7 Steps to Transforming Your Practice Into An Oncology Medical Home
Community Oncology Conference Thursday April 23rd, 2015
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Harder Than It Sounds
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Intent of OMH
Develop a new approach to health care:• Starting with cancer care• With emphasis on:
– Developing the right strategies – To do the right things– Proving that you did the right things – Getting recognized – Getting rewarded
Be ahead of industry changes that are inevitable
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#1 – Think Differently
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#1 – Think Differently
The OMH is good for patients and for healthcare
Everything you do matters Everything you do makes a positive impact However….
• Every action causes a reaction• Are your results positive? • What about quality?• What about value?• Are you getting better?• How do you know you are getting better?
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#2 – Design it
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#2 – Design it
Your goal should be efficient, comprehensive, timely and effective in proving that your team IS the best cancer team on the planet.
Not just printed policy or procedure, but workflow change
Educate the care team, change the mindset Be creative Remove prior boundaries and pre-conceived
notions
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#3 – Do the Right Thing
No argument – you do good things Can you do better? Is your “good” aligned with the needs of
Patients, Families, Payers, Employers? How do you know? How do they know?
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Quality, Value, Outcomes Measures
Patient Care Measures
% of cancer patients that received a treatment plan prior to the administration of chemotherapy.
% of cancer patients with documented clinical or pathologic staging prior to initiation of first course of treatment.
% of chemotherapy treatments that have adhered to NCCN guidelines or pathways.
Antiemetic drugs given appropriately with highly emetogenic chemotherapy treatments.
% of cancer patients undergoing treatment with a chemotherapy regimen with a 20% or more risk of developing neutropenia and also received GCSF/white cell growth factor.
NEW 08/07/13 - Appropriate use of advanced imaging for early stage breast cancer patients.
NEW 08/07/13 - Appropriate use of advanced imaging for early stage prostate cancer patients.
NEW 08/07/13 - Presence of patient performance status prior to treatment.
Resource Utilization
# of emergency room visits per chemotherapy patient per year.
# of hospital admissions per chemotherapy patient per year.
Survivorship
% of cancer patients that received a survivorship plan within X days after the completion of chemotherapy.
% of chemotherapy patients that received psycho/social screening and received measurable interventions as a result of the psycho/social screening.
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Survivorship
Survival rates of stage I through IV breast cancer patients.
Survival rates of stage I through IV colorectal cancer patients.
Survival rates of stage I through IV NSC lung cancer patients.
End of Life
% of patients that have Stage IV disease that have end-of-life care discussions documented.
Average # of days under hospice care (home or inpatient) at time of death.
% of patient deaths where the patient died in an acute care setting.
A measurement of chemotherapy given near end of life.
Other
Patient satisfaction reporting and scoring.
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Example:
Patient Phone Triage
Active chemotherapy patient needs an
appointment.
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This is Mary at Community Cancer Center. May I help
you?
Yes ma’am, this is …
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#4 – Prove you are doing the right things
OMH is not Meaningful (Meaningless) Use Some measures are numbers/reports only Some measures are process driven Change your process MEASURE and REPEAT!
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#4 – Prove what you are doing
Category National State Practice Size %Medicare
Overall 91.19% 92.95% 90.98% 91.78%Timeliness 84.22% 87.61% 83.73% 85.37%Thoroughness 91.32% 92.89% 91.41% 91.69%Communications
98.89% 99.07% 98.74% 99.00%
Friendliness-Helpful
96.96% 97.99% 96.47% 97.53%
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#5 – Share what you are doing
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#5 – Share what you are doing
Practice Team/Teams New Patients Families of New Patients National Payers Local Payers Local Employers Other Practices for “Best Practices”
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#6 – Make progress
Visits, revenue, volume – NO PROBLEM What about?
• Quality• Value• Satisfaction• OMH 19 Measures• Financial assistance• Pathway compliance• Etc.
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#6 – Make progress
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#6 – Make progress
Category National State Practice Size %Medicare
Date Range 1st 2nd 1st 2nd 1st 2nd 1st 2nd
Overall 91.42% 92.51% 92.97% 93.10% 92.16% 92.27% 91.54% 92.86%
Timeliness 84.88% 86.81% 88.39% 87.41% 86.17% 85.91% 85.16% 87.27%
Thoroughness 91.35% 92.08% 92.91% 92.96% 92.13% 92.29% 91.50% 92.32%
Communications 98.97% 99.10% 99.00% 99.22% 98.90% 99.11% 98.97% 99.16%
Friendliness-Helpful
97.29% 98.00% 97.81% 98.32% 97.37% 97.85% 97.33% 98.24%
1st 2ndIn the last 12 months, when you phoned this provider’s office after regular office hours, how often did you get an answer to your medical question as soon as you needed?
Never 5.90% 3.90% Sometimes 6.50% 6.50% Usually 17.40% 16.30% Always 70.10% 73.30%
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#7 – Teach others
State societies Trade journals COA CoC ASCO ACCC ONS
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#7 – Teach others
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7 Steps to Becoming an OMH
1. Think differently2. Design it 3. Do the right thing4. Prove you are doing the right
things5. Share what you are doing6. Make progress7. Instruct others
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Questions/Comments
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