Promoting the Spread of Health Care Innovations Web Seminar April 9, 2013 Follow this event on...
-
Upload
audra-joseph -
Category
Documents
-
view
214 -
download
0
Transcript of Promoting the Spread of Health Care Innovations Web Seminar April 9, 2013 Follow this event on...
Promoting the Spread of Health Care Promoting the Spread of Health Care InnovationsInnovations
Web SeminarWeb Seminar
April 9, 2013April 9, 2013
Follow this event on Twitter Follow this event on Twitter Hashtag: #AHRQIXHashtag: #AHRQIX
Using the Webcast Console Using the Webcast Console and Submitting Questionsand Submitting Questions
2
Click the Q&A widget to get the Q&A box to appear
To submit a question, type question here and hit submit.
Accessing PresentationsAccessing Presentations
Download slides Download slides from consolefrom console– Click on the Click on the
“Download “Download Slides” widget Slides” widget for a PDF for a PDF versionversion
3
What is the Health CareWhat is the Health CareInnovations Exchange? Innovations Exchange?
Publicly accessible, searchable database of health policy Publicly accessible, searchable database of health policy and service delivery innovationsand service delivery innovations
Searchable QualityToolsSearchable QualityTools Successes and attemptsSuccesses and attempts Innovators’ stories and lessons learnedInnovators’ stories and lessons learned Expert commentariesExpert commentaries Learning and networking opportunitiesLearning and networking opportunities New content posted to the Web site every two weeks New content posted to the Web site every two weeks
Sign up at Sign up at http://www.innovations.ahrq.gov under “Stay under “Stay Connected”Connected”
4
Innovations Exchange Innovations Exchange Web Event SeriesWeb Event Series
Archived Event MaterialsArchived Event MaterialsAvailable within two weeks under Events & Podcasts Available within two weeks under Events & Podcasts at http://www.innovations.ahrq.gov at http://www.innovations.ahrq.gov
Next EventsNext EventsThursday, April 25, 2013 1-2 pm ETThursday, April 25, 2013 1-2 pm ET
Payment Models that Support Medical Home and Payment Models that Support Medical Home and Accountable Care Organization Principles: Maryland’s Accountable Care Organization Principles: Maryland’s Experience Experience
Thursday, May 9, 2013 1-2 pm ETThursday, May 9, 2013 1-2 pm ETA Close Look at Care Coordination: West Virginia’s A Close Look at Care Coordination: West Virginia’s
Experience Experience 5
Today’s Event ModeratorToday’s Event Moderator
Ronie Nieva, PhDRonie Nieva, PhD
Vice President, Westat and Editor-in-Chief of the Vice President, Westat and Editor-in-Chief of the AHRQ Health Care Innovations ExchangeAHRQ Health Care Innovations Exchange
6
Essentia HealthEssentia HealthLinda Wick, RN, CNPLinda Wick, RN, CNP
7
Manager, Heart Failure ProgramManager, Heart Failure Program
RespondentRespondent
Janell Moerer, MBAJanell Moerer, MBA
Group Vice President, Strategy and Group Vice President, Strategy and Business Development, Centura HealthBusiness Development, Centura Health
Essentia Health Essentia Health Heart Failure ProgramHeart Failure Program
First visit 5-7 days after discharge Cardiology oversight – once per year Patients managed in clinic: 4-7 office visits
the first year Registered nurses do case management: use
protocols, manage home telescale data, follow up on lab/test data, and triage phone calls
Program ComponentsProgram Components
CoachingCoaching EducationEducation SupportSupport Consistency of care providerConsistency of care provider Immediate feedback on health choicesImmediate feedback on health choices Prescheduled follow-up appointmentsPrescheduled follow-up appointments Relationship building with patient/familyRelationship building with patient/family Multidisciplinary team approach to careMultidisciplinary team approach to care Engaged/passionate staffEngaged/passionate staff
TripleTriple Aim
OutcomesOutcomes – Use of guideline directed medications/devices
– Total yearly admissions/30 day readmissions
Patient SatisfactionPatient Satisfaction Reduced Cost of CareReduced Cost of Care
– Total yearly admissions/30 day readmissions
– Reduce duplication of testing
– Using the right provider at the right time for the right diagnosis
Readmission RatesReadmission Rates
Note: 6 month rates for heart failure patients N=294-229 FY2005-2010
Essentia Health St. Mary’s Hospital Readmissions
0
10
20
30
40
2010 2011 2012
Nat'l Avg
All Cause
HF
“Times They are a Changing”
Essentia Health is an Accountable Care Organization
CMS Bundled Payments for Care Improvement Initiative
Primary care is using health care home model: stable Heart Failure Program patients discharged to primary care physician
Challenges: Challenges: Administrative Buy-InAdministrative Buy-In
Ongoing challenge of administrative buy-in
Dialog changed once organization became an Accountable Care Organization: risk/benefit
