MedSouth Clinical Integration and Technology

1
MedSouth Clinical Integration and Technology

• Ellen Burkett, MD
• Case Studies from the Field Breakout Session
• June 24, 2005

2
What is Clinical Integration?

• In 1996 the FTC published Statement 8 outlining a
  new way for physicians to contract as a
  non-exclusive group
• Clinical integration involves significant
  information sharing and integration of group
  goals
• Goals are to improve and standardize performance,
  reduce redundancy and improve patient care
  outcomes
• Allows the IPA members to contract as a group

3
MedSouth

• A multi-specialty IPA in South Denver
• The IPA transformed from a PHO to capitation to
  the current structure a physician
  owned IPA
• The first group in the country to contract using
  a clinical integration model

4
Philosophy

• Physicians working together in an integrated,
  coordinated, interdependent quality improvement
  program
• Evidence based clinical guidelines form the
  structure
• Innovative plan that coordinates sharing of
  clinical information with the use of new
  technology

5
Implementation

• Keep it as simple and inexpensive
• Dont interrupt work flow-enhance it
• Adapt technology that is user friendly
• doctors are cheap and techno phobic
• vs
• doctors migrate to things (technology) that
  meets their needs

6
Physician investment

• Palm pilot pilot
• A computer in every office
• Internet connection modem vs cable
• Website review and sign off of clinical
  guidelines

7
Technology Partners

• MedPlus
• Quest Diagnostics
• LabCorp
• Schering Plough
• RMD

8
Cost/Benefit

• Each of these partners has provided a low cost
  information system for physicians
• Easy to use
• Hippa compliant
• Shares information in office and between offices

9
MedPlus/Quest Diagnostics

• Multiple iterations of the program over 5 years
• The most current is Care360-- free
• Integrated with Quest lab data, retrieval, order
  entry, clinical messaging
• Add on modules for fee
• Eligibility checking
• Electronic prescribing
• Local Quest Business Unit provides training and
  sales of the extra modules
• Can be set up for an individual doctor or a
  group/IPA

10
LabCorp

• Newer player in the technology field locally
• Uses Medicity- as the internet partner
• Provides lab data, retrieval, on line ordering,
  can do reporting on group performance
• Integrates with RMD

11
Schering Plough

• Partnership with MedSouth
• Provides a patient information system with
  educational materials on heart disease, asthma,
  diabetes (non-branded)

12
RMD

• Communication system/internet based
• Multiple connections
• MedSouth lt-gt Physicians
• Interoffice communication
• Intraoffice communication
• Patient lt-gt physician email
• Can be used for sharing of fee schedules
  /messenger model contracting

13
RMD

• Messaging to physicians and patients is archived
  and retrievable
• Current financial model assists physicians by
  financing with partners
• Disease management systems for diabetes and CHF
  set up
• Patient module- request appt, refill, referral,
  load information for patient use

14
RMD

• E-mail with patients
• Notification on regular email
• Password protected- HIPPA compliant
• Patient fee portion of the fee comes to the
  doctor
• Can be loaded with common replies
• Is set up for the practice by RMD with website
  for the practice

15
Colorado Care Network

• RHIO- regional health information
• Initial meetings to develop a regional Colorado
  information consortium
• Currently includes 6 IPAs from the Denver Area,
  the El Paso County Medical Society and Rural
  Health group
• Working with RMD to develop a program to share
  information with all of these participants
• Collaborating with COHIE project( Denver Health,
  University, Childrens)

16
Value

• When physicians work together they add value to
  patients, other physicians, health plans and
  community
• There is great potential for improving care
  outcomes and reducing redundancy through the
  sharing of information
• Clinical guidelines provide structure and goals
  for the organization
• Through a group, adoption of technology is
  easier, more affordable and ultimately more
  useful
• The use of systems which coordinate and are
  transparent will make future plans more feasible