August 06, 2008

The Rochester Individual Practice Association Board of Directors, at its May 31, 2008 planning retreat, voted to lead formation of a community wide healthcare quality improvement effort. The collaborative would seek to pool data and develop feedback tools across payers and health systems so that practitioners will have access to a single source of information across their entire patient population.


RIPA staff are currently working to identify key tasks and milestones required to get such a collaborative effort off the ground. In addition, many discussions have occurred with community stakeholders with additional meetings in the planning stages.


To assist in more broad understanding of the reasoning behind the Board's recent decision, we are continuously developing presentations and publications designed to provide details on this effort. A presentation, "What is QI" outlines how a quality improvement initiative might be developed from hypothesis through evaluation within the context of an ENT Advisory Committee project in 2005-2006. In addition, we have developed a list of "Frequently Asked Questions." We will periodically update this so please check back.


As part of the planning process, we have identified several existing quality improvement collaboratives throughout the country. In many instances, these have been highly successful. Massachusetts Health Quality Partners "is a broad-based coalition of physicians, hospitals, health plans, purchasers, consumers, and government agencies working together to promote improvement in the quality of health care services in Massachusetts. MHQP was first established in 1995 by a group of Massachusetts health care leaders who identified the importance of valid, comparable measures to drive improvement." The Pittsburgh Regional Health Initiative "was the first regional consortium of medical, business and civic leaders to address healthcare safety and quality improvement as a social and business imperative. Turning its own community into a demonstration lab, PRHI strives to accelerate improvement and set the pace for the nation."


Many other regional and state-wide collaboratives also exist. From time to time, we will add links to the RIPA website.


Regional quality improvement has also been the subject of some excellent publications. The California Healthcare Foundation published "It Takes a Region: Creating a Framework to Improve Chronic Disease Care" in 2006. And the Commonwealth Fund published "Physician Organization in Relation to Quality and Efficiency of Care: A Synthesis of Recent Literature" in April 2008. Each of these papers provides excellent and thorough background on the vital components for success of community-wide quality improvement collaboratives. You are encouraged to visit these web sites to download these articles.


We will continue to add additional updates as new developments occur. Please check back often.

July 03, 2008

Rochester RHIO, our community's regional health information organization, is up and running with an extended pilot. The original participants - 26 physicians from five different practices - are continuing to test the RHIO's full "virtual health record" (VHR) capability, viewing insurance eligibility, test results, medication history and other patient information electronically. The VHR pilot is also being expanded to additional specialist practices, nursing homes, and home healthcare settings.

Many more physicians are using the exchange today to receive electronic test results and for e-prescribing. Any physician with a computer and internet access can receive lab results electronically, within a week of signing up for the exchange.

Organizations providing data to the RHIO exchange today include ACM Medical Laboratories, Elizabeth Wende Breast Clinic, Excellus BlueCross BlueShield, Preferred Care, Unity Health System and University of Rochester Medical Center.  Many others will be added in the coming months, including Clifton Springs Hospital, Lakeside Hospital, Nicholas H. Noyes Memorial Hospital, Thompson Health, United Memorial Medical Center, and ViaHealth.

The state health department recently gave Rochester RHIO two of the largest grants in the state to expand services, under the Health Efficiency and Affordability Law of New York.

•$6.7 million will help 75 independent practices to purchase EMR hardware and software, with implementation support from Monroe County Medical Society. Physicians interested in EMR adoption through the MCMS EMR Service Bureau may contact Nancy Adams at 585-473-4072.

•$6.1 million to improve continuity of care by expanding RHIO access to EMS providers, emergency departments, and long term care facilities. RHIO will also use this grant to provide direct links to Medicaid patient information, and to develop a portal that will allow patients to view their records online.

Deployment will continue and a public advertising campaign are expected to begin in the fall. Rochester RHIO will provide all participating offices materials to educate office staff and support their efforts to manage the patient consent process.

Specific information regarding costs, technology, the consent process, security and more can be found at http://www.grrhio.org/pat_providers.shtml. Physicians interested in joining Rochester RHIO may call Jessica Hasler at 877-865-RHIO (7446). For more information, visit www.grrhio.org

December 20, 2007

Community practice guidelines can now be viewed and downloaded at the Monroe County Medical Society website. Guidelines were developed as part of the Rochester Community-Wide Clinical Guidelines Initiative, an initiative currently facilitated by the Monroe County Medical Society with representation from Aetna, Excellus BlueCross BlueShield, GRIPA, Kodak, The Monroe County Health Department, The Monroe County Medical Society, The Monroe Plan for Medical Care, Preferred Care, RIPA, Thompsonhealth, University of Rochester Medical Center/Strong Health, Unity Health System and ViaHealth.

To view and download the guidelines, visit the Medical Society's website guidelines area at http://cwcg.mcms.org

July 02, 2007

Financial Incentives Provided for Quality Reporting


PQRI establishes a financial incentive for eligible professionals to participate in a voluntary quality reporting program. Eligible professionals who successfully report a designated set of quality measures on claims for dates of service from July 1 to December 31, 2007, may earn a bonus payment, subject to a cap, of 1.5% of total allowed charges for covered Medicare physician fee schedule services.

The PQRI program applies to Medicare fee for service patients but not to those enrolled in Medicare Advantage plans such as Medicare Blue Choice. The CMS website has detailed information on how the initiative works. Go to www.cms.hhs.gov/pqri/for more information.

January 26, 2007


Rochester area internists and family physicians have a unique opportunity to participate in a program designed to improve job satisfaction and reduce physician burnout. The program is being offered free of charge as part of a research project sponsored by the American College of Physicians and funded by the Physicians Foundation for Health System Excellence. In addition to free participation in the year long program, practitioners will receive CME credit. Participation involves training in mindfulness; an open approach to exploring those aspects of our lives we find most challenging and stressful.


The Monroe County Medical Society and RIPA are playing a lead role in assisting a team of local physicians to recruit internists and family practitioners for this year-long intervention. Two groups of physicians will be convened with the first beginning training in mid-spring and the second beginning in the fall. The groups will meet regularly in the evening, developing a familiarity with mindfulness practice. They will also utilize narrative examples from their own practice experience and Appreciative Inquiry - a strength based approach to change management - to explore the practice of mindfulness and how it relates to one's professional and personal life. The project will also be looking at the effects of this intervention on physician well-being and burnout, as well as practice quality, efficiency and patient satisfaction. Participation is  free of charge and up to 50 hours of CME may be awarded. Participants will also be paid for filling out a number of surveys during the year.


For information about the project, contact Mick Krasner, MD at (585)341-7236 or Mary Jane Milano at the Monroe County Medical Society at (585)473-4072. There is also an information page at the Medical Society's web site at www.mcms.org. For more information about the Physicians Foundation for Health Systems Excellence, visit their web site at www.physiciansfoundation.org.