Rhode Island Prevention Connection
Your resource for optimizing the use of your electronic health record (EHR) system to improve the quality and frequency of preventive health care services |
Welcome to the Premiere Edition of Rhode Island Prevention Connection
Welcome to the premiere edition of Prevention Connection! The Prevention Team at Quality Partners of Rhode Island appreciates your participation in this cutting-edge initiative and is grateful for the opportunity to provide up-to-date information to our practices through this forum. There are a total of 53 Medicare Quality Improvement Organizations (QIOs) located throughout the 50 states and territories participating in this project.
The Quality Partners Power up for Prevention project has recently been recognized as ranking in the top 5% of QIOs in the country for having 100% baseline reporting from their participating practices. In addition, this EHR-reported baseline data, for each clinical measure, was equal to or greater than the national average.
The clinical measures for the Power Up for Prevention project include breast and colorectal cancer screenings, as well as influenza and pneumonia vaccinations.
CONGRATULATIONS to those practices participating in this important project and on your commitment to delivering quality healthcare to your patients! Together we are making a difference.
Sincerely,
H. John Keimig, CEO
Christopher Campanile, MD, PhD, Clinical Coordinator |
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Doctor's Corner
by Christopher Campanile, MD, PhD
A General Approach to Improving a Preventive Health Quality Measure
 Rather than focus on clinical content, I would like to use this initial column to describe what I feel are the basic steps to effecting a performance improvement in a preventive health quality measure, such as the ones being addressed by the Quality Partners' Power Up for Prevention project.
I think this work can be distilled down to three basic components: identify the target population; facilitate the accessibility of needed resources to satisfy the measure; and address with the patient any barriers, real or perceived, that may hinder providing the service related to the measure.
Let's apply this general approach to the specific case of colorectal cancer screening (CRC).
1. Identify the target population
Create a list of patients that represent the denominator for the measure. As defined in Power Up for Prevention, the denominator for CRC screening is patients, ages 51-80 years, who have had an office visit in the previous 2 years.
2. Facilitate the accessibility of needed resources
Identify the specialists who would be able to perform a colonoscopy on the patients in your denominator. For the one or two specialists or groups that you may use the majority of the time, it would be a good idea to have a meeting, or at least phone connection.
Through this, you could explain that you support the recommendation of CRC screening through colonoscopy and that you would like to be able to facilitate access to this procedure for your patients.
3. Address patient barriers
Though it seems it is becoming a more acceptable procedure, there are still many patients who cannot imagine having a lighted tube equipped with cautery and biopsy instruments being passed into and through their entire large intestine. For the patient who is apprehensive about the procedure, you could start by telling him or her that colon cancer is not rare.
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Local Breast Cancer Resources
October is a great time to recognize how well we take care of one another in Rhode Island.
As we all know, it is National Breast Cancer Awareness Month - a time to focus on breast care and prevention of disease, as well as early detection, access to treatment, and services available to women with breast cancer and those closest to them.
In Rhode Island, in 2008:
- 770 women were newly diagnosed with breast cancer
- 40 women died as a result of the disease
The American Cancer Society tells us that we can expect those numbers to increase and projects 810 new cases by the end of this year. Compared to other states, our incidence rate continues to be in the top ten.
Those numbers certainly tell a story of the statistics of a disease, but perhaps the truer story in Rhode Island is told between the numbers. It is in the wealth of support and services available to women in this state.
On October 10, 2009, the Prevention Team at QPRI had the honor of participating in the 4th Annual "Flames of Hope™...A Celebration of Life" Event in Downtown Providence, organized by the Gloria Gemma Breast Cancer Resource Foundation. The event was very well attended and a smashing success. Congratulations to all involved!
The Gloria Gemma Breast Cancer Resource Foundation was established in 2004. Its mission is to raise breast cancer awareness, increase breast health education, and generate funding for critical breast health programs.
The Rhode Island Breast Cancer Coalition (RIBCC), serving the state since 1992, is dedicated to "ensuring that all women have access to screening and treatment for breast cancer, to increasing support for research, and to advocating for legislative initiatives to improve the quality of healthcare for women and their families".
