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The New World Of Healthcare
“According to Marketing”
October, 2014
Today’s Objective
• To provide a basic understanding of the following
– Why is marketing healthcare important in today’s world?
– Why does it matter to a pediatric practice?
– What does healthcare marketing look like today?
– What external forces are at play?
– How do you position your practice for success?
Marketing in Healthcare
Then and Now The 20th Century—The 21st Century
50 Years of Marketing
• 60s Mad Men and Don Draper
– Messages pushed out to the masses-few mediums
• 70s Creative and responsible
– Introduction of commercials with popular music - ered
• 80s Introduction of Direct to Consumer Advertising
– Expanding to more mediums
• 90s Branding and more targeted audiences
– Matching products to customers
• 2000s The Age of Digital
– Traditional methods like direct mail and print ads (outbound marketing) have given way to inbound marketing
• The customer finds you through searches (paid or organic, social media such as Facebook, online rating sites)
Healthcare Marketing Then
• The home visit
• Doctor hangs a shingle-visible advertising to people passing by
• Physicians gave the orders – Patients followed their orders
• Referrals from other doctors
“Because the Doctor Said So…..”
The New Consumer
• Armed with greater access to healthcare information and have multiple options for care
– In 2013, 72% of all internet users searched for health information online
• 39% were searching for information regarding another person’s health
• All of them were influenced by others sharing similar concerns
– According to the Social Mom report of 2013 by BabyCenter.com 70% of new and expectant moms are online
• Rely on others for opinions on healthcare
• Described as “the most social consumer you will ever meet”
What Does the New Mom Look Like?
• Informed and empowered – Armed with smart phones, e-readers, tablets
• Instantly research symptoms
• Consult with friends via social media – 45% of new moms are communicating more
through social media and emailing less often
– Why???? “I get the information quicker!”
• Make self-diagnosis on sites such as Web MD
• Self-prescribe or tell the physician what to prescribe
• Ordering products and services on-line
The New Mom is telling the doctor how to practice medicine!
ITunes and the App Store
• Apps are allowing this beyond the desktop
– Pregnancy & Newborn, Today’s Parent Milestone, Healthy Habits, Kids Doctor-Hospital
– Children’s Health • http://itunes.apple.com/app/id336547254?mt=8
– Asperger’s Syndrome, Asthma in children, Bullying, Cancer in children, childhood immunization, ear infections, newborn screening, etc., etc., etc.
Why Is Knowing This Important to Your Practice?
• The trend is here to stay
– In order to compete in today’s market, you have to insert your brand (practice identity) into the consumer’s decision-making process
• How do you manage your brand when you don’t have all the control?
– Monitor the trends and ratings
– Use this new technology to differentiate yourselves from others and your competitive offerings
– Communicate more responsive care and greater safety
How to Engage Your Patients
• If you don’t have a Website-Get one!!!!
– Basis for all other mobile applications
• If you haven’t updated your Website lately-Just Do It!
– Includes content, photos, health information, interactivity, search engine optimization, social media platforms, physician bios
– Develop a patient portal to include online bill pay (ensure HIPAA compliance)
• Be proactive in your communications
– Remind parents not to wait until the last minute to schedule their “Back to School” visits
• Communicate, communicate, communicate
– Email, Facebook, Email marketing campaigns
• Embrace the new technology, or you will get
Technology is Not the Only Factor Affecting Healthcare Today
• Continued concerns about the economy
• Uncertainty in the government’s role in healthcare
• Increased insurance premiums and co-pays
• Decreased reimbursement to providers resulting in increased balance billing
What is the Impact?
• Delays in seeking treatment
– Reduced visits to pediatrician’s office
– Opting out of certain treatment options
• Alternative treatment options
– The newest remedy in homeopathic care
• Shopping for more affordable providers
– The Retail Clinic-3 of the most dreaded words in healthcare today
Encroachment: Retail Clinics in the Pediatric Medical Home Space
• Retail clinics have been in place for > 14 years – By 2015 there will be 3,000 retail clinics in the
US alone • Why do people go to a retail clinic?
– Convenience-one stop shopping – Geographic proximity – Perceived immediate access to care
• My pediatrician’s office can’t get me in until 1 PM
• My pediatrician’s office is closed during lunch – Perceived less cost-transparency in pricing – Relative speed of treatment
Why is this encroachment particularly significant to your business?
