1. The Value of a Healthcare Community Network Early Implementation Experience Rick MacCornack, Ph.D. Director of Quality Improvement Northwest Physicians Network

3. Northwest Physicians Network (NPN) an Independent Physician Association OXYMORON: Independent Association

4. Background on NPN 10 years old 435 total providers (102 primary care) 248 owners 167 contracted providers 34 specialties Managed care / delegated services Hard but successful road Chronic Care Improvement Collaboratives since 2001 Health Improvement Foundation 2003 Pay for Performance started 2004

5. Entrepreneurial / innovative Organized to achieve common goals Improve health of individual patients and healthcare in their community Demonstrate value Patient centered / physician directed care

6. Importance of NPN’s efforts to connect physicians, patients, hospitals, labs, etc. in our community: 1. Patient centered / physician directed 2. Independent physicians in small practices represent ~80% of physicians in US

7. Local Market Three highly competitive hospital systems currently buying up physicians (again) Electronic moats created by each Most area physicians admit patients to 2 hospital systems Patients use multiple systems (insurance driven) About 60% of the 1,200 physicians in the area are independent

8. E-connectivity important but independents face many barriers  Cost  Support infrastructure Partnership: Siemens, ReachMyDoctor and WorldDoc Co-Sponsorship: NPN with Pierce County Medical Society

10. Elements of The Network Secure communication (administrative and clinical) Provider Provider Patient Provider Clinical data pushed to MD’s PC from creation source (hospital, ER, labs, SNF, etc) Interactive educational content for patients

11. Elements ( continued ) Cuts across electronic silos Develops appetite for EMR Partnership  All parties pay to support the Network  All parties build a reserve to support maintenance over the long term  Governance Physician Advisory Committee  reflects the provider community

12. Basis of a community approach to connectivity Compete on:  coordination of care  desired outcomes of care  service excellence …rather than  institutional market share/control of patient information

13. Implementation Chronology Decision to Implement: July 2004 Co-Sponsor agreement: September 2004 Implementation team formed: September 2004 Pilot team launch: October 28, 2004 Grant writing initiated: December, 2004 Post–pilot Expansion: January 2, 2005 Physician Advisory Council: February 1, 2005

14. Network Activity Since October 28, 2004:  150+ providers have signed up 33 in pilot 120 since January 2 half PCP, half specialty Half NPN members, half non-NPN  17,000+ network communications have been generated  37 patients registered One communicating with her MD from western, rural China

15. Development Challenges 2005-06 System: Hospital system participation Governance Reserves – “There’s no free lunch” Practice: Workflow integration Patient recruitment

16. “Americans always do what is right, but only after trying everything else” -Winston Churchill