Transcript Million Hearts Practice Change Package

Million Hearts
Quality Improvement
Team Training Day
Saturday, March 14, 2015
8:00 a.m. – 1:00 p.m.
Embassy Suites – Dublin, OH
Welcome Practice Teams!
Housekeeping Items
Located on each table is your team Practice Guidebook Binder and each participant should have
been given a folder at registration. Folder contents include:
 CME
In each folder you should have received a CME certificate which indicates that you will receive up to
4 Prescribed credits from the American Academy of Family Physicians. Please keep in mind that the
CME credit you earn today is on top of the 20 CME credits you will earn when you complete the
American Board of Family Medicine’s MC-FP Self-Directed Quality Improvement Effort (Part IV).
 Program Evaluation
The second item I would like to acknowledge is the program evaluation. It is critical that you complete
the evaluation at the conclusion of today’s program and return it to the registration desk before
leaving. The feedback you provide will help OAFP provide future programming that suits your needs.
 Practice Change Package
A copy of the practice change package is enclosed and will be referenced throughout today’s training.
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Practice Contact Information
In effort to keep the lines of communication open among all participants of our QI project, a full list of
participating practices is enclosed. Tapping into the knowledge of your peers also participating in the
program, is a great way to overcome barriers and learn best practices.
Welcome, Introductions and
Connection to the National Million
Hearts Initiative
Barbara Pryor, MS, RD, LD –
Manager, Chronic Disease Section
Ohio Department of Health
Collaborating Partners
Million Hearts Initiative
Million Hearts® is a national initiative to prevent 1 million heart attacks and strokes by 2017. Million Hearts®
brings together communities, health systems, nonprofit organizations, federal agencies, and privatesector partners from across the country to fight heart disease and stroke.
Website offers:
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Practice
resources
Patient videos
Action guides
Treatment
protocols
www.millionhearts.hhs.gov
Project History: Where it all started…
2011-2012
 The Ohio Academy of Family Physicians (OAFP) in partnership with the Ohio Department of Health (ODH)
designed a two-part outreach plan aimed to improve cultural sensitivity and communication skills among
primary care physicians and a point-of-care patient information package for African-American men who
are at risk for high blood pressure and high cholesterol. The tools created included: Physician guide,
patient brochure, folder and helpful tip-sheets.
2012-2013
 The second phase in the project was to work with a small group of family physicians to pilot the
effectiveness of the educational materials contained in the toolkit and secondarily to provide physicians
with guidelines to help them achieve better outcomes and encourage positive doctor-patient
partnerships. The “Check It. Change It. Control It.” patient and physician toolkits were developed based
on the findings from focus groups with African-American male patients and structured interviews with
family physicians “in the trenches.”
2013-2014
 The Association of State and Territorial Health Officials (ASTHO), took notice of our partnership and work
product and encouraged us to apply for the Million Hearts State Learning Collaborative Project. Our
proposal was selected by ASTHO and partners from the Centers for Disease Control as one of ten states to
participate in this national endeavor. An overview of project outcomes is in your folders.
2015-18 Ohio Million Hearts Objectives
For participating practice teams:
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Improve the use of EHR data to identify and manage patients with diagnosed but not controlled hypertension
(>140/90)
Ability to create and monitor patient self-management plans systematically through the practice’s EHR
Use a QI framework to develop policies or systems in that encourage team-based care for hypertension
management
Promote use of the Check it. Change it. Control it. Your heart depends on it. Toolkit to address disparities in blood
pressure control among African-Americans
For statewide dissemination to PCMH practices:
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Identify practice-improvement strategies that use EHR data and team-based care to improve hypertension
management
Expand Million Hearts to management of the ABCS for all patients in PCMH practices
For focused activities in local counties:
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New CDC funding that supports five local public health projects in Athens/Washington, Lorain,
Montgomery, Richland and Summit Counties to establish Hypertension Collaboratives, improve use of EHR data,
build support for lifestyle change programs, and link clinical to community services
Bridging Clinical Guidelines to
“In the Trenches” Primary Care
“Check it. Change it. Control it.