• Located in areas that constitute families with
higher incomes and insurance coverage
• Moved beyond minor illnesses and injuries
• Sports physicals
• Vaccinations
• Obesity management
• Other
• Less likely to return to a primary care physician
Why is this encroachment particularly significant to your patients?
• Disruption in the continuity of care
• Potential for missed diagnosis of acute issue
• Potential for missed diagnosis of more serious, underlying issue
Pediatric Practices Mapped
• Children’s Medical Group • Cobb Pediatric Associates, PC • Dawson Pediatrics • Dunwoody Pediatrics, PC • DV Pediatrics, LLC • East Cobb Pediatrics & Adolescent Medicine, PC • Kennesaw Pediatrics, PC • Holcomb Bridge Pediatrics • La Clinical Del Nino, PC • North Fulton Pediatrics, PC • Northside Pediatrics and Adolescent Medicine • Pediatrics & Adolescent Medicine, PC • Pediatric Associates of North Atlanta • Pediatric Physicians, PC • Roswell Pediatric Center, PC • Sandy Springs Pediatrics and Adolescent Medicine
Kids Health First Pediatric Practices Northern Sec-Outside of 285
CVS-Minute Clinic Locations
Walgreens Pharmacy and Clinic Locations
Rite Aid Pharmacy Locations
Kroger Pharmacy Locations
Comparison of Locations
Cost-Quality-Convenience
• Timely
• Relevant
• Audience
specific
• Delivered on a
regular basis
• Identifies the
benefits to the
customer
• Cross sells
25
• Print advertisements and radio spots feature kids
• Back-to-school physicals, sports physicals and vaccinations
• Use illustrations and child-friendly photography
Target the Pediatric Population
Retail Clinics: Marketing
26
Retail Clinics: Marketing
• Highlight neighborhood locations
• Promise to make healthcare easy to access
– No appointments, no waiting
– Visits last only 15 minutes
– Open seven days a week, extended hours
Promote Convenience
27
Retail Clinics: Marketing
• Attract patients by promoting services that are affordable
• Offer a clear list of conditions treated and associated cost
• Highlight insurance plan coverage
Provide Transparent Pricing
28
Retail Clinics: Marketing
Promise Quality Care
• Promotes the delivery of quality healthcare via clinicians who are thoughtful, caring and qualified
• Highlight technology used to guide care and ensure follow-up
The Consumer Promotion and the Race is On
Creating a Patient/Retail Clinic Relationship
• Targets informed consumer via marketing/advertising in print, online, direct mail and other avenues
• Offers a robust list of services, including health screenings, sports physicals, vaccinations
• Promotes convenience, promising 15 minute turnaround times
• Provides pricing, thus increasing transparency
• Located inside pharmacies and grocery stores, providing convenience and one stop shopping for the “busy mom”
• Electronic medical records makes it easier to communicate results to PCP, if indicated
Added Credibility and Validity
How to Minimize the Effect
• Identify retail clinics in close proximity
• Assess their relationship with your patients
• Most retail clinics provide referral sources for situations they can’t treat-offer to be that referral
– Under the age of two
– Suspected UTIs in children
– X-Rays
– Lacerations which require suturing
• Retails clinics take their “meal break” outside of the 12-1:30 time period-adjust yours
• Promote the continuity of care and the pediatric medical home
• Counter their marketing efforts by being more proactive in yours
– Consider a Back-to-School Campaign or a Summer Safety communication
– Post information on conditions treated
Social Media and the Perfect Platform
Most Popular SM Platforms
Kids Health First Integration of Social Media
Other*
25/37 6 8 0 1 2
68% 16% 37% 0% 2% 5%
* Blog post, Foursquare, RSS
Why Social Media?
