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)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 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 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

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!