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October 2007
PRISM 3 - A Huge Success!
On September 20th, over 150 providers, office staff, allied health professionals, administrators and public health professionals gathered at the Harraseeket Inn in Freeport for the THIRD Practice Improvement Series Meeting (PRISM) which focused on family- and patient-centered care.
The keynote address, "Recognizing Patient- and Family-Centered Care," was given by Dr. William Schwab, Professor at the University of Wisconsin School of Medicine and Public Health. Other presentation topics included: Spirituality, COPD, Motivational Interviewing, Communicating with Patients while using an EMR, Group Visits, Patient Satisfaction Surveys, Self-Management Peer Support and Wellness for Caregivers.
In addition to attending workshop sessions, participants were given an opportunity to network over fantastic food at the Harraseeket and share ideas for improvement and models for patient- and family-centered care at their worksite.
One participants said, "Loved it all. The opening remarks by Dr Schwab really hit home. It is easy to say "Patients are but to hear it in so many different formats really brought it home for me."
You don't want to miss PRISM 4 on January 17th! The theme for PRISM 4 is "Turning Information into Action."
Reserve your space in advance by emailing mhlc@mmc.org or call 207-541-7558. When doing so, include your name, address, phone number and email address.
Save the Date for PRISM 4
You are invited to attend our first Practice Improvement Series Meeting (PRISM) for 2008 on January 17th from 7:45 a.m. -3:30 p.m. at the Harraseeket Inn in Freeport, Maine. The theme for PRISM 4 is "Turning Information into Action."
Reserve your space in advance by emailing mhlc@mmc.org or call 207-541-7558. When doing so, include your name, address, phone number and email address.
Sign up NOW for the Health, Culture and Literacy Conference in Freeport on October 26th
According to a recent report from the US government, billions of dollars are wasted every year as the result of poor communication between health care providers and patients. The ability for patients and consumers to understand and act on complex health information affects patient safety and the quality of care, in addition to cost.
Act now to register for one of the most important and useful conferences of the year! Health, Culture, and Literacy: Solutions for Clear Health Communication will take place on Friday, October 26th at the Hilton Garden Inn in Freeport, Maine. The program is for health care professionals, including physicians, nurses, mental health and dental health providers, health professions students, public health professionals, and health educators. Anne Fadiman, author of the best-selling "The Spirit Catches You and You Fall Down" will keynote the event. Dr. Terry Davis, from Louisiana State University will present findings from the recent national adult literacy study. Dr. Mary Ann Abrams, Director of Quality for Iowa Health Systems will discuss the results of a statewide rural health literacy collaborative, among other regional and state experts.
Go to http://www.mainehealthliteracy.org for online registration and detailed information about the conference.
Registration is $75 for physicians, $50 for all others, and $25 for students; scholarships are also available. Continuing education credits for physicians (allopath and osteopath), nurses, social workers, and health educators will be provided. Participants will be surveyed immediately after the conference to determine preferences for followup topics and venues.
This conference will kick off a year long series of activities that are aimed at raising awareness of doctors and other health care workers about the scope of the problem and practical solutions.
MaineHealth is hailed as a LEADER in Practice Improvement: 2 National Groups Visit Maine
From September 20th - 21st, ten individuals from New Health Partnerships, led by faculty member Judith Schaefer, visited Maine to attend the Practice Improvement Series Meeting 3 (PRISM 3), hosted by the MaineHealth Learning Community. The group also spent time learning more about MaineHealth's Depression Program, Caring for ME, touring the Learning Resource Center in Portland, and meeting with MMC PHO Care Managers to learn more about the role care managers play in self-management support.
The group expressed admiration for the work that is being done by MaineHealth and were very satisfied with their visit. MaineHealth was able to benefit from the visit by the sharing the group offered at PRISM about the work they were doing in their own organizations around patient- and family-centered care.
New Health Partnerships (NHP) is a program of the Robert Wood Johnson Foundation and the Institute for Healthcare Improvement. The purpose of the program is to help healthcare organizations enhance their work on patient self-management for chronic illness and to help them involve patients and family members as part of their quality improvement teams.
MaineHealth participated in the predescessor to NHP, which was called Quality Allies. A team from Scarborough Family Physicians worked on improving self-management support for people with depression. Because of the experience that was gained from that program, MaineHealth was asked to host a site visit for current NHP participants.
Also, from September 6th and 7th, a group of providers and staff from WellSpan Health's Chronic Care Collaborative, based out of the Adams-York County area of Pennsylvania (about one hour north of Baltimore), visited the MaineHealth system to learn more about how other healthcare systems and providers have implemented the Planned (Chronic) Care Model. The group also was interested in MaineHealth's work in re-designing patient flow through practices and defining the components of patient engagement and education that can and should occur in every office practice.
