May Journal Club Webinar – Sitapati: Retention in Patient Centered Medical Homes
WEBINAR POLLING RESULTS
WEBINAR CHAT TRANSCRIPT
National Quality Center NQC: Hello friends! Welcome to the May Meet the Author Journal Club presentation
Terri Moncus: (15:06) We recently had our JCAHO visit and expect to be recognized as a PCMH soon
National Quality Center NQC 3: (15:17) Ask questions or share your agency experience with using Registries
Terri Moncus: (15:19) we are currently using MYSIS which shows "preventive health measures". We use this as reminders for when certain tests, etc are due, such as RPR,Lipid panel. We designed what we wanted to populate in the PHM depending on what diagnosis is entered. This has been very helpful for us.
Amy Heine: (15:22) database is used as registry for CQI and tracking lost to f/u patients but not integrated currently into medical record.
Katie Omohundro: (15:23) We use reports from CAREWare and eClinicalWorks to get the data we are looking for (i.e. visit w/ provider in the last X amount of months). Unfortunately, this does not attach to a patient, rather, we'd have to look at the report to see if a specific patient is a "hit" on the report. I've never heard of it referred to as a registry. Having this information come up when we open a patient's record would be great!
Paul A. Moore: (15:25) We don't have a clinic but we use the Florida ADAP Database to alert us to clients missing certifications or medication pick-ups and refer them to our treatment adherence program (PROACT).
Helena Tsotsis: (15:37) Are the reports you showed custom to your version of Epic's EMR or standard? If custom, how long does it take for you to get a report ready?
Terri Moncus: (15:38) Since going from PPD screening to QuaniFERON screening we went from <40% screened for LTBI to 99% screened. Credit must go to the nursing staff who recognizes that this test is needed and ensures that it is ordered. just thought I would throw that out there for anyone who is considering changing.
Katie Omohundro: (15:42) Yes, that test has helped us as well. Getting people to come back to have their PPD test read was difficult.
Lindi Kim: (15:42) How much do you pay for Quantiferon screening? Do most insurance companies cover? I just inquired with our local lab and they said it would be over $200 each. We would like to do TB testing via quantiferon, but it doesn't seem feasible when a ppd skin test is $5.
Terri Moncus: (15:43) Our CHC has it's own lab, we were able to purchase the equipment and our lab runs the test
Lindi Kim: (15:43) How much was the equipment? Ballpark?
Terri Moncus: (15:44) don't know for sure Lindi, but if you want to email me, I will try to find out for you from our lab director -
Lindi Kim: (15:44) Thank you. I'll send you an email
Rachel McLaughlin: (15:46) What Whitman-Walker did to bring the price down for quantiferon was determine the average reimbursement rate from the insurance companies for a quantiferon test. Then, we determined the average annual loss from our uninsured patients, and used the average payment rate to bargain down the price of a quantiferon lab for our uninsured patients to the average reimbursed rate in order to lessen our annual loss.
Terri Moncus: (15:48) Rachel, since going to Q-TB has your number of LTBI cases increased? Ours certainly has. Found 50+ the first year
Rachel McLaughlin: (15:50) Yes! We went from 26% to 73%!
Abigail Viall: (15:51) I'm curious--for people that have worked to reach out to patients that have fallen out of care, have you received assistance from (or even sought such assistance from) your local or state health departments?
Greta Immermann: (15:54) I just requested from our state PNAP staff assistance with locating those who have fallen out of care -- she agreed to try & we'll be meeting & I'll be providing her with some basic patient identifying information for those we would like to see again. More to come . . .
Amy Heine: (15:54) As changes are needed for new initiatives or measures does the hospital provide IT support for these changes?
Katie Omohundro: (15:54) We are looking to hire someone specifically to work on retention with patients. For those that have staff in this type of position, what does that look like (i.e. do they do home visits, call to remind patients, etc?)? I am curious what their day-to-day duties are.
Abigail Viall: (15:55) Thanks Greta. Here at CDC, we've been actively thinking about health departments can work with and support patient-centered medical homes for PLWH. Anyone else have any thoughts/experiences they could share around such collaborations?
Rachel McLaughlin: (15:55) In DC, the DOH did provide some assistance about 2 years ago through a project known as a "recapture blitz." CHCs sent in lists of patients who were lost to care and they aggregated the data and sent it back to the CHCs with information about whether or not the patients had received service in another agency. We found it very helpful in giving us a patient list to target.