Demonstrate how model fits Triple Aim Markets within the organization have
different priorities NCQA accreditation process fits model
Challenges: Provider Buy-InChallenges: Provider Buy-In
Progress with physician and provider buy in: show data on outcomes
Culture changing from physician- centered to patient-centered
Culture changing from individual provider-based to team-based care
Other chronic disease programs changing to Heart Failure Model within Essentia
Challenges: WorkforceChallenges: Workforce
Sustaining workforce with potential nursing shortage
Clear staffing roles Inclusion/exclusion criteria for patients Using Telehealth technology
Scale Up and SpreadScale Up and Spread
Added Telehealth video visits to remote sitesAdded Telehealth video visits to remote sites Added program staff to neighborhood clinics Added program staff to neighborhood clinics Developed interface with primary care case Developed interface with primary care case
managers: shared care planmanagers: shared care plan Integrated home scale data into electronic Integrated home scale data into electronic
medical records with options for coverage from medical records with options for coverage from other sitesother sites
Closing ThoughtsClosing Thoughts
If everything seems under control, you’re not going fast enough –
– Mario Andretti
RespondentRespondent
Janell Moerer, MBAJanell Moerer, MBA
Group Vice President, Strategy and Group Vice President, Strategy and Business Development, Centura HealthBusiness Development, Centura Health
Comments and ConsiderationsComments and Considerations
Continuity of leadership and passion for Continuity of leadership and passion for the service has assisted growth and the service has assisted growth and adoptionadoption
Data beginning to reflect intended Data beginning to reflect intended impact to new value equationimpact to new value equation
Impact of Changing EnvironmentImpact of Changing Environment
Transformation and disruption of the norm Transformation and disruption of the norm has accelerated adoption and scalehas accelerated adoption and scale
Fee-for-service payment to Fee-for-service payment to bundle/Accountable Care Organization bundle/Accountable Care Organization
Change in value equation: outcomes/costChange in value equation: outcomes/cost
Shift to Team-Based CareShift to Team-Based Care
Emphasis on team-based care: patient-Emphasis on team-based care: patient-centered medical homes/health homescentered medical homes/health homes
Heart Failure Program and team are Heart Failure Program and team are more “part of” the delivery vs. “separate more “part of” the delivery vs. “separate from” due to emphasis on team-based from” due to emphasis on team-based care.care.
Overarching QuestionsOverarching Questions
Where does this program need to reside in the Where does this program need to reside in the short term, mid-term, and long-term?short term, mid-term, and long-term?
Who should “own” it? Accountability?Who should “own” it? Accountability? How are the physician champions engaged in How are the physician champions engaged in
development and adoption with peers?development and adoption with peers? How will guardrails for compliance within the How will guardrails for compliance within the
delivery system be addressed?delivery system be addressed?
Key ConsiderationsKey Considerations
How will the challenges and opportunities change due How will the challenges and opportunities change due to the transformation of payment and care delivery?to the transformation of payment and care delivery?
Administrative buy-inAdministrative buy-inPhysician adoptionPhysician adoptionDelivery system needs and compositionDelivery system needs and compositionData gathering to data aggregation and segmentationData gathering to data aggregation and segmentationNew competitors New competitors
Key ConsiderationsKey Considerations
How and what will the Heart Failure Program How and what will the Heart Failure Program need for innovation and to accelerate need for innovation and to accelerate adoption with sustainable value?adoption with sustainable value?
Community partnerships i.e. parish nursing, Community partnerships i.e. parish nursing, community emergency medical servicescommunity emergency medical servicesTelehealth to clothing with monitoring devices; Telehealth to clothing with monitoring devices; iHeart FailureiHeart FailureTechnology partnershipsTechnology partnershipsRetail competitors and opportunitiesRetail competitors and opportunitiesPatient/consumer experience and literacyPatient/consumer experience and literacy
The Innovations ExchangeThe Innovations Exchange
Visit our Web site:Visit our Web site:
http://www.innovations.ahrq.gov/ andhttp://www.innovations.ahrq.gov/ and
Scale Up and Spread VideosScale Up and Spread Videos
Follow us on Twitter:Follow us on Twitter:
#AHRQIX#AHRQIX
Send us email:Send us email:
[email protected]@innovations.ahrq.gov
30