The New Mom
“The most social consumer you will ever meet”
The Five Myths of Social Media
• We can’t control social media
• Social Media is just another marketing campaign
• We can’t track social media
• Social media is taking place on desktop computers
• Social media will kill our brand
The Fear in Social Media
• HIPAA penalties
• $250K and up
• Imprisonment up to 10 years
• Result
– Many healthcare organizations shy away from social media and online communities
• Lose out on the many opportunities and benefits that social technologies offer
Case In Point
• Damage to the Brand – Children’s Hospital of Philadelphia
• Multiple posts on Facebook objecting to hospital’s refusal to schedule a patient’s kidney transplant
• An image/brand crisis – Responded quickly – Took the situation offline
• Fines/Penalties
– An ED physician identified a patient, not by name, but by recounting some of the experiences within the ED visit as well as the type of injury-was fined
Social Media
“While social media offers tremendous opportunities for personal and timely communication, the ease with which we accept and utilize this new medium must be tempered with caution for protecting the privacy and trust we expect and which the law legislates.” Medsafe-The Total Compliance Corner
The Balancing Act
The Overriding Benefits of Social Media
• Increases visibility of your practice
• Can increase patient traffic which translates to more volumes
• Act as a filter-refer your patients to credible sites and resources
• Actively communicate with your patients and influence their decision making
• Creates a deeper and more meaningful relationship with your patients
• Can help build a referral network
• Be a preferred provider
• Save money on traditional marketing
What Do You Need In Your Practice
• A social media policy in place
• Privacy and Terms of Use on the Website to include HIPAA statement
• A social media crisis policy in place
• A point person to monitor incoming comments/posts
• Q assessment to determine effectiveness, resources required, benefits, concerns
A Word to the Wise
Don’t launch and ignore
Most Importantly-DO NOT MIX
Personal with professional life
Dr. Katherine Chretian-”having a dual relationship with a patient that is financial,
social or personal can lead to serious ethical issues that can impair professional
judgment. The mere existence of a patient-physician relationship could be a
violation of HIPAA.” (Excerpted from Journal of American Medical Association
article)
The 2nd Most Feared 3 Words
• ONLINE RATING SITES
– Strike fear in the hearts of doctors
– Not going away-Growth is inevitable
– The patient empowerment goal of the Affordable Care Act gives credibility to patient feedback as an integral part of patient care
– We rate restaurants, movies, books-Why not doctors?
Online Reputation Management
• Why is this important? – Even one bad review can undermine your best efforts
– Study by Nielsen
• 70% of customers trust online reviews
– Study by Harvard Business School
• Even a 1 star improvement in restaurant reviews on Yelp increased revenue
– Site such as Healthgrades, Facebook and YouTube testimonials can influence your target audience
– Consumers use this as a way to find a new pediatrician
What and How to Manage
• Most sites are free to consumers
– Exception Angie’s List
• Most allow providers to interface with their sites, giving you the opportunity to post current, relevant and timely bios
– Most prevalent error-wrong address
– Creating an account generally allows you to monitor and respond to reviews
• Each site it different in terms of access, ratings, information provided – Be familiar with these sites and monitor your physician’s ratings
– And—if you patients know you are listed, they are more than likely going to provide positive reviews, which counteract the negative reviews
Online Sites to Consider
• General Consumer Sites
– Angie’s List
– Kudzu.com
– Yelp
• Specific Healthcare Sites
– www.healthgrades.com
– www.zocdoc.com
– www.drscore.com
– www.ratemd.com
– www.vitals.com
Consumer Rating Site: www.zocdoc.com
Demographics
• Name
• Address/Location
Accepts Insurance type
• Select Now
• Select later
Other search fields
• Languages Spoken
• Gender
• No preference
• Male
• Female Picture
Name, address, phone #
Available appointments
Map with locations of
physicians’ offices
revealed as part of
search results
Don’t Forget Your Own Online Reputation: www.Cmg-PC.com
Our Providers
• Overview
Listing
• Picture
• Name
• Credentials (FAAP)
• Picture
• Location
Other info
• Birthplace
• Undergraduate training
• Medical School
• Residency
• Board Certification
Picture
Bio
Community and professional involvement
The Old Rules in Traditional Marketing Still Apply
• Customers are kinetic
– Don’t always have smartphone in hand
– Easier to refer to paper
• Face-to-face connection
– Better communication
– Allows expansion of the initial objective opening the door for an additional touch point
– Promotes trust and assurance
• Websites are not all equal
– Difficult to navigate
– Lack of information
• The first line of defense is always the best line of defense
The New Rules of Marketing
• Establish a cohesive presence online and off
• Make it easy for your customers to recognize your brand and access your communications to them
• Maximize your mobile presence and make their experience friendly whether it’s visiting your Website or social media pages
• Optimize your message for multiple devices
• Make it personal
– Customized communication has become prevalent and customers not only expect it, but demand it
• Be transparent, even if you have to justify the cost-remind them the value you receive is greater
• Make your Website a voice for your brand
– Keep your content fresh, relevant and timely
– Be consistent in your messaging
• Play close attention to Online Reputation Management
• Add video to your marketing toolkit if possible
• Make social media a priority
Marketing is Everyone’s Responsibility
Marketing begins at the front door whether it is the first phone call, the first encounter with the physician, or the first visit to your Website.
