Clinically Integrated Network News
Call to Action
Q1 Call to Action — Influenza
The season for the Influenza immunization measure continues until March 31, 2020. If you use Epic, continue to use the Influenza Best Practice Advisory (BPA) and Health Maintenance (HM) workflow to address and counsel patients on the importance of this immunization.
You may also reconcile into Epic external immunizations from CHIRP or enter patient reported immunization dates into Epic in order to complete the care for our patients.
RESULTS: We will share the percent of patients who had the care completed during the 2018/2019 flu season compared to the 2019/2020 flu season in our next newsletter.
Success Story
While working on a LEAN certification in collaboration with the Parkview Physicians Group – Grabill office, and Dr. Jerry Dearth, we recognized that the office was running into barriers assisting patients who were needing breast cancer screenings. The Francine’s Friends mobile mammography unit had already been on site once and unfortunately had no further availability for 2019. The PPG office began sending letters to patients who were still needing screenings but did not get a large response.
This particular community has a large Amish population. Due to the declination of preventative care within the Amish community, the staff must be consistent in spending more time with these patients. Increased conversations and education with the patients in the office on the importance of mammogram screenings would be key to their success.
Clinically Integrated Network (CIN) Provider Relations Specialist (PRS) Melody Spencer began working behind the scenes to find a way to bring back the mobile mammography unit. After checking with the Francine’s Friends scheduling team, she was able to schedule PPG – Grabill during a time slot for which the unit had a recent cancellation.
The office did a great job filling the schedule for the unit. This was largely due to the increased education about mammograms and persistence to have the patients complete this care.
Due to financial and transportation barriers, this mobile unit is the only resource that some patients in the Grabill community would ever have to receive breast cancer screening care.
We are proud to say that in December Francine’s Friends was completely booked, providing 14 mammograms to women in the Grabill community who otherwise would not have received care.
Great work to Dr. Dearth and his fantastic care team, as well as PRS Melody!
Diabetes Column
2020 Diabetes Prevention Priorities
A prediabetes registry was recently completed, totaling just over 140,000 persons in the Parkview Health Epic instance. The criteria to be included in the registry are meeting at least one of the following:
- Blood value in the prediabetes range for:
- Fasting glucose = 100-125 mg/dL
- HbA1C = 5.7%-6.4%
- OGTT – 140-/+199 mg/dL
- ICD-10 Code = R73.03
- ADA Risk Score of > 5
Be on the lookout in 2020 for updates on our continued awareness and solutions for this population to help decrease and prevent their risk for developing diabetes.
Questions or comments can be sent directly to Chad Shirar, director, Diabetes Care Strategy, at chad.shirar@parkview.com.
Provider Relations Highlight
Karen Evans, MD, was new to the CIN this year as a Family Medicine provider. She and her care team have been highly engaged and working with her PRS. We want to congratulate Dr. Evans and her team on their 52 percentage point (179%) increase since January!
Frequently Asked Questions
How will we be updated and educated on 2020 measures?
Your PRS sent an email between Dec. 18 and 19, 2019 and would welcome the opportunity to attend a provider/section meeting to review and answer questions. The CIN team also attends APP orientation, participates in Preceptor Program ongoing education and attends the PPG – Primary Care manager meeting in February.
Provider relations specialists reach out quarterly to all providers. If further education or clarification is needed, it can be requested or noted at that time.
Providers may also attend the January CIN Collaborative Learning Session (see below for more information).
When will I know my final 2019 score?
Final scores will be emailed on Feb. 12, 2020, following CIN Quality and Performance Improvement Committee (QPIC) approval on Feb. 11, 2020.
Quality
Improving performance as a new provider to the network
Interview with Dr. Karen Evans
- What were your initial thoughts of Clinical Integration?
I didn’t know anything about it and I struggled with understanding what it was.
- What barriers did you have to overcome?
The first barrier to overcome was understanding what clinical integration was and then the why behind it. Next, because I was a former nursing home director, attribution was another barrier we had to overcome because of my large attribution. Many patients were being attributed to me because of being a medical director, but they were no longer under my care when I came into PPG. We had to narrow my attribution down to just the patient population I manage.
- What were the steps/tools you utilized to overcome those barriers?
The first tool we utilized was our provider relations specialist who helped organize our team and give us a plan of how to overcome the measures. Our provider relations specialist also organized weekly to bi-weekly meetings at the beginning to hold us accountable and answer any questions we had because it was new. Second, it took a team effort from myself and the clinical staff to address the care gaps and run reports to find patients who needed care gaps closed. I will also add that in medicine, we are so busy with day-to-day activities and it helped to have someone (our provider relations specialist) to remind us of CIN and the measures we are being scored on.