While in Maine, the group visited MaineHealth Clinical Integration, the MMC PHO management staff, care managers, Greater Portland Medical Group - Westbrook, Maine Medical Partners, Greater Portland Medical Group - Cape Elizabeth, and Maine Medical Center Family Practice. The group expressed sincere appreciation for the opportunity to visit MaineHealth and learn about our efforts to improve chronic illness care across conditions.
WellSpan is a community-based, not-for-profit, integrated system of healthcare services that is dedicated to improving the health and well-being of the people it serves. The system supports two hospitals, York and Gettysburg Hospital, totalling 630 beds and 653 physicians. MaineHealth became associated with WellSpan through the Aligning Forces for Quality Initiative, funded by the Robert Wood Johnson Foundation, of which both systems are grantees. This program is designed to help communities across the country improve the quality of health care for patients with chronic conditions such as diabetes, asthma, depression and heart disease.
Meta-Analysis Shows Benefit of Collaborative Care for Depression by Neil Korsen
A meta-analysis published in the Archives of Internal Medicine in November of 2006 demonstrated strong evidence to support the use of 'collaborative care' for depression in primary care.
Collaborative care, for the purposes of this study, refers to interventions involving combinations of 3 distinct professionals working together within the primary care setting to provide care for people with depression: a primary care clinician, a care manager, and a mental health specialist. For inclusion in this meta-analysis, a study had to include at least 2 of these 3 professionals.
Using high quality search strategies, the authors identified 37 randomized trials with 12,355 patients that met inclusion criteria. These studies showed a benefit using a collaborative care approach compared to usual care. This benefit was noted at 6, 12, and 18 months of follow-up, but not at 24 months. One study showed benefit at 5 years, but clearly more long-term evaluation of outcomes needs to be done. An accompanying editorial suggests there is an important role for studying outcomes in current efforts in health care organizations that implement collaborative care programs.
Further analysis showed that one key component of improved outcomes was improved adherence with prescribed medications. Care management has been shown to improve adherence by maintaining regular communication with the patient between office visits.
Another effective component of collaborative care is the role of a consulting mental health professional, such as a psychiatrist, in overseeing the care of a population with depression and offering advice as needed to help more patients achieve remission of symptoms. Unfortunately, this role for psychiatrists is not currently reimbursable. An interesting project in Minnesota is developing mechanisms to offer payment for this type of service.
Many of the studies included in this meta-analysis included other components of depression care consistent with the Care Model, including use of a registry, use of a standard assessment tool such as the PHQ-9, and self-management support for patients. The MacArthur RESPECT-Depression study, in which 10 MaineHealth practices participated, was one of the studies included in the meta-analysis.
It is often said that after adequate evidence accumulates for an intervention in medical care, it takes about 15 years for that intervention to become usual practice. The authors of this meta-analysis did a 'cumulative random-effects meta-analysis' to determine at what point the evidence for collaborative care became adequate to say with certainty that it is evidence-based care. That happened in 2000. We are now 7 years after that, or about halfway through the 15-year timeline. I hope we can accelerate that process, so our patients with depression don't have to wait too long for a better chance at remission.
Gilbody et al, Collaborative Care for Depression: A Cumulative Meta-Analysis and Review of Longer-term Outcomes. Archives of Internal Medicine (2006), Vol. 166, pages 2314-2321. For the full text article click here.
For more information about this topic or the MaineHealth Depression Program, Caring for ME, please contact:
Neil Korsen, MD
Cynthia Cartwright, RN, M.Ed
Caring for ME Depression Program
39 Forest Avenue
Portland, ME 04101
Phone: 662-3529
Fax: 662-3118
Email: cartwc@mmc.org
Patient Education Tools from the American Heart Association
The American Heart Association (AHA) provides free Web-based programs and products that you can recommend to your patients, their caregivers, and families. These programs offer a wide variety of information and resources to help your patients learn more about their risk, help manage their condition, and improve and maintain a healthy lifestyle.
When you visit the AHA website, you will find: - Treatment Decision Tools
- Patient Education Materials and Video
- Online Risk Assessment
- Health Tools (quizzes, trackers, medical illustration library)
- Cardiology Patient Page
- And a number of downloadable resources
For more information, please visit the American Heart Association website by clicking here.
For more information about this topic or the Cardiovascular Health Program at MaineHealth, please contact:
Cindy Richards
Program Manager, Cardiovascular Health Program
465 Congress Street, Suite 301
Portland, ME 04101
Phone: 541-7545
Email: richac2@mmc.org
Asthma Educators are Only a FAX Away!
Caring for patients with asthma can be time consuming for your busy practice. That's why there are asthma educators available in southern, central, and western Maine to help you and your patients. Click here to see how asthma educators are having a positive effect on decreasing ED visits and inpatient admissions. You'll also have access to a FAX referral form that you can use today!
