Healthcare Intelligence Network

Although CMS does not currently require physicians in the Physician Quality Reporting Initiative to have electronic health records, nearly 75 percent of American Academy of Family Physicians members are already using EHRs, estimates Dr. Bruce Bagley, AAFP medical director of quality improvement. CMS' inclusion of two structural measures for 2008, one for EHRs and the other for e-prescribing, are more likely CMS' attempt to provide measures that both family physicians and specialists can report on, says Dr. Bagley, as well as support President Bush's mandate that EHRs move forward. Dr. Bagley advises PQRI participants to proactively examine their own reported data to chart a performance improvement plan rather than wait until mid-2008 for feedback from CMS. Dr. Bagley, along with Sue Kincer, consultant and certified professional coder with Pershing Yoakley and Associates and Lorraine Larrance, consulting senior manager with Pershing Yoakley and Associates, delved into the requirements for PQRI for 2008 and drew upon their past experiences with physician quality reporting to recommend how to succeed in the 2008 program during a January 22, 2008 webinar, Physician Quality Reporting in 2008: What Every Physician Practice Should Know.

Gregg Lehman, president and CEO of HealthFitness, discusses the levels of "C-Suite support", employing wellness champs in the workplace, preventing illness versus managing existing illness and the impact C-Suite endorsement can have on an initiative. Lehman, along with David Sensibaugh, director of integrated health at Eastman Chemical Company, will describe the key steps in creating a culture of health that engages both the C-suite and employees during a December 4, 2007 webinar, Creating a Culture of Health by Engaging the C-Suite and Employees to Promote Better Health.

Some aspects of a health coach's performance are easier to assess than others, says Darcy Hurlbert, health and wellness product specialist at Ceridian LifeWorks. Employees themselves can provide valuable data on the effect of coaching on workforce productivity and absenteeism, she says, and this can be supplemented with administrative data. Satisfaction surveys administered three months post-enrollment can capture employee and member feedback on the coaching experience. Hurlbert, along with Ted Borgstadt, TrestleTree founder and chairman, described the types of metrics that can and should be used when evaluating the effectiveness of both health coaching programs and individual health coaches during a November 15, 2007 webinar, Health Coaching ROI Metrics and Measurements.

It is possible to demonstrate solid ROI after coaching individuals on the verge of serious health issues, says Ted Borgstadt, TrestleTree founder and chairman. He presents a case study on ROI for coaching individuals in pre-diseased states, talks about his organization's psychologist-led training in telephonic health coaching, and presents a four-point plan for evaluating a health coach's performance --- one that can pinpoint an individual's movement in the stages of change in six goal areas. Borgstad, along with Darcy Hurlbert, health and wellness product specialist at Ceridian LifeWorks, described the types of metrics that can and should be used when evaluating the effectiveness of both health coaching programs and individual health coaches during a November 15, 2007 webinar, Health Coaching ROI Metrics and Measurements.

Senior citizens put a lot of effort into planning for their retirements and deaths, but don't always plan for the medical emergency that might occur in between those two life events, explains Nora Baratto, manager of the case management department at St. Peter's Hospital's CHOICES program in Albany, New York. That's why the community partnerships her program forges are critical to its success. Her program measures customer satisfaction and delivery at multiple intervals and conducts depression screening for its population during inpatient, outpatient and in-home assessments. Baratto, along with Michelle Berry, director of Broome County, New York's Community Alternative Systems Agency, described the strategies their organizations have used to improve the hospital discharge process during an October 23, 2007 webinar, Best Practices in Hospital Discharge to Reduce Preventable Readmissions.

Broome County, New York's Community Alternative Systems Agency -- also known as CASA -- has a bird's eye view of every type of care setting, explains its director, Michelle Berry. The program's in-home longterm care assessment looks beyond the individual's physical condition, she says, taking note of social, emotional and environmental factors. To help patients own their care plans and improve recordkeeping, CASA hopes to soon train the homebound to use a "guest book" that will require visiting caregivers -- nurse, physician, physicial therapist, etc. -- to "sign in" and record the reason for each visit. This hard copy record would be the prototype for an eventual online care record, Berry explains. Berry, along with Nora Baratto, manager of the case management department at St. Peter's Hospital's CHOICES program in Albany, New York, described the strategies their organizations have used to improve the hospital discharge process during an October 23, 2007 webinar, Best Practices in Hospital Discharge to Reduce Preventable Readmissions.

Dr. Peter Kongstvedt, a partner in the health and managed care consulting services division of Accenture, comments on how to effectively use new media in today's healthcare arena, as well as what many healthcare organizations are calling the biggest road block pay for performance initiatives. Experts from key areas of healthcare examined the trends that are shaping today's healthcare industry. Kongstvedt, commented on health plan trends, Nathan Kaufman, on hospital trends, Dr. Joel Diamond, on trends impacting physician groups and Elizabeth Opland, on trends impacting the wellness and health promotion sector during a October 10, 2007 webinar, Healthcare Trends and Forecasts in 2008.

Dr. Karen Amstutz, regional vice president and medical director at Wellpoint State Sponsored Business, and her colleague Dr. Lakshmi Dhanvanthari, staff vice president and medical director at Wellpoint, discuss how their organization educates patients on appropriate ED use and how health literacy of members is a key element in reducing ED overuse. Dr. Amstutz and Dr. Dhanvanthari described WellPoint's strategy for reducing ED overuse during a September 25, 2007 audio conference, Developing Effective Strategies to Reduce Non-Emergent Emergency Department Use.

Dr. Jim Glauber, medical director for Neighborhood Health Plan of Massachusetts, defines ED overuse for his organization and discusses the differences between urgent care and emergent care and when patients should use each. Dr. Jim Glauber provided details on the strategies his organization has implemented to address non-emergent ED use during a September 25, 2007 audio conference, Developing Effective Strategies to Reduce Non-Emergent Emergency Department Use.

When you ask patients for feedback on care, you may not always like what you hear. Nonetheless, HealthPartners includes patients in program design sessions, and its patient advisory councils have more candidates than the organization can currently use. Beth Waterman, HealthPartners vice president of primary care and clinic operations, describes how patients and others were selected to participate in the two-day rapid design session in 2002 that developed the award-winning prepared practice team model. The prepared practice teams have since been carefully duplicated at more than 20 HealthPartners clinics. A Care Model Process oversight team sends quarterly program updates to all practice teams to ensure the structure and consistency that are program hallmarks. Waterman will describe the role of practice teams in her organization during a September 19, 2007 audio conference, Building Patient Care Continuity with Prepared Practice Teams.