- What was the most important piece that led to your CIN success?
Teamwork from every person on our team, including the provider relations specialist and the information the provider relations specialist was able to provide to us, such as reports, areas of opportunity, a clinical integration introduction, etc.
- If you could give advice to a struggling provider within the CIN, what would it be?
Embrace clinical integration, because it is important and so is the basic level of care we provide. It allows us, as providers, to keep preventable illness low in our patient population so that we can focus on other illnesses that are not preventable. Engage your team because you cannot achieve high scores alone. The team needs to involve everyone from your clinical staff to leadership and make sure that everyone recognizes the importance of clinical integration, as well as the time and resources involved in creating success. Lastly, having a therapeutic relationship with your patients so they are more inclined to have testing completed. I believe many of my patients have their care gaps addressed because I let them know it is important and they trust me.
Education
Tentative Collaborative Learning Session (CLS) Topics for 2020
Meetings are held on the 4th Tuesday of the month at 7:30 a.m., Noon and 4:00 p.m.
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Skype meeting – contact parkviewcarepartners@parkview.com if you are currently not receiving outlook invites for this meeting.
Suggested Attendees:
- Clinic managers
- Directors
- Quality leads
- Clinical staff who support providers in the CIN
- Physicians (depending on the topic)
In the Know
PPG Specialties NEW to the CIN: CIN Measure Update
First, we want to thank our PPG specialists for their support and engagement with the CIN team as a whole. We made it our goal to meet with each specialty to determine quality measures and we were successfully able to meet with over 50 specialties, with physician representation in each, allowing us to determine relevant and specific measures. Thank you.
Determining the measures is one part of the process. Following measure approvals, our team works closely with IS and Business Intelligence (BI) to automate the collection of the data. It was during that time that we learned there was opportunity to either establish or standardize some workflows within Epic to most effectively demonstrate that we are meeting certain quality measures. While the workflow piece to that process has added to our timeline, it is an integral part to our collective success.
As a result, we believe that it would be in the best interests of PPG specialists to start CIN measures in 2021 rather than 2020. This will allow the CIN, IS, BI and your teams to work together to determine the workflows, validate the data and educate sections on the CIN scorecard, measures, workflows, etc. before being scored on them.
The CIN will continue to work closely with teams so that everyone is set up for success with the new measures starting in 2021. In the meantime, unless otherwise informed by PPG Quality, your 2019 measures will remain the same in 2020. Should you have any questions or concerns, please don’t hesitate to reach out to a CIN team member. Again, thank you.
New Governance Members
We are excited to welcome Dr. Mike Yurkanin and Dr. Michele Helfgott to our physician leadership team. As a physician-led organization, we appreciate all of our governance members for their time, effort and expertise.
- Dr. Mike Yurkanin – joined the CIN Board of Managers
- Dr. Michele Helfgott – joined the CIN Quality and Performance Improvement Committee (QPIC)
Clinically Integrated Network's Governance Structure
Board
Thomas Gutwein, MD - Sectretary
Thomas Curfman, MD
Raymond Dusman, MD
Michael Grabowski, MD
Alan McGee, MD
Berry Miller, MD
David Stein, MD
Mitch Stucky, MD
David Jeans
Ben Miles
Quality & Performance Improvement (QPIC)
Lemuel Barrido, MD
Fen-Lei Chang, MD
Harin Chhatiawala, MD
Paul Conarty, MD
Michele Helfgott, MD
James Ingram, MD
Greg Johnson, DO
Vijay Kamineni, MD
Jeffrey Nickel, MD
Richard Nielsen, MD
Andrew O'Shaughnessy, MD
Jason Row, MD
Ronald Sarrazine, MD
David Stein, MD
Anusha Valluru, MD
Administrative Team
Vice President Enterprise Management - Joni Hissong
Director Clinically Integrated Network - Nicole Krouse
Supervisor Clinically Integrated Network - Katrina Koehler
Finance Committee
Raymond Dusman, MD
Scott Karr, MD
Jason Row, MD
Greg Johnson, DO
David Jeans
Contact Us
If you have questions or suggestions about measures, appeals, scorecards or other CIN tools, please contact your provider relations specialist. You may also contact Katrina Koehler, RN, CIN supervisor, at 260-266-6530 or Katrina.Koehler@parkview.com.
If you would like to join or have general questions about Parkview Care Partners, please contact Nicole Krouse, CIN director, at 260-266-3709 or Nicole.Krouse@parkview.com.