Integrating Intelligence IQ and Action EBM to Improve Outcomes and Facilitate the Patient Visit

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• Integrating Intelligence (IQ) and Action (EBM) to
  Improve Outcomes and Facilitate the Patient Visit

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What is EBM?

• Evidence-Based Medicine
• Evidence-Based Medicine represents a systematic
  approach to clinical problem-solving which allows
  the integration of best available research
  evidence with clinical expertise and patient
  values to make clinical decisions in a manner
  that enhances the opportunity for optimal
  clinical outcomes and quality of life.
• Sackett, D.L. Strauss, S.E. Richardson, W.S.
  Rosenberg, W. and Haynes, R.B. Evidence-Based
  Medicine How to Practice and Teach EBM. 2nd
  edition. London Churchill-Livingstone, 2000.
  (Emphasis added)
• Evidence-Based Management
• Managers (like doctors) can practice their
  craft more effectively if they are routinely
  guided by the best logic and evidenceand if they
  relentlessly seek new knowledge and insight, from
  both inside and outside their companies, to keep
  updating their assumptions, knowledge, and
  skills.
• Pfeffer, J., and Sutton, R.I. Evidence-Based
  Management. Harvard Business Review. January
  2006.

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Evidence-Based Management/Medicine
Best Practices

• Mission and Vision
• Strategy and Tactics
• Goals and Objectives
• Plans
• Processes and Procedures

Expertise (cumulated experience, education, and
skills)

• Intervene

Continuous Quality Improvement
Expectations (patient/customer values, expectation
s, and concerns)

• Study processes
• Collect and evaluate data
• Develop action plan

• Outcomes (hard and soft)
• Side Effects

• Evaluate outcomes
• Compare to internal and external benchmarks

• Adjustments

Evidence (best evidence, based on relevant and
valid research)

• Measurement and Reporting
• Evaluation and Assessment (consider validity and
  applicability of evidence)

Best Outcomes
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Core Components of EBM

• Commitment to EBM/CQI
• Willingness to put aside belief and conventional
  wisdom
• Willingness to value and commit resources to the
  gathering, evaluation, and use of evidence
• Willingness to experiment (where possible) and
  learn from mistakes
• Willingness to change and go where the evidence
  leads
• A Clear Definition of the Desired Outcomes
• Clear Strategies and Tactics, Goals and
  Objectives
• Quantifiable and Measurable Gauges of Success
• A Plan and the Ability to Execute the Plan
• Operational Tools and Resources (systems, staff)
• Defined Processes
• Access to Outcomes Data and the Ability to
  Evaluate the Data
• Access to Information (real time)
• Comparative Data (norms, benchmarks, baselines)
• Analytic Tools
• Willingness and Ability to Change and Go Where
  the Evidence Leads

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• Population Health Management

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What is MY Population ?
Network Population Provider networks managing
the health of the populations they serve
Transition to care delivery by networks of
providers
Transition to management of patient populations
Network Patient Primary and specialty care
physicians and other health care providers
collaborating on the care of individual patients
Provider Population Individual physicians
managing the health of their patient populations
Provider Patient Individual physicians
rendering services to individual patients
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Provider Patient Individual physicians
rendering services to individual patients
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What the physician needs to know ?
Insurance coverage's
A1C level
Foot Examination
Formularies
Are meds being taken?
Eye examination
Microalbumin
Previous diseases
Cholesterol levels
Is Aspirin needed?
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Diabetes 101

• Evidence based Medicine basis for HgA1C control
• A1C levels Estimated Benefits of Glycemic Control
  in Microvascular Complications in Type 2 Diabetes
  
• Sandeep Vijan, MD, MS Timothy P. Hofer, MD, MS
  and Rodney A. Hayward, MD 1 November 1997
  Volume 127 Issue 9 Pages 788-795
• Conclusions This probability model, based on
  extrapolation from the experience with type 1
  diabetes, suggests that patients with early onset
  of type 2 diabetes will accrue substantial
  benefit from almost-normal glycemic control. In
  patients with later onset, moderate glycemic
  control prevents most end-stage complications
  caused by microvascular disease. These results
  have important implications for informing
  patients and allocating health care resources.

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• M3/IQ
• What Can We Do Today?

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What is M3/IQ? (Some Examples)
Reports
Expert Systems
Alerts
Data Migration
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• IC-Chart and M3/IQ

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MED3OOO Database Integration
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Expert Systems M3/IQ EBM Improved Outcomes
Evidence-Based Medicine

• Population Health Management
• Care Delivery Optimization
• Patient Compliance
• Patient-Provider Communications

Outcomes

• Revenue Maximization
• Capacity Management
• Overhead/Expense Reduction
• Regulatory Compliance

Data Migration
Evidence-Based Management
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What is MY Population ?
Network Population Provider networks managing
the health of the populations they serve
Transition to care delivery by networks of
providers
Transition to management of patient populations
Network Patient Primary and specialty care
physicians and other health care providers
collaborating on the care of individual patients
Provider Population Individual physicians
managing the health of their patient populations
Provider Patient Individual physicians
rendering services to individual patients
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OptimizingProvider Patient Interactions
Provider Patient Individual physicians
rendering services to individual patients Key
Issues Optimizing the effectiveness and
efficiency of the provider-patient interaction
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OptimizingProvider Population Interactions
Provider Population Individual physicians
managing the health of their patient
populations Key Issues Ensuring that the
practice is effective in providing needed
services to all of the patients whose health they
manage, including those patients who dont
present for services
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OptimizingNetwork Patient Interactions
Network Patient Primary and specialty care
physicians and other health care providers
collaborating on the care of individual
patients Key Issues Ensuring efficient and
effective coordination of care
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OptimizingNetwork Population Interactions
Network Population Provider networks managing
the health of the populations they serve Key
Issues Ensuring that the network optimally
allocates available resources to maximize the
health of the population it manages
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What the physician needs to know ?
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• Helping Physicians and Provider Networks
• Improve the Health of their Practices and
• The Populations They Serve
• One Patient at a Time