Your Heart Depends on it” Family Toolkit
Patient Education - Point of Care Resources
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Folder printed with information about hypertension and
high cholesterol
Self-assessment questionnaire to gauge patient’s risk for
hypertension and high cholesterol
Brochure explaining both conditions
List of questions to ask their doctor
Information sheet explaining blood lipid screening
Hypertension and high cholesterol trackers for checking
progress over time
Diet and physician activity tip sheet
List of factors that will help patients be successful
Physician Toolkit
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Patient toolkit materials
Guidelines for patient-centered communication
Guidelines for positive interactions with African-American male patients
Lifestyle counseling for changing diet
Lifestyle counseling guidelines for increasing activity level
Resource list
Smartphone apps
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Free iPhone and Android versions to help your patients monitor and track
their blood pressure readings over time
Check it. Change it. Control it.
Apps for iPhone and Android
Phones – Free!
Search with keywords:
“Check it”
Importance of Team Engagement
and Quality Improvement
Ted Wymyslo, MD – Chief Medical Officer
Ohio Association of Community Health Centers (OACHC)
Features of a Medical Home
(in a nutshell…)
The patient-centered medical home is an approach to the delivery of
primary care that is:
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Patient-centered: Supports patients in learning to manage and organize their own care at the level
they choose, and ensures that patients and families are fully informed partners in developing care
plans.
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Comprehensive: A team of care providers is wholly accountable for a patient’s physical and mental
health care needs, including prevention and wellness, acute care, and chronic care.
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Coordinated: Ensures that care is organized across all elements of the broader health care system,
including specialty care, hospitals, home health care, and community services and supports.
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Accessible: Delivers accessible services with shorter waiting times, enhanced in-person hours, 24/7
electronic or telephone access, and alternative methods of communication through health IT
innovations.
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Committed to quality and safety: Demonstrates commitment to quality improvement through the
use of health IT and other tools to guide patients and families to make informed decisions about
their health.
Recognized Patient-Centered
Medical Homes in Ohio
Public access to a map of PCMH sites is
available on the Ohio Department of
Health’s website: www.odh.ohio.gov
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The number of Patient-Centered Medical
Homes in Ohio has grown from 157 in June 2012
to 569 as of February, 2015.
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The sites are comprised of 511 NCQA (National
Committee for Quality Assurance)-recognized
sites, 7 AAAHC (Accreditation Association for
Ambulatory Health Care)-accredited sites, and
51 Joint Commission-accredited sites.
Practice Change Management
I’ve been there! A front office associate calls in sick; you’re several days
behind on your billing; there’s a little squabble between your office
personnel that may fester; you need to coordinate interviews to fill a
vacant office position; your EHR is not working properly, and of course,
payroll is due tomorrow. On top of all that, we are asking you to
CHANGE!!! Yeah right…
Importance of Teamwork
It takes time and effort to
create positive work
relationships, but the payoff
is worth it!
AAFP’s Family Practice
Management Resources:
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Practice management, general
Communication
Staff management
Interprofessional Relations
Office Management
Personnel Management
Practice Management, Medical
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Workplace Issues
www.aafp.org
What is Quality?
HRSA
 Systematic and
continuous actions
that lead to
measurable
improvement in health
care services and the
health status of
targeted patient
groups.
IOM
 High quality care is
safe, effective,
patient-centered,
timely, efficient, and
equitable.
Why Quality Improvement?
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Leads to better patient care and outcomes
Improves patient satisfaction
Enhances patient safety
Improves staff satisfaction
Improves overall efficiency and effectiveness of the
organization
 Minimizes liability risk
 Strengthens the bottom line – payment for value
National Quality Strategy
March, 2011
 Three aims
• Better care
• Healthy People/ Healthy Communities
• Affordable Care
National Quality Strategy (Continued)
 Six Priorities
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Patient safety
Patients as partners
Effective communication and coordination of care
Use most effective treatment and prevention strategies
Promote use of best practices for healthy living in
communities
• Make quality care more affordable with new delivery
models
IHI Model for Improvement
Three Fundamental Questions
1. What are we trying to accomplish? (AIM)
2. How will we know that a change is an improvement?
(MEASURES)
3. What changes can we make that will result in
improvement? (INTERVENTIONS)
Importance of Team Engagement in
Pursuing Quality
 Consistency/Uniformity in:
• messaging, commitment, engagement
 The Broken Record
 Performance Review/Accountability
 Staff job satisfaction
 Successful goal achievement
Share the Vision
 “If you want to build a ship, don’t drum up
people to collect wood and don’t assign them
tasks and work, but rather teach them to long
for the endless immensity of the sea”.
