Premier Pulse. Trends in consumer-centric health care. News for Premier Health Physicians. premierhealth.com

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Premier Pulse News for Premier Health Physicians Trends in consumer-centric health care Dan Bailey, DPM, chief medical officer, Upper Valley Medical Center VOLUME 2 ISSUE 5 JUNE 2015 As the health

To achieve our goal, we are working to transform our system into one focused on consumercentric health care, a concept that falls under the experiential pillar of the Premier Blueprint 2017, our

1 Premier Pulse News for Premier Health Physicians Trends in consumer-centric health care Dan Bailey, DPM, chief medical officer, Upper Valley Medical Center VOLUME 2 ISSUE 5 JUNE 2015 As the health care landscape continues to change, Premier Health is focused on transforming the patient experience into one that is unmatched when it comes to patient engagement, quality of care, and outcomes. To achieve our goal, we are working to transform our system into one focused on consumercentric health care, a concept that falls under the experiential pillar of the Premier Blueprint 2017, our strategic plan. We have adopted the following four tenets to put the consumers of health care, our patients and their families, at the core: transform access to care with new and consumer-friendly options become a trusted navigator who guides and coaches patients on their journeys create disease management programs that meet the customer s health care needs extend our community outreach and improve heath in the community. Our industry is no longer driven solely by volumes, but rather by quality of care, which is precipitating rapid change. Consumers of health care are also changing they are now technologically savvier, better-educated about their health conditions, cost-sensitive, and willing to challenge and question their providers. Consumers are raising their expectations when they interact with the health care industry, and rightfully so. They now, more often compare their experiences to those in the retail sector, so we have to adopt that same yard stick. continued on next page. premierhealth.com

2 Physician Profile Rajesh Patel, MD, see patients at Dayton Respiratory Care What is your specialty? Pulmonary, critical care, and sleep. What brought you to Premier Health? When I finished my Fellowship at University of Cincinnati, My wife still had a couple of years to finish her training, and so we were looking to stay in the area to allow her to finish, and I also had family living in Dayton. When I first came to Dayton I established myself at Good Samaritan Hospital which later became part of Premier Health. Why did you choose medicine as a career? In high school I was interested in the sciences, and I was encouraged to pursue medicine. Who are the people who influenced and/or mentored you? My parents were hard working people and well respected in their community. Their values and ethics are what influenced my life, my drive to excel, and my ambition to be the best I can be. How do you describe your bedside manner? Direct and honest even when it s hard to hear, I think patients should hear the whole truth. I have patients who have been a part of my practice for over 20 years with them it is more like an extended family. What is one thing most people don t know about you? I was captain of my medical school cricket team in Mumbai we weren t very good. How do you want to be remembered? As someone who genuinely tried to help maintain the tradition of excellent and innovative care at Good Samaritan Hospital. What is the last book you read? The Fred Factor Mark Sanborn What is your favorite song in your playlist? I m usually listening to Bollywood music. iphone or Android? Android, but I did have a blackberry for quite some time. Early bird or night owl? Early to bed, early to rise, makes a man healthy, wealthy, and wise Beach bum or mountain hiker? Mountain hiker at heart who gives in to the temptation of being a beach bum. Unless there s a golf course. Dress shoes or tennis shoes? Dress shoes. Always. Unless we re golfing. Trends in consumer-centric health care (continued from front) If our patients aren t satisfied, we need to investigate why we aren t measuring up and make modifications accordingly. We need to be honest our patients have options and they will seek, what they view, as the better choice. Patients and their families, who often serve as advocates, are now better-educated, with ready-access to an incredible amount of information; they are taking the time to complete their own Internet research. As care providers, we have to respect that. It can result in more effective conversations between consumers and health care providers, creating more equal relationships between them. Consumers also seek physical spaces that are convenient and efficient, so our new facilities are being designed to meet those needs. Services available at local pharmacies and grocery stores are gaining popularity; hence, Premier s newly-established electronic medical records partnership with CVS. The implementation of electronic medical records systems helps us offer more efficient and affordable care. Use of electronic communication, through applications such as MyChart, increases consumers ability to talk directly with physicians. The gatekeeper has been removed in some cases, making consumers more comfortable with asking what can be rather sensitive questions. We are learning from the individual practices that have taken it upon themselves to collect and analyze patient data. Such research has resulted in more effective treatments and better patient outcomes. Consumer-centric care is an important focus for Premier Health, and we are paying attention to the trends. We are listening to our consumers the people taking the journey through our health care system. They may meet our admissions staff, nurses, physicians, lab technicians, therapists, and many other team members along the way, so it is our responsibility to provide a seamless, successful experience, whenever possible.

