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Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

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Page 1: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

Primary Care Access

Deanna Willis, MD, MBA

Medical Director of Quality and Medical Management

IU Medical Group-Primary Care

Page 2: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

IU Medical Group-Primary Care >20 clinical venues in

Indianapolis area Around 400,000 patient visits

per year Around 120 Physicians Affiliated with 2 hospital

systems: Wishard, Clarian Host continuity clinics of over

100 resident physicians Since 2000 have hosted over

60 research studies recruiting over 15,000 patients

Page 3: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

The chronic illness Symptoms:

Phones not being answered in timely manner

High utilization of urgent care venues

Patient complaints of “unable to get appointment”

Diagnosis: Mismatch of supply and

demand

Page 4: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

Treatment Options Leave unmet demand Increase capacity

Previously accomplished through adding providers

Workforce shortage of primary care physicians across country is worsening

Clinic size constraints Limited offsetting revenues because of payor mix

Desire to achieve system optimization

Page 5: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

Desired Therapeutic Benefits Minimize “symptoms” Avoid side effects

Maintain “continuity” Patient centered Medical Home

Improve outcomes Increase the reliability of care delivery

Chronic illness care

Page 6: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

Assessing Therapeutic Intervention What has been your experience in working

with engineering/statistics research teams and implementing research findings? Systematic evaluation and data driven solutions

Evaluating multiple aspects of complex environment

Clear identification of solution(s) that are based on data

Page 7: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

Assessing Therapeutic Intervention What has been your experience in working

with engineering/statistics research teams and implementing research findings? Minimizing perception that some problems don’t

have solutions Identifying solutions to complex and complicated

problems has been liberating

Page 8: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

Assessing Therapeutic Intervention What has been your experience in working

with engineering/statistics research teams and implementing research findings? Rapidity of changing environment

Problems today are addressed, ignored, or replaced tomorrow—adapting to avoid obsolescence

Premises that are central to a research study change

Page 9: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

Assessing Therapeutic Intervention What has been your experience in working

with engineering/statistics research teams and implementing research findings? Suboptimal Organizational Behaviors are

Amplified Decision making with incomplete or lack of data Changing for the sake of change Inadequate implementation planning Inadequate prioritization of competing demands

Page 10: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

Assessing Therapeutic Intervention What has been your experience in working

with engineering/statistics research teams and implementing research findings? Buy-in challenges

Front line managers don’t understand/believe the results

Resource allocation to implementation is suboptimal

Used to have research in sites, but not used to having to implement/adapt to results

Page 11: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

Assessing Therapeutic Intervention What can researchers and practitioners

learn from your experiences?

Success factors Strong communication between research

team and site personnel Learning how to adapt Minimize data collection for office staff

Page 12: Primary Care Access Deanna Willis, MD, MBA Medical Director of Quality and Medical Management IU Medical Group-Primary Care

Assessing Therapeutic Intervention What can researchers do to better support

practitioners in their quest to improve healthcare?

Implementation is difficult in a constantly changing environment with limited resources—helping sites develop clear, action oriented implementation plans and timelines