and chronic conditions that need the attention of the medical community. Seems to be majority agreement on where that attention should go. Focus not on scores but on improvement. Focus on population health rather than health of individual patients.

Technology/Data/Systems/IT Data sharing & networking.

Take advantage of data and reporting systems already in the community. Structure systems based on age appropriate initiatives. Building systems using technology. Identify standard outcome measures where possible. Systems that are better to collect data. Leverage existing systems. Clarity to decide if we want to make this volunteer opportunity available to the largest number of those potentially interested or do we immediately start to limit it through definition of what info sources we need to keep inviting others to engage. Use of current data systems to drive at least initial set up of reporting capabilities. Utilize/aggregate existing data. Better IT and data sharing capabilities.

Physicians/Primary Care

Physicians are more aligned with ?? ??? type programs. Employers are enticing patients into being more active in their healthcare. Give providers the information they need to improve care.


Raise satisfaction of both provider and patient. Plenty to choose from. Need to better engage the entire practice team. Need to engage the patient to meet providers halfway in improving their health and the health of the community. Interest and commitment of stakeholders--currently does not include consumers. Make the data actionable. Engaging physicians in being able to measure their actual performance. Competitive approach to quality improvement.

Challenges Collaboration Tendency to jump to the "how's". Arrive at common understanding. Competing health systems. Must impact cost to be attractive to employers.

Work cooperatively and not competitively. Understand and appreciate community and public health are key players, not just the hospital systems. Relationship building among diverse stakeholder groups will take some time. Provide for the easy opportunity for all participants to remain involved--will be especially true as more become aware of this work. Keeping track of what truly needs to be done for this project. Something will have to be given up to get these done--can we negotiate with NCQA,CMS,PQRS to allow for these community measures. Education, training, and broader buy-in will be a challenge but can be accomplished. Being able to address top concerns for all stakeholders. Consumer participation. Potential desire for this project to move at the pace of common denominator. How to agree on focus.

What to report/measure

EMR's are not universal in the community. What to report on? 3 different populations with different issues and conditions they consider important. Children/adult/elderly Agreeing on what is important to measure. Build from existing sources so we don't add additional burden/administrative costs. Keep number of measures manageable, practical, and reasonable for busy practices. What to do if you don't have HER. Realizing that what is measured for kids and adults should be different. Keep the context of the practice population in mind.


Mental illness has enormous impact on health and cost, difficult to measure and difficult to find resources, but impact would be huge if a difference could be made. Narrowing down what quality measures to decide on. Keep it simple for the clinician. Priority to the measure that will give the most common good. What is most modifiable? Impact cost. Impact those coming up pipeline. Measure outcomes in efficiencies--bed days, measure of not happen difficulty. Being able to establish/track metrics for some of the most costly/serious conditions--mental illness. Once chronic conditions and preventative measures are identified as important, what level of successful management or outreach demonstrates high quality care? Determining measurement levels that address patient wellness as well as cost and efficiency considerations. Having all data necessary for good outcomes/measurements. Having some kind of standard among payers, providers, employers on metrics, outcomes, etc.

Technology/Data/Systems/IT Collecting reliable & valid data consistently. Data collection, and design.

Getting EMR implemented throughout the community. Consistent reporting and data collection especially in the area of outcomes. Time needed for implementation of EMR over all providers

Getting process and outcome data that is valid. Systems with EMR that do not lend to data reporting. Diverse number of systems that need to be able to share data. Lack of single IT platform. Common/unified sources of data.

Physicians/Primary Care Provider acceptance of program specifics and results.

Many conditions don't have measure which makes it difficult to change behaviors. Cost to employ can be prohibitive.


Do not want to add any additional burden to primary care docs. Multiple Quality Improvement & Reporting program already in place Lack of full participating from PCPs and cost of EMR implementation. Minimizing financial impact on doctors who are asked to report. Lacking subjective info from consumers of health care regarding their perception of quality. Time, infrastructure. Provider buy in--need to know their data will be fairly portrayed with context of patients and practice. Providers no longer wanting to care for more difficult and noncompliant patients. PCPs are reporting for multiple organizations at this time, additional reporting may be a challenge from time and work load standpoint. Patient engagement is a big part of success of this effort and really isn't covered. Is pay for performance my performance, the patients, or both?

