State of the Clinic

1. State of the Clinic Belleville Family Health Center September 5, 2013

2. Introductory comments • Many thanks to Wen-Jan Tuan for assistance with data gathering for this talk • Please complete the required IPHIT participant form for our HRSA grant. • Please complete the evaluation form at the end or email me any feedback you have about this presentation so we can continue to improve upon it. Thanks– Jen andThe Integrating Public Health Inquiry and Transformation (IPHIT) team

3. Objectives • Review Belleville Clinic demographics, geo-maps and quality metrics • Share the state of clinic finances • Look at different ways in which data can be queried and presented • Explore examples of how to data can inform future investigations and interventions

4. Goals • As you look at this data, formulate your own questions: • How was this data extracted? • Do we think it is accurate? • What else do you want to know? • What seems to be missing? • What assumptions are we making?

5. Our patients • As of June 1, 2013 5,633 patients were assigned to a PCP at Belleville clinic and have had some contact with UW Health in the past 3 years. From this we have panel-based data. • From 7/1/12 to 6/30/13 (FY13) 4,633 patients were actually seen at Belleville at least once during this year. From this we have service-based data.

6. This is how it looks: Not Belleville assigned Service Panel • Panel: patients assigned to a PCP at BV on June 1 2013 and contact with UW in the past 3 yrs • Service: patients seen at BV during 7/1/12-6/30/13 • Not BV assigned: patients not assigned to a PCP at BV

7. Panel vs Visit Data Which questions are best answered with panel data? Which questions are best answered with visit data?

8. Visit data • FY 2013 (July 1, 2012 – June 30 2013): • There were 19,425 visits – includes faculty, residents, nurses, lab and x-ray.

9. Physician visits month by month 2011-2013

10. RVUs month by month 2011-2013

11. Nurse visits month by month 2011-2013

12. Lab visits month by month 2011-2013

14. DEMOGRAPHICS

17. Belleville Patients Count of Patients by Census Tract 1,600 1

18. Moving on to diagnoses… • What do you think our top 5 patient issues are?

19. Top 5 issues for Belleville panel members

20. Top 5 visit diagnoses Belleville FY 2013

21. A comparison of panel diagnoses to visit diagnoses

22. LOTS to think about here… • What are the questions that come to mind for you? • What would you like to know more about? • How could we query this data?

23. Let’s choose our top diagnosis of obesity as an example of how we can break this down into more detail.

24. Where do we begin – defining and identifying obesity in our patient population • How would you identify our obese patients in Epic? • Problem list? • Billing diagnosis code? • BMI from vital signs?

25. How obesity was defined for this report • BMI>=30 as recorded in the vital signs

26. How obesity was defined for this report • BMI>=30 as recorded in the vital signs • Any problems with this?

27. How obesity was defined for this report • BMI>=30 as recorded in the vital signs • Any problems with this? • No differentiation made for age of the patient • - misleading data for children in this report: under-reporting

28. Age breakdown for obesity

29. Belleville Obese Patients Count of Patients by Census Tract 200 1

30. Show me the money…

31. 2013 Payor mix

32. 2013 Belleville payor data