Learning Session 4 April 9, 2013 Hershey Lodge Hershey, PA

1. Learning Session 4 April 9, 2013 Hershey Lodge Hershey, PA

2. Welcome! Robert A. Gabbay, MD, PhD Professor of Medicine, Penn State College of Medicine

3. Tonight is a Celebration! CONGRATULATIONS for all your hard work!

4. Thank You For Joining Us!…We’re Pleased to See You! • Robert Gabbay, MD, PhD – Principal Investigator • Alan Adelman, MD, MS – Co-Principal Investigator • Sharon Adams – SC AHEC Practice Facilitator • Laura Manley — Research Coordinator • Erin McGinley — Research Assistant • Pat Bricker — Research Coordinator • Jessica Wright – Research Coordinator • James Herman, MD, MSPH – Chair, Family & Community Medicine • Linda Kanzleiter, MPsSc, Ded — PA AHEC Director

5. A Special “Hello” To Our Guests! • Michael Wolf, MBA – Secretary of Health • Marcela Myers, MD – Director of Center for Practice Transformation and Innovation • David Kelley, MD – Chief Medical Officer of the Department of Public Welfare • Holly Alexander – Director of the Office of Clinical Quality Improvement • Craig Hillemeir, MD – Vice Dean for Clinical Affairs, Chair Department of Pediatrics, Medical Director Penn State Hershey Children’s Hospital • Yesenia Rosado Bane –Senator Teplitz’s Office • Frank Mazza –Senator Toomey’s Office • Page Babbit, MHSA, BSHIM – Director of Provider Engagement, Performance and Partnerships at Highmark

6. Michael Wolf, MBA Acting Secretary of Health

7. Introductions • Your name • Your practice/Your title • Your role in the practice and your role on the improvement team/Your role within your company and how it relates to primary care improvement

8. Impactful Initiative • Who have YOU reached? • 17 Practices • 85 Physicians • 18 Physician Assistants • 23 Advanced Practice Nurses • 30 Registered Nurses • Over 160,000 Patients

9. Background • Pennsylvania is 1 of 4 states funded by the Agency for Healthcare Research and Quality (AHRQ) to develop a Primary Care Extension Service (PCES) to support primary care transformation according to the Patient Centered Medical Home (PCMH) model • Other funded states: North Carolina, New Mexico, Oklahoma • PA supports 3 dissemination states – New Jersey, New York, and Vermont • A total network of 17 states are involved

10. Model for Primary Care Extension Service • Based on the Agricultural Cooperative Extension Model, the most successful innovation spread program in the US • Helped farmers adopt best practices • Small farms parallel Small primary care practices • Part of Affordable Care Act

11. Parallels Between Extension Services • Lots of small practices [farms] • Better evidence-based approaches available • Limited adoption • Need local support

12. Primary Care Extension Service Vision • Create practice learning communities • Organized around state/regional hubs • Include university-based center of excellence and state health department • Provide technical assistance to practices • Facilitate training for health professionals • Coordinate data collection and quality improvement • Assist practices in engaging in community resources Source: Grumbach K, Mold JW. JAMA. June 24, 2009. 301; 24, p. 2589-91.

13. Goals – Improve Quality, Reduce Cost! • Patients want more from the health system and from their physician • Purchaser (individuals, employers, government) are looking for quality and value • Bottom line: Improve quality of care and reduce cost

14. Goals of PA SPREAD • Develop infrastructure for supporting and spreading primary care transformation through PA AHEC • Primary Care Extension Service • Apply lessons learned from state initiative to 2 new regional learning collaboratives (SC and NW) • Disseminate model, lessons learned in 3 other states (NJ, NY, VT)

15. Regional Learning Collaboratives • Southcentral and Northwest PA • Practice Facilitators (1 per region, PA AHEC Executive Directors) • Quarterly Evening Learning Sessions • Monthly Data Reporting • Monthly Webinars • Daily correspondence with practice facilitators and members of the PA SPREAD research team

16. BUILDING FROM SUCCESS Building From Success

17. PA Chronic Care Initiative • Public-private partnership • Multi-stakeholder statewide effort • Staggered regional rollouts involving 150+ diverse, but mostly small practices • Almost 1,000 providers involved caring for 1 million patients • Diabetes initial focus then spread to other conditions

18. PA SPREAD Activities • Website Dissemination (www.paspread.com) • Partners Meetings • National Advisory Group • Practice Facilitator Forum • Curriculum Development • Four State Meeting (PA, VT, NY, NJ) • Large 17 state meeting – National PCES • State Innovation Model

19. PA SPREAD Partners • PA Department of Health • PA Department of Public Welfare • PA Pharmacists Association • PA Regional Extension and Assistance Center for HIT • PA Medical Society • Pennsylvania State University • Pittsburgh Regional Health Initiative • Quality Insights of PA • The Wright Center • United Health • UPMC • Wellspan Medical Group • Aetna • Aligning Forces for Quality South Central PA • American College of Physicians • AmeriHealth • Capital Blue Cross Blue Shield • Gateway • Geisinger Health Plan • Highmark Blue Cross Blue Shield • Independence Blue Cross • Lehigh Valley Health Network • PA Academy of Family Physicians • PA American Academy of Pediatrics • PA Area Health Education Centers • PA Association of Community Health Centers

20. Tonight’s Agenda • Practice Sharing: Best Practices • Data Discussion • Spread & Sustainability • CME & MOC Credit Explanation • Practice Sharing: How this initiative’s quality improvement efforts have impacted a patient • Closing

21. Tonight is a Celebration! CONGRATULATIONS on all your hard work!