Antoine de Saint-Exupery
Partnering With Patients to
Achieve Better Health
 RWJF – Building a Culture of Health in America
 Health vs. Illness Model
 Prevention/Screening Integration into
Healthcare
 Sometimes Less is More (Choosing Wisely)
 Patient Engagement/Empowerment
PCMH/ ACO Resources
 Ohio Academy of Family Physicians
www.ohioafp.org
 American Academy of Family Physicians
www.aafp.org
 Ohio Department of Health/Ohio Patient Centered Primary Care
Collaborative (OPCPCC)
www.odh.ohio.gov
 Patient Centered Primary Care Collaborative (PCPCC)
www.pcpcc.org
Additional articles and materials can be found in your practice
guidebook
Patient Perspective:
How the Team-Patient Relationship
Impacts Hypertension Management
Ms. Rosemarie (Rose) Eckl – Medicare Beneficiary
from Independence, Ohio
Improving Heart Health is a Family
(and Practice) Affair
Gary LeRoy, MD, FAAFP –
Interim Vice President of Multicultural Affairs and
Community Enhancement
Wright State University Boonshoft School of Medicine
Hypertension Prevalence
 29% prevalence among US adults (2011-12)
• 33% among adults 40-59
• 65% among adults 60+
• 42% among non-Hispanic blacks
 Approximately 67 million adults have HTN
• 35.8 million adults with uncontrolled HTN
 Of that total, 5.7 million are diagnosed and untreated and 14.1 million are
“unaware”
Reference: Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: National Health
and Nutrition Examination Survey, 2011–2012. NCHS data brief, no 133. Hyattsville, MD: National Center for Health
Statistics. 2013.
Valderrama AL, Gillespie C, King SC, George MG, Hong Y, Gregg E. Vital signs: awareness and
treatment of uncontrolled hypertension among adults — United States, 2003–2010. MMWR. 2012;61:703-709
“Unaware” – A Closer Look
 79.5% have health insurance
 81.9% report having a usual source of care
 59.6% have received care 2 or more times in the past year
 17.9% have received care in the past year
National Health and Nutrition Examination Survey 2007-2012
High-Risk Population
African-American male patients are at high risk of cardiovascular disease.
No conclusive studies exist that explain why that’s true.
Regardless of the cause(s), the effects are alarming:
 African-American men are 1.5 times as likely as non-Hispanic white men to have
hypertension.
 African Americans overall have the highest rate of hypertension of all groups
and tend to develop it at a younger age than other groups.
 African-American stroke survivors are more likely to become disabled and have
difficulties with activities of daily living than their white counterparts.
 Nearly 45 percent of African-American men have borderline-to-high cholesterol.
In Ohio, the statistics are staggering
 38.5% of African Americans have a diagnosis of HTN compared to 33.7%
for whites.
 In 2011, more than half of stroke deaths in African- American men were
before the age of 75, and 37% were before the age of 65.
 In 2011, more than 60% of heart disease deaths in African-American men
were before the age of 75; over 40% were before the age of 65.
 African-American men are 49% more likely to die from stroke and 21%
more likely to die from heart disease than white men.
Recommendations
In late 2013, two different sets of hypertension treatment recommendations were
issued.
 2014 Evidence-Based Guideline for the Management of High Blood Pressure in
Adults (JNC8)1
 An Effective Approach to High Blood Pressure Control: A Science Advisory From the
ACC, AHA and CDC2
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1James PA,
et al. JAMA, 2013 Dec 18.
2Go AS, et al. Hypertension, 2013, Nov 15.
JNC 8 Guidelines
 Nine recommendations made based on three questions related to high
blood pressure management. In adults with HTN:
1. Does initiating antihypertensive pharmacologic therapy at specific
BP thresholds improve health outcomes?
2. Does treatment with antihypertensive pharmacologic therapy to
a specified BP goal lead to improvements in health outcomes?
3. Do various antihypertensive drugs or drug classes differ in
comparative benefits and harms on specific health outcomes?
JNC 8 Recommendations
Patient Subgroup
> 60 years
< 60 years
>18 years with CKD
>18 years with diabetes
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Target SBP
(mmHg)
<150
<140
<140
<140
General nonblack population: Thiazides, CCB, ACEI, or ARB initially
General Black Population: Thiazides or CCB initially
CKD: Treatment should include ACEI or ARB
Increase dose or add therapy after one month if BP goal not reached
 Do not use ACEI and ARB together
 Refer to HTN specialist if still not at goal
Target DBP
(mmHg)
<90
<90
<90
<90
ACC/AHA/CDC Science Advisory
 Recommend use of evidence-based algorithms for treatment of HBP as well as
lifestyle changes to control HTN
 Recommend blood pressure goal <139/89 mm Hg. Lower targets may be appropriate
for some populations such as African-Americans, the elderly, people with diabetes or
CKD
 Recommend lifestyle modification and consideration of thiazide diuretic for stage 1
HTN (SBP 140-159 mm Hg or DBP 90-99 mm Hg)
 For stage 2 HTN (SBP >160 mm Hg or DBP >100 mm Hg) recommend combination
therapy with a thiazide diuretic and ACE inhibitor, ARB or CCB
 If goal BP not reached, increase medication dose or add drug from a different class;
address adherence; advise on self-monitoring.