Attachment 2

Primary Care Quality Reporting Work Session Participants, 11/9/2012

First Name: Last Name: Organization:

Karen Agrawal, MD Humana

Tyrome Alexander Columbus Metropolitan Library

Michael Anthony Mount Carmel Medical Group

Laura Baciu Medical Mutual of Ohio

Melissa Bayus Mount Carmel Medical Group

Jeff Biehl Access HealthColumbus

Phil Cass Columbus Medical Association

Scott Cooper School Employees Retirement System of Ohio

Brad Courter American Health Network

Michael Curtin UnitedHealthcare of Ohio

Carol Deibel Access HealthColumbus

Cindy Doroba Nationwide

Pam Doseck The Ohio State University

Sarah Durfee Ohio Public Employees Retirement System

Pat Ecklar Mt. Carmel Health System

Michelle Groux Columbus Public Health

Lynne Hamilton State Teachers Retirement System

Tom Horan Columbus Neighborhood Health Center

Darren Huff Columbus Neighborhood Health Center

Ben Humphrey, MD The Medical Group of Ohio

Mary Jordan UnitedHealthcare of Ohio

David Kageorge, MD Mount Carmel Medical Group

Lisa Kaiser Health Action Council

Cheena Kapoor-Cantlie Columbus Public Health

Christa Klein Humana

Tina Latimer OSU Health System

Jodi Leis Franklin County Cooperative Health Benefits Program

Christine Lester Nationwide Children's Hospital

Lori Lewellen The Dispatch Printing Company

Geoffrey Losekamp Anthem

Donald Mack, MD Ohio Academy of Family Physicians

Michelle Mathieu Aetna

Marty Miller Heart of Ohio Family Health Centers

Alison Mincey Nationwide Insurance

Jennifer Nickell-Thomas Nationwide

Shane Olson Humana

Greg Pawlack State of Ohio

Malcolm Porter Access HealthColumbus

Kim Raderstorf Access HealthColumbus

Dianne Radigan Cardinal Health

Diana Riggsby Gardner The Dispatch Printing Company

John Schmeling, MD The Medical Group of Ohio

Lindsay Sharrock Mount Carmel Health System

Kamilla Sigafoos OSU Physicians, Inc, OSU Faculty Group Practice

Angela Smith Heart of Ohio Family Health Centers

Maggie Snow Franklin County Cooperative Health Benefits Program

Ann Spicer Ohio Academy of Family Physicians

Rob Strohl Central Ohio Primary Care

Mike Stull Employers Health Coalition, Inc.

Olivia Thomas, MD Nationwide Children's Hospital

Ken Thompson Franklin County

Susan Tilgner Franklin County Public Health

Dana Vallangeon, MD Lower Lights Christian Health Center

Bruce Wall, MD The Ohio State University Health Plan

J. Todd Weihl, DO OhioHealth

Beth Weinstock, MD Village Family Medicine

Mary Jo Welker, MD The Ohio State University

Melissa Wervey Arnold Ohio Chapter, American Academy of Pediatrics

Randy Wexler, MD The Ohio State University

Jon Wills Ohio Osteopathic Association

Greg Wise, MD MediGold

Bill Wulf, MD Central Ohio Primary Care

Ashlea Zimmerman Medical Mutual of Ohio

Laurel Zulliger, MD American Health Network

11/19/2012 20121109-pcqr-participants.xlsx

Primary Care Quality Reporting Work Session

November 9, 2012

Welcome!

Lead Support Major Support Additional Support

100% Access HealthColumbus

Board & Staff

Individual & Corporate Donations

1

What would it take to improve quality reporting

of local patient-centered primary care?

Explore

2

1. Increase shared knowledge on the value of improving quality reporting of patient-centered primary care.

2. Partner with others to shape the design of a local improvement project.

3. Explore potential opportunities and challenges of the local improvement project.

Help Launch a Primary Care Quality Reporting project in Central Ohio

Today’s objectives

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Today’s agenda

8:30 Welcome & Introductory Remarks 8:35 Small Group Introduction 8:45 What is the value of Primary Care Quality Reporting? What are others doing? Q&A 9:15 Shaping Project Design – Small Group Work Sessions 10:15 Planning Next Wise Steps 10:25 Closing Comments

Introductions &

Why are you attending today?

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What is the value of Primary Care Quality Reporting?

What are others doing?

5

Comprehensive Primary Care Initiative

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Today

Clarity on WHY & WHAT

Begin Shaping Project Design (version 1.0)

Q1 2013

Finalize Project Design

(version 1.0)

Q? 2013

Build local primary care

quality reporting (version 1.0)

Proposed Local Project Path

WHY?

Health care delivery can be improved to • yield better outcomes • reduce unnecessary utilization • advance high value services

In every community across America, health care

delivery can be improved to yield better outcomes, reduce unnecessary utilization, and advance high value services.

