Rheumatoid Arthritis Learning Collaborative Sponsored by AMGF and AbbVie

Transcription

1 1 Rheumatoid Arthritis Learning Collaborative Sponsored by AMGF and AbbVie August 13-15, 2014 Springfield Clinic Rheumatology Jennifer Boyer RN, MBA Carla Osterholt

2 2 Medical Group Profile Founded in 1939 by 5 physician partners. Today an independent multi-specialty medical group 252 physicians 138 mid-level providers Practicing in 80 medical specialties and sub-specialties. Rheumatology is made up of 4 physicians and 1 NP Serving patients in 12 locations Treats 18,000 patient encounters, per year. SC has been using Allscripts since Interfaced with the local hospitals to share results, electronically. Patients can access their personal health information and communicate with providers through a patient portal.

3 3 Team Composition Management: Jennifer Boyer RN, MBA Neuro Muscular Skeletal Service Line Director Carla Osterholt, Manager of Operations Physician Champion: Michael Pick, MD Physician Participation: Jason Guthrie, MD Jeffrey Horvath, MD Mark Stern, MD IT/PA: Linda Buttry, Decision Support Nursing Staff: Kimberly Porter, LPN Other: Two patients with the diagnosis of Rheumatoid Arthritis

4 4 RA Goals & Objectives Develop metrics for population management of the Rheumatoid Arthritis patients Create a standardized, evidence based pathway that is acceptable to all providers Develop a robust patient education program with a multi-disciplinary team

5 5 RA Intervention & Population Baseline In 2013, 33% of our Rheumatology patient volume had a diagnosis of Rheumatoid Arthritis years of age are the highest RA population (27.3%), (24.3%) (23.1%) (9.4%) (9.2%), (3.9%) (1.6%) >90 (0.9%) <20 (0.2%) These patients were identified using the patient s problem list and billed diagnosis in the electronic health record.

6 RA Intervention & Population Baseline 6

7 7 Improvement Interventions Create a more robust patient education process such as group visits/support meetings. Allowing patients to learn about disease process, medications, diet, and exercise. Seek patient feedback on how to develop the RA program to be more patient-centered.

8 8 Improvement Interventions Development of MDHAQ and RAPID 3 and Pain scale on an electronic system (ipad) that the patient completes while waiting. The results would flow into a discrete field in the EHR which enables us to track data more effectively.

9 9 Measures Used PQRS 108, 177, 178 CGCAHPS and patient satisfaction scores are collected and monitored through Press Ganey and the internal SC dashboard. By the 4 th quarter of 2014, SC will have a new platform implemented for tracking populations of patients. Humedica s Optum One will be used for population analytics to navigate managing risks, reducing costs, ensuring best practices are followed, and to benchmark provider performance.

10 10 Challenges Physician commitment to standardization Education to primary care physicians of when to refer to Rheumatology versus another specialty Changing to meet the goals and objectives

11 11 Outcomes and Successes To be successful we will: Learn from others in the RA Collaborative Set the vision of the RA program at SC with measurable goals. Understanding the Why we need to change and making the changes to improve patient care/outcomes, physician s work, and staff s work environment Communication and feedback (allowing staff to have input into designing the process will assist in gaining staff commitment) Setting a time line in which goals must be accomplished Education to referring offices on appropriate Rheumatology referrals Physicians to attend other department meetings Physicians send thank you notes to referring offices

12 12 Future Steps Develop metrics and processes to easily capture data Keep the physicians engaged in the process Engage Marketing, Process Improvement, and Nurse Education departments to assist in the process of creating improved patient-centered care for patients with Rheumatoid Arthritis

13 Lessons Learned 13

14 Questions 14