Consider referral to HTN specialist if all primary care options have been exhausted
Care Planning: What to document in your
Electronic Health Record (EHR)
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Family history
Race and gender
Age
Obesity (BMI > 30 kg/m)
Dyslipidemia
Excess dietary sodium intake
Alcohol consumption
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Smoking
Diabetes
Stress
Lack of physical activity
White-coat syndrome
List of medications
(Note: Some EHRs have templates built into the system that offers a menu of
suggestions that can be added to the patient’s individual care plan.)
Patient Self-Management Care Planning
Clinical suggestions for creating a
personalized, patient self-management plan
can address the following:
* Weight loss
* Exercise
* Medication management and adherence
* Behavior modifications:
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Alcohol consumption
Smoking
Excess dietary sodium intake
Patient “buy-in” is critical to success
Sometimes only one intervention is
necessary to make a significant health
improvement.
Self-Management
Blood Pressure
Planning…
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Prepare teams
Clinical protocols
Empower patients
Encourage payer
coverage
Chronic Care Management Plans
Beginning January 1, 2015, physicians can bill Medicare for “non-face-to-face” chronic care
management (CCM) according to the final 2015 Physician Fee Schedule (PFS) adopted by the
Centers for Medicare and Medicaid Services (CMS) on October 31, 2014
CMS suggested the following elements to be included in a chronic care plan:
• Problem list
• Expected outcome and prognosis
• Measurable treatment goals
• Symptom management
• Planned interventions
• Medication management
• Community/social services ordered
• How the services of agencies and specialists not connected to
the practice will be directed/coordinated
• The individuals responsible for each intervention
• Requirements for periodic review and, when applicable revision
of the care plan
Additionally, CMS expects the provider to reflect a full list of
CCM details can be found on the OAFP
problems, medications, and medication allergies in the EHR to
website: www.ohioafp.org
inform the care plan, care coordination, and ongoing clinical care.
We all need reminders…
Take blood pressure readings correctly, each and every time!
What can you do to affect change?
Participating in this QI initiative is the best first step!
 Raise Practice Team Awareness
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High-risk populations
Educational materials available to help discuss health behaviors
Appropriate blood pressure readings
Care management planning with patient engagement
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Encourage clinicians to explore their data
Use registry functionality
Explore existing reports in EHR
Engage their EHR vendor
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HSAG & CliniSync
Ohio Academy of Family Physicians & Ohio Department of Health and Million Hearts National Collaborative
Ohio Association of Community Health Centers
Peer practices engaged in this QI initiative
 Encourage Data Exploration
 Develop a Protocol and Action Plan
 Reach Out to Partners
 Keep Patient-Centered
 Share and Repeat Best Practices
Million Hearts Practice Change Package:
Your Tool for Population Management
Carol Saavedra, Health Informatics Specialist - HSAG
Practice Benefit:
Electronic Health Record Data Collection Assistance
EHR experts are here to help you!
Questions about pulling data from the
following EHRs?
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Allscripts
Athena Clinicals
Centrix-Healthland
GE Centricity
Greenway Medical Technology
Epic
McKesson Practice Partner
NextGen
Cathy Costello: [email protected]
or (614) 664-2607
Scott Mash: [email protected]
or (614) 541-2296
Questions about pulling data from the
following EHRs:
* eClinicalWorks
* e-MD's
Carol Saavedra: [email protected]
or (614) 307.1830
Practice Change Package
QI Plan Cover Sheet
Provides an overview of
your practice’s aim
statement, baseline
measurement and
targeted goal. Suggested
practice interventions are
listed for consideration.
Practice Change Package
Protocol and
Action Steps
This tab houses your
practice’s protocol
and action plan.
Its contents will be
developed as part of
today’s activities.
