The Utility of PPRNet Reports in a Federally Qualified Health Center and Residency Program Kimberly Williams, MD August 22, 2014 Smoky Hill Family Medicine Residency

Outline Setting Requirements for residency Requirements for faculty Requirements for Federally Qualified Community Health Center (FQHC)

Who We Are Salina, KS Rural, community based unopposed family medicine residency Affiliated with University of Kansas School of Medicine-Wichita 6 faculty physicians 12 resident physicians

Who We Are Federal Qualified Community Health Center 4 full time providers (2 NPs, 2PAs, 1 MD) Level 3 NCQA-certified patient-centered medical home Services offered in house – Dental, behavioral medicine, pharmacy, diabetes education, lab, x-ray

Our Patients Patient mix by payer – Self Pay % – Medicaid % – Medicare % – Private Insurance % Spanish Speaking – Self-reported 10%

Residency RRC Requirements – Residents must receive regular reports of individual and practice productivity, financial performance and clinical quality basis, as well as the training need to analyze these reports – Each FMP site must involve all members of the practice in ongoing performance improvement, and must demonstrate use of outcomes in improving clinical quality, patient satisfaction, patient safety and financial performance – Residents should complete two scholarly activities, at least one of which should be a quality improvement project – Residents must complete part IV maintenance of certification prior to sitting for boards

Residency RRC Requirements – Residents must receive regular reports of individual and practice productivity, financial performance and clinical quality basis, as well as the training need to analyze these reports – Each FMP site must involve all members of the practice in ongoing performance improvement, and must demonstrate use of outcomes in improving clinical quality, patient satisfaction, patient safety and financial performance – Residents should complete two scholarly activities, at least one of which should be a quality improvement project – Residents must complete part IV maintenance of certification prior to sitting for boards

Residency Monthly Resident/Faculty Meetings – Choose several metrics each month from reports – Rotate metrics each month – All providers data handed out

Monthly Provider Feedback

Residency RRC Requirements – Residents must receive regular reports of individual and practice productivity, financial performance and clinical quality basis, as well as the training need to analyze these reports – Each FMP site must involve all members of the practice in ongoing performance improvement, and must demonstrate use of outcomes in improving clinical quality, patient satisfaction, patient safety and financial performance – Residents should complete two scholarly activities, at least one of which should be a quality improvement project – Residents must complete part IV maintenance of certification prior to sitting for boards

Residency RRC Requirements – Residents must receive regular reports of individual and practice productivity, financial performance and clinical quality basis, as well as the training need to analyze these reports – Each FMP site must involve all members of the practice in ongoing performance improvement, and must demonstrate use of outcomes in improving clinical quality, patient satisfaction, patient safety and financial performance – Residents should complete two scholarly activities, at least one of which should be a quality improvement project – Residents must complete part IV maintenance of certification prior to sitting for boards

Residency Quality Improvement Projects – One project per PGY class – Teaching, lit review, choice of project – Preventive health for women Pap/Mammo/Dexa – Adult Immunizations Tdap, pneumovax

Residency RRC Faculty Requirements – The faculty must establish and maintain an environment of inquiry and scholarship with an active research component. – Faculty should encourage and support residents in scholarly activities – Two scholarly activities over the course of 5 years

Residency RRC Faculty Requirements – The faculty must establish and maintain an environment of inquiry and scholarship with an active research component. – Faculty should encourage and support residents in scholarly activities – Two scholarly activities over the course of 5 years

Residency QI competition – Improvement in diabetes outcomes – On average improved 8% Working on provider dashboard for tri-annual review

Residency RRC Faculty Requirements – The faculty must establish and maintain an environment of inquiry and scholarship with an active research component. – Faculty should encourage and support residents in scholarly activities – Two scholarly activities over the course of 5 years

FQHC Healthcare Plan – Some measures dictated by federal government Unified Data Set – Choose some measure within a category Pediatric, chronic care – Annual report Denominator is very specific Usually done by chart audits – Track numbers on quarterly basis with PPRNet reports

Clinical Coordinator 16 metrics, deals with 1-2/month Generates patient lists Sends provider message, or contacts patient directly Examples – Ischemic vascular disease and ASA – Pap smears

Summary Residency – Resident Scholarly Activity – Faculty Scholarly Activity – Foster a culture of QI FQHC – Helps us regularly track numbers we report annually Improve patient care