Trends in Disease Management Quality Improvement

1
Trends in Disease Management Quality
Improvement

• THE QUALITY COLLOQUIUMAugust 22, 2006

2
Speakers

• Carolyn Hartley, MLA, Moderator
• Michael Bryant, MD, FACS, President Sandhills
  Physicians, Inc., Doctors Direct Heatlhcare, LLC
• Harry Spring, Chairman and CEO InforMed Medical
  Management Services

3
(No Transcript)
4
Introduction
5
Objectives

• Identify trends in disease management
• Improve competency in using technology to capture
  and process relevant health data
• Identify high risk patients using secure access
• Develop care plans to manage chronic care
  patients.
• Understand how quality care directly affects
  employer health costs through a dynamic case
  study.

6
Trends in Disease Management
Michael Bryant, MD, FACS, President, Sandhills
Physicians, Inc. Doctors Direct Heatlhcare, LLC
7
Trends in Disease ManagementData is King

• Refined data collection and reporting
• Detailed costs in Category of Care (COC)
• Evaluation of financial and clinical data
• Education of patient, physician and employer
  

8
How Technology Improves Competency

• Focuses on clinical areas of improvement
• Allows immediate reference to clinical guidelines
• Allows provider evaluation
• Collective data for Pay for Performance (P4P)

9
Identify High Risk Patients

• Disease Risk Profile (HRA)
• KNOW YOUR NUMBER
• High dollar claimants
• Identifies and categorizes diseased populations
• Identify high cost cases (both long term and
  short term services)

10
Care Plans

• Development of specialty specific clinical
  guidelines
• Monitoring patients with specific disease states
• Physician and patient compliance with evidence
  based medicine guidelines
• Foundation of P4P initiative

11
Sandhills Physicians Story

• Data management and repository
• Informed
• Clinical guidelines/EBM connect
• Healthy Living program
• Physician directed disease mgt/ case mgt
• IPA initiated P4P

12
Case Study
13
Pay for Performance

• Performance of Internal Medicine Providers

14
Summary

• Identify trends in disease management
• Improve competency in using technology to capture
  and process relevant health data
• Identify high risk patients using secure access
• Develop care plans to manage chronic care
  patients.
• Understand how quality care directly affects
  employer health costs through a dynamic case
  study.