Feature: Colorado HIE leader dishes on White House meeting, future plans
 |
| Gregory C. Reicks, DO |
After working on quality improvement activities for several years, as well as the local HIE, Reicks said he realized that a Beacon grant could serve as "the perfect opportunity" to take efforts to the next level and expand to surrounding communities. His community was one of 17 selected to receive a Beacon grant back in 2009. Several Beacon community leaders headed to Washington, D.C., to discuss their experience and share successes.
The Town Hall meeting served to “recognize individuals in communities who had been very active in leading health IT deployment and practice transformation,” said Reicks. Attendees from Beacon communities met with officials from the Office of the National Coordinator for Health IT (ONC). The following day, the group had a roundtable discussion, moderated by ONC head Farzard Mostashari, MD, at the White House. Each attendee had an opportunity to discuss what was happening in their community regarding health IT or make a request of the ONC regarding federal funding.
For his part, Reicks said that one of the primary goals of the Colorado Beacon has been engaging patients and getting them more involved in their own healthcare. He cited a patient who is a longstanding, poorly controlled diabetic with a few complications. Using a new tool that considers numerous factors, including blood pressure, weight, age, gender, family history and cholesterol level, Reicks showed the patient his future risk of further complications. The tool also helped Reicks show the patient how much his future risk could be reduced if he got his blood sugar under better control. That served as a real eye-opener, said Reicks, and the patient agreed to try a new medication. The new treatment is costly, but “based upon what I showed him, the cost was worth the benefit.” Now the patient’s blood sugar is under much better control, and he is more engaged in trying to stay healthy. “I attribute that to the technology available right in my office.”
The benefits of being a Beacon community have been twofold, Reicks said. One benefit is getting a better handle on available technology and using it to its highest potential. “Prior to Beacon, we weren’t really using our population health management tool as effectively as we could have." The Beacon commitment, including the required reporting, forced Reicks and his practice to use tools more proactively.
The second benefit is access to more resources, including the opportunity to have coaches work with the practice staff on a regular basis on practice transformation. The coaches have introduced different strategies for problem-solving and the practice has used Beacon’s Play, Do, Study, Act (PDSA) method to make several rapid-cycle improvements. “Having those resources has been a much more effective way to make changes and make those changes stick.”
Regression to the old ways of doing things must be fought daily, Reicks said. “We continue to remind ourselves when we identify an issue that we’re really taking a different approach to solving it.” That includes examining the process and using flowcharts, process maps and PDSA cycles on a small population and evaluating the effect.
The focus on population health management combined with the extensive quality measure reporting required as part of the Beacon program means Reicks’ practice is using registry tools to proactively identify patients with certain chronic conditions. “Before those patients come in for a visit, we have a plan.” Part of the plan, and another Beacon project, is motivational interviewing. Practitioners have learned motivational interviewing strategies which they then use to evaluate patients’ readiness to make lifestyle changes. “Everyone is a little different and just being able to identify that readiness has been helpful. We can get those folks that seem ready the right resources.
As the Beacon communities near the end of their three-year grants, Reicks said he is continually looking at other grant opportunities “to continue what we’ve been doing and maybe go beyond.” In fact, Colorado recently was awarded a Comprehensive Primary Care Initiative grant, a four-year program in which the Centers for Medicare & Medicaid Services (CMS) will pay primary care practices a care management fee to support enhanced, coordinated services.
Other future plans include having the majority of primary care practices in his region become meaningful users of health IT and deploying additional resources through those communities, such as patient activation tools. Reicks also plans to measure outcomes “to see if we’re having the impact we hope we’re having with some of the disease we hope to get our hands around and hospitalizations, complications and reduction of heart attack and stroke.”
One of the most helpful aspects of the Beacon project, Reicks said, is that “it’s given us the opportunity to get together with other practices within and outside the community to learn from each other.” Part of the Colorado Beacon project was a series of learning collaboratives. “That is a huge benefit, particularly with technology, learning what the struggles have been for other folks.”
Considering the sometimes intense competition among practices, Reicks said the outlook now is that practices want to do better and continue to keep up with their peers. “We’re all comparing our data with each other and that’s motivating also. We all want to continue to improve.”
Beth Walsh,
Editor
Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.