1. Jack Millaway and Melody Robinson LPHI
Using Population Health Analytics to Improve UDS Quality Awards
Jack Millaway and Melody Robinson
LPHI

2. Pathway to data-driven population health management
Data Entry
Data Monitoring
Proactive Use

3. Pathway to data-driven population health management
Data Entry
EHR Optimization
Reportable fields
Data Monitoring
Selected measures
Reports
Monitoring frequency
Proactive Use
Registries
Dashboards
Workflows

4. How does QI fit in?
Quality improvement (QI) consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups. 
QI is the driving force of the effort, it defines the focus of the project
Data
Goals
QI Plan
PDSA
Date Review
Data Collection
Measured Improvement
Sustainability
Improvement

5. UDS Quality Awards UDS Quality Awards Why the UDS Quality Awards?
Millions of dollars just in PCCP states has been awarded
Focus areas are Quality, Access to Care, Data Reporting, and cost effectiveness
UDS Quality Awards
Established guidelines and program
Universal across all FQHC’s
Focus on quality goals is translatable outside the FQHC experience
Why the UDS Quality Awards?
Clinic sustainability
Award categories align with Triple Aim and PCCP focus areas
How does this align with PCCP priorities?

6. LPHI TA pilot project
This approach is unique in that it aligns directly with the UDS Incentive Award measures.
Proactive technical assistance focused on UDS improvement
QI incentives can be proactively maximized .
All PCCP participant FQHCs left money on the table in 2015.

7. Analysis of previous UDS Quality Awards report
Components
Analysis of previous UDS Quality Awards report
Select opportunities for improvement that aligned with organization’s priorities
Practice coaching

8. Clinic selection Three clinics selected for pilot
All clinics were primed for optimization
Had analytics software or were in process of procuring
Review of 2014 UDS Quality Awards showed opportunities for improvement

9. Clinic committed to
Engagement from QI leadership and overall clinic leadership
Devote staff time and resources required, including a change team
Implement co-designed interventions
Provide relevant data to LPHI before, during, and after the project
Offer feedback to the LPHI team regarding the experience

10. Panel Ann Papadelias Judy Mitchell Tammy Lee
Escambia Community Clinics
Judy Mitchell
Franklin Primary Health Center
Tammy Lee
Mostellar Medical Center

11. What did you work on with LPHI?
Question 1
What did you work on with LPHI?
Probe: Which measures did you choose to focus on and why?

12. How are you using analytics to improve population health?
Question 2
 How are you using analytics to improve population health?
Probes: How does (or will) analytics software help you operationalize quality improvement?
How important do you believe analytics is to successfully managing population health?

13. How has this process affected your clinical and data workflows?
Question 3
 How has this process affected your clinical and data workflows?

14. Question 4
 What effects have a focus on population health had on your UDS reporting?
Probes: Ease of preparation?
Accuracy of reports? 

15. Question 5
 How have you communicated to staff about your population health activities and outcomes?
Probes: How do you share data? (Format? Frequency?)
How have you addressed staff concerns about data validity?

16. Share an accomplishment related to your population health work.
Question 6
 Share an accomplishment related to your population health work.

17. Share a challenge you encountered in your population health work.
Question 7
Share a challenge you encountered in your population health work.

18. Question 8
 What are your plans to maintain and/or advance population health management?
Probes: Which staff members will be responsible for leading it?
What do you see as the value of population health efforts in the future?
Have you seen, do you anticipate effect on staff satisfaction?

19. Additional questions from the audience?

20. Thank you!