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"

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

  1. 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. 2. 5 myths about physicians
  3. 3. or walk a mile in a physician’s shoes
  4. 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. 5. take-aways
  6. 6. THIS IS ABOUT BEHAVIORAL CHANGESHOW ME THE DATATRY SOMETHING DIFFERENT, REALLY
  7. 7. why?
  8. 8. doing the samething over and over andexpecting different results is insanity
  9. 9. change
  10. 10. MYTH YOU CAN CHANGE A PHYSICIAN’S PRACTICE #1
  11. 11. BUT THAT DOESN’T MEAN PHYSICIANSWON’T CHANGE THEIR PRACTICE
  12. 12. FROM WITHIN, CHANGE MUST COME
  13. 13. motivation1.0
  14. 14. motivation2.0
  15. 15. motivation3.0
  16. 16. MOTIVATIONLearning & Challenging Incentives & Punishment intrinsic extrinsic
  17. 17. MOTIVATIONLearning & Challenging Incentives & Punishment intrinsic extrinsic
  18. 18. MOTIVATIONLearning & Challenging Incentives & Punishment intrinsic extrinsic
  19. 19. MOTIVATION VLearning & Challenging Incentives & Punishment intrinsic extrinsic
  20. 20. VLearning & Challenging Incentives & Punishment intrinsic extrinsic
  21. 21. reframe
  22. 22. how?
  23. 23. rethink your assumptionsthat physicians don’t careabout quality
  24. 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. 25. take advantage ofwhere physicianscome from
  26. 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. 27. use bj fogg’sbehavioral designmethodology
  28. 28. “changingbehaviorleads tochangedattitudes”BJ Fogg, PhDDirector, Persuasive Technology LabStanford University
  29. 29. this is not aphysicianbehavioral changeproblem
  30. 30. this is ahumanbehavioral changeproblem
  31. 31. risk
  32. 32. MYTH PHYSICIANS DON’T KNOW HOW TO MANAGE RISK #2
  33. 33. no one was bornknowing how tomanage riskit’s a skill that youhave to learnjust like riding a bike
  34. 34. why?
  35. 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. 36. how?
  37. 37. shared savingsbundled paymentACOpartial capitationfull risk
  38. 38. performance
  39. 39. MYTH PHYSICIANS WILL RESPOND TO P4P BONUSES #3
  40. 40. don’t worry, it’s just a horse that’s playing dead. really.
  41. 41. why don’t P4P programs work?
  42. 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. 43. documentation
  44. 44. MYTH MY OFFICE NOTES ARE FOR HELPING YOU #4 WITH YOUR BLAH BLAH BLAH
  45. 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. 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. 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. 48. so what did we get for our $6.6 billion?
  49. 49. we converted our paper siloes to electronic siloes
  50. 50. Patient
  51. 51.  has
  52. 52.  a
  53. 53.  history
  54. 54.  ofno
  55. 55.  one
  56. 56.  payingattention
  57. 57.  to
  58. 58.  herhistory.See
  59. 59.  EMRfor
  60. 60.  details...
  61. 61. what’s the solution?
  62. 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. 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. 64. engage
  65. 65. MYTH YOU CAN ENGAGE PHYSICIANS WITH JUST THE #5 RIGHT PROGRAM AND BONUS MONEY
  66. 66. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  67. 67. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  68. 68. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  69. 69. from: Jeanne Liedtka and Tim Ogilvie, Designing for Growth (2011)
  70. 70. 1drawtheBIGpicture
  71. 71. 2showmetheDATA
  72. 72. gowiththeFLOW3
  73. 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. 74. to build trust
  75. 75. to act as teammates
  76. 76. toincludethepatient
  77. 77. patientascostdriver
  78. 78. it’snotjustaboutdata
  79. 79. it’salsoaboutwhomyour DATAservingdata to
  80. 80. savvyconsumers
  81. 81. not current error prone MPASTEEno comparator
  82. 82. unadulterated
  83. 83. nonjudgemental
  84. 84. There are noshortcuts toanywhereworth goingPublilis Syrus
  85. 85. culturalrevolution
  86. 86. THIS IS ABOUTBEHAVIORALCHANGESHOW ME THE DATATRY SOMETHING DIFFERENT
  87. 87. YES WE CAN!WAR PRODUCTION CO-ORDINATING COMMITTEE
  88. 88. qa
  89. 89. THRASYS thankyou contactinfo wayne.pan@thrasys.com @waynepan linkedin.com/in/waynepan slideshare.net/bonedoc97

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