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Tuesday, June 19, 2018

Logic Model Explanation - QMPA CARE Project


Queens Medical Professional Association (QMPA)
Core Assessment Review Evaluation Program (CARE Program)
Healthcare professionals have struggled to effectively utilize Electronic Health Records (EHR) into the workflow of their private practices for the treatment of chronic diseases. This ineffective use of EHR software wastes a significant amount of time and resources possibly leaving patients vulnerable during the gaps between health services.  QMPA aims to help health professionals integrate EHR software more effectively into their clinical routines with an eye towards possible alternative payment models.

Inputs

QMPA will be using our present headquarters in Corona, Queens for meetings and workshops. The program funding will come from the contributions of our members (in kind donations of at least $10,000) and grant funding. The funds will be used for other inputs such as to pay our staff, maintain a third party consultant, and gain access to multiple EHR software troubleshooting services.

Our Core Assessment Review Evaluation (CARE) program requires staff skilled or at least knowledgeable about the various EHR software programs used in private practices. For human resources we will require a minimum of three program managers, an EHR specialist, an IT assistant, an executive assistant, and a president. A variety of skills will be required to reach optimum efficiency. Since the program managers will be performing most of the interactive work, they are expected to have excellent communication skills. Their discussions with health care providers on the field will be vital to quick adjustments to designed models. The EHR specialist must be familiar with at least ten of the top leading EHR software, “Familiar” meaning at least three months of experience using the software. Some well known EHR software are Allscripts, Aetnahealth, Cerner, eClinicalworks, eMDs, Epic, Healthfusion, Kareo, McKesson, MDland, Meditech, Praxis, Care 360, SOAPware, and WEBeDoctor. The executive assistant is expected to have exceptional time management skills, as they will be in charge of organizing the data gathered by the program managers as well as arranging meetings and paperwork. The president, Dr. Amigon, will oversee the program and make priority decisions regarding basic objectives and core assessments. However, most of the time his intervention in policy will be minimal.

Outputs

The first month consists of each project manager visiting his or her 10 different medical practices. The three project managers are laying the foundation for further QMPA interactions and suggestions. Thus, project managers must become acquainted with all the staff. It is during this first month that project managers will compile all patient data regarding nine health-related conditions prior and status post treatment. The nine health-related conditions are cholesterol, cancer, hypertension, diabetes, obesity, mental health, gastro-intestinal health, smoking, and drinking. At the basic level two fraction numbers are produced, patients with said condition and patients without the condition. More specific details such as level of obesity through BMI and stage of cancer will be included on further quarterly reports after the third month. In addition, the project managers will compile a preliminary report each practice regarding number of staff, average patient load, doctor’s basic procedure, and practice workflow. The reports are rough drafts containing just basic information and not much else.

On the second month, there will be a QMPA meeting with all QMPA members of project CARE to validate collected patient data (scrubbed free of identifying information to avoid violating the Health Insurance Portability and Accountability Act). A randomized 10% of each practice will be pulled from the patient groups with one of the nine health-related conditions as well as 10% from the patient group without the conditions. The randomly selected groups will be analyzed for health history and to determine if the necessary conditions exist or that the patient’s health falls into the parameters of listed health condition. Patient records that do not pass the test are placed on a list for later reference to discuss with the health professionals. All the while the project managers will continue to visit the medical practices to build up on their preliminary report.

On the third month, the first report on all 30 primary care practices will be completed. There will be a group meeting at the QMPA headquarters to discuss the results. The unique aspects of each practice’s workflow will be analyzed in depth. Environmental and community factors surrounding each practice will also be discussed. The executive assistant will produce minutes of meeting.

After the third month of analysis of the practice, QMPA will start to host weekly workshops regarding EHRs as well as meetings for improved workflow designs. The weekly workshops will be held on a weekday or weekend depending on medical professional availability. Each workshop will feature three EHR software programs and their order sequences for analyzing core health assessments. Also will include specific troubleshooting questions and possible efficiency improvements. Finalized workflow charts of each practice are devised after the project manager believes he or she has sufficient understanding of the practice’s ins and outs. A second report regarding staff utilization of workshops and any changes or new details to note about practice workflow will be published at the end of the month. After the second report, a report is expected every quarterly regarding workflow changes and challenges.

