Healtheast Emergency Medicine Practice

State of the Practice

Healtheast Emergency Medicine

• Healtheast Visiono "Building on our benchmark performance, HealthEast will be a national leader in

clinical quality, patient experience and cost effectiveness – the best value – by 2015.”

• Emergency Medicine Practiceo Best Practice Emergency Medicine

• Clinical quality• Patient Experience

o Practice of choice for area EM Providerso Financially Responsible Practice

• 3 Departments• 93,000 pts• 35 MD’s• 7 PA’s• 2 NP’s

Department Demographics

• Johnso 40,000 ptso 27% Admissionso 74% of inpt admissions from EDo LOS 230 min

• Joeso 24,000 ptso 31% Admissionso 60% of inpt admissions from EDo LOS 255 min

• WW’so 29,000 ptso 16% Admissionso 59% of inpt admissions from EDo LOS 171 min

Practice Demographics

0-5 10 MD’so Ashley Seiverso Dan Thomaso Eric Rotho Jeremy Joyo Alex Gerbigo Shani Goo Cindy Winebrennero Dana Stephenso Jocelyn Wongo Jennifer Englund

6-10 10 MD’so Maryam Shaplando Scott Nicholso Tony Nardio Verna Arcedoo Kai Tuomineno Nancy Blonigeno Kurt Keogho Deb Lidahlo Kearney Stakeso Pete Tanghe

> 10 14 MD’so Brian Nesso Grant Nakamurao John Flipovicho Paul Sovello Paul McCormicko Ed Feinsteino Mark Newmano Bob Kileo Sam Riceo Tim Thompsono Dan Berndto Brad Bartho Jon Grimeso Al Autreyo Gerald Hill

Practice Demographics

Joes• Mark Newman• Bob Kile• Sam Rice• Nancy Blonigen• Tim Thompson• Dan Berndt• Brad Barth• Brian Ness• Verna Arcedo• Al Autrey• Gerald Hill

WW’s• Ashley Seivers

• Cindy Winebrenner• Kurt Keogh• Deb Lidahl• Jocelyn Wong• Maryam Shapland• Scott Nichols• Jon Grimes• Matt Beatty• Dan Spielman

Johns• Kearney Stakes• Jennifer Englund• Pete Tanghe• Dana Stephens

• Dan Thomas• John Flipovich• Kai Tuominen• Paul Sovell• Jeremy Joy• Paul McCormick• Alex Gerbig• Ed Feinstein• Eric Roth• Shani Go• Mike Meyers• Jen Kipp• Deena G• Jason Dukes

FinancialsJohns

o MD FTE 9.11o Mid FTE 3.88o Total FTE 12.9o Expenses 6,156,221o Pro-fee Revenue5,790,016

Joeso MD FTE 6.81o Expenses 4,122,049o Pro-fee Revenue3,653,722

WW’so MD FTE 6.2o Mid FTE 1.91o Total FTE8.1o Expenses4,099,871o Pro-fee Revenue4,072,163

Clinical Measures• Malpractice Claims

o 8 “claims” in the last 3 yearso 1 Indemnity paid (HIPPAA issue)

• Core Measures (clinical process)o 2012 3/7 at 90th percentileo PCI in 90 min, blood cultures, abx choice

• HCAHPS (pt experience)o Pain mgmt, MD Communication, overallo 1/9 at 90th percentile

• VBP (combine Core Measures and HCAHPS)o 1% withhold of Medicare dollarso EDCAPS coming 2014

Where were we?

Lots of Change• Amion• Dedicated Scheduler• Coding Education• Scribes• Productivity Payments• McKesson• Telestroke, OFI’s• Nighthawk Differential• Studor initiatives• QIP changes• Robust, EM only Peer Review• ED Clinical Council• Email communication

Progress at what expense?

• Frustration

• Defections

• Disengagement

Our Vision• Vibrant, stable Emergency Medicine Practice which

contributes positively to Healtheasts mission

• Engaged (Satisfied) physicians and MLP’s with wide variety of backgrounds and experience level

• Group of provider partners who are interested in and see value in:o Best Practice

• Clinical Excellence• Patient Experience• Efficient Flow

o Positive participation in group initiativesANDo Perceive themselves as leaders in departmento Maintain Collaboration with departmental staff

What is providers role?

• Captain of Ship?• One of the team• “Just a trench doc”• Emergency Medicine Physician• “Nurses run the department”• “You guys” make the decisions, I just follow

orders• Shift worker• Partner• Employee• Independent Contractor

What do you want from a practice?

• Input?• Improvement?• “Just see patients”• Participate?• Grand Rounds• Education• Career development• Stability• More money