Theresa Rubin: (15:56) Our Bridge counselors start with phone calls, move to mail and then will make home visits.
National Quality Center NQC 2: (16:02) Once we receive a job description template, it should be posted on the Resources page of our website, under the folder ‘Local Quality Champions’
Amy Heine: (16:04) use of text, email and social media in the future for reaching patients lost to care
WEBINAR EVALUATION RESULTS
WEBINAR PARTICIPANTS (those that self-identified)
Clara Ramos: clararamos
Amy Sitapati:Owen Clinic, UCSD
Theresa Rubin: NC Part B program
BJ Boshard: BJ Boshard, University of Missouri
Jamelia Beckford: Jamelia Beckford, Southwest Community Health Center, Bridgeport CT
Jocelyn Loren: LA GLC
Debbie Konkle-Parker: University of Mississippi Medical Center, Jackson, MS
LaVonda Johnson: Sandhills Medical Foundation, Sumter, SC
Tannasia Gonzalez: Center for Comprehensive Care of St. Luke's-Roosevelt Hospital Center in New York, NY
Militza: Owen Clinic-University of California, San Diego Medical CenterHealth Communication Specialist
Terri Moncus: Rural Clinic, Care Coordinator, Albany, GA
LaVonda Johnson: HIV Part C program director
Mike Young: Michael Young - Stockton CA, CMC Case Manager/Aurora Correljo/ benefits Counselor
Andy: Data Specialist with RW Part B provider, University of AZ in Tucson, AZ
Rich: Consumer & Community Relations Manager, AIDS Care, Rochester, NY
Alyssa Simpson: Primary Health Care, Des Moines, IA, Ryan White HIV Program
Jaime Martinez: Program Director for the Adolescent Medicine Program at the CORE Center / Stroger Hospital.
Katie Omohundro: Matthew 25 Henderson, Kentucky; social worker and quality leader
Casey Smith: AIDS Project of Central Iowa, Des Moines
Kaytriona Lewis: Chicago,IL-Erie Family Health; Intern
Greta Immermann: United Health Services Binghamton, NY I'm the HIV Program Coordinator
Rose Farnan: ID Program Manager, Truman Medical Center, Kansas City, MO
Frank Sullivan: People's CHC Baltimore MD
Marianne Wetherill, MPH, RD/LD: Director of Support Services, Tulsa CARES, an ASO in Oklahoma
CourtneyMcCrellias: Siouxland Community Health Center, Sioux City, IA, Case Manager and HIV+ Prevention
Loraine Sanders: CQI Nurse Sandhills Medical Foundation, Sumter SC
Darla Peterson: Siouxland Community Health Center HIV Program Manager Sioux City Iowa
Helena Tsotsis: University of Wisconsin -Madison HIV Care Program, Database administrator, quality team member
Barbara Szelag: Data Quality Manager, Florida Family AIDS Network, USF, Tampa
niko: Nicholas Welch, Evaluation Manager AETC NCHCMC
Aaron O’’Brien: from Roper St Francis healthcare in beautiful Charleston South Carolina!
Crimilda Rivera: Boriken Neighborhood Health Center, New York, NY. I am the HIV Case manager.
Mary Caffery: UCSD Mother Child & Adolescent HIV Program
Patricia Lev: Director of CQI and CM, Elgin IL
Garrett Boardman: Siouxland Community Health Center, Sioux City IA Case Manager, Housing, Outreach worker
ObiCheretakis: RN Brockton MA
Benjamin Harris: Quality Improvement Analyst
Detra Purcell: Program Consultant for the NC Communicable Disease Branch
Amy Heine: University of N. Carolina- Chapel Hill
Mariana Lozoya: UCSD Mother Child & Adolescent HIV Program,Part D Peer Navigator
tom panzella: Physician assistant HEAT Program SUNY Downstate
Rachel McLaughlin: Whitman-Walker QI Dept. Washington, DC!
Carla Brown: RW Part C Mississippi, RW Part A Memphis, TN
Lindi Kim: Waikiki Health Center, RW Part C. Registered Dietitian and HIV Program Manager
Dana Gray: The Rural Clinic, RW Part C
Warren Lakhan: RW Part A - Orlando EMA
Bonnie Long: Program Coordinator, Rural Clinic, RW Part C Albany, GA
heather sell: peoples community health centers Baltimore, md