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Q&A With DeeAnn Broussard & Michelle Story

DeeAnn Michelle Aug 2017As noted in an earlier issue, the Quality Forum partnered with the Louisiana Department of Public Safety and Corrections (DPS&C) in late 2016 to select a certified electronic health record (EHR) system for their headquarters, seven state correctional facilities and more than 30 eligible providers. The two groups are currently working to implement and integrate the EHR system, which is designed to support the DPS&C’s ability to monitor and improve the health and safety of approximately 17,000 incarcerated offenders in their custody. DeeAnn Broussard (Client Executive) and Michelle Story (Project Manager) are among the Quality Forum team members supporting the DPS&C initiative. They recently spoke with me about the project’s scope and challenges.

Q. What role does the Quality Forum team play?
A. Michelle Story: Currently, we have a six-person EHR development team working with the DPS&C representatives and the EHR vendor to identify correctional health functionality that is necessary to pilot the system; identify and resolve operational workflow issues; test the system; and assist with the primary data migration. As we move ahead, the team may include training and production support staff.

Q. How do you support the DPS&C initiative?
A. Michelle Story: My role involves coordination with the EHR vendor to determine the next steps in implementation and to facilitate the collection of inputs and outputs that need to be mapped into the programming and development of the EHR. In addition, I collect workflows from the individual correctional centers. As a project manager, I’m also responsible for identifying and assessing potential risks as well as project planning, control and execution.
A. DeeAnn Broussard: I work closely with all the groups involved – the DPS&C, the Quality Forum and the EHR vendor – to ensure open communication between the team members. Keeping everyone up-to-date and on the same page is critical for a project like this. Likewise, I also manage and coordinate the different meetings, workgroups and site visits so we can remain laser-focused on our objectives and the timeline.

Q. What do you see as the project’s biggest challenge?
A. Michelle Story: I think change itself always presents challenges, and the adoption of new technology in health care is a major change.
A. DeeAnn Broussard: I agree with Michelle regarding the challenge of change. This initiative, when successfully implemented, will make a huge difference in the daily work processes of the DPS&C. By remaining positive and encouraging, we feel the team can, and will, accomplish and overcome any challenges that come our way.

Q. What is it that keeps you engaged and motivated regarding this project?
A. Michelle Story: For me, it’s working with the medical staff. I think their commitment to excellence in providing care to offenders within Louisiana’s correctional facilities is impressive and commendable.
A. DeeAnn Broussard: This project has been, and will continue to be, an incredible learning experience for me. Having the opportunity to understand and appreciate the daily challenges the DPS&C faces from a health care provider perspective is extraordinary. And all the while, the staff remains committed to making this project successful. We have an incredible team, and everyone brings so much knowledge and experience to the table.

Editor’s Note: To learn more about this initiative, please see Cindy Munn’s Quality column in the September/October 2017 issue of Healthcare Journal of Baton Rouge and Healthcare Journal of New Orleans when the publications are posted online in early September. The column features an in-depth interview with Raman Singh, MD, Medical/Mental Health Director for the DPS&C.

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Q&A with Jody Marsh

Jody MarshSince the Quality Forum was established in 2007, the Patient-Centered Medical Home (PCMH) model of care has been a primary focus of the organization. Today, the Quality Forum team supports physicians across the state that are pursuing recognition as medical homes. According to the Patient-Centered Care Collaborative, providers must provide care that is “patient-centered, comprehensive, team-based, coordinated, accessible and focused on quality and safety.” Practice Consultant Jody Marsh has worked closely with different groups since 2012 as they transform primary and specialty care delivery for their patients. She recently shared her thoughts and experiences related to the PCMH model and the road to practice transformation.

Q. What do you see as the key benefits of PCMH recognition for a practice or group?
A. I think one of the main benefits is that becoming a PCMH creates and strengthens personal relationships between providers and their patients. The process itself builds a foundation within the practice for physicians and their staff to provide coordinated, comprehensive and personalized care plans for their patients. In addition, it also prepares the practice to better adapt to a value-based payment system.