The Cost of a Dissatisfied Customer
• 86% of people who are unhappy with you will say nothing
• For every one complaint received, there are 24 people who say nothing
• More than 90% who are dissatisfied with the service they receive will not return
• The average person with a complaint tells ~ 10 people
– 13% will tell > 20 people
• The “social mom” on Facebook tells “everyone” she knows and they tell everyone they know, and they tell everyone they know………………………………………………………………………..
The New World of Healthcare Marketing
One of the key components to the patient experience is patient engagement, of which social media has become a leading measure of a parent’s perception about many aspects of life, including healthcare.
As more and more new and expectant mothers enter the healthcare spending arena, social media will continue to expand its influence in the decision making process.
Physicians will need to embrace this mode of communication to remain relevant and top of mind in the healthcare decision process.
By not engaging, the patient experience with the PCP becomes less important and alternative options for seeking medical care will be explored.
Embrace the Movement
• Don’t – “Dig in your heels” and refuse to be part of the solution
– “Be a day late and a dollar short” or you will be left behind
• Do – Engage your patient and families
– Encourage all employees and physicians to promote your brand and be a positive influence as the face of your brand by communicating effectively and positively
Contact Information
Sue A. Lindstrom, Healthcare Marketing Consultant
4004-680-2802
http://www.linkedin.com/in/lindstromsue
Resources • The Doctor Will See You Now: How the Internet and Social Media are Changing Healthcare by Jam Kotenko, April 2013.
• Social Mom Report, 2013, BabyCenter, www.babycentersolutions.com
• Social Media-Institute of Medicine, http://www.iom.edu/About-IOM/Social-Media.aspx
• Success Awaits Those Whose Patient Care Includes Understanding the Care of Patients, www.geileon.com
• Getting to Know a Patient Before He Arrives H&HN, January 2014, www.hhnmag.com
• Through Your Patients’ Eyes by Marty Stempniak,Trustee-The Magazine for Health Care Governance, April 2014 Vol. 67 No. 4
• Creating a Culture of Patient Satisfaction H&HN, www.hhnmag.com March 7, 2013
• Technology-key to engagement at the individual level by Marty Stempniak, HH&N, June 2014, www.hhnmag.com
• Putting the Patient First, Healthcare Strategy Alert, Forum for Healthcare Strategists, 2013 Issue
• Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices by Kevin Pho, MD and Susan Gay
• Creating Value for Patients/Inbox HH&N, June 2014, www.hhnmag.com
• How to Achieve a Great—and Profitable—Customer Experience, Bloomberg Businessweek Research Services, February 2011
• How to Create Perfect Posts for the Most Popular Social Platforms by Veronica Maria Jarski, Marketing Profs, April 19, 2014
• Five Branding Characteristics that Connect with Women(Without Losing the Men) by Megan Stephens, Marketing Profs, September 3, 2014
• A Marketer’s Guide to the Empowered Healthcare Consumer, mdgadertising.com/healthcare
• Healthcare is On Sale by Marcus Pickett, http://netquote.com/healath-insurace/news/retail-clincs.asp#ixzz34Kwewlll
• Envisioning a Medicaid Future for Convenient Care Clinics: Can CCCs Alleviate Primary Care Pressures and Emergency Department Costs After Medicaid Expansion by Hilary Barlett, WWS402-J: Health Care and the States, May 3, 2011.
• Evidence About Whether Retail Medical Clinics Disrupt Doctor-Patient Relationship is Mixed, a Rand Corporation study; senior author Dr. Ateev Mehrotra, associate professor at University of Pittsburgh School of Medicine; researcher at RAND, a nonprofit research organization.
