university medical partners town...

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NBME | January 24 + 25, 2017

UNIVERSITY MEDICAL PARTNERS TOWN HALL

MARCH 6, 2017

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UMP PROVIDER ENGAGEMENT WORKSHOP | MARCH 6, 2017

PARTICIPANTS

Gloria AlcalaElizabeth AnthonyNikhil ApteJanet ArnestyLauren AlanchardVandana BoparaiErica BromleyJohn CarperEdward ChanKalaokalani ChandlerLara CharnecoDavid CheeShara Mae ChenEliza Lo ChinErica ChongGrace ChouPascale CoucySabra DalyMichael DeRosaRenu DeshpandeWilliam DewolfCarrie DuffyCatherine EgelhoffJames EichelPatricia EspichaMary FisherYelena GambarinMagdy Girgis

Marci Gottlieb

Talia Gracer

Vanessa Gulla

Setareh Hafezi

Penny Harris

Heidi Heal

Erin Herman

Richard Ho

Sarah Holmgren

Carolyn Hudson

Ronald Hull

Irogue Igbinosa

Naoko Ikeda

Nicole Kaipust

Bhoomika Kamath

Samata Kanagala

Rens Kleinman

Anne Parker

Irene Kelly

Aimee Keyashian

Michael Kim

Charmi Shah

Karen Kline

Donald Knotts

Anthony Koh

Eric Kohleriter

Hiva Kolodrubetz

Donna Kwong

Donald Lai

Emily Lash

Carolyn Le

Jaya Karnani

Kevin lee

Calvin lei

Jennifer Lin

Ivy Lorilla

John Louie

Nithya Mani

Maki Matsumura

Anand Mehta

Clare Moynihan

Shazia Mughal

Stanley Ng

Dean Nickles

Sayaka Ogata

Terri Pagano

Chirag Pandya

Denise Yun

Rama Polisetty

Sarah Pontell

Cheruba Prabakar

Maliha Qadir

Melinda Ragins

Jyothi Ratti

Rebecca Riseman

Misha Roitshteyn

Katherine RollerRichard SankaryRobert SantosCaroline SchreiberWilliam SellmanSaket ShahAndrew LeeJohn SheppardElizabeth SivesindSheri TaskLeslie TimRandall TomAnupama VelpuriJamie WallachMae WillkomElaine WongJuliana WongBill WongRachel WakrusJohn WeeJerry YenKaty Young-Lee

Angela DeftosKatherine AutinJaneen PetersonBrandon EngelbertNicholas GlogovacStephanie GoncalvesDaniel DiazBryan BohmanDaisy GonzalezDaniel PennebakerKenneth MunstermanHilary GarriganJyotika RattiaPaul LudmerRachel SeamanEena DuggalMatt PerdueRahi Desai

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NBME | January 24 + 25, 2017

PRESENTATIONS + DISCUSSION

LANGDON MORRIS | MAGDY GIRGISRICHARD SANKARY | ANGELA DEFTOS

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LANGDON MORRIS

Good evening ladies and gentleman! Many of you recognize me from the boot camp a few weeks ago. We have a different town hall for you tonight with various activities demonstrating your clinical and non – clinical expertise. First, Dr. Girgis is going to start us off.

MADGY GIRGIS

I cannot believe my eyes when I’m looking around tonight. This whole thing started in 2014 with a nucleus of 7 doctors.

Six of us spoke enthusiastically about what we were going to do at a weekend offsite. When it came to me, I was truthful. I left my family and tennis and was unsure that the offsite weekend was what I wanted to be doing. I didn’t have

much faith or trust that this would materialize into what I see here tonight but Richard proved me wrong.

I was told to tell a couple of jokes. I hope that this doesn’t embarrass my group or offend anybody. Are there any other Egyptians here? Fine, I’m the only one. The Nile river runs south to north. It’s the only river that does. All of the jokes in Egypt are about Upper Egypt, because they are said to not be very smart. It’s okay for me to say so because I’m from Upper Egypt. The joke goes, “if I tell you the exact number of chicken in the bag, can I have one” The Upper Egyptian says, “if you guess the exact number I will give you all 3.”

I know that this is courtesy laughing but that’s alright with me. One Egyptian said, “the Russians and Americans have gone to the moon but we will do them one better. We’re going to the sun.” The other Egyptian said, “won’t it be hot?” The first Egyptian replied, “yes, that’s why we will go at night.”