The Women's Cancer Screening Program, managed through the Rhode Island Department of Health, provides no-cost pelvic exams, Pap tests, clinical breast exams, and mammograms to eligible women in the state. Since its inception in 1995, over 24,000 women have been screened through the program. Of that number, approximately 3,000 - 3,500 women receive breast and/or cervical cancer screening annually.
This October, while we educate our patients about the wisdom of routine screening and early detection through mammography, we can also celebrate our community. The depth of services available in Rhode Island that support breast health and women diagnosed with breast cancer range from grass-roots beginnings through to legislated programs managed at the state level. We extend our appreciation and gratitude to the physicians and other health care providers throughout the state who care for the health of women in Rhode Island everyday!
Click here to review the full article and learn more about these great resources.
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In the News
Smoking Linked to Increased Risk of Breast Cancer
"...a woman smoker can reduce her risk of breast cancer by stopping smoking as soon as possible" Dr. Ivana Croghan of The Mayo Clinic is quoted as stating.
Dr. Croghan and her group published a study in the September/October 2009 issue of The Breast Journal finding smoking to be strongly predictive of a 25% increase in incidence of breast cancer diagnosis. The treatment of tobacco addiction can be a daunting and somewhat frustrating process, often requiring consistent support and follow-up through your patients' multiple quit attempts.
QuitWorks-RI provides the resources you need to provide evidence-based treatment for your patients who are considering quitting. It is a fax-referral based quitline offered free to all Rhode Island residents regardless of insurance status.
Click here to view the abstract from the Mayo Clinic Study. |
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Prevention Update
The Prevention Team at Quality Partners of Rhode Island is working with 26 practices and more than 80 providers across the state to improve their screening rates for breast and colorectal cancer, as well as their immunization rates for influenza and pneumonia, through the use of their electronic health record (EHR).
The task of gathering baseline data is complete and we are now in the process of collecting monthly re-measurement data for each of the four measures. We are contacting the offices to arrange monthly meetings in which we plan to share best practices, assist you with overcoming any barriers you have encountered, and share your data with you.
Our hope is to benchmark de-identifiable data within each practice and eventually across the project with those who wish to participate in that process. |
Sharing Best Practices
In an effort to increase patient education for the prevention measures, Thundermist Healthcare has incorporated the four prevention measure patient educational handouts (see Tools section in sidebar above), provided by the Quality Partners of Rhode Island Prevention Team, into their EHR.
This process improvement enables the provider to just click and print, saving them valuable time to discuss prevention more openly with the patient and answer any questions they may have.
Keep up the great work!
Please contact us with your best practices and we will share your successes in our newsletter.
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This material was prepared by Quality Partners of Rhode Island, the Quality Improvement Organization for Rhode Island, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. |
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Quote of the Month
When you come to the end of your rope, tie a knot and hang on.
~Franklin D. Roosevelt |
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Tip of the Month
Does it really matter where you document in the EHR, as long as the information is in the system? The answer is YES.
There may be a number of different places to enter preventive care information in your system.
For example, scanning reports or documenting a test in the progress note does not translate into a reportable data field. Your EHR is only as good as the information you put into it. In order to report data it must be in a discrete data field of a locked encounter.
Across the country it has been found that standardizing the documentation process in each practice creates a foundation for reporting that more accurately reflects the data.
To be value added, Quality Partners of Rhode Island has created a documentation guide, customized for your practice. You can download the appropriate documentation tool below.
For our NextGen users, we are currently finalizing your tool. |
 Tools Patient Education
Brochures
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Medicare Quick References
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EHR Tools
eClinicalWorks
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Feedback Requested
Our goal of this newsletter is to provide information that can support your efforts to improving the quality of healthcare through the use of your EHR.
Your feedback is very important to us and will help us target areas that you feel will add value to your work. Please let us know if there are specific topics you would like to see included in this newsletter, or other ways in which we can be of assistance.
Thank you for your commitment to quality.
If you have questions or comments or require technical assistance on the Power Up for Prevention Project, please contact
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