The Value of a Healthcare Community Network

1. The Value of a Healthcare Community Network Early Implementation Experience Rick MacCornack, Ph.D. Director of Quality Improvement Northwest Physicians Network

3. Northwest Physicians Network (NPN) an Independent Physician Association OXYMORON: Independent Association

4. Background on NPN • 10 years old • 435 total providers (102 primary care) • 248 owners • 167 contracted providers • 34 specialties • Managed care / delegated services • Hard but successful road • Chronic Care Improvement Collaboratives since 2001 • Health Improvement Foundation 2003 • Pay for Performance started 2004

5. Entrepreneurial / innovative Organized to achieve common goals Improve health of individual patients and healthcare in their community Demonstrate value Patient centered / physician directed care

6. Importance of NPN’s efforts to connect physicians, patients, hospitals, labs, etc. in our community: Patient centered / physician directed Independent physicians in small practices represent ~80% of physicians in US

7. Local Market • Three highly competitive hospital systems currently buying up physicians (again) • Electronic moats created by each • Most area physicians admit patients to 2 hospital systems • Patients use multiple systems (insurance driven) • About 60% of the 1,200 physicians in the area are independent

8. E-connectivity important but independents face many barriers Cost Support infrastructure Partnership: Siemens, ReachMyDoctor and WorldDoc Co-Sponsorship: NPN with Pierce County Medical Society

10. Elements of The Network • Secure communication (administrative and clinical) • Provider Provider • Patient Provider • Clinical data pushed to MD’s PC from creation source (hospital, ER, labs, SNF, etc) • Interactive educational content for patients

11. Elements (continued) • Cuts across electronic silos • Develops appetite for EMR • Partnership • All parties pay to support the Network • All parties build a reserve to support maintenance over the long term • Governance • Physician Advisory Committee • reflects the provider community

12. Basis of a community approach to connectivity Compete on: • coordination of care • desired outcomes of care • service excellence …rather than • institutional market share/control of patient information

13. Implementation Chronology • Decision to Implement: July 2004 • Co-Sponsor agreement: September 2004 • Implementation team formed: September 2004 • Pilot team launch: October 28, 2004 • Grant writing initiated: December, 2004 • Post–pilot Expansion: January 2, 2005 • Physician Advisory Council: February 1, 2005

14. Network Activity • Since October 28, 2004: • 150+ providers have signed up • 33 in pilot • 120 since January 2 • half PCP, half specialty • Half NPN members, half non-NPN • 17,000+ network communications have been generated • 37 patients registered • One communicating with her MD from western, rural China

15. Development Challenges 2005-06 System: • Hospital system participation • Governance • Reserves – “There’s no free lunch” Practice: • Workflow integration • Patient recruitment

16. “Americans always do what is right, but only after trying everything else” -Winston Churchill