Resources
• AAP Principles Concerning Retail-Based Clinics, Committee on Practice and Ambulatory Medicine; Pediatrics; originally published online February 24, 2014; DOI: 10.1542/peds.2013-4080
• www.minuteclinic.com
• www.walgreens.com/clinic
• www.thelittleclinic.com
• www.walmart.com/cp/Walmart-Clinics
• Retail Clinic Visits and Receipt of Primary Care, Journal of General Internal Medicine, April 2013, Volume 28, Issue 4, pp 504-512
• Urgent care centers must be made ready for kids: New AAP guidelines, http://medicalpress.com/news/2014-04-urgent-centers-ready-kids-aap.html
• Top 10 Challenges Facing Physicians in 2014 Medical Economics, http://medicaleconomics.modernmedicine.com
• 10 Trends to Watch in Pediatric Medicine: Part 1, Boston Children’s Hospital, September 2013
• Predictions About the Future of Pediatrics Contemporary Pediatrics, http://contemporarypediatrics.modernmedicine.com/print/149821
• Market Forces in Pediatrics http://www.aap.org/en-us/professional-resources/practice-support/Business-of-Pediatrics
• Primary Care in an Era of Health Care Reform, Strategies for Reorienting the Health Care Delivery System Toward Primary Care, Health Care Strategies & Solutions, Inc.
• Price Transparency (Its Time Has Come) by Lola Butcher, H&HN, June 2014, www.hhnmag.com
Appendix
Best Times to Post
• A blog post 11 AM
• YouTube 1-3 PM
• Facebook 1-4 PM
• Twitter 1-3 PM
• Google+ 9-11 AM
• LinkedIn 7-9 AM and 5-6 PM
• Tumblr 10 PM
• Pinterest 2-4 PM and 8 PM-1 AM
Worst Times to Post
• A blog post 6 AM
• YouTube 3 AM-7 AM
• Facebook 8 PM-8 AM
• Twitter 8 PM-9 AM
• Google+ 6 PM-8 AM
• LinkedIn 10 PM-6 AM
• Tumblr 6 AM
• Pinterest 5 PM-7 PM Marketing Profs 4-19-2014
Donuts#SocialMediaAnalogy Social Media The Message
Twitter I’m eating a # donut.
Facebook I like donuts.
Foursquare This is where I eat donuts.
Instagram This is a vintage photo of my
donut.
YouTube This is how you eat a donut.
LinkedIn My skills include donut eating
These are all the different
donuts you can eat, make and
buy.
10/15/2014
1
Developmental Milestones for a CIN Practice
Practice Administrator’s Meeting 10/16/2014
Current State
We are an association of individual private practices who are committed to providing the highest level of quality
pediatric healthcare to improve children's overall health and well being
10/15/2014
2
Future State as Part of a CIN
A Clinical Integration Network (CIN) is a collaborative effort among physicians, usually supported by a health care system, to actively develop clinical
initiatives that will improve the quality of health care services and control costs.
Common Objectives
• Keep your individual identity • Preserve the private practice model • Complement what each entity does well • Improve efficiencies • Reduce costs • Limit duplication of efforts • Increase access to data • Improve communication • Improve access
10/15/2014
3
How do we get there?
Baby Steps
Sit‐up Crawl Walk Run
10/15/2014
4
Developmental Milestones for a CIN Practice “Baby Steps”
Sit‐up•Commit to CCN
•Develop a communication channel
•Education on measures
• Link to technology
•Gather Baseline Data
Crawl•Create quality infrastructure (CI Champ, Q Coor, PA)
•Acceptance of Core Measures
•Coding education
•Benchmark Data
• Set priorities
•Start to implement process changes in practice
Walk•Take Action
• Implement project plans
•Active participation from all staff
• Collect data / analyze results
• Identify Barriers
• Establish ongoing processes
•Education on PDSA cycles and development of SMART Aims
•Re‐evaluation
•Submit best practices
Run• Identify areas of need from data
•Easy acceptance of new programs
•Periodic assessments
•Population buckets
•Peer interaction
Year 1
Year 1‐2
Year 2‐5
Year 5+
Each stage identifies checkpoints for practices
KHF practices have experience in all stages, but not with multiple programs and PHM reporting
Sit‐Up Crawl Walk Run
CCN • Build Program Foundation
• Governance/structure• Membership
recruitment • Outline expectations of
participation • Select technology &
build measures, obtain data
• Introduction of QI Programs to members
• Get payor buy‐in• Develop participation
measures and some process measures
• Benchmark data • Set performance goals
and timeline• Activate QI programs • Training practices on the
science behind QI
• Re‐Assess • Identify best practices • Identify barriers • Refine measures • Focus on process
measures • Implement non‐
compliance process • Publish Data
• Hold physicians accountable
• Assume Risk • Outcome Measures • Focus on care mgmt
programs • Identify new programs • Identify
commonalities in data
Practice • Commit to CCN• Establish communication
channel• Link to technology (PHM
tool) • Gather baseline data
• Create Quality infrastructure (CI Champ, PA, Q Coor.)