RICHARD SANKARY


Welcome to UMP’s first town hall. Like Magdy, a lot of our clinicians were skeptical about the challenge of forming UMP. How did we pull this off?

We have an excellent board of directors who are all here tonight. Carrie Duffy, Eric Kohleriter, Dean Nickles, Robert Santos, and Caroline Schreiber. Let’s give our board a round of applause.

We have outstanding partners. University HealthCare Alliance, Stanford Health Care, Stanford School of Medicine and our colleagues from the other UHA medical groups. We have representatives of UHA and the other medical groups here tonight. Thank you for your support.. Finally, we have a wonderful management team led by Angela Deftos, our VP of People and Medical Group Strategy. Angela is an amazing colleague. We all appreciate her commitment and excellent service in the build and transformation of UMP.

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ANGELA DEFTOS

I’m honored to be here- 176 working days working for the medical group. The first 100 days was getting formed and organized. We have such amazing support from the medical group leadership and team.I want to thank this team so much for how hard they have worked.


Katherine Autin, Director of Business Operations

Nicholas Glogovac, Director of Provider Relations and Recruitment Services

Dan Diaz, Director of Provider Network

Brandon Engelbert, Financial Analyst

Janeen Peterson, HR Specialist and Project Manager

Stephanie Goncalves, Provider Recruiter and Integration

Rahi Desai, Administrative Support

Melissa Mirasol, Administrative Support

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How will UMP distinguish itself as the preferred medical group? On your tables, you have a set of cards on rings. I wanted to share with you, the mission and vision that our team developed.

To deliver on the promise of Precision Health and Wellness to our patients, their families, and the

community we serve. We partner with Stanford Medicine in a common vision of clinical excellence, education, and

innovation.

Let’s also review 3 key aspects to UMP. One is design. We know that health care is changing and we will design change from front line. We are calling on you to design the future. The 2nd core principle is the owners. Our clinicians are engaged in our success as owners. The final principle is one team. We are all University Medical Partners.

Angela said that I have 3 minutes to tell the UMP story in 10 words or less with no powerpoint. Fortunately, we have the answer in our website. Go to “learn more” on our website where you can watch a video.

Langdon, now we are ready for the fun part.


RICHARD SANKARY

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UMP Speed Draw Video

http://universitymedicalpartners.org/about/



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NBME | January 24 + 25, 2017

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LANGDON MORRIS

I think that you all know that we did a boot camp on February 1. We did a cut of designing the UMP project initiatives. We want to get a representative of each project up here to brief us on the project. We will ask that you sign up for 2 of them. Youcan identify which projects you choose with your name tags.

We want to know the obstacles and enablers of each project for your chosen initiatives.

Can we begin with Chronic Disease Management?


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NBME | January 24 + 25, 2017