Practice Change Package
Data Collection Panel
This will be your most utilized
tab in the Practice Change
Package as it will serve as your
practice’s data collection sheet
for the duration of the project.
Each practice is asked to record
patient data on six key
measures on a monthly basis
and report your findings to
OAFP staff by the 5th of each
month via fax or email.
Practice Change Package
References
Comprehensive list of online patient
engagement or clinical resources
Practice Change Package
Narrative
Captures your answers about the goals and
objectives of the program and should be
completed in early July after the conclusion of
the project. The answers captured in the
narrative match the questions required for
ABFM MC-FP Part IV credit through the SelfDirected QI Effort process.
Million Hearts: How to Use Your
EHR to Improve Quality
Cathy Costello, JD - Director, CliniSyncPLUS Services
Setting Up Your EHR System for
Maximum Benefit
Clinical Quality
Measure Reporting is
Enabled
Patient Portal is Used
for Patient Reminders;
Patient Education
Patient List is Created
Clinical Decision
Support Rules are
Enabled/Templates
Created
Problem List and Meds
List Are Captured for
Each Patient
Clinical Quality Measure
Reporting Turned On
Clinical Quality Measure
Reporting is Enabled
Patient Portal is Used
for Patient Reminders;
Patient Education
Patient List is Created
Clinical Decision Support
Rules are
Enabled/Templates
Created
Problem List and Meds
List Are Captured for
Each Patient
Clinical Quality Measure Report
Turned On
 Want to track Clinical Quality Measure (CQM) NQF 0018/CMS 165: “% of
patients 18 – 85 yrs. with diagnosis of hypertension whose BP is adequately
controlled <140/90”
 Numerator: Those patients seen during the reporting period whose BP is
<140/90
 Denominator: Patients 18 – 85 yrs. with diagnosis of essential hypertension
w/in 1st 6 mos. of reporting period or previously
 Exclusions: ESRD, dialysis or renal transplant; pregnancy
Clinical Decision Support
Enabled
Clinical Quality
Measure Reporting is
Enabled
Patient Portal is Used
for Patient Reminders;
Patient Education
Patient List is Created
Clinical Decision Support Rules
are Enabled/Templates Created
Problem List and Meds
List Are Captured for
Each Patient
CDS: Why It’s Important
Clinical decision support is the brains behind an
advanced implementation of electronic health
records.
Expanded Definition of CDS
 Intent is to ensure providers have tools to help them make timely and
informed decisions.
 Flexibility in the types of CDS interventions employed
 Is not limited to “pop-up” alert interventions
 Includes problem-based order sets, clinical guidelines, documentation
templates, diagnostic support, contextually relevant reference information
Problem List and Meds List
Workflow Established
Clinical Quality
Measure Reporting is
Enabled
Patient Portal is Used
for Patient Reminders;
Patient Education
Clinical Decision
Support Rules are
Enabled/Templates
Created
Problem List and Meds List Are
Captured for Each Patient
Patient List is Created
Problem List and Med List
Medication reconciliation should be done with each
visit; will help you capture the use of “aspirin” therapy
as part of Million Hearts
Problem list should be reviewed for any additions or
changed conditions
Patient Lists Created
Clinical Quality Measure
Reporting is Enabled
Patient Portal is Used for
Patient Reminders;
Patient Education
Patient List is Created
Clinical Decision Support
Rules are
Enabled/Templates
Created
Problem and Meds List is
Captured for Each Patient
Patient Lists
 Set the guidelines you are following for Million Hearts as filters:
o Age: Patients between 18 – 85 years with diagnosis of hypertension
(>140/90mm Hg)
o Ethnicity: Of these, how many hypertensive patients are African American
(drawn from demographics)
o Test Results: Patients between 18 – 85 years under control (<140/90mmHg)
o African Americans between 18 – 85 years under control
o Prescriptions: Make self-management care plans as orderable
orders/prescriptions that can then be tracked through a patient list
Patient Portal Utilized
Clinical Quality
Measure Reporting is
Enabled
Patient Portal is Used for
Patient Reminders; Patient
Education
Patient List is Created
Clinical Decision
Support Rules are
Enabled/Templates
Created
Problem List and Meds
List Are Captured for
Each Patient
Process Mapping Exercise
Individual Team Work
Gary LeRoy, MD, FAAFP and Kate Mahler, CAE
Overview
Workflow & Process Mapping Exercise
Eliminating unnecessary or wasteful steps in a process makes work run more smoothly and is more
satisfying for staff. A workflow & process mapping exercise creates a visual map of the steps that the
entire practice team (including the patient) takes to conduct a routine visit where discussions about
hypertension risk, prevention, and control are appropriate.
