Michigan IPIP/PCMH

1. Michigan IPIP/PCMH Transformation of Primary Care Practice Project with ABMS & RWJF Working Together for a Healthier Michigan

2. Sponsors & Gold Supportersfor Michigan IPIP/PCMH Project Diabetes Section Thank You! Working Together for a Healthier Michigan

3. Spring 2007 – Michigan was ready for IPIP! • MPCC – The Michigan Primary Care Consortium formed a Practice Transformation Committee to evaluate practice needs and opportunities for improving care delivery • AIAG – The Automotive Industry Action Group Health Focus group, in collaboration with Michigan Medical Group Management Society, was piloting the use of industry trained quality improvement experts to redesign health care facilities. • Industry/Health Care Collaboration IPIP offered a great partnership opportunity Working Together for a Healthier Michigan

4. A state-based, nationally led quality improvement initiative Created and sponsored by the American Board of Medical Specialties to Primary care physicians that include participation in quality improvement activities Funded in large part by the Robert Wood Johnson Foundation. Four phases: Cohort 1: Prototype through CO and NC (2006) Cohort 2: Re-focus with MI and PA (2007) Cohort 3: Spread through MN, WA and WI (2008) Cohort 4: Associate Partners Improving Performance in Practice (IPIP) www.ipip.qiteamspace.com Working Together for a Healthier Michigan

5. Mission & Purpose for Michigan IPIP/PCMH Project • A Primary Care Quality Improvement Initiative & Collaboration between industry (AIAG) & primary health care (MPCC) • Goals: • Improve the chronic care practices of patient populations • Move primary care practices towards PCMH • Target inefficiencies & waste • Increase spread to other practices Working Together for a Healthier Michigan

6. IPIP Project Development June - Aug 2007 IPIP idea is born, ABMS/RWJF Grant submission, August 6, 2007 September 2007 Champions are identified & ABMS notifies team of award Jan - May 2008 Full-time Director MI IPIP, Program Manager, & Project Support hired August 2008 Interviewing & screening IPIP practices for Readiness May & June 2008 MAY: Recruitment of practices begins JUNE: Interviewing & screening IPIP project coaches start 2004 State begins addressing challenges in primary care & options for addressing them 2005 - 2006 MMGMA/AIAG process improvement pilot projects 2008 Planning & strategizing IPIP MI model detail; Establishing Committees & focus groups November 2008 First wave of IPIP practice teams start & begin reporting to IPIP National MATCHING FUNDS: Secured with Sanofi-Aventis, Pfizer, Allergan, & MDCH IN KIND: MDCH Diabetic Educator, Automotive sector QI coaches & SSMBB from Ford Working Together for a Healthier Michigan

7. Michigan IPIP/PCMH Methodology • Use methods successful in the manufacturing environment to improve the quality in the healthcare environment • Select coaches with backgrounds in: • Quality Improvement • Lean • Quality System Management • System Integration • Select practices ready to “change” • Match practice + 2 coaches • Facilitate the transformation Working Together for a Healthier Michigan

8. IPIP Project Implementation Sept 2009 Learning Collaborative II: Understanding Diabetes, Asthma & Self Management June 2010 IPIP MI project & funding is complete IPIP MI sharing of data & metrics Jan 2010 Changing of the guards (State Director) November & December 2008 End of Year 1 of ABMS/RWJF Grant June 2009 Second wave of IPIP practice teams Final wave of IPIP practice teams Sept 2010 Final evaluation & project summary February & July 2009 Learning Collaborative I: Introduction to PCMH & CCM (repeated to roll in later practices) Mar 2010 Learning Collaborative III: Outcomes & Lessons Learned Working Together for a Healthier Michigan

9. Sharing the Data • The Final Report Data: • IPIP Leadership Team Evaluation • MPHI External Evaluation • Organization: • Project Outcomes • Clinical Outcomes • Lessons Learned • Next Steps Working Together for a Healthier Michigan

10. IPIP Project: Start to Finish * Data gathered from formal MPHI evaluation Working Together for a Healthier Michigan

11. Diabetic Measures (30 practices) Start of Project Close of Project OUTCOMES: • More practices engaged • PCPs measuring & monitoring their populations • PCPs are getting closer to goal • PCPs are tracking more clinical information Working Together for a Healthier Michigan

12. Asthma Measures (3 Practices) Close of Project Start of Project Percent Percent OUTCOMES: • More practices engaged • PCPs measuring & monitoring their populations • PCPs are getting closer to goal • Integration of IT systems will allow for further measuring Working Together for a Healthier Michigan

13. Diabetic Measure Changes Working Together for a Healthier Michigan

14. Asthma Measure Changes Working Together for a Healthier Michigan

15. Learning Collaborative Working Together for a Healthier Michigan

16. Practices found IPIP project to be helpful Increase in knowledge of PDSA Increase in satisfaction of care Increase in QI efforts Practices made improvements because of the IPIP model Office efficiencies Registries Small successes drove momentum Transformation takes longer than initially expected Build a more sustainable funding model Practice Coaching added value to the program Industry engineers can assist in transformation Strong fits Practice Coaches needed to: Be strong facilitators & change managers Start simply (PDSA & standardization) Eliminate waste Start measuring & monitoring Learning Collaboratives + continually learning are helpful in the process MI IPIP Model was visionary, valuable, viable & exemplary Summation: Lessons Learned Working Together for a Healthier Michigan

17. Next Steps for Michigan IPIP/PCMH Project • IPIP ABMS/RWJF Project ended June 30, 2010 • Finalizing official reports • Sharing our story • IPIP National in process of defining how to proceed • MPCC & AF4Q discussing ways to make an IPIP-like experience with coaching available October 2010 www.mipcc.org Working Together for a Healthier Michigan