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Let's hear from the providers - 7th RISE Summit, Nashville, TN 11MAR13

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Presentation given at the 7th RISE Summit at the Hilton Nashville, 11MAR13 - panel discussion entitled, "Let's hear from the providers"

Presentation given at the 7th RISE Summit at the Hilton Nashville, 11MAR13 - panel discussion entitled, "Let's hear from the providers"

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  • 1. THRASYS Let’s hear from the Providers! Wayne Pan, MD, MBA Chief Medical Officer Thrasys, Inc.7th Annual RISE Summit • Nashville, TN • March 11, 2013
  • 2. 5 myths about physicians
  • 3. or walk a mile in a physician’s shoes
  • 4. How can you realistically change practicepatterns?Risk-sharing practices exploredWhich P4P programs actually work?What can plans do to ensure good physiciandocumentation practices?How can plans and practices effectivelyengage providers?
  • 5. take-aways
  • 6. THIS IS ABOUT BEHAVIORAL CHANGESHOW ME THE DATATRY SOMETHING DIFFERENT, REALLY
  • 7. why?
  • 8. doing the samething over and over andexpecting different results is insanity
  • 9. change
  • 10. MYTH YOU CAN CHANGE A PHYSICIAN’S PRACTICE #1
  • 11. BUT THAT DOESN’T MEAN PHYSICIANSWON’T CHANGE THEIR PRACTICE
  • 12. FROM WITHIN, CHANGE MUST COME
  • 13. motivation1.0
  • 14. motivation2.0
  • 15. motivation3.0
  • 16. MOTIVATIONLearning & Challenging Incentives & Punishment intrinsic extrinsic
  • 17. MOTIVATIONLearning & Challenging Incentives & Punishment intrinsic extrinsic
  • 18. MOTIVATIONLearning & Challenging Incentives & Punishment intrinsic extrinsic
  • 19. MOTIVATION VLearning & Challenging Incentives & Punishment intrinsic extrinsic
  • 20. VLearning & Challenging Incentives & Punishment intrinsic extrinsic
  • 21. reframe
  • 22. how?
  • 23. rethink your assumptionsthat physicians don’t careabout quality
  • 24. rethink your assumptionsthat physicians don’t careabout quality give us all of the data work with us to help us analyze it do this in small groups stand back and watch what happens
  • 25. take advantage ofwhere physicianscome from
  • 26. take advantage ofwhere physicianscome from we are high achievers we are competitive we recognize patterns we use data to solve problems we always want what’s best for the patient
  • 27. use bj fogg’sbehavioral designmethodology
  • 28. “changingbehaviorleads tochangedattitudes”BJ Fogg, PhDDirector, Persuasive Technology LabStanford University
  • 29. this is not aphysicianbehavioral changeproblem
  • 30. this is ahumanbehavioral changeproblem
  • 31. risk
  • 32. MYTH PHYSICIANS DON’T KNOW HOW TO MANAGE RISK #2
  • 33. no one was bornknowing how tomanage riskit’s a skill that youhave to learnjust like riding a bike
  • 34. why?
  • 35. in the hands of a group of trained providers, healthcareresources are best managed at the provider level, if the incentives are properly aligned
  • 36. how?
  • 37. shared savingsbundled paymentACOpartial capitationfull risk
  • 38. performance
  • 39. MYTH PHYSICIANS WILL RESPOND TO P4P BONUSES #3
  • 40. don’t worry, it’s just a horse that’s playing dead. really.
  • 41. why don’t P4P programs work?
  • 42. why don’t P4P programs work? it’s not about the money OK, it is about the money it has to involve my entire practice
  • 43. documentation
  • 44. MYTH MY OFFICE NOTES ARE FOR HELPING YOU #4 WITH YOUR BLAH BLAH BLAH
  • 45. lay enthusiasts have have imbued routineoffice notes with more value than theyactually haveClement McDonald, MDDirector, Lister Hill National Center for Biomedical CommunicationsNational Library of Medicine
  • 46. CMS began making Medicare EHRincentive payments in May 2011 and, asof September 2012, had paid about$4 billion to 82,535 professionals and1,474 hospitalsDaniel LevinsonNovember 2012 report, “Early assessment finds that CMS faces obstacles inoverseeing the Medicare EHR incentive program”Office of the Inspector General
  • 47. CMS anticipates spending an estimated$6.6 billion in incentive paymentsbetween 2011 and 2016Daniel LevinsonNovember 2012 report, “Early assessment finds that CMS faces obstacles inoverseeing the Medicare EHR incentive program”Office of the Inspector General
  • 48. so what did we get for our $6.6 billion?
  • 49. we converted our paper siloes to electronic siloes
  • 50. Patient
  • 51.  has
  • 52.  a
  • 53.  history
  • 54.  ofno
  • 55.  one
  • 56.  payingattention
  • 57.  to
  • 58.  herhistory.See
  • 59.  EMRfor
  • 60.  details...
  • 61. what’s the solution?
  • 62. what’s the solution? have a system that identifies new HCCs use NPs for documentation EHRs may be helpful but they have to be interoperable
  • 63. the real solution is to rethink medical education to teach core behaviors, not core knowledge to be thorough, accountable, reliable, 100% Larry Weed, MD Father of the Problem-Oriented Medical Record
  • 64. engage
  • 65. MYTH YOU CAN ENGAGE PHYSICIANS WITH JUST THE #5 RIGHT PROGRAM AND BONUS MONEY
  • 66. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  • 67. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  • 68. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  • 69. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  • 70. 1drawtheBIGpicture
  • 71. 2showmetheDATA
  • 72. gowiththeFLOW3
  • 73. make the new way of doing things,feel just like the old way of doing thingsto get faster adoption, quicker resultsbehavior change that will lead to achange in attitude
  • 74. to build trust
  • 75. to act as teammates
  • 76. toincludethepatient
  • 77. patientascostdriver
  • 78. it’snotjustaboutdata
  • 79. it’salsoaboutwhomyour DATAservingdata to
  • 80. savvyconsumers
  • 81. not current error prone MPASTEEno comparator
  • 82. unadulterated
  • 83. nonjudgemental
  • 84. There are noshortcuts toanywhereworth goingPublilis Syrus
  • 85. culturalrevolution
  • 86. THIS IS ABOUTBEHAVIORALCHANGESHOW ME THE DATATRY SOMETHING DIFFERENT
  • 87. YES WE CAN!WAR PRODUCTION CO-ORDINATING COMMITTEE
  • 88. qa
  • 89. THRASYS thankyou contactinfo wayne.pan@thrasys.com @waynepan linkedin.com/in/waynepan slideshare.net/bonedoc97