Benefits of Process Mapping
There are a number of benefits to mapping out and recording your process. Listed below are just a
few:
• The visual display allows everyone to see what role/contribution their colleagues make to the
overall goal and creates appreciation for what other members of the care team do.
• A process map allows everyone to see their work in the context of the overall process, which
increases staff satisfaction.
• This exercise allows the care team to see where work backs up, where work can be standardized
to improve patient flow/work flow and to identify problem areas that can be tweaked for
maximum efficiency.
Process Mapping Exercise
Steps to Create a Process Map
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Identify everyone who is involved in the
process of discussing hypertension risk,
prevention, and control (patient, physician,
nurses, front office staff, medical
assistants, etc.)
As a group, identify the starting and end
points of the process you are mapping
(example: from the time the patient
appears in the office for an appointment to
the time the patient leaves the building
with a follow-up appointment scheduled.)
Next, draw “swim lanes” and label with the
names of each member of the care team.
Post the sticky notes in the appropriate
lane according to current office process.
If in your process you encounter a fork or
scenario where two or more outcomes
drive future action steps, take a sticky note
of contrasting color and write “FORK” on
it, then place it on the map in appropriate
sequence of steps identified. For example,
if the results of the colonoscopy are
normal, abnormal or inconclusive, this
action signifies a “FORK” and therefore
changes course for the following steps in
the process.
Take time to reflect and ask
the following questions:
 Is this the most efficient process for the task at hand?
 Could members of the care team, not previously
identified, be better utilized in this process?
 Is the right information available at the right time?
 Can your workflow be simplified?
 Could other office processes follow suit to ensure
simplified office systems that maximize the team?
Tailoring an Office Protocol to
Fit the Practice / Action Planning
Gary LeRoy, MD - Interim Vice President of Multicultural
Affairs and Community Enhancement
Wright State University Boonshoft School of Medicine
Drafting Your Practice Protocol
Million Hearts® encourages widespread adoption and use of standardized treatment protocols
for improving blood pressure control. Simple, evidence-based protocols can have a powerful
impact in improving practice improvement and patient health outcomes.
Protocol Aim:
Increase blood pressure control
by ensuring that each diagnosed
hypertensive patient has a selfmanagement care plan.
Final Charge and Expectations
Kate Mahler, CAE – Deputy Executive Vice President
Ohio Academy of Family Physicians
Data Collection Reporting Schedule
Please submit your data collection
panel by the 5th of each month to
Kate Mahler at the OAFP by fax:
(614) 267-9191 or email:
[email protected].
Kate’s contact information is on the
back of your practice guidebook.
Your final narrative page will not be
due until July.
Reminder:
Data Pull/Registry Assistance
CliniSync and Health Services Advisory Group, two statewide healthcare IT organizations, have
offered free technical assistance to all of our Million Hearts QI practices in pulling data from your
own Electronic Health Record.
If you need hands-on assistance please contact the people according to the EHR you are using:
Carol Saavedra: [email protected] or (614) 307.1830
EHR:
• eClinicalWorks
• E-MD’s
Contact information is printed on the
back of your practice guidebook.
Cathy Costello: [email protected] or (614) 664-2607
Scott Mash: [email protected] or (614) 541-2296
EHR:
• Allscripts
• Athena Clinicals
• Centrix-Healthland
• GE Centricity
• Greenway Medical Technology
• Epic
• McKesson Practice Partner
• NextGen
Practice Support
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AAFP Prescribed CME is accepted by the following national organizations:
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American Academy of Physician Assistants (AAPA)
National Commission on Certification of Physician Assistants (NCCPA)
American Nurses Credentialing Center (ANCC)
American Association of Nurse Practitioners (AANP)
American Academy of Nurse Practitioners Certification Program (AANPCP)
American Association of Medical Assistants (AAMA)
Don’t forget to claim today’s 4 CME Credits!
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Program Website: www.ohioafp.org
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PCMH/ Leadership Webinar Series
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Practice acknowledged as a partnering practice
Link to resources and program contacts
Held over the traditional lunch period so members of the care team can participate
CME accredited by the AAFP for .75 prescribed credits each
Free to all OAFP members and their practice teams
Register online at www.ohioafp.org
Questions?
Thank you!
Don’t forget to pick up a bag of
heart-healthy snacks for the drive home!