IHI- 15 Annual International Summit-2014- Macro and Micro Level data
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This document discusses using practice-level clinical data to facilitate transformation to the patient-centered medical home model. It describes a multi-payer initiative in Massachusetts involving 49 practice sites that collected monthly quality measure data over 30 months. The analysis found significantly improved process measures and measures for specific patient populations over time. It concludes that practice transformation takes time, processes of care are more likely to improve before outcomes, and using a clinical quality measure set is important for developing quality improvement skills and evaluating the impact of new practices on patient care.
IHI- 15 Annual International Summit-2014- Macro and Micro Level data
- 1. AIMS • Learn how to effectively utilize practice level data • Understand the essentials of making data more personal to practices • Explore creative ways to utilize data in practice transformation innovations TEAM UMMS Facilitation and MA PCMHI Practice Teams METHODS DESIGN Massachusetts Patient-Centered Medical Home Initiative (MA PCMHI): • Multi-payer, statewide initiative, sponsored by MA Health & Human Services • 49 participating practice sites • 3-year demonstration; Start: March 2011 DATA • Self-reported monthly clinical quality measures data from all MA PCMHI practices from June 2011 through November 2013 • Clinical quality measures cover the domains of: adult diabetes, pediatric asthma, care coordination and care management, and adult prevention ANALYSIS • Linear Mixed Model and Practice Run Charts • Data were divided into three-month periods: Time 1 (June - Aug 2011) to Time 10 (Sept - Nov 2013) • Change over time: Time 1 or Time 2 (Care Coordination and High Risk Care Management measures collection started at later time) vs.Time 10 DISCUSSION In the first 30 months of the MA PCMHI, participating practices have shown significantly improvement in: • Process measures • New processes and/or newly documented processes • Measures for specific patient populations PRACTICE RUN CHARTS CLINICAL QUALITY MEASURES CHANGE OVER TIME AGGREGATE RESULTS CONCLUSIONS • Primary care practice transformation takes time • Processes of care are more likely to improve before outcomes are impacted • Use of a clinical quality measures set is important for: - Developing practices’ skillset in QI, a PCMH component - Evaluating the impact of implementing PCMH processes on patient care and outcomes INTRODUCTION BACKGROUND Clinical Data is a key driver in Patient-Centered Medical Home (PCMH) transformation. Using available data to make micro (practice) level changes that can result in macro (system) level changes helps guide the process and monitor the usefulness of interventions. Data can be presented in creative ways to practice members to stimulate their involvement and create a self-reinforcing QI culture. Macro and Micro Level Data in the Patient-Centered Medical Home Center for Health Policy and Research Commonwealth Medicine 333 South Street, Shrewsbury, MA 01545 508.856.6222 l 800.842.9375 http://chpr.umassmed.edu Sai Cherala, M.D., M.P.H. Jaime Vallejos, M.D., M.P.H. 65.4*