• Understanding of measures • Evaluate data for care
opportunities • Start to implement process
changes in practice
• Implement changes in practice
• Determine barriers• Establish ongoing
processes• Practice discussions
• Easy acceptance of new measures in process flow
• Peer interaction • Management of
patient populations
Strategic Focus
• Commitment• Selection of successful
QI programs • Use of technology
• Participation focus • Adopt care guidelines• Measure and share data
• High Cost • High Risk• High frequency• Quality/Utilization and
financial reporting
• Enhance capabilities• PCMH potential• Continuum/transitions• Identifying patterns from CCN data
Year 1 Year 1‐2 Year 2‐5 Year 6+
10/15/2014
5
Role of the Practice Administrator
• Ambassador and Champion • All quality improvement programs at some point will flow through the Practice Administrator
• Coordinate efforts between providers, front office, back office
• Understanding of the business side of the practice
• Open dialogue to identify barriers • Critical to the success of the CIN!
Next Steps for Practice
– Receive formal notification from Kids Health First of IPA participation in CIN
– Link to population health management tool to exchange data
– Review and understand core quality measures
– Establish a process flow to accept clinical data for your patients outside your current data system
– Develop a communication channel within your office • How do you accept information from external sources?
• How do you communicate it with your team?
• Who is responsible for acting on it?
• How do you communicate with multiple practice locations?
10/15/2014
6
CCN Status Update as of 10/15/14• Official CIN Name: The Children’s Care Network • Recruitment: next 2‐4 weeks • Physician Agreements: Approved• KHF Requirement: Not in beginning but will likely become required • Data: McKesson Population Management Tool – contract signed will pull
all claims‐based data from participating practice's EMR or PM system • CCN Staff: currently recruiting (Ex Dir., Med Dir., CI staff)• Membership Dues: TBD, to be paid through your KHF Dues• Contracting: none at this time CMO likely first, Commercial by end 2015• Core Measures: Approved by CCN BOD
– Mostly HEDIS based – Anticipated baseline data to be puled Q4‐ 2014
• Membership Meetings: CHOA Medical Staff Meeting 11/5/2014 6:00 p.m.– 4 Quality forums in 2015‐ TBD
• KHF Role: (value‐added programs, CI Programs) – Under Negotiations
Visit www.CHOA.org
Core Measures
• Developed from programs already participated in by KHF practices
• HEDIS‐based • Focus on well child visits, immunizations, appropriate screenings, concussion, asthma, and obesity
• Detailed handout in packet
Contact: Elizabeth Hogan(770) 333‐0033 ext: [email protected]
1 | P a g e
CoreClinicalProgramMeasures(BoardApproved)
Bluedenotesyear1measurethatwillrequireadditionalchartreviewwithPHMtoolRed denotes year 2 or later measure
PreventativeCareWellChildVisits The percent of children who have had six (6) or more well child visits with a PCP during their
first 15 months of life.
The percent of members age 12 months to 24 months who had a well child visit with a PCP during the measurement year.
The percent of members age 12‐19 years of age who had an annual well child visit with a PCP during the measurement year.
The percent of members 3‐17 years of age who had an outpatient visit with a PCP and who had evidence of BMI percentile documentation, counseling for nutrition and counseling for physician activity during a measurement year (duplicate Obesity measure).
AppropriateScreenings The percent of members who completed at least three standardized developmental
screenings by 30 months of age. (Recommended ages 9 months, 18 months and 24 or 30 months).
The percent of children who completed standardized autism‐specific screening tools at 18 and 24 months of age.
The percent of women 16‐24 years of age who were identified as sexually active and who have had at least one test for Chlamydia during a measurement year.
The percent of infants and children 2 weeks to 18 months of age who presented for a well child exam where documentation of screening for risk factors and documentation of appropriate exam maneuvers was notated in the medical record (MOC Program).
ImmunizationsChildhood Immunization Status:
The percentage of children 2 years of age who have had: 4 DTaP 3 HepB 2‐3 RV 3 IPV 1 VZV 2 Flu
1 MMR 4 PCV 3 Hib 1 HepA * This measure calculates a rate for each vaccine and nine separate combination rates.
Immunizations for Adolescents:
Percentage of adolescents 13 years of age who have had one dose of meningococcal and one tetanus, diphtheria and acellular pertussis vaccine (Tdap) or one tetanus, diphtheria toxoids vaccine (td) by their 13th birthday. *This measure calculates a rate for each vaccine and one combination rate.
