Ohio Health Quality Improvement Plan

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Appendix IV — Co m m e n t s f r o mStatewide Or g a n iz a t io n s40statewide children’s hospital collaborative (‘07). In2009, an initiative, “Solutions for Patient Safety” waslaunched with the support of Cardinal Health, the OhioBusiness Round Table, 17 Central Ohio hospitals andeight children’s hospitals. This project will addressmedication errors and hospital-acquired infections.OHA also partners with The Joint Commission to helphospitals attain a level of continuous survey readinessfor accreditation surveys, and leads other state andlocal quality and patient safety initiatives.• The OHA Data Services Department has beenworking to develop web-based data submission andprocessing applications for hospital data, includinga comprehensive statewide information technologyexchange that allows data sharing among providers.The goal is to adopt data standards for healthinformation by the end of 2009, and to disperse thetechnology through existing collaborative purchasingmodels.OHA’s principles for health care reform directly touch thedecision point evaluating and choosing payment reformmodels. The system should be organized to meet the needsof the community and the individual patient, with a goalof customer value. The system should provide incentivesfor managing controllable costs, and should include:reliance on a balance of fair market forces and appropriategovernment regulations, a seamless delivery system to meetthe needs of the patient, a comprehensive system focusedon prevention and wellness, flexibility to meet the changingneeds of the purchaser/consumer, care in the most costeffective setting, a fair and balanced tort resolution process,and personal accountability. For more information on theOhio Hospital Association’s vision, goals, and principlesfor health care reform, refer to http://www.ohanet.org/reform/default.htm.Thank you for the opportunity to be part of this process andto comment on the final report.Ohio Nurses AssociationAll health care should be center on the individual not uponthe profession providing the care. In this day and age weneed to stop protecting turf and start trying to provide theright care, at the right time that is affordable. Access tocare for all should be the driver for the future of health carewith the health care providers being adequately reimbursedfor provided service. Prevention should be started youngand practiced by all through the ages so that less health careservices are required and the quality of life is enhanced.Ohio Osteopathic AssociationThe Ohio Osteopathic Association is pleased to endorse thefour collaborative transformation strategies contained in theOhio Health Quality Improvement Plan. Health promotionand disease prevention, health information technologyand payment reform using the Medical Home and Payfor Performance models are high priorities of the OOA.We are uniquely qualified to assist the state in these areasbecause:• According to The Physician Supply and DemandConsultation to the Ohio Board of Regents, publishedFebruary 27, 2007: “88% of direct patient carephysicians in Ohio are allopathic physicians (MD) and12% are osteopathic physicians (DOs). Osteopathicgraduates of Ohio medical schools [the Ohio UniversityCollege of Osteopathic Medicine] are more likely to bein direct patient care, primary care (36.7% vs. 43.6%),are more likely to practice in a rural area (10.8% vs16.0%), and more likely to be in a Primary Care HealthProfession Shortage Area (7.1% vs. 9.9%)”• The American Osteopathic Association (AOA) wasone of the four physician organizations that developedJoint Principles of the Patient-Centered MedicalHome (March 2007). In addition, the AOA serveson the Executive Committee of the Patient CenteredPrimary Care Collaborative, a coalition of more than500 employers, consumer groups, patient qualityorganizations, health plans, labor unions, hospitals,physicians and others who have joined together todevelop and advance the patient centered medicalhome.• The AOA’s Clinical Assessment Program (CAP),developed under the leadership of George Thomas,DO, Cleveland, and Richard J. Snow, DO, Columbus,measures current clinical practices in the physician’soffice and compares the physician’s outcomes measuresto their peers using national evidence-based clinicalpractice standards. Measure sets include CoronaryArtery Disease, Diabetes Mellitus, and Women’s HealthScreenings. CAP is among 32 medical registriesqualified to submit quality data to the Centers forMedicare and Medicaid Services (CMS) on behalf of
