Let's hear from the providers - 7th RISE Summit, Nashville, TN 11MAR13

7th Annual RISE Summit • Nashville, TN • March 11, 2013

Let’s hearfrom the

Providers!Wayne Pan, MD, MBA

Chief Medical OfficerThrasys, Inc.

THRASYS

5 myths about physicians

or walk a mile in a physician’s shoes

How can you realistically change practice patterns?

Risk-sharing practices explored

Which P4P programs actually work?

What can plans do to ensure good physician documentation practices?

How can plans and practices effectively engage providers?

take-aways

THIS IS ABOUT BEHAVIORAL CHANGE

SHOW ME THE DATA

TRY SOMETHING DIFFERENT, REALLY

doing the same

thing over and over

and expecting different

resultsis

insanity

change

YOU CAN CHANGE A PHYSICIAN’S PRACTICEMYTH#1

BUT THAT DOESN’T MEAN PHYSICIANS WON’T CHANGE THEIR PRACTICE

FROM WITHIN, CHANGE MUST COME

motivation1.0

motivation2.0

motivation3.0

MOTIVATION

Learning & Challenging Incentives & Punishmentintrinsic extrinsic

MOTIVATION

Incentives & Punishmentextrinsic

Learning & Challengingintrinsic

MOTIVATION

Learning & Challenging Incentives & Punishmentintrinsic extrinsic

MOTIVATION

Learning & Challenging Incentives & Punishmentintrinsic extrinsicV

Learning & Challenging Incentives & Punishmentintrinsic extrinsicV

reframe

rethink your assumptions that physicians don’t care about quality

give us all of the datawork with us to help us analyze itdo this in small groupsstand back and watch what happens

rethink your assumptions that physicians don’t care about quality

take advantage of where physicians come from

we are high achievers

take advantage of where physicians come from

we are competitivewe recognize patternswe use data to solve problemswe always want what’s best for the patient

use bj fogg’s behavioral design methodology

“changingbehaviorleads tochangedattitudes”BJ Fogg, PhDDirector, Persuasive Technology LabStanford University

this is not a physician behavioral change problem

this is ahumanbehavioral change problem

PHYSICIANS DON’T KNOW HOW TO MANAGE RISKMYTH#2

no one was bornknowing how tomanage riskit’s a skill that youhave to learnjust like riding a bike

in the hands of a group of trained providers, healthcare

resources are best managed at the provider level, if the

incentives are properly aligned

shared savingsbundled paymentACOpartial capitationfull risk

performance

PHYSICIANS WILL RESPOND TO P4P BONUSESMYTH#3

don’t worry, it’s just a horse that’s playing dead. really.

why don’t P4P programs work?

why don’t P4P programs work?

it’s not about the money

OK, it is about the money

it has to involve my entire practice

documentation

MY OFFICE NOTES ARE FOR HELPING YOU WITH YOUR BLAH BLAH BLAH

MYTH#4

lay enthusiasts have have imbued routine office notes with more value than they actually have

Clement McDonald, MDDirector, Lister Hill National Center for Biomedical CommunicationsNational Library of Medicine

CMS began making Medicare EHR incentive payments in May 2011 and, as of September 2012, had paid about $4 billion to 82,535 professionals and 1,474 hospitals

Daniel LevinsonNovember 2012 report, “Early assessment finds that CMS faces obstacles in overseeing the Medicare EHR incentive program”Office of the Inspector General

CMS anticipates spending an estimated $6.6 billion in incentive payments between 2011 and 2016

Daniel LevinsonNovember 2012 report, “Early assessment finds that CMS faces obstacles in overseeing the Medicare EHR incentive program”Office of the Inspector General

so what did we get for our $6.6 billion?

we converted ourpaper siloes to

electronic siloes

Patient�� has�� a�� history�� ofno�� one�� payingattention�� to�� herhistory.

See�� EMRfor�� details...

what’s the solution?

what’s the solution?

have a system that identifies new HCCsuse NPs for documentationEHRs may be helpful but they have to be interoperable

the real solution is to rethink medical education

to teach core behaviors, not core knowledgeto be thorough, accountable, reliable, 100%Larry Weed, MDFather of the Problem-Oriented Medical Record

engage

YOU CAN ENGAGE PHYSICIANS WITH JUST THE RIGHT PROGRAM AND BONUS MONEY

MYTH#5

from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)

drawtheBIGpicture

1

showmetheDATA

2

3

gowiththeFLOW

make the new way of doing things,feel just like the old way of doing things

to get faster adoption, quicker results

behavior change that will lead to a change in attitude

to build trust

to act as teammates

toincludethepatient

patientascostdriver

it’snotjustabout data

it’salsoaboutwhomyourserving data to

DAT

A

savvy consumers

not currenterror proneMPASTEE

no comparator

unadulterated

nonjudgemental

There are noshortcuts to anywhereworth going

Publilis Syrus

cultural revolution

THIS IS ABOUTBEHAVIORALCHANGE

SHOW ME THE DATA

TRY SOMETHING DIFFERENT

WAR PRODUCTION CO-ORDINATING COMMITTEE

YESWE CAN!

thankyoucontactinfo

[email protected]@waynepan

linkedin.com/in/waynepanslideshare.net/bonedoc97

THRASYS

Let's hear from the providers - 7th RISE Summit, Nashville, TN 11MAR13

Health & Medicine

Transcript of Let's hear from the providers - 7th RISE Summit, Nashville, TN 11MAR13