New faculty Orientation New faculty Orientation Peter Zwerner MD FACC

Ambulatory Care Overview o Ambulatory Structure o PATH o Ambulatory Policies o EPIC o Quality Metrics

3

4

Primary Care Carolina Family Care University Internal Medicine Family Practice

Affiliations and Outreach Primary Care West Ashley East Cooper Internal Medicine Park West Allergy & Immunology West Ashley Internal Medicine MUSC Health East Cooper Sewee Family Family Medicine East Cooper Family Medicine James Island Internal Medicine Rutledge Avenue 30 Bee Internal Medicine MUSC Health North Charleston * 16 Locations Dorchester Internal Medicine Flowertown Family Medicine James Island Internal Medicine Kiawah Island Family Medicine Park West Internal Medicine Family Medicine Calhoun Street

Operational Structure

PATH (Patient Access To healthcare)

Clinical Call Triage J. Martines BSN, RN Clinical Call Triage J. Eisnerman, BSN,RN MUSC Health Director Enterprise Access Matthew Long Patient Access Operations Adam Bacik Call Center Operation 6 Call Center Patient Access Supervisors 64 Call Center Patient Access Agents 3.5 Master Schedulers 2 Business Analyst MUSCP COO J. D’Agostino MUSCP CMO P. Zwerner, MD Sr. Manager of Quality Andrea Swartz PATH ORGANIZATIONAL CHART Central 70% Non Central 30%

Children’s Services Internal Medicine Medicine Sub-Specialties Dermatology (Adult & Ped) ENT (Adult & Ped) Urology (Adult & Ped) Family Medicine (Adult & Ped) Storm Eye Institute (Adult & Ped) Women’s Services Orthopedics (Adult & Ped) Pain Management Transplant Hollings Cancer Center Surgery - Located at Cannon Park Place CENTRAL SPACE CENTRAL MANAGEMENT  Neurosciences  Psychiatry DECENTRALIZED SPACE CENTRAL MANAGEMENT  Carolina Family Care  Digestive Diseases Center  Physical /Occupational Therapy  Speech Pathology  East Cooper OB/GYN  Transplant  Sleep Lab/EEG Lab/EMG Lab  *Radiology  *Radiation Oncology  *Dentistry DECENTRALIZED SPACE DECENTRAL MANAGEMENT *Different System Patient Access Center

PATH PROGRESS Performance Standards Operating Agreements Signed agreements between the Department and the Patient Access Center to hold each other mutually accountable; (46 of 48 currently completed) Patient Communication Currently researching new appointment reminder vendors for a more comprehensive reminder strategy to decrease no-shows Changing new patient packets to more effectively communicate with our patients Practice Management Oversight Councils Physician led, multi-disciplinary teams with decision rights to quickly identify and eliminate barriers to the clinical enterprise across all locations New Metrics New PATH Vital Signs are currently being validated Full implementation will be completed by the end of Q2 FY15 Call Center vital signs have been established and score cards will roll out Q3 FY15 Focus on Service Level (80% of calls answered in 30 seconds or less) 11

PATH PROGRESS Policies and Procedures Bump Policy –Drafted and ready for approval No Show Policy –Drafted and ready for approval. Physician Referral Policy – Eliminate medical record review prior to placement on a provider’s schedule, giving priority to internal referrals. Drafted and ready for approval. Outpatient Records must be completed, signed, dated and timed as soon as possible after the service takes place but in no case more than 14 days after the date of service.

Matt Long Cell

Epic Personalization Topics Do you use SmartPhrases to template common documentation? If you use NoteWriter, do you have macros for your ROS and Physical Exam documentation? Do you use filters in Chart Review to find information more quickly? Do you have a personal preference list for your common orders? Do you have personalized follow-up buttons to indicate follow-up more quickly? Do you use QuickActions to more efficiently handle In Basket – Results messages? Do you have a list of your common recipients to send In Basket messages more quickly? Do you have default letter templates to communicate with referring providers more efficiently? Do you have the Epic app called Haiku for your iPhone/Android or the Epic app called Canto for your iPad? Do you know the Epic SuperUser for your specialty? If you’ve answered No to most of these questions, you would benefit from Epic Personalization You can reach the Training Team by contacting Laura Camacho, PhD, at Remember, if you need immediate Epic assistance at any time, you should call the Help Desk at

Epic Personalization Topics Do you use SmartPhrases to template common documentation? If you use NoteWriter, do you have macros for your ROS and Physical Exam documentation? Do you use filters in Chart Review to find information more quickly? Do you have a personal preference list for your common orders? Do you have personalized follow-up buttons to indicate follow-up more quickly? Do you use QuickActions to more efficiently handle In Basket – Results messages? Do you have a list of your common recipients to send In Basket messages more quickly? Do you have default letter templates to communicate with referring providers more efficiently? Do you have the Epic app called Haiku for your iPhone/Android or the Epic app called Canto for your iPad? Do you know the Epic SuperUser for your specialty? If you’ve answered No to most of these questions, you would benefit from Epic Personalization You can reach the Training Team by contacting Laura Camacho, PhD, at Remember, if you need immediate Epic assistance at any time, you should call the Help Desk at

Ambulatory Quality Perf ormance CG-CAHPS: ( Clinician & Group Consumer Assessment of Healthcare Providers and Systems.) survey to measure patient perceptions of care delivered by a provider AVATAR: measures a patient’s expectations, satisfaction and experience Meaningful Use: Medical record maximization The Physician Quality Reporting System (PQRS) incentive payments will begin 2015, to encourage eligible health care professionals (EPs) to report on specific quality measures. VBPM: reports about the quality and costs of care that provided to fee-for-service Medicare patients

Individual Provider Group performance PCP based % -2% (+/-) 2% -6% % -2% (+/-) 2% -7% % -2% (+/-) 2% -8% % -2% (+/-) 2% -9% MU PQRS VBPM Payment at Risk

MUSC Health East Cooper