Appendix IV — Co m m e n t s f r o mStatewide Or g a n iz a t io n sthe 2008 CMS Physician Quality Reporting Initiative(PQRI).• The Ohio University College of Osteopathic Medicine(OU-COM) is a leader in information technology.OhiONE and COREnet have been two of the mostinnovative components of the college’s medicaleducation consortium, known as the Centers forOsteopathic Research and Education (CORE). Utilizingthese technology-based systems, the College and itstraining hospitals throughout Ohio provide high qualityeducational programs, conduct meetings, and supportresearch across the entire CORE consortium. Thesetechnologies allow our member hospitals to integratepostgraduate training programs and share presentationsby nationally known lecturers. In recent years, OhiONEand COREnet have been so successful that they havegrown into one of the largest interactive systems in theUnited States.• From 1993 to 1999, OU-COM was designated by theU.S. Department of Health and Human Services asone of only 25 Centers of Excellence in the UnitedStates (and the only one in Ohio) to insure the trainingof a population of physicians who are skilled inmulticultural medicine. Part of the college’s longtermmission is to recruit, educate, train and retaineconomically disadvantaged and minority students insupport of a culturally competent physician work force.• The Osteopathic Heritage Foundations, Columbus,have approved over $100 million in grants designedto improve the health and quality of life of vulnerablepopulations and advance osteopathic medicine inCentral and Southeast Ohio since 1999. Communityfunding priorities include: obesity, homelessness andoral health care.Ohio State Medical AssociationI. Which strategies or tactics would your organizationbe able to help implement?The Ohio State Medical Association (OSMA) is able andwilling to participate in all four priorities. However, theOSMA will have very limited ability and resources to affectinformed and activated patients. The OSMA has limiteddirect access to educating patients. We could however,work with our physician members on messaging to theirpatients.II. Which strategies or tactics are already priorities foryour organization?Patient centered medical home (PCMH) and HealthInformation Technology (HIT) both are a priority for theOSMA. Payment reform is a priority for the OSMA at thestate level, and to the extent that a state medical associationcan affect payment reform as a national issue. Informedand activated patients are not currently a priority of theOSMA.III. What do you believe should be the top priority forthe Council?The four priorities are so complex and interdependent thatone cannot be effective without the others and the groupwould not be as effective if any one part is missing. Thepriorities create a new “system” that can be viewed ashaving two main components, service and payment. Theservice starts with the PCMH which is dependent on HITand informed and activated patients in order to be effective.The payment structure must be different than today’spayment environment in order to support the new system.This raises a challenging question that the health caresystem must address, do we invest in building a systemdesigned to work more effectively and save money in thelong-run, or do we reward through enhanced paymentsa system that has proven to be more effective and savesmoney? In other words, it’s not a question of who’s goingto pay for it, it’s a question of when. The top priority ofthe Council should be to create an implementation strategyinvolving all four interconnected priorities and to addressthe timing of payment reform.IV. What are the opportunities of integration betweenand among the four collaborative transformationalstrategies?As stated above there are not only opportunities forintegration, but it is critical that all four strategies arehighly integrated and happen simultaneously.V. What are your specific comments to any or all of thedecision points?The PCMH system will not function the same way in everycommunity. Each community has different infrastructureand resources and that community must work within theirgiven environment in order to set up a PCMH system thatdelivers the desired outcomes. While systems my looksomewhat different they should all have similar principlesand desired outcomes set for by this Council. The Council41
Page 1 and 2: Ohio Health QualityImprovement Plan
Page 3 and 4: Introduc tionIn November 2008, more
Page 5 and 6: In t r o d u c t io nimplementation
Page 7 and 8: Oh io He a l t h Qu a l it y Im p r
Page 9 and 10: Pa t ie n t Centered Me d ic a l Ho
Page 11 and 12: Pa t ie n t Centered Me d ic a l Ho
Page 13 and 14: He a l t h In f o r m a t io n Te c
Page 15 and 16: Pa y m e n t Re f o r m◦◦◦◦
Page 17 and 18: In f o r m e d a n d ActivatedPa t
Page 23 and 24: Me a s u r in g Su c c e s sPropose
Page 25 and 26: Ne x t StepsOhio Health Care Covera
Page 27 and 28: Appendix II — Response to Questio
Page 29 and 30: Appendix III — Su r v e y Results
Page 31 and 32: Appendix IV — Co m m e n t s f r
Page 39: Appendix IV — Co m m e n t s f r
Page 45: CORE PLANNING TEAMAmy Rohling McGee

Ohio Health Quality Improvement Plan

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