The Utility of PPRNet Reports in a Federally Qualified Health Center and Residency Program

Kimberly Williams, MDAugust 22, 2014

Smoky Hill Family Medicine Residency

Outline

• Setting• Requirements for residency• Requirements for faculty• Requirements for Federally Qualified

Community Health Center (FQHC)

Who We Are

• Salina, KS• Rural, community based

unopposed family medicine residency

• Affiliated with University of Kansas School of Medicine-Wichita

• 6 faculty physicians• 12 resident physicians

Who We Are

• Federal Qualified Community Health Center• 4 full time providers (2 NPs, 2PAs, 1 MD)• Level 3 NCQA-certified patient-centered medical

home• Services offered in house– Dental, behavioral medicine, pharmacy, diabetes

education, lab, x-ray

Our Patients

• Patient mix by payer– Self Pay- 27.46%– Medicaid- 35.78%– Medicare- 13.03%– Private Insurance- 23.73%

• Spanish Speaking– Self-reported 10%

Residency• RRC Requirements

– Residents must receive regular reports of individual and practice productivity, financial performance and clinical quality basis, as well as the training need to analyze these reports

– Each FMP site must involve all members of the practice in ongoing performance improvement, and must demonstrate use of outcomes in improving clinical quality, patient satisfaction, patient safety and financial performance

– Residents should complete two scholarly activities, at least one of which should be a quality improvement project

– Residents must complete part IV maintenance of certification prior to sitting for boards

Residency• RRC Requirements

– Residents must receive regular reports of individual and practice productivity, financial performance and clinical quality basis, as well as the training need to analyze these reports

– Each FMP site must involve all members of the practice in ongoing performance improvement, and must demonstrate use of outcomes in improving clinical quality, patient satisfaction, patient safety and financial performance

– Residents should complete two scholarly activities, at least one of which should be a quality improvement project

– Residents must complete part IV maintenance of certification prior to sitting for boards

Residency

• Monthly Resident/Faculty Meetings– Choose several metrics each month from reports– Rotate metrics each month– All providers data handed out

Monthly Provider Feedback

Monthly Provider Feedback

Residency• RRC Requirements

– Residents must receive regular reports of individual and practice productivity, financial performance and clinical quality basis, as well as the training need to analyze these reports

– Each FMP site must involve all members of the practice in ongoing performance improvement, and must demonstrate use of outcomes in improving clinical quality, patient satisfaction, patient safety and financial performance

– Residents should complete two scholarly activities, at least one of which should be a quality improvement project

– Residents must complete part IV maintenance of certification prior to sitting for boards

Residency• RRC Requirements

– Residents must receive regular reports of individual and practice productivity, financial performance and clinical quality basis, as well as the training need to analyze these reports

– Each FMP site must involve all members of the practice in ongoing performance improvement, and must demonstrate use of outcomes in improving clinical quality, patient satisfaction, patient safety and financial performance

– Residents should complete two scholarly activities, at least one of which should be a quality improvement project

– Residents must complete part IV maintenance of certification prior to sitting for boards

Residency

• Quality Improvement Projects– One project per PGY class– Teaching, lit review, choice of project– Preventive health for women• Pap/Mammo/Dexa

– Adult Immunizations• Tdap, pneumovax

Residency

• RRC Faculty Requirements– The faculty must establish and maintain an

environment of inquiry and scholarship with an active research component.

– Faculty should encourage and support residents in scholarly activities

– Two scholarly activities over the course of 5 years

Residency

• RRC Faculty Requirements– The faculty must establish and maintain an

environment of inquiry and scholarship with an active research component.

– Faculty should encourage and support residents in scholarly activities

– Two scholarly activities over the course of 5 years

Residency

• QI competition– Improvement in diabetes outcomes– On average improved 8%

• Working on provider dashboard for tri-annual review

Residency

• RRC Faculty Requirements– The faculty must establish and maintain an

environment of inquiry and scholarship with an active research component.

– Faculty should encourage and support residents in scholarly activities

– Two scholarly activities over the course of 5 years

FQHC

• Healthcare Plan– Some measures dictated by federal government• Unified Data Set

– Choose some measure within a category• Pediatric, chronic care

– Annual report• Denominator is very specific • Usually done by chart audits

– Track numbers on quarterly basis with PPRNet reports

Clinical Coordinator

• 16 metrics, deals with 1-2/month• Generates patient lists• Sends provider message, or contacts patient

directly• Examples– Ischemic vascular disease and ASA– Pap smears

Summary

• Residency– Resident Scholarly Activity– Faculty Scholarly Activity– Foster a culture of QI

• FQHC– Helps us regularly track numbers we report

annually• Improve patient care