Wednesday, January 25, 2012

#CISummit Bernadette Loftus KP and Patrick Conway CMO at CMS have a fireside chat

Bernadette Loftus - Be relentless in driving improvement

How to improve quality:
Extract data and present and share it. Set numerical discreet goals. 

It is not just a primary care job. The EMR prompts specialists to ensure follow ups happen - even outside their specialty.

Patrick Conway:

Acts as a clinical voice in CMS quality programs.

Set the goals and let people figure out the How.

How do you work on rapid cycle change (90 days)?

- First believe that you can make change happen.

- Line of sight accountability. Connect owners to action.

- Remove unnecessary regulation
- Focus on measures that matter to patients and clinicians
- Partnering to work with medicaid, CHIP and the exchanges. Act as a catalyst.

Physician Leadership - what is the role in Quality.

BL: Move the attitude to move the results. Be mindful and systematic.

What does success look like for CMS in 5 years?

The point of the innovation center is to test different models. Don't pre-suppose the answer. 
Fostering delivery systems  that offer high reliability in their change systems.

Move the vast majority of people in to "Systems of care"

How do you spread innovation?

BL: facilitate the conversation.
Reward the innovation

Innovation is also a process. Create innovation access points. - using Innovation Consultants in medical centers to give people an entry point for change.

Evidence-based medicine:
PC: Evidence should inform coverage decisions. 

Cancer Screening approaches:
BL: Screening tests must be deliverable across a mass population. 

Forward sweep - Watch for people on planned visits - what tests are they missing.
Clinical Workflow - Do all tests during appointments.
Back sweep - Look at those that missed testing

How can this group of participants help CMS?

PC: - do more of what is being done - faster!

We need to speed up the pace of change. Engage broad collaborations. 
Collaborate and innovate.
Learn from best practice.

Keep in mind:
"What would you do if you knew you couldn't fail?"\
"What is best for the patient?"

How do we embed better care in the community?

- Move from volume to value reimbursement.
- Workforce redesign

Moving from Sick Care to Well Care

KP has moved from a primary care comprehensive testing (multi-phasic) approach to a connected network of physicians that can address their specialties and ensure that there are no gaps in testing and care. Patients can attend an appointment and have multiple specialist encounters in a single visit.

Move Faster:
Testing models quickly. Does it save money and does it scale. 

The Next Generation of Patients
How do we educate people to establish their electronic health records and sharing their electronic records with researchers.

We need to develop the capability for shared decision making. Making sure their is real engagement.

What is CMS doing to change how Patients are engaged in the policy discussions?
PC: we need more patient engagement in clinical and policy arenas.

The patient needs to be the decision maker. 

KP is putting more emphasis on the voice of the patient.

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