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Focus on Quality Colorectal Cancer Screening April 27, 2018 Indiana Primary Health Care Association

Introductions If you only called in please state your name and health center. If there are multiple people in the room, enter their names and email into poll

Today’s Presenters IPHCA and IQIN Team Carla Chance, CHC Programs Manager Angela Boyer, IQIN Director Jasmine Page, Quality and Data Coordinator Kislaya Kunjan, IQIN Health IT Director Indianapca.org to contact Staff Today’s Presenters IPHCA and IQIN Team

Agenda Review Focus on Quality structure and tentative calendar Review measures of focus and 2017 data Reporting requirements Interactive Data Dashboard demo CRC Screening Improvement strategies Announcements and Upcoming Events Numbers according to Azara DRVS TY March

Today’s Objectives Gain understanding of how the Focus on Quality measures were developed Locate the Interactive Data Dashboard and use it to benchmark the six measures of focus Identify at least one tool or strategy to help improve colorectal cancer screening

Advisory Group Special Thanks to Advisors: Sheila Allen, HealthNet Dr. James Gingerich, Maple City Stephanie Jeffery, Valley Professionals Brooke Lockhart, Wabash Valley Laura Pryor, Windrose Dr. Ruth Stevens, HealthLinc Corianne Vanderkolk, Green County CHC

Advisory Group Role Assist in selecting areas of focus for the IPHCA QPI Strategy Advise on training topics and modalities Advise on dissemination strategies for promising practices Encourage and support the exploration of new ideas and approaches to improving toward the quadruple aim

Focus on Quality Structure Systems Alignment APCM Improvers High Performers Others Brief Training QI Tools QI Models Data Experts Resources Benchmarks Clinical Measures Critical Systems Peer Learning

Focus on Systems

Measures of Focus- Selection Business and Operational Initiatives Advisory Group feedback 6 Core Measures Number of measures Burden of Reporting High Priority Opportunities for growth Quality Improvement Synergies UDS MU HP 2020

Measures of Focus * IN UDS 2017 (Baseline) UDS HEDIS MU ISDH Healthy People 2020 Childhood Immunizations 38% * Colorectal Cancer Screening 40% Cervical Cancer Screening 48.4% Diabetes Control 34.3% Hypertension Control 61.8% Behavioral Health- depression screening 52.3% (2016)

Focus on Quality Calendar 2018 Meeting the 2nd Wednesday of each month at 11am Eastern Rotating 6 clinical measures throughout the next 18 months Colorectal Cancer Screening Quarter 2 Identifying gaps in care Tools and resources from national guidelines Diabetes Control Quarter 3 Peer sharing on improvement models and change packages PDSA reviewing and group visits Hypertension Control Quarter 4 Using technology to engage patients in care American Heart Association and Tobacco Prevention & Cessation tools

Data Drill down Interactive Dashboard and Reporting Is it possible to have a focus on quality dashboard with quarterly reports that populate automatically? Data Drill down

Data Reporting Each quarter reporting on all 6 measures Second meeting of the quarter review benchmarks and trends Drill down to measure of focus each quarter UDS definition (NQF) ISDH report sharing through Syncplicity (pending) Working to see CHIRP can provide data Quarterly reporting trailing year, reported to IPHCA Quarterly run charts internally

Reporting Guidelines Guidelines will be forthcoming For each measure show: Numerator (patients who had a visit and met the criteria during the quarter) Denominator (patients who held in a visit in that quarter) Percentage (Numerator/Denominator%)

Demonstration of Dashboard Inclusion of 2017 HP 2020 Depression Screening measure Other measures of interest Drill down to health center level Share screen for Kislaya

CRC Improvements- 2016 to 2017 UDS

CRC Improvers UDS Data Healthnet: 2016: 31% to 2017: 54% NorthShore: 2016: 49% to 2017:63% DRVS Users Jane Pauley ( March 2017:4%- March 2018: 26%) Riggs (March 2017: 18% to March 2018: 33%) Neighborhood Health: March 17: 16% to March 18: 28%

Colorectal Cancer Screening Improvement Strategies Four essentials for improved screening rates* Provider recommendation Office policy - Only a systematic approach can insure that the physician’s recommendation is delivered to all patients Reminder system(s) Effective communication system *http://nccrt.org/wp-content/uploads/CRCToolboxSlideSet_2009.pdf Factors to consider in an office policy: 􀀂􀀁Individual Risk Level (“risk stratification”) 􀀃􀀁Medical resources (endoscopy available?) 􀀄􀀁Insurance (insured? covered? deductible? copay?) 4. Shared Decisions, Informed Decisions, and Decision Aids; Staff Involvement; standing orders are just a few examples. 􀀅􀀁Patient Preference

Whiteboard CHC Innovations

Announcements & Events Operational Site Visit Training June 5, 2018, Indianapolis Presenters: Toni Estep and Andrea Lytle provide governance and clinical guidance for on site visits Indiana Cancer Consortium Colorectal Cancer Summit May 15th at Clark Memorial Hospital, Jeffersonville Clinical Leadership Conference Keynote Speaker: Paul Batalden, IHI Founder October 2018, Indianapolis

Announcements and Events Hiring Quality Improvement Coordinator Hiring Oral Health Director Midwest Clinicians Network Diabetes group study Contact Carla or Angela for more info