It is important for leaders from business, government, health care, and the social sector to have access to accurate, objective information on the quality of health care

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WHAT can become available? Based on nationally endorsed measures, local comparative quality of care data can be compiled and reported. Awareness and knowledge of the measures and what their values reflect about the quality of health care in our community can be increased and utilized.

9

Physicians and providers have

accurate information to identify areas for quality

improvement

Payers can provide incentives

to high-value primary care teams to accelerate

transformation of care

Primary care teams improve

quality of care and demonstrate increased value by measuring

performance and care outcomes

Purchasers can promote

utilization of high-value primary care teams via value-based insurance/benefit design

WHAT value is it?

Primary Care Quality Reporting Islands of Content & Data Sourcing

Medicare Physician Quality Reporting System

(PQRS)

Medicare Physician Compare Website

NCQA ACO Accreditation Program

Medicaid Health Plans

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US Preventive Services Task

Force Services Lists

National Quality Forum Measures

Application Partnership

Medicare & Medicaid

Electronic Health Record Incentives

Medicare ACO program measures

Medicare Advantage Health Plans

Commercial Health Plans

Source: Agency for Healthcare Research and Quality (AHRQ), National Healthcare Quality Report, 2011

Adults age 40 and over with diagnosed diabetes who received four recommended services for diabetes in the calendar year

Primary Care Quality Reporting Islands of Content & Data Sourcing

Medicare Physician Quality Reporting System

(PQRS)

Medicare Physician Compare Website

NCQA ACO Accreditation Program

Medicaid Health Plans

13

US Preventive Services Task

Force Services Lists

National Quality Forum Measures

Application Partnership

Medicare & Medicaid

Electronic Health Record Incentives

Medicare ACO program measures

Medicare Advantage Health Plans

Commercial Health Plans

What would it take to improve quality

reporting of local patient-centered primary care for ALL

patients?

Source: Aligning Forces for Quality Communities www.forces4quality.org

Aligning Forces for Quality – Communities Map 4

http://www.forces4quality.org/

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Current Quality Reporting Efforts by Communities – Cleveland

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Current Quality Reporting Efforts by Communities – Cincinnati

“Through the Health Collaborative, physicians, hospitals, health systems, health plans, employers and patients/consumers have come together to create a performance measurement and public reporting system that is objective, using evidence-based measures helpful to both providers and patients.”

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Current Quality Reporting Efforts by Communities – Albuquerque

Albuquerque Coalition for Healthcare Quality

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Current Quality Reporting Efforts by Communities – Humboldt County, CA

The Community Health Alliance of Humboldt - Del Norte, Inc. (CHA) is a network of health care providers, consumers, employers, and community leaders serving as the North Coast's forum for community-based health planning and advocacy.

• Include stakeholders in the development of reporting, including physicians and providers, primary care team members, payers, and purchasers.

• Involve physicians from the very beginning to help select measures and review their data.

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Applying Lessons Learned from Other Communities

• Involve information technology professionals from the start to help identify technical solutions and facilitate subsequent improvement efforts.

• Report on conditions or diseases most relevant to the community.

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Lessons Learned from Other Communities

• Develop quality reporting for system improvement and not for patient inquiry, at least initially.

• Develop an established process for adding conditions and metrics to existing reports.

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Sources Pros Cons

Claims/Hedis Familiar & Standard

Not all payers represented

Electronic Medical Records

Can extract all patients’ data (regardless of

payer)

Some practices not capable

Surveys Can attain non-

traditional clinical measures

Costly / often low response rates

Applying Lessons Learned from Others – Sources of Quality Data

Questions?

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Primary Care Quality Reporting Shaping Project Design

Shaping Project Design Handout 1

1. In determining what to report/measure, where is a good place to start?

a. A few measures of: i. Prevention

ii. Chronic Conditions

iii. Both Prevention & Chronic Conditions

b. By measuring: i. Clinical Process

ii. Clinical Outcomes

iii. Both Clinical Process & Outcomes

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Shaping Project Design Handout 2

2. What are the top 2-3 conditions that would be a good place to start with Primary Care Quality Reporting in Central Ohio?

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Planned Follow Up & Reflections

What do you foresee as opportunities & challenges with this project?

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Primary Care Quality Reporting

Work Session

Tentative Next Work Session February 1, 2013 8:00-10:30 AM

Broad Street Presbyterian Church Columbus, Ohio

THANK YOU!

Lead Support Major Support Additional Support

100% Access HealthColumbus

Board & Staff

Individual & Corporate Donations

28

November Work Session Record of Learning

Documents

Transcript of November Work Session Record of Learning