OBSTACLES, ENABLERS, + COMMITMENTS TEAM 1: CHRONIC CONDITION MANAGEMENT

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COMMITMENTS

Team 1: CHRONIC CONDITION MANAGEMENT

Team 2: MEDICARE WELLNESS VISITS

Team 3: CHART CLOSURES

Bhoomika Kamath

Carolyn Le

Catherine Egelhoff

Dean Nickles

Eliza Chin

Grace Chou

Heidi Heal

Ivy Lorilla

John Sheppard

Katherine Roller

Katy Young – Lee

Leslie Tim

Mac Willkom

Maki Matsumura

Patricia Espicha

Razia Rangwala

Renu Deshpande

Richard Ho

Sarah Holmgren

Sarah Pontell

Shagun Bindlish

Talia Gracer

Terri Pagano

William DeWolf

Catherine Egelhoff

Donald Knotts

Eliza Chin

Elizabeth Anthony

Jaya Karnani

Jennifer Lin

Mae Willkom

Rensina Kleinman

Robert Santos

Samata Kanagala

Stanley Ng

Bill Wong

B. Anne Parker

Bhoomika Kamath

Calvin Lei

Carrie Duffy

Charmi Shah

Chirag Pandya

Clare Moynihan

Donna Kwong

Elaine Wong

Elizabeth Sivesind

Erica Chong

Gloria Alcala

Irene Kelly

Jamie Wallach

Janet Arnesty

Jaya Karnani

Jennifer Lin

John Yee

Juliana Wong

Kalaokalani Chandler

Karen Kline

Katy Young – Lee

Kevin Lee

Lara Charneco

Mae Willkom

Mary Fisher

Melinda Ragins

Misha Roitshteyn

Naoko Ikeda

Nikhil Apte

Nithya Mani

Pascale Coucy

Penny Harris

Rachel Yakrus

Rama Polisetty

Randall Tom

Razia Rangwala

Rebecca Riseman

Renu Deshpande

Richard Ho

Ronald Hull

Saket Shah

Setarch Hafezi

Shagun Bindlish

Shara Chen

Sher Task

Stanley Ng

Yelena Gambarin

Team 3: CHART CLOSURES

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COMMITMENTS

Team 4: EFFICIENT CHARGE CAPTURE – OB

Team 5: NETWORK CONTINUITY OF CARE

Team 6: IMPROVING PATIENT ACCESS BY

OPTIMIZING SCHEDULING

Team 6: IMPROVING PATIENT ACCESS BY

OPTIMIZING SCHEDULING

Carrie Duffy

Chirag Pandya

Elaine Wong

Irene Kelly

Irogue Igbinosa

Janet Arnesty

John Carper

Kalaokalani Chandler

Magdy Girgis

Rachel Yakrus

Rama Polisetty

Sayaka Ogata

Setarch Hafezi

Sheri Task

Aimee Keyashian

Anthony Koh

Bill Wong

Calvin Lei

Carolyn Le

Charmi Shah

Cheruba Prabakar

Donald Knotts

Eliza Chin

Elizabeth Anthony

Erica Chong

Erin Herman

Grace Chou

Heidi heal

Ivy Lorilla

James Eichel

Jamie Wallach

Juliana Wong

Karen Kline

Kevin Lee

Leslie Tim

Maki Matsumura

Mary Fisher

Melinda Ragins

Micahel Morford

Naoko Ikeda

Nikhil Apte

Rebecca Rheman

Sabra Daly

Samata Kanagala

Sarah Pontell

Sayuka Ogata

Stanley Ng

Terri Pagano

William DeWolf

Yen – Cung Lee

Aimee Keyashian

Anthony Koh

B. Anne Parker

Cheruba Prabakar

Clare Moynihan

Donna Kwong

Elizabeth Sivesind

Gloria Alcala

Irogue Igbinosa

James Eichel

Katherine Roller

Lara Charneco

Mae Willkom

Magdy Girgis

Micaheal DeRosa

Michael Morford

Misha Roitshteyn

Nithya Mani

Pascale Coucy

Patricia Espicha

Penny Harris

Rachel Yakrus

Randall Tom

Rensina Kleinman

Ronald Hull

Sabra Daly

Saket Shah

Samata Kanagala

Sarah Holmgren

Shara Chen

Sheri Task

Yelena GambarinTeam 5: NETWORK CONTINUITY OF CARE

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NBME | January 24 + 25, 2017

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OVERVIEW

Our team wants same day access for acute needs for chronic conditions. We want to work within teams, across teams, and even across clinics. We can send a patient down from Oakland to Hayward.

We want to have each interaction with the patient be an opportunity to do improved health. Incremental actions are important here. For instance, make sure that diabetics have their needs met at each visit apart from the purpose of their visit. You can use Healthy Planet. This is a dashboard to see where you are falling short in your health care.

Let’s look for ways to provide care that are not apparent. For instance, I found a patient that had chlamydia but didn’tknow it and I treated her.

1. CHRONIC CONDITION MANAGEMENT

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NBME | January 24 + 25, 2017

OBSTACLES, ENABLERS, + COMMITMENTS

TEAM 2: MEDICARE WELLNESS VISITS

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OVERVIEW

Medicare has had this benefit (wellness visits) for some time and the usage has been variable. We need proof that this has a bottom line according to guidelines and that it is documented a certain way. We want to have a “smart phrase” to use for documenting the visit and education for the staff and patient around the benefits of wellness visits. This will provide a doorway to capture HCC coding although it’s not a primary focus. We have to be careful not to stuff too much into Medicare.

2. MEDICARE WELLNESS VISITS

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NBME | January 24 + 25, 2017


TEAM 3: CHART CLOSURES

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OVERVIEW

We wanted to design an initiative for coding, billing, and documentation. We felt that chart completion was impactful and scalable for UMP. I have difficulty completing my charting in a timely manner.

