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The Primary Care Office of the Future: Demonstrating Innovative Technology, Design, and Workflow Concepts cipci.org/future

The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

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Page 1: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

The Primary Care Office of the Future: Demonstrating Innovative Technology, Design, and Workflow Concepts

cipci.org/future

Page 2: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Introductions

Tom Agresta, MD, MBICIPCI Informatics LeaderProfessor of Family MedicineUniversity of Connecticut

Jeri Hepworth, PhDCIPCI Co-DirectorDirector of Medical EducationSaint Francis Hospital & Medical CenterProfessor of Family MedicineUniversity of Connecticut

Rebecca Andrews MD, MSCIPCI Education Leader

Associate Professor MedicineUniversity of Connecticut

Rachael Ingersol, MACIPCI Project Supervisor

Catherine MacLeanCIPCI Research Associate

www.cipci.org

Page 3: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Disclosures

The presenters have no financial relationships or affiliations with commercial interests.

Demonstrations include examples of tools that are available, but CIPCI does not endorse or have financial interests in any vendor or product.

The presentation does not include any discussion of unapproved or investigational uses of products or devices.

Page 4: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Goals and Objectives

Participants will be able to:Describe several innovative concepts identified with the

Primary Care Office of the Future exhibit.Describe how innovative technology can enhance patient

engagement, team based care, and clinician satisfaction.Discuss how Connecticut physicians are using some of the

ideas displayed. Consider innovations to be included in their own practices.

Page 5: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Outline of SessionPart I1. Overview of Office of the Future2. Discussion of key concepts3. Demonstration of select Office of Future tools

Break – 30 minutes

Part II1. Examples of regional implementation of concepts2. Create your future - group discussion exercise3. Wrap-up

Page 6: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

CIPCIOur MissionDeliver practical value for patients, providers, and payers by transforming primary care in ways that are palpable and sustainable.

Our Aims Serve as a trusted partner and resource Involve patients and patient perspectives Improve training for primary care providers Increase retention of primary care providersHelp practicing providers manage change

Page 7: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Expose primary care stakeholders to innovative and practical solutions that improve patient care and provider and staff experience.

Purpose

Page 8: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

better health

better care

lower cost

cliniciansatisfaction

quadruple aim

Bodenheimer, T., & Sinsky, C. (2014). From triple to quadruple aim: care of the patient requires care of the provider. The Annals of Family Medicine,12(6), 573-576.

Page 9: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

The Primary Care Office of the FutureA hands-on demonstration of new

practice designs and technology for primary care transformation.

Page 10: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,
Page 11: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Introduction to Office of the Future

cipci.org/future

Page 12: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

care anywhere

cipci.org/care-anywhere

Page 13: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

patient engagement centercipci.org/patient-engagement-center

Page 14: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

clinical team hub

cipci.org/clinical-team-hub

Page 15: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

cipci.org/clinical-team-hubexam room

Page 16: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Space designed to facilitate communication and collaboration

Page 17: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Telemedicine to connect to specialists or family members

Page 18: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

population health center

Page 19: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Learn more and engage your team:

www.cipci.org/future

Page 20: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

The Primary Care Office of the Future: Demonstrating Innovative Technology, Design, and Workflow Concepts

cipci.org/future

Page 21: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Introductions

Tom Agresta, MD, MBICIPCI Informatics LeaderProfessor of Family MedicineUniversity of Connecticut

Jeri Hepworth, PhDCIPCI Co-DirectorDirector of Medical EducationSaint Francis Hospital & Medical CenterProfessor of Family MedicineUniversity of Connecticut

Rebecca Andrews MD, MSCIPCI Education Leader

Associate Professor MedicineUniversity of Connecticut

Rachael Ingersol, MACIPCI Project Supervisor

Catherine MacLeanCIPCI Research Associate

www.cipci.org

Page 22: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Disclosures

The presenters have no financial relationships or affiliations with commercial interests.

Demonstrations include examples of tools that are available, but CIPCI does not endorse or have financial interests in any vendor or product.

The presentation does not include any discussion of unapproved or investigational uses of products or devices.

Page 23: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Goals and Objectives

Participants will be able to:Describe several innovative concepts identified with the

Primary Care Office of the Future exhibit.Describe how innovative technology can enhance patient

engagement, team based care, and clinician satisfaction.Discuss how Connecticut physicians are using some of the

ideas displayed. Consider innovations to be included in their own practices.

Page 24: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Outline of SessionPart I1. Overview of Primary Care Office of the Future2. Discussion of key concepts3. Demonstration of select Office of Future tools

Break – 30 minutes

Part II1. Examples of regional implementation of concepts2. Create your future - group discussion exercise3. Wrap-up

Page 25: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Review Concepts – Video from FMX

Page 26: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

The Future is Now

Page 27: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,
Page 28: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,
Page 29: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Tips

Use available codesMake changes to ease workflows

and improve careProfessional organizations have tool

kits for change

Page 30: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Transitional Care Management

Page 31: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Pros

More time with patients Better care Patients like being seen when

discharged Visit does not need to be done by

the doctor You know what’s going on with

your patients

Cons

Hurdle of getting admit/discharge notification Tight schedules Patients like seeing you when

discharged

Page 32: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Chronic Care Management

Page 33: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Pros

Reimbursement for work you are already doing and documenting Includes all patients on Medicare

with 2+ diseases

Cons

Associated co-payOnly Medicare

Page 34: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Financial Reality

Current reimbursement with co-pay

$40 334 patients per monthor 2.08 per hour based on 40 hours

Pays you back with increased quality reimbursements under MACRA

Page 35: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Remote Monitoring Solutions in Use in CTHeart failure – Reduced mortality &

hospitalizations @ 90 days1

CHF and hypertension• Home blood pressure & glucose

recorded in patient portal (Asylum Hill Family Medicine)

• EHR configuration to accept data from Apple Healthkit and Google Fit

1. Agboola S, Jethwani K, Khateeb K, Moore S, Kvedar J. Heart Failure Remote Monitoring: Evidence From the Retrospective Evaluation of a Real-World Remote Monitoring Program. EysenbachG, ed. Journal of Medical Internet Research. 2015;17(4):e101. doi:10.2196/jmir.4417.

Page 36: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Telemedicine and Reimbursement in CT Private insurance “Parity Law” – payment for telemedicine on par with

in-person services – Variable implementation ProHealth had pilot in 2015-16 –reassessing best uses Pilot of OB/GYN and behavioral Health in Hartford

State Medicaid exploring reimbursement. Check back in 2017. New England eConsult Network – Medicaid paying in demonstration

project Regional, including centers in Maine CHC, Inc. through Weitzman Center and UConn Health Dermatology, Cardiology, Endocrine, and Orthopedics

Corrections Medicine in CT – telemedicine from prison to UConn Health specialists

Page 37: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Teams need a “Virtual Assistant”

ProHealth – Automated medication refill wizard

Page 38: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Space and connectedness matter

Page 39: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,
Page 40: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Back to Reality

What can you and your team do?

Page 41: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Challenge Video

cipci.org/create-your-future

Page 42: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Engaging All ParticipantsWrite – Pair – Share

What are specific changes that you can make to facilitate efficient workflow, team collaboration, or clinical tool implementation?

Page 43: The Primary Care Office of the Future: Demonstrating ... · Tom Agresta, MD, MBI CIPCI Informatics Leader. Professor of Family Medicine. University of Connecticut. Jeri Hepworth,

Learn more and engage your team:

www.cipci.org/future