Health Information Technology: An Invaluable Tool for Managing Chronic Diseases

Partnership to Fight Chronic Disease Kori Krueger MD, FAAP Marshfield Clinic November 15, 2011

Formed 1916 Physician led 501(c)3 783 physicians in 86 specialties 6,450 employees 56 regional sites 374,468 unique patients/year 76K Medicare, 58K Medicaid 3,767,300 patient encounters/yr Over $1 billion in annual revenue Security Health Plan (170,000 Member HMO) Division of Laboratory Medicine Education Foundation Research Foundation Family Health Center FQHC (76K patients, 443K encounters annually) Seven Dental Clinics in underserved areas An Academic Campus of UW School of Medicine and Public Health

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MISSION
The mission of Marshfield Clinic is to serve patients through accessible, high quality health care, research and education.

VISION
Marshfield Clinic will be the preferred system of cost-effective, evidence-based, quality health care. Through research, education and standardization of quality, we will reduce the burden of disease, disability and the cost for our patients and communities.

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Marshfield Clinic is providing value in care for patients, purchasers, and providers -

Value

Quality

Safety Satisfaction Cost

There is a continuing need to work WITH patients to provide safe, quality care that is satisfying to patients while controlling costs in an effort to maximize value in the marketplace for all stakeholders.

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Chronic Disease Management

More than 75% of Medicare spending occurs in

patients with 4 or more chronic diseases. (CB0)

25% of Medicare beneficiaries consume 85% of the

Medicare expenditures. (CBO)

10% of the US population consumes 65% of all health

care spending. (CMWF Health Affairs 2007)

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CMS Physician Group Practice Demonstration Project

Success of Marshfield Clinic in improving

quality while reducing cost Highlights the importance of the EMR in managing chronic disease in populations EMR allows for the rapid and efficient collection of data for feedback Sets the stage for movement toward new models of care delivery such as ACOs

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Value in Chronic Disease Management: Use of the EMR

Goal: Use the EMR to improve the value of care for patients, the care team, and payers Improve quality of care Improve availability of information for clinical decision support and shared decision making Improve feedback to and communication within the care team and Patient Centered Medical Home (34 NCQA level III sites) Improve accessibility of health information for the patient and care team (patient portals, visit summaries, HIEs) Reduce costs (goal to reduce or eliminate unnecessary and redundant medical care) Reduce or eliminate error in the healthcare experience

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Current vitals
Prevention

Services
Chronic Disease

Service Reminders

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Active Problems
Test Results Allergies Medications

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Upcoming Appts

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Directions to Portal

Place for Notes

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Feedback Dashboards Population based Patient Lists By Condition

Physician practice

Education Guidelines ICSI

Computer based CME

Patient Care External influences Public Reporting

Health Care Reform Payer Requirements

Applications Point of Care Patient Dashboard

PreServ

Planned Visits
iList

New Models of Care Patient Centered Medical Home

Care Coordination Accountable Care Organizations

Better Value
Improved Patient Outcomes Decreased Costs

Patients Entering the Care System

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Summary

EMR can assist in the management of chronic

disease
Collect and track quality metrics
Provide Point-of-care support to the care team Promotes communication between care team members Enables data collection for feedback to the care team Enables patients to have access to EMR (portal)

Real-time care plan availability

Reduces redundancy in care leading to reduced costs

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