Medical Home Monitor
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October 19, 2009
Vol. II, No. 12

Medical Home Monitor Archives


Medical Home Q&A:
Motivating Physicians with
Comparative Performance Data

Medical Home Monitor

Q: How does Greenhouse Internists enforce and measure the use of evidenced-based guidelines by its physicians?

A: Greenhouse Internists is a five-doctor practice. Standardization is not always the easiest thing. Measurement is key. We do performance run charts in the office. Over the microwave oven, we post a series of HEDIS measures related to diabetes reported by doctors in the practice for the last month — the percentage of your diabetics who had A1C’s over 9, the percentage who had A1C’s under 7, and so on. There’s a color-coded graph produced by our health educator. When you go to put your sandwich in the microwave oven, you can’t help but stare at this chart and see where you are relative to your colleagues. Presenting doctors with comparative data about performance is very motivational. It gets people to think differently about what they do and to wonder why they’re behind the doctor down the hall in achieving certain metrics. Ours is a data-driven strategy where we report on performance from within our own practice.

There are two things doctors say when you give them performance reports in which they don’t look terrific. One is, “My patients are sicker.” And the other is, “Your data are bad.” The ‘my patients are sicker’ is pretty hard to argue in a five-doctor practice where we share a lot of the clinical load. There are doctors who are more sympathetic than others and tolerate patient behavior more than others. They set stricter standards for them. That may be good, that may be bad. It may be that the stricter standards actually help the patients move in the right direction. Presenting comparative performance data does help motivate doctors to change, gives them a sense of how they’re doing with respect to evidence-based guidelines and moves them along that improvement curve. (Richard J. Baron, M.D., F.A.C.P., president, Greenhouse Internists)

For more strategies for adopting and implementing evidence-based guidelines in the medical home, please visit:
http://store.hin.com/product.asp?itemid=3936


Innovative Medical Home for Seniors Removes Barriers to Preventive Care

A new study by The Robert Graham Center: Policy Studies in Family Medicine and Primary Care will examine WellMed Medical Management's best practices as a high-functioning medical home for seniors.

Last year, DMAA's Care Continuum Alliance awarded WellMed its Outstanding Quality Initiative Award for the radical process redesign of its disease management program, known as HealthRight, which serves seniors with high-risk, high-volume, high-cost and/or problem-prone disease states including congestive heart failure, ischemic heart disease, diabetes and COPD/asthma.

WellMed provides many patients with no-cost medical transportation and underwrites prescription co-pays for several chronic diseases as tools to remove barriers to quality preventive healthcare. These initiatives have dramatically improved kept appointment rates and filled prescription rates. Patients at high risk for cardiovascular disease experienced improved cholesterol levels and fewer hospitalizations. The physician-owned practice management company operates more than 30 medical clinics in Texas and Florida.

For more details on the study, please visit:
http://www.wellmedmedicalgroup.com/pdf...

HealthSounds Podcast: Advice on Achieving NCQA Medical Home Recognition

Grand Valley Health Plan's (GVHP) workgroup approach helps the staff model HMO to successfully disseminate workflow changes resulting from its NCQA medical home recognition process, explains Barbara Luskin, GVHP quality manager, and also created location champions in the process. Luskin describes how GVHP demonstrates compliance with the most challenging NCQA "must-pass" elements and shares GVHP's early returns in patient satisfaction ratings, quality of care and healthcare utilization.

To listen to this complimentary HIN podcast, please visit:
http://www.hin.com/podcasts...


Medical Home “House Calls” Cost-Effective Model for Improving Blood Pressure

Combining home-based blood pressure monitoring and telephone counseling significantly improves a person's blood pressure control at a minimal cost, according to a study published online in the Annals of Internal Medicine by researchers at Duke University Medical Center.

During the two-year study, people trained to monitor their blood pressure at home while getting regular phone calls from a nurse lowered their blood pressure by 11 percent compared to a 7.6 percent decrease in blood pressure for the home monitoring group and 4.3 percent for people only getting calls.

The phone intervention entailed bi-monthly phone calls from a nurse who would also discuss medication side effects, nutritional recommendations, exercise tips and smoking cessation advice. The at-home blood pressure monitoring was conducted three times each week and the nurse was not provided with the results.

Fewer than 40 percent of people with hypertension in the United States have adequate blood pressure control, putting them at risk for heart attack and stroke. Duke researchers said the objective of this study was to identify a tailored and cost-effective intervention that could help prevent the development of more serious cardiovascular disease.

"We’ve shown that the ‘medical home’ model does not require a patient to come to the primary care setting — we can bring the care to them," said Hayden B. Bosworth, PhD, the study’s lead author and research professor at Duke, an early innovator of the "medical home" concept.

For more details on the Duke study, please visit:
http://www.dukehealth.org/HealthLibrary/News/...

HIN Survey of the Month: Healthcare Trends in 2010

Healthcare reform, a fragile economy, high numbers of uninsured, the lingering threat of H1N1 and emerging care delivery models are just a few factors that promise to drive changes in the healthcare industry in the coming year. To learn how other healthcare organizations are preparing for 2010, complete HIN's fifth annual survey on Healthcare Trends in 2010 by October 30 and receive a free executive summary of the compiled results.

Complete the survey by visiting:
http://www.surveymonkey.com/...

Healthcare Trends Update: 2009 Patient Education and Outreach Benchmarks

Healthcare organizations are learning that an investment in patient and member education programs is money well spent. What is the chief impact of patient education programs, who conducts education programs and how do organizations measure ROI from patient education efforts? Download this complimentary summary of the 2009 Patient Education and Outreach Benchmarks e-survey, which identifies emerging trends and metrics in patient education and outreach and their effect on health outcomes, medication adherence and healthcare cost and utilization through an analysis of responses from 134 healthcare organizations.

To download this complimentary white paper, please visit:
http://www.hin.com/library/registerpeo.html

Low-Cost Low-Tech Medical Home Approaches to Reducing Readmissions — Save 10% on New Resource

Evidence is mounting that low-cost interventions by primary care practices — as basic as making a phone call to a patient — can dramatically reduce hospitalizations and readmissions among individuals with chronic disease. Medical home activities focused on patient education, engagement and empowerment are custom-built to reduce readmissions of the chronically ill and the healthcare spend associated with these hospitalizations.

Low-Cost Low-Tech Medical Home Approaches to Reducing Readmission presents case studies from Group Health Cooperative, Geisinger Health System, Henry Ford Health System and Community Care of North Carolina — four healthcare organizations whose use of low-cost, low-tech tools in their medical homes is already reducing hospitalizations by up to 36 percent and improving care for Medicare beneficiaries in general and for patients with heart failure and diabetes in particular.

Use ordering code MHMP to reserve your specially priced medical home resource by visiting:
http://store.hin.com/product.asp?itemid=3946




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Editor: Patricia Donovan, pdonovan@hin.com;
Sales & Marketing Coordinator: Deirdre McGuinness, dmcguinness@hin.com;
Publisher: Melanie Matthews, mmatthews@hin.com;

HIN's Medical Home Monitor Archives put at your fingertips complimentary video, podcasts, white papers and blog posts on the advancement of the PCMH — plus back issues of this e-newsletter and links to additional medical home resources. Please bookmark this site and check back often for new content:
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