SLIDE 1
Implementation
Parag Agnihotri ,MD Medical Director, Continuum of Care Sharp Rees-Stealy Medical Group San Diego, California
Implementation Parag Agnihotri ,MD Medical Director, Continuum of - - PowerPoint PPT Presentation
Implementation Parag Agnihotri ,MD Medical Director, Continuum of - - PowerPoint PPT Presentation
Implementation Parag Agnihotri ,MD Medical Director, Continuum of Care Sharp Rees-Stealy Medical Group San Diego, California What are we trying to achieve? Implementing Choosing Wisely Reduce Inappropriate care Appropriate Appropriate
SLIDE 2
SLIDE 3
Appropriate imaging for low back pain Appropriate antibiotic usage Achieve reduction in cardiac stress testing
Implementing Choosing Wisely
Reduce Inappropriate care
SLIDE 4
How do we achieve this as part of the ABIM/RWJF Challenge ?
SLIDE 5
Goal Setting
Baseline rate Commercial HMO Improvement by 2018 Avoidance of antibiotics for Acute Bronchitis 75% 25% 20% fewer antibiotics Reduce inappropriate imaging for low back pain 83% 17% 20% Fewer images Reduce pre-operative cardiac stress testing /? 8.75/1000 rate Need to improve 20% fewer cardiac stress tests
SLIDE 6
Our Steps
Resources Practice Variation Education Technology Measure Effectiveness Patient Engagement Align Stakeholders
SLIDE 7
How do you address this in a large multispecialty medical group with …
250,000 assigned patients 1.4 million visits 500 Physicians 60 NP/PA 2000 Clinic staff 21 Clinic locations
SLIDE 8
Aligning Stakeholders
Antibiotic Use
Urgent Care Primary Care
Back Imaging
MSK/PM&R Neurology Primary Care
Stress Test
Primary Care Cardiology
SLIDE 9
Clinical Guidelines Cardiac Stress Testing Guidelines
SLIDE 10
Clinical Guidelines Low Back pain Management Guidelines
SLIDE 11
Appropriate Coding Education
SLIDE 12
Appropriate Coding Education Example
SLIDE 13
Provider and Staff Educational Resources
SLIDE 14
Practice Variation Reports by Site
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Sharp Rees-Stealy Medical Centers Monthly Antibiotics for Acute Bronchitis Commercial Members 18 - 64 yrs August 2015
Current LBP Rate Baseline 2014 SRS Goal: 95% SRS Overall: 75.21%
Site 1 Site 2 Site 3 Site 4 Site 5 Site 6 Site 7 Site 8 Site 9 Site 10 Site 11 Site 12 Site 13 Site 14 Site 15
SLIDE 15
Peer to Peer Consult Process Established
SLIDE 16
Web Portal Links Education to Appointments
SLIDE 17
Shared Decision Making: Engage the Patient
Form personal connection Face to face interaction Step by step wellness plan Coordination of care Patient specific education material Shared care plans Medication adherence reporting
SLIDE 18
Shared Decision Making: Consumer Reports
SLIDE 19
Shared Decision Making: Consumer Reports
SLIDE 20
Change
SLIDE 21
Implementation at Sharp Rees-Stealy
Parag Agnihotri MD parag.agnihotri@sharp.com Sharp Rees-Stealy Medical Group San Diego, California