It’s Not About The Box Improving Care at Group Health with People, Process and Technology

October 14, 2009

Resource Stewardship

Filed under: Radiology — Tags: , , , — admin @ 5:37 pm

I am sitting at our Medical Staff meeting on Central Campus – my second of these fall meetings, first one down in Olympia. A great turnout tonight. Even in these difficult financial times, I am very hopeful. We are having direct discussions about resource stewardship, really for the first time in our history (well, except for prescribing). And when our group decides to tackle a difficult issue, we have a great track record.

Uwe Reinhart, the health economist from Princeton, posed a great question – “How can the best medical care in the world cost twice as much as the best medical care in the world?”. He was referring to data from top medical centers in the country, which showed that care at Cedars-Sinai cost twice as much as care at Mayo, with the same outcomes. In our group, we are now confronted by data about our use of high end imaging, which demonstrates three fold variation in imaging rates by clinic, and up to five fold variation within clinics/service lines. Time for us to have conversations to make sure that we are consistently providing the most cost effective care for our patients, learning from each other. We will be tracking our rates in the months ahead, and i expect that we will start to see significant improvements.

December 1, 2008

More on High End Imaging

Filed under: Radiology — Tags: , — Matt Handley @ 7:26 am

A few people have expressed interest in the high end imaging work – basically building simple decision support into Epic (the American College of Radiology appropriateness criteria) to better manage the value and safety of imaging that clinicians in GHP order.

That work is based on work done in Minnesota, where 5 different medical groups (including Health Partners and Mayo) who all use Epic worked together to implement the same strategy – which we are now adopting here.   Their use of imaging (in commercial groups, in outpt care) is just over half what our is.

A few select slides from their presentation are below, and another post about this topic can be accessed here

health partners imaging build in epic

health partners imaging outcomes

November 19, 2008

The Triple Aim – IHI’s biggest initiative

Filed under: Population management,Quality / Affordability — Tags: , , — Matt Handley @ 9:36 am

I  am at a meeting of the “Triple Aim” collaborative in Chicago right now – The Institute for Healthcare Improvement (IHI) is sponsoring this effort to help like minded organizations collaborate in their efforts to simultaneously solve for quality/health, the care experience and affordability.  I had dinner last night with participants from KP Colorado and KP MidAtlantic, Breakfast with participants from Great Britain.  All kinds of different perspectives on population health.

My goal at this meeting is to find some other organizations to help us accelerate the content of care work – benchmarking in consultative specialty areas and share best practices.  While hopeful, there are only a few groups with high performing specialty groups like ours.

One of the challenges all organizations face is helping us all get out of our silos in thinking about satisfaction, cost and quality.  Our Primary Care leadership has done a great job in doing this with the Medical Home work.  The team from Bolton, a Primary Care Trust in England has a great diagram to help keep it simple – you can see it here:  Bolton Triple Aim diagram

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