Q. What type of services does the Quality Forum offer to help providers with this transformation?
A. Our team provides on- and off-site consulting/coaching for providers and their staff with regard to PCMH standards set by the National Committee on Quality Assurance (NCQA) as well as practice and workflow redesign, project management and education/outreach. It begins with a practice assessment to evaluate current processes and capabilities. Once the assessment is complete, we work with the office manager to implement necessary policies and procedures. Then, we assist with training the staff to incorporate medical home procedures into their daily operations and ensure that the documentation meets evidence-based standards for preventive, acute and chronic care management. Proper documentation is important because it is sent to NCQA for approval of recognition.

Q. What role does health information technology (IT) play in the PCMH model of care?
A. We have found that a practice’s health IT infrastructure plays a major role in the PCMH transformation process. Some electronic health record (EHR) systems are limited in reporting capabilities, and the practice may not be able to provide every detail on a report requested by NCQA to prove compliance. Because of the Quality Forum’s experience in helping providers implement and meaningfully use EHRs and administering Louisiana’s health information exchange – LaHIE – we can optimize a practice’s EHR utilization and HIE integration.

Q. What do you see as the biggest challenges that practices/groups face when pursuing PCMH recognition?
A. One of the major barriers is that our current health care environment still utilizes a fee-for-service payment model. Physicians and group practices are seeing as many patients as they can in a day, but they aren’t being properly reimbursed for taking the extra time to provide meaningful quality care and to document that care. As we move closer to a value-based payment system, I am hopeful that more and more small practices will turn to practice transformation. Other factors that may pose challenges include staff and patient engagement. The key to successfully working within these two areas lies in empowering the health care team and patients so they better understand the rationale for the coordinated services, the evidence-based care and increased access to the clinical staff.

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MACRA | A Brave, New World

Linda MorganLinda Morgan
Marketing/Communications Director
Louisiana Health Care Quality Forum

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) launched Jan. 1, 2017, and ushered in a “brave, new world” for health care stakeholders. Along with providers, payers and patients, purchasers/employers will also be impacted. By providing health insurance to employees, employers may experience increased productivity, reduced absenteeism and reduced costs related to workers’ compensation, in addition to enhanced employee recruitment/retention. Healthy workplaces can, in turn, play a key role in promoting healthy communities.

I asked Cheryl Tolbert, president and CEO of the Louisiana Business Group on Health, for her thoughts about MACRA and how these changes will affect employers.

Cheryl Tolbert, CHRS
President & CEO | Louisiana Business Group on Health

Do you believe that employers are knowledgeable about MACRA and ready for implementation?
Louisiana employers are very sophisticated when it comes to benefits, and this was especially evident with the implementation of the Affordable Care Act. Our employers are also very knowledgeable about MACRA. Generally, as Medicare makes changes, those changes also impact employer-sponsored plans. To ready themselves for implementation, the health plans will manage the process, therefore, employers should talk to their health plan/third party administrator.

How will the implementation of MACRA impact employers in the short-term? Long-term?
New payment models that reward value rather than volume not only help to increase efficiency, they also help improve the delivery of care. Some examples include greater care coordination, increased shared care planning and partnerships with patients at all levels of care as well as with patient experience of care.

For employers, what are the biggest challenges associated with MACRA?
In my opinion, there are several key challenges:

  • In general, employers will need to work with health care providers to gain enough leverage to influence the process.
  • The measures need to reflect private employers because measurement alignment puts all parties moving in the same direction.
  • It will be important to share feedback on metrics that employers feel are priorities with plans, brokers and providers.
  • Transparency will be vital for employees to be effective health care purchasers. As a result, information needs to be made available quickly. This will help encourage consumerism.

