Collaboration for Consensus Provider Messages and Materials

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Collaboration for Consensus Provider Messages and
Materials

• May 2008
• Reita Jones
• Kentucky Diabetes
• Prevention and Control Program
• 502-564-7996, ext. 3810
• Reita.Jones_at_ky.gov

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Overview

• Describe 3 individual partnership groups
  linkages developed for joint projects
• Profile collaborative work of these 3 groups
• Highlight consensus materials, messages, measures
  values
• Share survey responses re provider reports
• Identify resources for project work
• List benefits of this collaboration

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3 Health-Related KY Collaborations
KENTUCKY DIABETES NETWORK, INC.
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Kentucky Diabetes Network, Inc.(KDN) Initiated
by KDPCP in 1999
MISSION Improve the treatment and outcomes for
individuals with and at risk for diabetes
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KDN Members or Member Types

• KDN is a statewide partnership of organizations,
  associations, and individuals who have a
  professional or personal interest in diabetes.
  Members have input to the board of directors for
  setting goals, processes, and the structure for
  KDN. It is primarily a volunteer organization.
  Some of the members are listed below

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Kentuckiana Health Alliance Initiated by UAW
Ford Motor Co. in 2001
GOAL Improve community health using broad-based
community collaboration in the Louisville area
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Auto Health Initiatives in the Nation

• 8 Auto Initiatives in U.S.
• Flint, MI (GM-UAW)
• Warren, OH (GM UAW)
• Anderson, IN (GM-UAW)
• Kenosha, WI (DC-UAW)
• Kokomo, IN (DC-UAW)
• Newark, DE (DC-UAW)
• Kansas City, MO/KS (UAW-Ford)
• Louisville, KY (UAW-Ford)

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Kentucky Health Quality Agenda(KHQA) Initiated
by Health Care Excel (QIO) in 2004
GOAL Promote best practices and improved patient
care throughout Kentucky
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KHAQIC KHQA Collaborators

• A widely representative core group that is
  responsible for setting goals, processes,
  structure, and administrative support for KHAQI-C
  and KHQA. Core group members are listed below

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Coordination Collaboration Among the Three
Groups

• Depth breath of focus varies among the groups.
  All include but are not limited to a focus on
  diabetes.
• All 3 groups do various efforts individually
  retain separate unique identities
• There is cross participation. regular
  communication and purposeful coordination of
  efforts to avoid duplication.
• Promote each others materials messages as
  appropriate and work jointly on various projects
  
• Profile a project where KHAQI-C UAW/Ford takes
  the lead with various partners contributing
  resources for the effort

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Collaborative Effort Began in 2006 is Ongoing
GOAL Promote best practices to improve patient
outcomes in the Louisville area statewide
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Kentucky Diabetes Network(KDN) Initiated by
KDPCP in 1999
MISSION Improve the treatment and outcomes for
individuals with and at risk for diabetes
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Project Goals

• The project goals are to improve patient outcomes
  and promote best practices by collaboratively
  developing and implementing practice guidelines
  and quality measures, promoting physician and
  patient education, providing office tools and
  utilizing data to promote benchmarks and improved
  patient care.

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Project Model

• Project was modeled after a similar project in
  the Kansas City area, where collaborators
  demonstrated improved patient care and outcomes
  (www.kcqic.org). The Kansas City Star (1/2006 )
  published the following about the Kansas City
  Quality Improvement Consortiums (KCQIC) success
  
• "In 2002, the blood-sugar levels of more than a
  third of diabetic patients, 37.5 percent, were
  uncontrolled. By 2004, just 8.2 percent of
  patients had blood-sugar levels that were too
  high."

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Consensus Materials/ToolsDeveloped and/or
Adopted2006

• Adopted KHAQI-C Guideline for the
• Management Adult Diabetes
• through committee consensus
• Based on ADA standards and included recommended
  lab tests, exams, medical checks, and essential
  patient education.
• Consistent with the KDN Diabetes Care Tool (DCT)
  and Standing Orders
• Mailed the guideline, KDNs DCT Diabetes Care
  Standing Orders for ambulatory care to Louisville
  area providers

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Diabetes Care Tool (Flow Sheet)
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Diabetes Standing Orders
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Consolidated Measurement Reports 2006

• Reports on diabetes care were created from health
  plans administrative data based on 2005 annual
  Diabetes Health Plan Employer Data and
  Information Set (HEDIS).
• Physicians that managed the care for a minimum of
  five individuals, ages 18-75, with Type 1 or Type
  2 diabetes who were enrolled in the participating
  health plans received the report
• A contracted company handled all data aggregation
  
• 404 physicians in the Louisville area were
  confidentially mailed these reports for their
  qualifying patient population (Nov. 2007)
• Data analysis costs 16,000 were funded by 2
  project partners