Association s Get With The Guidelines for Stroke program. In addition, every program was named to the Target: Stroke Honor Roll, which is a tremendous achievement for the Premier Health system.

3 Premier Stroke Programs Earn Award Premier Health stroke programs recently caught the attention of the American Stroke Association. Each of Premier Health s four stroke programs at Atrium Medical Center, Good Samaritan Hospital, Miami Valley Hospital, and Upper Valley Medical Center earned the Silver Award for the American Stroke Association s Get With The Guidelines for Stroke program. In addition, every program was named to the Target: Stroke Honor Roll, which is a tremendous achievement for the Premier Health system. Stroke strikes 785,000 Americans each year. The Get With The Guidelines for Stroke program is an in-hospital program for improving stroke care by promoting consistent adherence to the latest scientific treatment guidelines. The Get With The Guidelines for Stroke award recognizes commitment and success with implementing a higher standard of stroke care, by ensuring that stroke patients receive treatment according to nationally accepted standards and recommendations. Earning Silver status places Premier Health in an elite group of hospitals recognized by the American Heart Association/American Stroke Association. Each of Premier Health stroke programs individually maintained at least an 85 percent compliance in seven specific measures for the past year. This recognition is tangible evidence of Premier Health s hard work and commitment to saving lives. It is also an important differentiator and a competitive edge for Premier Health, says Jim Pancoast, president & CEO of Premier Health. He adds, Being honored for providing outstanding patient care is the best recognition a hospital system can get. We are proud of our physicians, nurses, and quality improvement professionals for their commitment to care excellence. Since its initiation in 2003, 1,656 hospitals have entered more than two million patient records into the Get With The Guidelines for Stroke database. Numerous published studies demonstrate the program s success in achieving measurable patient outcome improvements. Miami Valley Hospital Joint Commission accredited and first Joint Commission certified Comprehensive Stroke Center in the greater Dayton region Good Samaritan Hospital Dayton Joint Commission accredited and certified Advanced Primary Stroke Center Atrium Medical Center Joint Commission accredited and certified Advanced Primary Stroke Center Upper Valley Medical Center Joint Commission accredited and stroke ready Choose the in Advanced Stroke Care

4 CareFinders Profile Updates Needed It is time to update your areas of practice interest for conditions, procedures, and treatments (CPT) associated with your CareFinders profile. If it hasn t already arrived, to the attention of your practice manager, you will soon receive a CPT survey, via U.S. mail, for you to fill out. For more than a decade, CareFinders has been the area s leading physician referral program. Our service region, as well as the greater community, trusts CareFinders to connect them to the physicians who continue to lead with care. An integral aspect of our service to our physician partners is the maintenance of up-to-date information about your specific area(s) of practice. As such, we are committed to providing you with the annual CPT survey, the completion of which will ensure that we have your current information in our database. The updated information that you provide will replace your existing area(s) of interest, and will populate the web tool that allows consumers to find your online profile, based on a patient s specific condition. It s imperative that you complete the survey, as failure to do so will result in the absence of your area(s) of interest and expertise from the CPT web-based search tool. Please complete the form in its entirety, sign, and return, via your preferred method, to: Celestine Taylor-Davis (937) (fax) ctaylord@premierhealth.com Thank you for taking the time to complete the survey. Paperless OPPE Profiles Go Live Ongoing Professional Practice Evaluation (OPPE) is a standard set by the Joint Commission with an expectation that medical staff leadership will monitor the competency of providers on a continual basis. This provides opportunity to detect performance issues early and also to identify providers that have practice patterns that result in improved patient outcomes. The four Premier Health medical executive committees have given approval for the Clinical Analytics team to roll out a webbased system that will provide you easy access to your individual performance data. Statit will be available for providers to access via the Physician Resources page. Functionality enables you to send messages back to Clinical Analytics if there are questions or data issues. On the Physician Resources page you will see a new icon for the application. You will log into Statit with your Citrix username and password. If you do not remember your username and password, please contact the Help Desk at (937) The Statit OPPE profile is organized into seven categories. The first category looks at Volume and Acuity (Case Mix Index). The remaining six categories are the six core medical staff competencies as defined by The Joint Commission for OPPE. Patient Care Medical and Clinical Knowledge Professionalism Interpersonal and Communication Systems Based Practice Practice Based Learning and Improvement In addition to the OPPE Profile, Clinical Analytics has also created some profiles designed to be used in conjunction with Performance Improvement initiatives for selected specialties. Tip sheets as well as detailed presentations for navigating Statit and understanding the data will be located on the Physician Resource page. Hands-on demonstrations will be scheduled for each facility.

Medicare Inpatient Only Surgical Procedures Annually, Medicare publishes its list of inpatient only procedures on the CMS (Center for Medicare and Medicaid services) web site.

postoperative recovery time, and the general physical condition of Medicare recipients.

