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Embracing the Past Moving Into the Future. Michael K. Butler, MD, MHA, CPE 10 th Annual Health Care Effectiveness Meeting January 16, 2007. In The Beginning. Matthew 13:57.
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Embracing the Past Moving Into the Future Michael K. Butler, MD, MHA, CPE 10th Annual Health Care Effectiveness Meeting January 16, 2007 In The Beginning
Matthew 13:57 And they were offended in him. But Jesus said unto them, A prophet is not without honour, save in his own country, and in his own house.
Mission of LSUHSC-HCSD On behalf of all citizens of Louisiana, the LSU Health Care Services Division shall: Provide access to high quality medical care. Develop medical and clinical manpower through accredited residency and other health education programs. Operate efficiently and cost effectively. While achieving our objectives, HCSD shall work cooperatively with other health care providers and agencies to improve health outcomes.
TRRAQSSS • Teaching • Research • Revenue • Access • Quality • Stakeholder Satisfaction • Service • Safety
Value Equation VALUE = QUALITY + SERVICE COSTS
Old Vs New Care Model Contrasting Delivery Model
Disease Management Definition Disease Management is a systematic approach to care for patients with selected diseases, based on treatment protocols that emphasize clinical and non-clinical intervention for which there is the greatest impact in maintaining a person’s good health.
Components of the LSU Disease Management • Evidence-Based Guidelines • Knowledgeable Providers • Engaged Patients • Actionable Patient Goal • Medication Assistance Program
Health Care Effectiveness Definition Health Care becomes effective when the systems of care continuously improve to meet patient needs, optimally uses patient resources, demonstrates value to all stakeholders, improves the health of the population served, and consistently satisfies all constituencies.
Asthma • Access To Medications • Focus On Patient Self-Management • Risk Stratification of Patients • Identifying True Patient Population • Certified Asthma Educators • Change From Emergency Department to Out-Patient Clinic Setting • NIH Evidence-Based Treatment Regimens
Cancer Screening “Virtual Breast Center” Pilot “In Reach Model” Cancer Navigator Concept Improved Screening Efficiency Digital Mammography Liquid Based Pap Smears Open Access Mammography Screening Cervical Screening in Primary Care Settings Mobile Mammography
Late Stage Breast CancerMedical Center of Louisiana at New Orleans
Congestive Heart Failure • Evidence-Based Medication Use—ACE Inhibitors, Beta-Blockers, and Diuretics • Video-based Patient Education • Sliding Scale Diuretic Management • Telemanagement alternative to the Emergency Department or Clinic Presentation • Withdrawal of contra-indicated medications
Diabetes • Certified Education Programs at All Hospitals • ADA Recognized Providers At All Sites • Diabetes Foot Program—Telemedicine and On-Site Care • Benchmarking to DQIP, HEDIS, and DHHS—Healthy People 2010 Goals • Medication Assistance Program
HIV • Special Project of National Significance (SPNS)—Labtracker • Established Quality Standards • Focus on the Most At Risk Patients (CD4 Counts < 50) • Emphasis on Prophylaxis and Prevention
Chronic Kidney Disease • Identify At Risk Population • Stratification of Population for Intervention • Focus on Patient Self-Management • Certified Kidney Disease Education • Evidence-Based Treatment Guidelines (K/DOQI) • Early Referral for Vascular Access
Chronic Kidney Disease 3,073,780 Creatinines Screened 575,102 Unique Patients 3,404 GFR <60
Weight Control—Overweight and Obesity • Physician Primer • Treatment Algorithm • Quarterly Newsletter in Development • Annual subscription to Obesity Management • Patient Registry
Medication Assistance Program • Supply/Stock on Hand (same day availability) • Same Day Appointment/Application • Limited Formulary • Automated/Computerized Application • Financially Self-Supporting • Power of Attorney, MD, and Patient • Centralized Location