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Consolidated Measurement Reports

• These feedback reports allow physicians to
  privately compare their data to a regional
  average and benchmark
• The consolidated data did not include patient
  identifiers and complied with the protocol of
  HIPAA
• Physician reports were created for the sole
  purpose of improving management of diabetes care

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Consensus Materials/ToolsDeveloped and/or
Adopted2007

• Updated the diabetes guideline with 2007 ADA
  Clinical Practice Recommendations
• Adopted KHAQI-C guideline for the management of
  asthma cancer screening through committee
  consensus
• Mailed the 3 guidelines, the KDNs Algorithm for
  Glycemic Management of Type 2 Diabetes and some
  other resources the mailing was expanded
  statewide
• All collaborators promote the same materials in
  their respective networks

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Algorithms for Glycemic Management for Type 2
Diabetes
Provider tools can be accessed at
KentuckyDiabetes.Net
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Consolidated Measurement Reports 2007

• In addition to diabetes, reports were expanded to
  include measures on pediatric asthma, and
  mammography screening
• Healthcare Excel of Kentucky, Medicare QIO for
  KY, handled all data aggregation.
• In November, 2007 providers in KY were
  confidentially mailed these reports
• Diabetes, nearly 1,500 reports
• Mammography, 3,200 reports
• Asthma, 170 reports
• Data analysis costs were nearly 26K and were
  funded by donations from several project partners

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Consolidated Measurement Reports
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Consolidated Measurement Aggregation Report
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HEDIS criteria changed from 2005 to 2006 for
these measures and cannot be compared.
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Chronic Care of DIABETES CME

• Authored by KHQA
• Promoted by KY Medical Association all partners
  
• Available from January 1, 2007 through December
  31, 2008 for CME credit without charge
• CDs of the program were mailed to 8,500 KY
  physicians
• In addition, the program is available for
  download on the KMA website

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Total Materials Distribution
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Survey Results on Consolidated Measurement Reports
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Resources for the Project

• Anthem (data analysis data submission, logo
  design)
• Humana (data analysis data submission)
• Kentucky Diabetes Network (financial
  responsibility, envelopes, development use of
  provider tools)
• KY Diabetes Prevention Control Program
  (printing of provider tools envelope stuffing)
• KHAQI-C (leadership, guidelines, provider
  reports, provider surveys)

• Plantinum Sponsors
• Anthem Blue Cross Blue Shield (2006, 2007)
• sanofi-aventis (2006)
• Gold Sponsors
• Health Care Excel (2007)
• Silver Sponsors
• Greater Louisville Medical Society (2007)
• HealthService Council of Metro Louisville (2006)
• Jewish Hospital St. Mary's Healthcare (2007)
• Norton Healthcare (2007)

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Resources for the Project (Cont.)

• UAW Ford Motor Co. (leadership, guideline
  development, administrative support, printing,
  postage, envelopes)
• Program Promotion KMA Exhibit, GLMS Take AIM
  Kickoff, the many newsletter articles published
  by committee members organizations, and
  individual discussion
• Expertise The committee members and their
  organizations experts provided invaluable advice
  and guidance in developing the guidelines

• KHQA (leadership for state reports mailing,
  authored CME)
• KMA (promotion of CME and provision of credits
  without charge to physicians)
• Passport Health Plan (data analysis data
  submission)
• Quality Surgical Solutions (survey creation,
  postage, and data analysis)

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2008 PROJECT DESCRIPTION

• Collaborators are continuing this effort in 2008.
  Each year the partners carefully review the NCQA
  Effectiveness of Care measures for inclusion in
  provider reports. After careful consideration,
  the following provider metrics were selected for
  2008
• Comprehensive Diabetes Care
• Breast Cancer Screening
• Appropriate Testing for Children with Pharyngitis
• Appropriate Treatment for Children with URI
• Use of Appropriate Medications for People with
  Asthma
• Persistence of Beta-Blocker Treatment After a
  Heart Attack
• Use of Imaging Studies for Low Back Pain (acute)
• In addition, two critical clinical areas listed
  below will be aggregated at the community level
  but not at the individual provider level.
• Cervical Cancer Screening
• Colorectal Cancer Screening (This measure may
  vary from the HEDIS measure by only reporting on
  individuals ages 50-52 that received colorectal
  screening).

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Benefits Conclusions

• The collaboration has been effective to
• Broaden consensus among key stakeholders
• Provide more consistent provider messages
• Generate consolidated data reports that KDPCP
  alone had lacked resources to accomplish
• Provide wider support distribution of QI tools
• Establish baseline values benchmarks for key
  diabetes measures that are targeted for
  improvement
• Initiate processes that have been shown to
  improve diabetes care practices
• Maximize resources limit duplication of effort