5 Medicare Inpatient Only Surgical Procedures Annually, Medicare publishes its list of inpatient only procedures on the CMS (Center for Medicare and Medicaid services) web site. Medicare s stance is these procedures, defined by CPT code, cannot be appropriately performed in an outpatient setting, due to the nature of the procedure, the need for at least 24 hours of postoperative recovery time, and the general physical condition of Medicare recipients. Therefore, these procedures, billed as either outpatient or observation, will result in no reimbursement for the hospital or the surgeon. The majority of the Medicare HMOs also follow the rule. Medicare recipients having one of these surgeries are exempt from the two-midnight rule requirements. There is no length of stay requirement for these surgical admissions. To bill these procedures as an inpatient, Medicare requires the order for inpatient admission be written BEFORE the patient goes to surgery. Upon opening the patient s chart, if it meets the inpatient only procedure criteria, the following Best Practice Advisory displays: Click Accept and the Admission Order populates into Manage Orders. Accept and Sign the order. Notes: When you enter the order through the BPA process, the system automatically designates the order as being related to an inpatient only procedure allowing the physician to bypass the certification statement components of the order. When you enter the order through the BPA process, the order is posted to the specific surgical encounter. The BPA will continue to fire until the inpatient order is entered. Need Epic Inpatient help? Contact the Customer Support Desk at (937) and ask for the Epic Inpatient Medical Staff Trainer on-call.

Orthopedics and Sports Medicine Updates News Our physician and strategic partnerships not only continue to be a mainstay of our service excellence, but comprise two of the primary pillars of the

6 Orthopedics and Sports Medicine Updates News Our physician and strategic partnerships not only continue to be a mainstay of our service excellence, but comprise two of the primary pillars of the Premier Health strategic plan. The Premier Health orthopedics and sports medicine service lines are pleased to offer an update on various efforts throughout the region. Osteoporosis Screening Update Premier Health currently offers osteoporosis screenings at nine locations. As a result of the request from the Premier Health Orthopedic and Sports Medicine Institute (OSMI), program managers were brought together to discuss an opportunity to more closely integrate services to better serve our patients and physicians. Service information was provided to leadership, and will be further developed. Our goal is to integrate the program, where possible, in order to improve the screening process, so that intervention can begin sooner. SSI DVT/PE The OSMI approved the recommendations to standardize specific processes that are designed to reduce surgical site infections, DVTs, and PEs. The recommendations were the result of the orthopedic work team collaborating with other facilities, while researching best practices, which are in the implementation design phase. Those practices will be applied consistently across the Premier Health system, relevant to patients who undergo joint integration. The overarching goal is to move toward having zero surgical site infections, or DVTs/PEs. Quality Improvement The orthopedic scorecard that tracks volume; length of stay; complication rates; 30-day readmission rates; and patient safety indicators, has demonstrated consistent improvement over the past two years. To further integrate and build upon positive momentum, both the orthopedic work team and orthopedic quality team will be brought together to form the orthopedic quality and safety team. An orthopedic surgeon from each Premier Health hospital, who works collaboratively with his/her colleagues, will provide direction and assist with creating priorities for quality improvement. Osteoarthritis Osteoarthritis continues to be one of the major conjuring factors to joint

replacement. Orthopedic surgeons and sports medicine/family practice physicians are conducting joint pain seminars from May through October 2015.

7 replacement. Orthopedic surgeons and sports medicine/family practice physicians are conducting joint pain seminars from May through October The goal behind the seminars is to educate patients about surgical and nonsurgical options that manage joint pain, as well as to answer attendee questions. In order to create awareness about arthritis, Premier Health has once again partnered with the Arthritis Foundation to conduct the seminars. Neurocognitive Testing The physician-led sports medicine design team has been integral in establishing the guidelines for neurocognitive testing for the 44 school partnerships in place throughout Premier Health. Concussion management continues to be of great concern for athletics of all levels, so Premier Health has initiated a program, in conjunction with ImPact, to perform baseline testing for all athletes who fall under our partnership, which means that approximately 20,000 athletes will receive baseline neurocognitive tests that can referenced, in the event that the athlete has a concussion. This important information, available to the treating physician, will ensure that all of our athletes receive the same level of care. The response from our school partners has been positive, and the Premier Health program will be the largest in the Midwest. Managing Patient Status/Class Orders Best Practice Advisories (BPAs) are being implemented for duplicate status orders and for changing a status order. The BPA informs the provider s/he is entering a duplicate order or notifies the provider the status is being changed. To minimize the risks associated with conflicting status orders, i.e. inpatient and observation orders within the same encounter, we have created a BPA which alerts the physician when a status order for either inpatient or observation is already on the patient s current hospital record. This will allow the physician to confirm their intent to change the patient s status from either observation to inpatient, or inpatient to observation. NOTES With any of these BPAs, clicking Accept allows you to proceed with entering the order as usual. Clicking on Cancel will stop the order entry process. The BPA will not fire when the order set includes an option for continue current status. Documentation in the patient s medical record should reflect the medical necessity for the status ordered, i.e. inpatient or observation. Need Epic Inpatient help? Contact the Customer Support Desk at (937) and ask for the Epic Inpatient Medical Staff Trainer on-call. Need help determining whether a patient should be inpatient or observation? Contact the CSI Department at (937)

