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Healtheast Emergency Medicine Practice
State of the Practice
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Healtheast Emergency Medicine
• Healtheast Visiono "Building on our benchmark performance, HealthEast will be a national leader in
clinical quality, patient experience and cost effectiveness – the best value – by 2015.”
• Emergency Medicine Practiceo Best Practice Emergency Medicine
• Clinical quality• Patient Experience
o Practice of choice for area EM Providerso Financially Responsible Practice
• 3 Departments• 93,000 pts• 35 MD’s• 7 PA’s• 2 NP’s
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Department Demographics
• Johnso 40,000 ptso 27% Admissionso 74% of inpt admissions from EDo LOS 230 min
• Joeso 24,000 ptso 31% Admissionso 60% of inpt admissions from EDo LOS 255 min
• WW’so 29,000 ptso 16% Admissionso 59% of inpt admissions from EDo LOS 171 min
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Practice Demographics
0-5 10 MD’so Ashley Seiverso Dan Thomaso Eric Rotho Jeremy Joyo Alex Gerbigo Shani Goo Cindy Winebrennero Dana Stephenso Jocelyn Wongo Jennifer Englund
6-10 10 MD’so Maryam Shaplando Scott Nicholso Tony Nardio Verna Arcedoo Kai Tuomineno Nancy Blonigeno Kurt Keogho Deb Lidahlo Kearney Stakeso Pete Tanghe
> 10 14 MD’so Brian Nesso Grant Nakamurao John Flipovicho Paul Sovello Paul McCormicko Ed Feinsteino Mark Newmano Bob Kileo Sam Riceo Tim Thompsono Dan Berndto Brad Bartho Jon Grimeso Al Autreyo Gerald Hill
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Practice Demographics
Joes• Mark Newman• Bob Kile• Sam Rice• Nancy Blonigen• Tim Thompson• Dan Berndt• Brad Barth• Brian Ness• Verna Arcedo• Al Autrey• Gerald Hill
WW’s
• Ashley Seivers• Cindy Winebrenner• Kurt Keogh• Deb Lidahl• Jocelyn Wong• Maryam Shapland• Scott Nichols• Jon Grimes• Matt Beatty• Dan Spielman
Johns• Kearney Stakes• Jennifer Englund• Pete Tanghe
• Dana Stephens• Dan Thomas• John Flipovich• Kai Tuominen• Paul Sovell• Jeremy Joy• Paul McCormick• Alex Gerbig• Ed Feinstein• Eric Roth• Shani Go• Mike Meyers• Jen Kipp• Deena G• Jason Dukes
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FinancialsJohns
o MD FTE 9.11o Mid FTE 3.88o Total FTE 12.9o Expenses 6,156,221o Pro-fee Revenue5,790,016
Joeso MD FTE 6.81o Expenses 4,122,049o Pro-fee Revenue3,653,722
WW’so MD FTE 6.2o Mid FTE 1.91o Total FTE8.1o Expenses4,099,871o Pro-fee Revenue4,072,163
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Clinical Measures• Malpractice Claims
o 8 “claims” in the last 3 yearso 1 Indemnity paid (HIPPAA issue)
• Core Measures (clinical process)o 2012 3/7 at 90th percentileo PCI in 90 min, blood cultures, abx choice
• HCAHPS (pt experience)o Pain mgmt, MD Communication, overallo 1/9 at 90th percentile
• VBP (combine Core Measures and HCAHPS)o 1% withhold of Medicare dollarso EDCAPS coming 2014
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Where were we?
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Lots of Change• Amion• Dedicated Scheduler• Coding Education• Scribes• Productivity Payments• McKesson• Telestroke, OFI’s• Nighthawk Differential• Studor initiatives• QIP changes• Robust, EM only Peer Review• ED Clinical Council• Email communication
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Progress at what expense?
• Frustration
• Defections
• Disengagement
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Our Vision• Vibrant, stable Emergency Medicine Practice which
contributes positively to Healtheasts mission
• Engaged (Satisfied) physicians and MLP’s with wide variety of backgrounds and experience level
• Group of provider partners who are interested in and see value in:o Best Practice
• Clinical Excellence• Patient Experience• Efficient Flow
o Positive participation in group initiativesANDo Perceive themselves as leaders in departmento Maintain Collaboration with departmental staff
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What is providers role?
• Captain of Ship?• One of the team• “Just a trench doc”• Emergency Medicine Physician• “Nurses run the department”• “You guys” make the decisions, I just follow
orders• Shift worker• Partner• Employee• Independent Contractor
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What do you want from a practice?
• Input?• Improvement?• “Just see patients”• Participate?• Grand Rounds• Education• Career development• Stability• More money