On the fifth and sixth months, as the weekly workshops continue, the first round of low tier suggestions will be brought up for possible implementation. Care will be made to see if the program has support of medical staff present at the health practices. If possible attempts should be made to elicit suggestions for improvements from the staff themselves. Suggestions with support will be implemented and kept in place for duration of three months.

On the ninth month, analysis of implementation of the first round of suggestion will to done to see if there is any room for improvement. Following the analysis of the first round of suggestions will be a second round of suggestions, this time any tier would be possible.

By the 12th month, there will be an annual review of the events of the past year as well as a review of the first and second round of suggestions. A look into any possible changes to the nine core assessments will also occur at this time. With improvements or changes in play, the next major step would be to introduce a top tier health insurance reimbursement model. This top tier suggestion in addition with maintaining already existing policy changes will be the focus until the next quarterly meeting.

Healthcare professionals and coordinators for those with chronic or terminal diseases are the primary participants in the patient compilation process. It is from these individuals that we will be able to eek out the nuances in each patient’s case. Chronic diseases (such as diabetes and arthritis) and are expected to be bulk of patient base and improvements to chronic care management will be expected to increase patient outcomes.

With 30 health care practices of varying sizes the staff participation percentages will be hard to estimate. However, we aim for at least one senior staff member (over five years of experience) from each practice to participate in the weekly meetings. From those 30 participants every week, we will obtain a survey from each of them about their level of satisfaction at the health practice’s current workflow.

Outcomes

Increasing the awareness of each EHRs strengths and weaknesses will help staff members in each practice to recognize the possible expansions and limits of the software. From this baseline of recognition, staff will be able to pursue policies that can mitigate their systems shortcomings or improve their workflow efficiency. Suggestions of possible improvements will be take from the staff. There is an expectation that there will be at least 30 suggestions from the medical professionals. This increase in staff input is combined by an increase motivation in both patients and staff to achieve higher or more efficient health goals.

Review of these new motivations and inputs will be evaluated by studying any changes in the patient portal statistics as well as changes to the nine core health-related conditions. By increasing use of EHR data, adding in additional methods of communication and by streamlining the workflow, the goal is to have a decrease of 10% in the time and or number of office visits for those suffering from chronic ailments. This decrease in visits is to be combined with an increase in patient portal use and pre-clinical screenings.

All of these improvements and changes amount to better health outcomes through focused efforts on specific health-related conditions as well as increases in health efficiency through less paperwork searching, pre-visit screenings, mixed media utilization, and expedited extraneous procedure removal.

Evaluation

Evaluation of the entire operation will be broken into chunks of audits and meetings. Each quarter will be evaluated through its action process. Since the earlier months are spent setting up the suggestions and systems, focus will be on the reports produced by the project managers. These reports will be cross-examined with patient data and health professional accounts of their clinical operations through a one-on-one discussion with the health professionals. Of the first three quartiles all the reports must be accurate to set a strong foundation for later suggestions. The information must be at least 90% accurate to verify for a solid foundation. 

Later quarterlies will focus more on workshop and suggestion implementation. A survey of the workshops will provide QMPA staff with overall morale of the healthcare professionals from each practice. It is expected that some of the practices will have health professionals with little to no motivation to change policies or workflows. Hope is to have the possible benefits of new EHR procedures dangled in front of the health professionals to act an incentive to already existing problems. Suggestions that are implemented should be evaluated on a before versus after basis. If at least 50% of the suggestions are successfully implemented, then the later quarterlies can be considered effective.

To evaluate final long-term outcomes, we will examine the change in the data connected to the nine core assessments. Changes regarding practice workflow comparison will be made from past program manager reports to current conditions. If there is a marked improvement on at least 50% of suggestions, the program will be considered a success.

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