AHRQ’s Health Care Innovations Exchange held a Web event on Promoting the Spread of Health Care Innovations on April 9, 2013. For more information, visit https://innovations.ahrq.gov/events/2013/04/promoting-spread-health-care-innovations.
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Promoting the Spread of Health Care Innovations
1. Promoting the Spread of Health CarePromoting the Spread of Health Care
InnovationsInnovations
Web SeminarWeb Seminar
April 9, 2013April 9, 2013
Follow this event on TwitterFollow this event on Twitter
Hashtag: #AHRQIXHashtag: #AHRQIX
2. Using the Webcast ConsoleUsing the Webcast Console
and Submitting Questionsand Submitting Questions
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Click the Q&A widget to get
the Q&A box to appear
To submit a question, type
question here and hit submit.
3. Accessing PresentationsAccessing Presentations
Download slidesDownload slides
from consolefrom console
– Click on theClick on the
“Download“Download
Slides” widgetSlides” widget
for a PDFfor a PDF
versionversion
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4. What is the Health CareWhat is the Health Care
Innovations Exchange?Innovations Exchange?
Publicly accessible, searchable database of health policyPublicly 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 weeksNew content posted to the Web site every two weeks
Sign up atSign up at http://www.innovations.ahrq.gov under “Stayunder “Stay
Connected”Connected”
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5. Innovations ExchangeInnovations Exchange
Web Event SeriesWeb Event Series
Archived Event MaterialsArchived Event Materials
Available within two weeks under Events & PodcastsAvailable within two weeks under Events & Podcasts
at http://www.innovations.ahrq.govat http://www.innovations.ahrq.gov
Next EventsNext Events
Thursday, April 25, 2013 1-2 pm ETThursday, April 25, 2013 1-2 pm ET
Payment Models that Support Medical Home andPayment Models that Support Medical Home and
Accountable Care Organization Principles: Maryland’sAccountable Care Organization Principles: Maryland’s
ExperienceExperience
Thursday, May 9, 2013 1-2 pm ETThursday, May 9, 2013 1-2 pm ET
A Close Look at Care Coordination: West Virginia’sA Close Look at Care Coordination: West Virginia’s
ExperienceExperience
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6. Today’s Event ModeratorToday’s Event Moderator
Ronie Nieva, PhDRonie Nieva, PhD
Vice President, Westat and Editor-in-Chief of theVice President, Westat and Editor-in-Chief of the
AHRQ Health Care Innovations ExchangeAHRQ Health Care Innovations Exchange 6
8. RespondentRespondent
Janell Moerer, MBAJanell Moerer, MBA
Group Vice President, Strategy andGroup Vice President, Strategy and
Business Development, Centura HealthBusiness Development, Centura Health
9. Essentia HealthEssentia 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
10. 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
11. 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
14. Essentia Health St. Mary’s
Hospital Readmissions
0
10
20
30
40
2010 2011 2012
Nat'l Avg
All Cause
HF
15. “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
16. 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
17. 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
18. Challenges: WorkforceChallenges: Workforce
Sustaining workforce with potential
nursing shortage
Clear staffing roles
Inclusion/exclusion criteria for patients
Using Telehealth technology
19. Scale Up and SpreadScale Up and Spread
Added Telehealth video visits to remoteAdded Telehealth video visits to remote
sitessites
Added program staff to neighborhoodAdded program staff to neighborhood
clinicsclinics
Developed interface with primary careDeveloped interface with primary care
case managers: shared care plancase managers: shared care plan
Integrated home scale data intoIntegrated home scale data into
electronic medical records with optionselectronic medical records with options
for coverage from other sitesfor coverage from other sites
21. RespondentRespondent
Janell Moerer, MBAJanell Moerer, MBA
Group Vice President, Strategy andGroup Vice President, Strategy and
Business Development, Centura HealthBusiness Development, Centura Health
22. Comments and ConsiderationsComments and Considerations
Continuity of leadership and passion forContinuity of leadership and passion for
the service has assisted growth andthe service has assisted growth and
adoptionadoption
Data beginning to reflect intendedData beginning to reflect intended
impact to new value equationimpact to new value equation
23. Impact of Changing EnvironmentImpact of Changing Environment
Transformation and disruption of the normTransformation and disruption of the norm
has accelerated adoption and scalehas accelerated adoption and scale
Fee-for-service payment toFee-for-service payment to
bundle/Accountable Care Organizationbundle/Accountable Care Organization
Change in value equation: outcomes/costChange in value equation: outcomes/cost
24. 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 areHeart Failure Program and team are
more “part of” the delivery vs. “separatemore “part of” the delivery vs. “separate
from” due to emphasis on team-basedfrom” due to emphasis on team-based
care.care.
25. Overarching QuestionsOverarching Questions
Where does this program need to resideWhere does this program need to reside
in the short term, mid-term, and long-in the short term, mid-term, and long-
term?term?
Who should “own” it? Accountability?Who should “own” it? Accountability?
How are the physician championsHow are the physician champions
engaged in development and adoptionengaged in development and adoption
with peers?with peers?
How will guardrails for compliance withinHow will guardrails for compliance within
the delivery system be addressed?the delivery system be addressed?
26. Key ConsiderationsKey Considerations
How will the challenges and opportunitiesHow will the challenges and opportunities
change due to the transformation ofchange due to the transformation of
payment and care delivery?payment and care delivery?
Administrative buy-inAdministrative buy-in
Physician adoptionPhysician adoption
Delivery system needs and compositionDelivery system needs and composition
Data gathering to data aggregation andData gathering to data aggregation and
segmentationsegmentation
New competitorsNew competitors
27. Key ConsiderationsKey Considerations
How and what will the Heart Failure ProgramHow and what will the Heart Failure Program
need for innovation and to accelerateneed 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 services
Telehealth to clothing with monitoring devices;Telehealth to clothing with monitoring devices;
iHeart FailureiHeart Failure
Technology partnershipsTechnology partnerships
Retail competitors and opportunitiesRetail competitors and opportunities
Patient/consumer experience and literacyPatient/consumer experience and literacy
30. 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:
info@innovations.ahrq.govinfo@innovations.ahrq.gov
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Hinweis der Redaktion
Alt Text: Image of attendee console with an arrow pointing to the box to type in questions and another arrow pointing to the Q&A widget.
Alt Text: Image of attendee console with arrow pointing to the Download Slides widget.
Alt Text: Image of Ronie Nieva
Alt Text: Image of Linda Wick
Alt Text: image of Janell Moerer
Alt Text: Bubble with words: “Show me the money” inside.
Alt Text: Image of a bar graph showing hospital readmission rates. The national average for all years (2005-2010) was 40; the rate for heart failure patients in 2005 was 6.6 , in 2006 was 2.8, 2007 was 3.1, 2008 was 3.5, 2009 was 2.9, and 2010 was 4.8; the rate for health failure patients in 2005 was 18.1, in 2006 was 20, 2007 was 18, 2008 was 11, 2009 was 10.9, and 2010 was 10.9.
Alt Text: Image of bar graphing showing Essentia Health St Mary’s Hospital readmission rates. In 2010 the national average was 25, all cause readmission at St. Mary’s was 30, and 5 for the heart failure program. In 2011 the national average was 25, all cause readmission at St. Mary’s was 15, and 5 for the heart failure program. In 2012 the national average was 25, all cause readmission at St. Mary’s was 21, and 7 for the heart failure program.
Alt Text: image of Janell Moerer
Alt Text: Bubble with words “show me the money” inside. Money is crossed out and replaced with value.
Alt Text: Image of attendee console with an arrow point to the Q&A widget.