Transcript Michigan OMH Meeting - Community Oncology Alliance

7 Steps to Transforming Your Practice
Into An Oncology Medical Home
Community Oncology Conference
Thursday April 23rd, 2015
Harder Than
It Sounds
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Intent of OMH
 Develop a new approach to health care:
• Starting with cancer care
• With emphasis on:
–
–
–
–
–
Developing the right strategies
To do the right things
Proving that you did the right things
Getting recognized
Getting rewarded
 Be ahead of industry changes that are inevitable
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#1 – Think Differently
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#1 – Think Differently
 The OMH is good for patients and for healthcare
 Everything you do matters
 Everything you do makes a positive impact
 However….
•
•
•
•
•
•
Every action causes a reaction
Are your results positive?
What about quality?
What about value?
Are you getting better?
How do you know you are getting better?
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#2 – Design it
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#2 – Design it
 Your goal should be efficient, comprehensive, timely
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


and effective in proving that your team IS the best
cancer team on the planet.
Not just printed policy or procedure, but workflow
change
Educate the care team, change the mindset
Be creative
Remove prior boundaries and pre-conceived notions
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#3 – Do the Right Thing
 No argument – you do good things
 Can you do better?
 Is your “good” aligned with the needs of Patients,
Families, Payers, Employers?
 How do you know?
 How do they know?
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Quality, Value, Outcomes Measures
Patient Care Measures
% of cancer patients that received a treatment plan prior to the administration of chemotherapy.
% of cancer patients with documented clinical or pathologic staging prior to initiation of first course of treatment.
% of chemotherapy treatments that have adhered to NCCN guidelines or pathways.
Antiemetic drugs given appropriately with highly emetogenic chemotherapy treatments.
% of cancer patients undergoing treatment with a chemotherapy regimen with a 20% or more risk of developing neutropenia and also received GCSF/white cell growth
factor.
NEW 08/07/13
- Appropriate use of advanced imaging for early stage breast cancer patients.
NEW 08/07/13 -
NEW 08/07/13
Appropriate use of advanced imaging for early stage prostate cancer patients.
- Presence of patient performance status prior to treatment.
Resource Utilization
# of emergency room visits per chemotherapy patient per year.
# of hospital admissions per chemotherapy patient per year.
Survivorship
% of cancer patients that received a survivorship plan within X days after the completion of chemotherapy.
% of chemotherapy patients that received psycho/social screening and received measurable interventions as a result of the psycho/social screening.
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Survivorship
Survival rates of stage I through IV breast cancer patients.
Survival rates of stage I through IV colorectal cancer patients.
Survival rates of stage I through IV NSC lung cancer patients.
End of Life
% of patients that have Stage IV disease that have end-of-life care discussions documented.
Average # of days under hospice care (home or inpatient) at time of death.
% of patient deaths where the patient died in an acute care setting.
A measurement of chemotherapy given near end of life.
Other
Patient satisfaction reporting and scoring.
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Example:
Patient Phone Triage
Active chemotherapy
patient needs an
appointment.
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Yes ma’am, this is
…
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This is Mary at
Community Cancer
Center. May I help you?
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#4 – Prove you are doing the right things
 OMH is not Meaningful (Meaningless) Use
 Some measures are numbers/reports only
 Some measures are process driven
 Change your process MEASURE and REPEAT!
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#4 – Prove what you are doing
Category
National
State
Practice Size
%Medicare
Overall
Timeliness
Thoroughness
Communications
FriendlinessHelpful
91.19%
84.22%
91.32%
98.89%
92.95%
87.61%
92.89%
99.07%
90.98%
83.73%
91.41%
98.74%
91.78%
85.37%
91.69%
99.00%
96.96%
97.99%
96.47%
97.53%
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#5 – Share what you are doing
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#5 – Share what you are doing
 Practice Team/Teams
 New Patients
 Families of New Patients
 National Payers
 Local Payers
 Local Employers
 Other Practices for “Best Practices”
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#6 – Make progress
 Visits, revenue, volume – NO PROBLEM
 What about?
• Quality
• Value
• Satisfaction
• OMH 19 Measures
• Financial assistance
• Pathway compliance
• Etc.
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#6 – Make progress
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#6 – Make progress
Category
Date Range
National
State
Practice Size
%Medicare
1st
2nd
1st
2nd
1st
2nd
1st
2nd
Overall
91.42%
92.51%
92.97%
93.10%
92.16%
92.27%
91.54%
92.86%
Timeliness
84.88%
86.81%
88.39%
87.41%
86.17%
85.91%
85.16%
87.27%
Thoroughness
91.35%
92.08%
92.91%
92.96%
92.13%
92.29%
91.50%
92.32%
Communications
98.97%
99.10%
99.00%
99.22%
98.90%
99.11%
98.97%
99.16%
FriendlinessHelpful
97.29%
98.00%
97.81%
98.32%
97.37%
97.85%
97.33%
98.24%
In the last 12 months, when you
phoned this provider’s office
after regular office hours, how
often did you get an answer to
your medical question as soon
as you needed?
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1st
5.90%
2nd
3.90%
6.50%
6.50%
Usually
17.40%
16.30%
Always
70.10%
73.30%
Never
Sometimes
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#7 – Teach others
 State societies
 Trade journals
 COA
 CoC
 ASCO
 ACCC
 ONS
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#7 – Teach others
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7 Steps to Becoming an OMH
1.
2.
3.
4.
5.
6.
7.
Think differently
Design it
Do the right thing
Prove you are doing the right things
Share what you are doing
Make progress
Instruct others
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Questions/Comments
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ONCOLOGY MEDICAL HOME