For more information about this topic or to find out more about MaineHealth Clinical Integration's Award Winning AH! (Asthma Health) Program, please contact:
Donna Levi, MS
AH! (Asthma Health) Program Manager
Maine Health, Clinical Integration
465 Congress St. Suite 301
Portland, ME 04101
Phone: 207-541-7566
E-mail: levid@mmc.org
Diabetes News: Earn CME Credit through the National Diabetes Education Initiative
This National Diabetes Education Initiative educational activity is designed for primary care physicians, internal medicine specialists, endocrinologists, diabetologists, cardiologists, and other healthcare professionals involved in the care and management of patients with type 2 diabetes, insulin resistance, and cardiovascular disease. If you would like more information regarding this exciting opportunity, please click here.
Annual Fall Diabetes Clinical Update Conference
Attend the Annual Fall Diabetes Update Conference from October 21st - October 23rd at the Sheraton South Portland Hotel. Click here for more information and to sign-up.
Updated TARGET Diabetes Guidelines Poster NOW Available
The TARGET Diabetes Guidelines Poster has recently been updated to reflect innovations in care protocols. These guidelines are adapted from the American Diabetes Association 2007 Standards of Care. Click here to see the new poster. If you would like to order copies for your office or practice and are a registered JSM user, the poster is available now on the JSM website. If you need to become a JSM user, please contact Elizabeth Lambert at lambee@mmc.org
For more information on the award-winning TARGET Diabetes Program at MaineHealth, please contact:
Kristina Scrutchfield
TARGET Diabetes Program Manager
Maine Health, Clinical Integration
465 Congress St. Suite 301
Portland, ME 04101
Phone: 207-541-7534
E-mail: scrutk@mmc.org
The MaineHealth Ambulatory Electronic Medical Record - An Update
As many of us know, the current trends in physician practice workflow, including growing needs to measure quality and outcomes, the growing importance of shared information in clinical decision making, and the increasing clerical and administrative burdens on practices, led MaineHealth Board of Trustees to call for a plan to develop a community-wide ambulatory electronic medical record.
MaineHealth selected Epic to be its chosen vendor this past summer and signed a contract with them at the end of September. The project governance has been established and a steering committee convened. MaineHealth expects to be able to offer the system to a large number of practices in less than a year. A communication plan is under development that will provide practices with: - Their estimated initial and ongoing costs should they partner with MaineHealth in this initiative
- A general timeline for system "rollout"
- Guidance on how the priority of individual practices will be established within this rollout schedule
For more information about the Ambulatory Electronic Medical Record, please contact Asher Kramer at 662-5677 or by email at kramea@mmc.org.
New Public Health Resource for Local Healthcare Providers
The City of Portland HHSD, Public Health Division has developed a new ToolBox for Healthcare Providers on their website. The ToolBox can be accessed by clicking here. The provider toolbox includes the following information:- Alerts and Clinical Updates on local and statewide disease outbreaks.
- Provider registration for City Watch. City Watch is free software used by the City of Portland to communicate with key stakeholders. We encourage all primary care providers in Cumberland County to register for this free service. We will use City Watch to provide you with pertinent clinical information regarding local disease outbreaks and public health emergencies.
- Health Alert Network (HAN) updates from the Maine CDC regarding disease outbreaks and public health emergencies.
- Updates on Seasonal Influenza, including weekly surveillance reports and the availability of vaccine in our community.
- Updates on Immunizations.
- Resources on Pandemic Influenza, including resources for clinicians, resources for patients, and updates on local planning
efforts. - Links to CDC Health Information. This includes patient handouts and information on a wide variety of diseases. Information is available in 9 different languages.
- Listing of clinical and non-clinical services provided by the City of Portland HHSD, Public Health Division.
MaineHealth Clinical Integration Offers Free NEW Educational Brochures
MaineHealth's Clinical Integration Division is pleased to offer its NEW patient brochures, which are ideal for display in patient waiting areas, free of charge! Brochures are available on the following topics: gestational diabetes, diabetes, cardiovascular health, heart attack, asthma, and depression. Click here to see a picture of the display.
You can order these brochures (in packets of 25) at http://www.jsmccarthy.com/mainehealth. If you need a user name and password, please contact Elizabeth Lambert at lambee@mmc.org. The site also has a wide range of patient and provider education materials. If you are already a registered user of this online program, simply sign in and choose the brochures and tools of your choice!
For more information about Clinical Integration's new brochures and communication materials contact:
Julie Osgood, MS
Program Director, Clinical Integration
465 Congress Street, Suite 301
Portland, ME 04101
Phone: 541-541-7515
Fax: 541-7547
Email: osgooj1@mmc.org
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