How do you see MACRA reshaping the health care landscape?
First, I think MACRA will help foster employer partnerships and collaboration that will in turn, support the move to value-based care. Similarly, it will drive more providers to value-based payment programs. In addition, I think it will encourage Increased benefits literacy and consumerism among employees while educating them on how to use the health care system. Finally, I believe new and creative employee engagement strategies will emerge to help employees take ownership of their health.

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A Life Lesson from Mike the Tiger

We are all saddened by the news that LSU’s live tiger mascot, Mike VI, passed away on Oct. 11 after a long battle with cancer. His illness also allows us to discuss the kind of care we might like to receive if we had to face our own serious advanced illness.

While many people think that it is very important to talk with physicians and family about the subject, few people actually do so and even fewer people write anything down. We should all consider and write down who we want to make decisions for us in the event that we can’t speak for ourselves (health care power of attorney) and what kind of decisions we would like the person to make on our behalf (living will/advance directive).

Mike VI couldn’t share his health care wishes with us, but I can only imagine that he wanted to be free of pain and other symptoms like nausea, shortness of breath, fatigue, insomnia, constipation and anxiety. We have excellent medications available to treat humans with these symptoms! He probably also would’ve liked to eat whatever he wanted to eat in whatever quantity he wanted – a few bites or a whole slab of meat. At some point, eating and drinking probably were of little or no interest to him. I also presume he would’ve preferred to be surrounded by his fans, but as his illness progressed, he may have become more reclusive and less interested in the world around him.

Appropriate end-of-life care is provided to humans by organizations known as hospices, and the care is provided in the patient’s home, or wherever the patient may live. The goal for any patient is to “live well until he/she dies.” Mike VI entered hospice care for a short time so that his caretakers could make sure he lived well and didn’t suffer. Rest in peace, Mike the Tiger – you’ve taught us a wonderful lesson.

Susan Nelson, MD
Hospice and Palliative Medicine Physician
LaPOST Coalition Chair

For more information about advance care planning, please visit

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Expanding the Value of Health IT

By Cindy Munn, CEO, Louisiana Health Care Quality Forum

For the last several years, the Louisiana Health Care Quality Forum has proudly partnered in National Health IT Week, Sept. 26-30, a weeklong, partner-driven effort to increase awareness about the value of health IT.

As an organization that has worked with more than 2,000 health care providers across the state in the transition to electronic health records (EHRs) and manages the statewide health information exchange (HIE), National Health IT Week provides us with an opportunity to educate others about the benefits of health IT.

These benefits speak for themselves, but there’s so much more that we can do – both as health care professionals and health care consumers – to drive health IT awareness. National Health IT Week is the perfect opportunity to do just that. Here are a few suggestions:

  • Visit our special website for patient engagement resources and information.

  • Are you a student? Take part in the NHIT Week Inaugural Student Challenge. HIMSS is challenging students from health policy, informatics, public policy, computer science, public health and related academic programs to develop and implement health IT advocacy issues in their state or region. (How great would it be if students at Louisiana’s wonderful colleges and universities took the lead on this?) The grand prizewinner will receive a travel stipend of $1,000 and free registration to the 2017 HIMSS Annual Conference and Exhibition, which is kind of like winning a free ticket to the Super Bowl.

  • Participate in a National Health IT Week event. From webinars and workshops to symposiums and events, there is a virtual smorgasbord of opportunities to get involved in health IT.

  • Share your story about health IT. The personal stories of health care professionals and patients can make a tremendous impact on policy related to health IT. By sharing your story, you can help promote the value of health IT to decision-makers across the country.

Regardless of how you choose to get involved, whether it’s attending an event or taking advantage of an opportunity to learn more about health IT through a webinar, we hope that you will take action. Health care is something that affects all of us, and together, we can make it better through health IT.

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    Louisiana Health Care Quality Forum

    8550 United Plaza Blvd., Ste. 301
    Baton Rouge, Louisiana 70809
    Ph (225) 334-9299 | Fax 225-334-9847

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