Concussion Documentation of prior concussion – Number of children 0‐19 years of age who sustained a
concussion in the last 12 months and had a 2nd concussion documented within the 12 months following initial concussion in the PCP office.
2 | P a g e
PCP visit for concussion – Number of children aged 0‐19 years with a visit at the PCP office for concussion in the last 12 months.
Referral for CT Scan – Number of children aged 0‐19 years (potential to carve out 0‐3 months) with a CT scan for concussion in the ED.
ED Visits – Number of ED visits for concussion for children aged 0‐19 years who had a visit at the PCP on the same day for concussion.
Return to Play/School Letter – Documentation of children aged 7‐19 years with successful completion of stages 1‐7 for Play and 1‐4 for School (Return to Play/School letter in PCP office).
Physician Survey for a) comfort level among pediatricians and b) use of concussion guideline.
Asthma Annual percentage of asthma patients with one or more asthma‐related emergency visits
(ages 2‐20).
Asthma action plan rate for children with asthma office visits in past year.
Asthma Assessment rate for children with asthma office visits in past year (based on AAP Asthma Assessment Questionnaire).
Flu immunization rate for children in the past year.
Percentage of members who were identified as having persistent asthma and who were appropriately prescribed medication.
Percentage of members who remained on asthma controller medication for at least 50% or at least 75% of their treatment period.
Number of children in the past year receiving spirometry with new diagnosis of asthma.
Number of children who have undergone serologic or skin prick testing to assess aero environmental allergic triggers.
Diabetes(Endocrinology) Diabetes‐DKA readmission rate at CHOA per endocrinology practice.
Average blood glucose meeting standard i.e. HbA1C ≤ 7.5%.
Percentage of patients aged 10 or > with type I diabetes mellitus (for 5 or > years) who received urine Microalbuminuria screening at least once within 12 months.
Celiac Panel for children with new diagnosis of type 1 diabetes with in 1st year of diagnosis.
% of kids with 1 severe hypoglycemic episode in the past 3 months.
% of kids with 2 or more severe hypoglycemic episodes in the past 3 months.
Patient Visit Rate (for Schedule Diabetes Office Visits) Compliance.
Obesity Members 3‐17 years of age who have evidence of BMI percentile documentation,
counseling for nutrition and counseling for physical activity during the measurement year.
Lipid screening, ordered and completed, for all patients at least 9 years old. Secondary Measures for Select Populations – Treatment
Documentation of Wellness Goal (fitness goal, follow up and BP).
Documentation of ordered and completed labs‐ ALT, AST and glucose for children greater than the 85 percentile of BMI and a minimum of 9 y.o.
KHF Total Utilization % of Total
99211 4597 2%99212 16980 9%99213 141191 71%99214 34152 17%99215 1223 1%
Web - Suggested Bell Curve
99211 5.0%99212 12.5%99213 65.0%99214 12.5%99215 5.0%
Kids Health First Network
Sick Coding Distribution for January - June 2014 - Kids Health First Netwo
The KHF Network distribution shown above includes data from 23 of 39 practices. If you submitted your data to me, you will receive your practice's sick-coding distribution by the end of the week. As always, t for your participation!
2% 9%
71%
17%
1% 0
20000
40000
60000
80000
100000
120000
140000
160000
99211 99212 99213 99214 99215
KHF Network
KHF Total Ut
5.0% 12.5%
65.0%
12.5% 5.0%
0.0%
10.0%
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ICD-10 Documentation and mapping for
Primary Care Pediatricians Date: Thursday, November 20, 2014 Time: 6:30 – 9:00 Location: Marriott Perimeter Mall - Dinner will be served RESERVATION IS REQUIRED – email Kristine Houze at [email protected] In an effort to prepare Primary Care Physicians for the upcoming ICD-10 Transition, Sanofi and Kids Health First will sponsor training In November that will focus on the following topics:
• ICD-10 documentation for the Pediatric PCP • ICD-10 mapping for the Pediatric Primary Care practice • Correct and ethical coding for 90212 – 90215
This training will be presented by Richard H. Tuck, MD, FAAP
PLEASE NOTE: Space will be limited and PCPs in TCHN will also be invited. Please RSVP as soon as you can in order to reserve your space for this important training.
SAVE THE DATE