System-Hospital News Good Samaritan Hospital Good Samaritan Hospital earned the Silver Plus Award and Target Stroke Honor Roll from the American Stroke Association s Get With The Guidelines for

Good Sam maintained at least an 85% compliance in seven specific measures for the past year, placing it in an elite group of hospitals recognized by the American Heart Association/American Stroke

8 System-Hospital News Good Samaritan Hospital Good Samaritan Hospital earned the Silver Plus Award and Target Stroke Honor Roll from the American Stroke Association s Get With The Guidelines for Stroke. Good Sam maintained at least an 85% compliance in seven specific measures for the past year, placing it in an elite group of hospitals recognized by the American Heart Association/American Stroke Association. The award recognizes commitment and success in implementing a higher standard of stroke care by ensuring that stroke patients receive treatment according to nationally accepted standards and recommendations. Good Samaritan Hospital received the VHA Central PEAK Award for Excellence for its ongoing commitment to patient safety and for achievements in reducing early elective deliveries and hospital readmissions as part of the federal CMS Partnership for Patients initiative in Miami Valley Hospital Miami Valley Hospital has been recognized as a top-performing hospital in the Midas+ Platinum Quality Award program. The award is based the hospital s 2014 performance in the Midas+ National Comparative Database for the key areas of utilization efficiency and clinical efficacy measures and severity-adjusted length of stay and mortality outcome measures. The scoring methodology evaluates comparative performance of more than 800 hospitals that participate in the Midas+ CPMS and DataVision solutions. Each area is weighted by a point system, and the total score is based on the total awarded points divided by the total eligible points. Midas+ Solutions selected the top five percent of eligible Midas+ hospital performers in each of the following categories: Average daily census less than 100 Average daily census Average daily census greater than 200 Miami Valley was selected as a top performer in the average daily census >200 winners. New Endoscopy Unit Officially Opens MVH s new endoscopy unit is officially open. To reach the new unit, take the B elevators to the second floor, and turn left. The unit is on the right side, toward the end of the hallway. The telephone number for the unit will remain the same (937) The nearly 10,000-square-foot unit is three times the size of it first floor location. It features five procedure suites, up from three, and offers the latest technology and other features designed to boost patient comfort, healing, and safety. Upper Valley Medical Center UVMC successfully achieved top decile performance in length of stay in April. As of April 18, UVMC s actual length of stay (LOS) was 3.49 (with top decile being 3.58). UVMC was congratulated for being the first hospital in the Premier Health system to hit top decile performance in LOS. Upper Valley Medical Center underwent an Ohio Department of Health survey on April 7 and 8. The survey was successful, with a positive outcome and no citations being issued. UVMC hosted the spring Scientific Sleep Medicine Conference at the hospital on April 23. More than 100 attendees participated in the all-day event, which was sponsored by the Ohio and Kentucky Sleep Societies. Our New Physicians New physicians join the medical staff at each of the Premier Health hospitals. Are you interested in knowing who joined the medical staff at each facility? You can find the lists in the Physician Portal. Atrium Medical Center go to atriummedcenter.org/ournewphysicians Good Samaritan Hospital go to goodsamdayton.org/ournewphysicians Miami Valley Hospital go to miamivalleyhospital.org/ournewphysicians Upper Valley Medical Center go to uvmc.com/ournewphysicians Editorial Board: Dr. Dan Bailey, Dr. Marc Belcastro, Dr. Judy Burichin, Dr. Atindra Chatterji, Dr. Jerry Clark, Dr. Jeffrey Hoffman, Dr. Tammy Lundstrom, Dr. Daniel Schoulties, Dr. Mark Williams Chief Communications Officer: Diane Ewing; Communications Director: Patrick Higgins; Editor: Kara Hitchens P-C-COM51325

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Stay Current. Our new website is easier to use. - Ease Your Back Pain - How to Save Money - Strong Bones for Life SUMMER 2010 Stay Current Our new website is easier to use - Ease Your Back Pain - How to Save Money - Strong Bones for Life one TO one newsletter for medicare advantage members friends fly-fishing near