Learning Session 4April 9, 2013

Hershey LodgeHershey, PA

Welcome!Robert A. Gabbay, MD, PhDProfessor of Medicine, Penn State College of Medicine

Tonight is a Celebration!

CONGRATULATIONS for all your hard work!

Thank You For Joining Us! …We’re Pleased to See You!

• Robert Gabbay, MD, PhD – Principal Investigator• Alan Adelman, MD, MS – Co-Principal Investigator• Sharon Adams – SC AHEC Practice Facilitator• Laura Manley — Research Coordinator• Erin McGinley — Research Assistant• Pat Bricker — Research Coordinator• Jessica Wright – Research Coordinator• James Herman, MD, MSPH – Chair, Family &

Community Medicine• Linda Kanzleiter, MPsSc, Ded — PA AHEC Director

A Special “Hello” To Our Guests!• Michael Wolf, MBA – Secretary of Health• Marcela Myers, MD – Director of Center for Practice

Transformation and Innovation• David Kelley, MD – Chief Medical Officer of the Department of

Public Welfare• Holly Alexander – Director of the Office of Clinical Quality

Improvement• Craig Hillemeir, MD – Vice Dean for Clinical Affairs, Chair

Department of Pediatrics, Medical Director Penn State Hershey Children’s Hospital

• Yesenia Rosado Bane –Senator Teplitz’s Office• Frank Mazza –Senator Toomey’s Office• Page Babbit, MHSA, BSHIM – Director of Provider

Engagement, Performance and Partnerships at Highmark

Michael Wolf, MBAActing Secretary of Health

Introductions• Your name• Your practice/Your title• Your role in the practice and your role on the

improvement team/Your role within your company and how it relates to primary care improvement

Impactful Initiative

• Who have YOU reached?• 17 Practices• 85 Physicians• 18 Physician Assistants• 23 Advanced Practice Nurses• 30 Registered Nurses

•Over 160,000 Patients

Background• Pennsylvania is 1 of 4 states funded by the

Agency for Healthcare Research and Quality (AHRQ) to develop a Primary Care Extension Service (PCES) to support primary care transformation according to the Patient Centered Medical Home (PCMH) model• Other funded states: North Carolina, New

Mexico, Oklahoma• PA supports 3 dissemination states – New

Jersey, New York, and Vermont• A total network of 17 states are involved

Model for Primary Care Extension Service• Based on the Agricultural Cooperative Extension

Model, the most successful innovation spread program in the US• Helped farmers adopt best practices• Small farms parallel Small primary care

practices• Part of Affordable Care Act

Parallels Between Extension Services• Lots of small practices [farms]• Better evidence-based approaches

available• Limited adoption• Need local support

Primary Care Extension Service Vision• Create practice learning communities• Organized around state/regional hubs• Include university-based center of excellence and

state health department• Provide technical assistance to practices• Facilitate training for health professionals• Coordinate data collection and quality

improvement• Assist practices in engaging in community

resourcesSource: Grumbach K, Mold JW. JAMA. June 24, 2009. 301; 24, p. 2589-91.

Goals – Improve Quality, Reduce Cost!• Patients want more from the health system and

from their physician• Purchaser (individuals, employers, government)

are looking for quality and value• Bottom line: Improve quality of care and reduce

cost

Goals of PA SPREAD

• Develop infrastructure for supporting and spreading primary care transformation through PA AHEC• Primary Care Extension Service

• Apply lessons learned from state initiative to 2 new regional learning collaboratives (SC and NW)

• Disseminate model, lessons learned in 3 other states (NJ, NY, VT)

Regional Learning Collaboratives

• Southcentral and Northwest PA• Practice Facilitators (1 per region, PA AHEC Executive

Directors)• Quarterly Evening Learning Sessions• Monthly Data Reporting• Monthly Webinars• Daily correspondence with practice facilitators and

members of the PA SPREAD research team

BUILDING FROM SUCCESS

Building From Success

PA Chronic Care Initiative• Public-private partnership• Multi-stakeholder statewide effort• Staggered regional rollouts involving 150+ diverse,

but mostly small practices• Almost 1,000 providers involved caring for 1

million patients• Diabetes initial focus then spread to other

conditions

PA SPREAD Activities

• Website Dissemination (www.paspread.com)• Partners Meetings• National Advisory Group• Practice Facilitator Forum• Curriculum Development• Four State Meeting (PA, VT, NY, NJ)• Large 17 state meeting – National PCES• State Innovation Model

PA SPREAD Partners• Aetna• Aligning Forces for Quality South

Central PA• American College of Physicians• AmeriHealth• Capital Blue Cross Blue Shield• Gateway• Geisinger Health Plan• Highmark Blue Cross Blue Shield• Independence Blue Cross• Lehigh Valley Health Network• PA Academy of Family Physicians• PA American Academy of Pediatrics• PA Area Health Education Centers • PA Association of Community Health

Centers

• PA Department of Health• PA Department of Public Welfare• PA Pharmacists Association• PA Regional Extension and Assistance

Center for HIT• PA Medical Society• Pennsylvania State University• Pittsburgh Regional Health Initiative• Quality Insights of PA• The Wright Center• United Health• UPMC• Wellspan Medical Group

Tonight’s Agenda

• Practice Sharing: Best Practices• Data Discussion• Spread & Sustainability• CME & MOC Credit Explanation• Practice Sharing: How this initiative’s quality

improvement efforts have impacted a patient• Closing

Tonight is a Celebration!

CONGRATULATIONS on all your hard work!