We have to track chart completion with EPIC to see how many days it takes to complete a chart. EPIC can then push open charts to your inbox. If you have more accurate and timely documentation, you will likely remember more and skirt around liability issues.

There will be better cash flow and revenue with timely chart closure. We have taken initial steps to see who has open encounters on a monthly basis. NexGen can help us see who needs to complete the charts as well.

3. CHART CLOSURES

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3. CHART CLOSURES

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3. CHART CLOSURES

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NBME | January 24 + 25, 2017


TEAM 4: EFFICIENT CHARGE CAPTURE – OB

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OVERVIEW

Through the use of Haiku (EPIC) Ob-gyns can submit records in real time.

At the boot camp, we talked about how magical your first delivery was but how miraculous it was to submit your deliveries and know that you are getting reimbursed for them. Now, you put a sheet in your purse and try not to lose it. You put it in a secure bag to send to Newark where you get credit for your deliveries eventually.

We hope that you can enter your time in Haiku to (also useful for scheduling) enter charges to the billing office. This will be a more efficient system. IT and our office manager have been working on this.

Where we are in the process right now is that we sent IT our registration information for the app. The wheels are turning and we will pilot for a month before rolling this out fully. We hope to benefit others outside of ob –gyns.

4. EFFICIENT CHARGE CAPTURE – OB

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4. EFFICIENT CHARGE CAPTURE – OB


TEAM 5: NETWORK CONTINUITY OF CARE

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OVERVIEW

We want a seamless relationship between the PCP and provider. Our mission statement is to ensure continuity of care in UHA and the Stanford network. Referrals were getting placed outside of UHA which contributed to our budget shortfall.

We have to know the scope and practice of specialists in the network. It’s useful to know areas of interest and language skills. Maybe there are ancillary resources that we should know about as well.

We need to attend networking events, like tonight. We need to address the EPIC referral database. It’s unclear who can go to other UHA clinics.

We want to engage in community practice events like grand rounds to increase our presence in the community. Our provider profile needs to be up to date.

The Stanford health care provider website, EPIC referral tool, and UHA internal network directory needs utilization.

5. NETWORK CONTINUITY OF CARE

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NBME | January 24 + 25, 2017

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TEAM 6: IMPROVE PATIENT ACCESS THROUGH

OPTIMIZED SCHEDULING

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OVERVIEW

Our initiative focused on optimizing our schedule with available appointments when we need them and times that patients need us. We have to strive to meet current patient needs as well as those of new patients. How can we start the day on time? How many patient facing hours are there?

If all providers see 2 patients an hour we can increase our revenue and have sufficient patient access. We have to complete non – patient facing tasks throughout the day so they are not left out.

Who is not seeing enough people per day? What is the reason? Staffing or templating? We need an administrator to help address this. We have providers whose days are not full so how can we get those providers filled up?

We discussed talking with providers that are not meeting the 2 patient an hour requirement. We can provide a dashboard monthly to understand these numbers a bit better.

LANGDON MORRIS

You may be thinking that the initiatives are tactical and they are. The goal was to address initiatives that are medium to short term.

6. IMPROVE PATIENT ACCESS THROUGH OPTIMIZED SCHEDULING

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NBME | January 24 + 25, 2017

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APPRECIATION + CLOSE

RICHARD SANKARY | BRYAN BOHMAN

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DR. HUDSON

This is is a celebratory time for us to get together under the UMP umbrella. I’d like to read a poem with a lot of imagery by James Weldon Johnson. I am going to preach “The Creation,” a negro sermon.

BRYAN BOHMAN

I want to salute all of the talent that we saw tonight and your courage.

I was at the boot camp and I see the same spirit here tonight. This is a tribute to your leaders and medical group. Thanks to the whole team! This is really gratifying for the medical group and foundation and I look forward to many more years of collaboration.

APPRECIATION + CLOSE

RICHARD SANKARY

What an evening! The winner of tonight’s performance is…UMP. We are one team. That’s the message that we demonstrated tonight. UMP’s success depends on your continued commitment. As designers, owners, and team members we are building the premier medical group. Thank you for your support of University Medical Partners.

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NBME | January 24 + 25, 2017

THANK YOU!

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