Capital Region Health Care

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Capital Region Health Care

• More than 2,600 employees
• 300 physicians on medical staff
• 75 employed physicians
• Serves 5 counties in central New Hampshire
• Approx. 750,000 patient contacts/visits per year

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170 Logician users caring for 125,000 patients
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170 Logician users caring for 125,000 patients

• which makes us one of the larger single-vendor
  EMR systems in the country
• and gives us a remarkable opportunity to improve
  health care in Capital Region.

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Leapfrog Groups 3 Bridges to Excellence Heart
Stroke Recognition Program Physician
Practice Connections
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Why diabetes?

• UK Prospective Diabetes Study
• 1.0 reduction in HbA1C led to
• 17 reduction in mortality
• 18 reduction in MI
• 15 reduction in stroke
• 35 reduction in cardiovascular endpoints
• 18 reduction in cataract extraction

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Harnessing Logicianto improve diabetes care

• Point of care tools
• Diabetes registry
• Strategies that enlist the patient

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Harnessing Logician to improve diabetes care

• Point of care tools
• Diabetes registry
• Strategies that enlist the patient

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Harnessing Logicianto improve diabetes care

• Point of care tools
• Diabetes registry
• Strategies that enlist the patient
• Diabetes letter to patient

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Harnessing Logicianto improve diabetes care

• Point of care tools
• Diabetes registry
• Strategies that enlist the patient
• Diabetes letter to patient
• Publicizing our efforts

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Moving on to the second Bridge...
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Our quality challenge for 2005

• Sustaining our diabetes improvements while we
  strive for Heart-stroke recognition.

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date of recognition
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date of recognition
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date of recognition
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Other irons in the fire

• Anticoagulation form for Coumadin
• Smoking cessation initiative
• Pain management project
• Obesity initiative
• Heart failure project
• and more...

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Our dilemma...

• To date, CRHC has received no third party
  reimbursement for our quality initiatives.
• Au contraire, weve been taxed a 5400
  application fee by the NCQA for DPRP recognition!
• Such perverse incentives are not compatible with
  long-term success.

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What have we received from govt?

• 0

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What do we need from govt.?

• Purchasers should identify ways to
• recognize quality,
• reward quality, and
• support quality improvement.
• Crossing the Quality Chasm, chp. 8, p182

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