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Lightning Round Sessions 

Lightning Round sessions are dynamic, quick, 15 minute interactive presentations enabling speakers to share key information and engage in discussions on implementation and hands-on learning experiences.

Group 1

Navigating MACRA: From Landlubbers to Sea Dogs

Lauren Patrick

The drive to value-based care is gathered steam from CMS. CMS has concluded that to improve quality of care, reduce costs, and empower patients to be better stewards of their health, the healthcare industry must move from fee-for-service reimbursements that do not account for quality and efficient care. The MACRA Quality Payment Program, including MIPS, creates both a framework and an incentive to healthcare providers for making this transition.
In this presentation, you will hear real-life experiences of providers that have begun MIPS reporting and learn from their lessons. Through an early implementation of the MIPS rules in a CMS Qualified Registry, these providers have begun their reporting process with a MIPS platform. Learn how they have started reporting in the three Performance Categories that are mandated for the 2017 reporting year: Quality, Advancing Care Information, and Improvement Activities.
We’ll provide an overview of reporting and scoring for each of the Performance Categories. Additionally, we will demonstrate how we are integrating opportunities for education and improvement, not only in the MIPS score, but more importantly, in the care of patients and their outcomes.

CE & QI Strategies Result in Sustainable Changes in Clinicians' Behavior in Caring for COPD Patients

Sandra G. Adams, MD, MS

Successfully facilitating changes in clinician behavior may be challenging and often require significant resources. In this session, we will discuss our experience implementing the WipeDiseases Foundation's COPD continuing education programs as well as quality improvement and information technology strategies in primary care clinical practices in the UT Health System in San Antonio, TX. We will demonstrate some of the techniques we utilized to encourage buy-in and participation. We will use clinical vignettes in order to provide strategies for addressing care that is suboptimal and to demonstrate techniques for motivating healthcare professionals to change their clinical practice. Finally, we will discuss strategies that can be implemented to help ensure these positive behavioral changes are sustainable beyond the interventional periods.

Benchmarking Success in Type 2 Diabetes QI: A Lesson for the Future

Sara Miller, MS; Richelle Thompson, EdS

Experts project that 1 billion people around the world will be living with or at high risk for the development of T2DM by 2035.[1] The human and financial costs of this disease are staggering; in 2014 uncontrolled T2DM was responsible for 4.9 million deaths and 612 billion dollars of healthcare expenditure.[1] Data from the Center for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS) suggest a slight decline in new cases of T2DM nationwide in the past few years.[2] However, the scenario is vastly different in the state of Arkansas where the rate of new cases of T2DM has increased sharply in recent years. In addition, patients in Arkansas who have already been diagnosed with type 2 diabetes receive many aspects of guideline-recommended care at rates that are lower than the national average and report poorer overall health. These illustrations of suboptimal care do not appear to be the result of a lack of medical care as 81% of patients report that they have seen a health professional for their disease.[2] The cornerstone of quality diabetes care is glycemic control. Despite demonstrated progress in glucose control among patients seen in clinics within the UAMS Regional Program, in 2015 less than half (42.7%) of patients with T2DM were achieving glycemic targets.[3] Similarly, data from previous UAMS initiatives suggest an opportunity for continued improvement in several markers of comprehensive care for patients with type 2 diabetes, including blood pressure and cholesterol management.[3] 

In this program, we’ll discuss the impact of a quality improvement initiative focused on caring for patients with type 2 diabetes in the community setting on validated measures of quality care including glycemic control, minimization of cardiovascular risk factors, and measures of comprehensive diabetes care. In this session we’ll explore the nuances of data collection and evaluation of clinician attitudes, how we addressed barriers to optimal care, and the impact of continuous measurement/reporting on patient care and outcomes. We will share our success and the not-so-positives in order to set a course for similar projects in the future. This session is designed to inspire others to develop and implement similar QI initiatives, particularly those focused in rural areas where there is likely to mismatch between need and available resources.

References:
1. http://www.idf.org/publications/annual-report. 
2. CDC United States Diabetes Surveillance System. Available at: http://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html# 
3. University of Arkansas Medical Sciences unpublished data. Data on file.

UNC Center for Health Innovation: A Practical Approach to Catalyzing Innovation

Carol Lewis

With healthcare transforming towards a value orientation, hospitals and integrated delivery systems nationally are seeking new approaches to rapidly cultivate and broadly adopt innovation. While many healthcare systems have long-standing quality and performance improvement functions that effectively implement continuous improvement, specialized innovation centers can often catalyze disruptive innovations. These centers come in many shapes and sizes with varying objectives and foci. Established in 2012, the UNC Center for Health Innovation’s (“Center”) mission is to initiate, evaluate, disseminate and support adoption of disruptive innovations in the delivery and financing of healthcare that are patient centered and increase value with improved health outcomes and lower costs. 

The Center’s small central team harnesses the talents of UNC’s large workforce to encourage innovations from germination to adoption, creating a learning environment for clinicians, researchers and administrators alike. Using this leveraged model, with a moderate ongoing investment, the Center has engaged and enabled a large number of employees with varying degrees of experience in innovation and has supported impactful, enduring changes.