opqc ob action period webinar...log elements • gestational age at rx • history of preterm birth...
TRANSCRIPT
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OPQC OB Action Period Webinar
November 19, 201512:15 – 1:15 PM
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Please put the call on mute not hold!
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Welcome• AGMC's Women's Health Clinic• Aultman Physician Center-OB/GYN
Clinic• Brown County Women's Health• Center for Women’s Health,
University of Cincinnati Medical Center
• Doctors Hospital Women's Health Center
• Faculty Medical Center—OB Resident Clinic GSH (TriHealth)
• Fairview Perinatal Department (Cleveland Clinic)
• Five Rivers Health Centers, Center for Women's Health (Miami Valley Hospital)
• MacDonald Women's Hospital Clinic (Family Practice and OB Faculty Clinic)
• Maternal Fetal Medicine at Hillcrest Hospital Atrium (Cleveland Clinic)
• Mercy OB/GYN Associates Family Care Center/ MFM Clinic
• MetroHealth Women's Clinic• Mount Carmel St. Ann’s OB/GYN
Clinic• Mt. Carmel West Outpatient Clinic• OSU McCampbell Clinic• OSU Martha Morehouse MFM• OSU East• Outpatient Care Center at Grant
Medical Center• ProMedica Center for Health
Services – Women’s Services (ProMedica Toledo Hospital)
• Riverside OB Community Care Clinic/ MFM Consultative Practice
• St. Elizabeth Boardman’s Health Center
• Tri-State Maternal Fetal Medicine Associates, Inc.
• Women's Health Center at Summa Akron City Hospital
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TodayTopic Objective Facilitator
Welcome Greetings Martha Rome
Improvement in Preterm Birth
Review ODH birth registry data(Do the happy dance!)
Dr. Jay Iams
Medicaid Partnership
• All teams, all Plans, all Medicaid patients
• Huddle with Plans• Skinny Forms /
Candidate Forms• Team Progress
Dr. Carole LannonMartha RomeTeams
Next Steps Complete work for November
Martha Rome
October Data Review inpatient data Dr. Jay Iams
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Decreased Preterm Birth Rate for Women with a Prior Preterm Birth!
Something’s going right…
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Great News !!!From January 2014 October 2015
Ohio Birth Registry Data • Recurrent preterm birth < 32 weeks decreased
by 20% at at OPQC hospitals• Recurrent preterm birth < 37 weeks decreased
by 11% at OPQC hospitals
• Recurrent preterm birth < 32 weeks decreased by 19% at all Ohio hospitals
• Recurrent preterm birth < 37 weeks decreased by 10% at all Ohio hospitals
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MEDICAID PARTNERSHIPDr. Carole Lannon
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OPQC and
The Medicaid Managed Care Plans
Goal: Identify pregnant women at risk of preterm birth and
adverse outcomes and quickly provide needed support and
intervention
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OPQC + Medicaid MCP ProjectEnsure that women receive progesterone 17 weeks gestational age and other evidence-based interventions as soon as possible. MCPs working in partnership with providers should:
– Identify needed care, medical and social/emotional as well as practical supports
– Arrange for, or provide transportation to health appointments, assistance with continuation of insurance coverage, smoking cessation, home care, payment for progesterone in office, etc.
– Monitor and coordinate care to enhance the health and wellbeing of each mother and child
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Need: Effective communication between
practice and MCPs to connect pregnant women at risk with
needed support
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COMMUNICATION FORMMartha Rome
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Communication (Skinny) Form
1. Brief risk assessment2. Communicate to Medicaid Managed Care Plan
for:– Expedited Progesterone– Decrease risk of loss of benefits (Plan contacts
County JFS)– Improves planning for care– Starts process for Care Management (if needed)
3. Collect data for improvement on some of our most vulnerable patients
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More About the Communication Form
1. It’s really short2. It takes the place of the PRAF, a much
longer form3. It’s the same form for each Medicaid Plan4. You can customize it by adding to the back
or additional pages5. You get paid for completing it
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Plan will partner to meet patient needs
How do you want return communication?
Plans will reimburse for first dose of Makenafree
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OPQC +Medicaid MCP Project• All OPQC OB teams asked to begin to use new form
on November 2, 2015.• Use the Communication Form for ALL Medicaid OB
patients. • If you would like to collect additional information, you
may add that on the other side of the form or on additional pages.
• Complete an additional form when there is a demographic or risk change.
• All 5 managed care plans will be expecting to receive the communication form, rather than any other notification of pregnancy.
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Communication Forms so far…
• 116 Forms• 12 Sites
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We recognize ‘skinny’ communication form is new
work. And that it provides new +
useful data.
So, we can stop collecting ‘old’ data.
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Candidate Forms
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Candidate vs. SkinnyCandidate Form• All progesterone
candidates• Clinic name• Patient ID (from log)• Progesterone reason• Progesterone
accepted/declined• Type of progesterone• GA @ Rx• GA at birth• Enter into OPQC website
Skinny Form• All Medicaid patients• Clinic Demographics• Patient Demographics• Progesterone reason• Date given/to be given
progesterone• Type of progesterone• Medicaid assistance• Fax to Plan• Reimbursement for
each form by Plans
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Progesterone Log
Keep the Log Log Elements
• Gestational age at Rx• History of preterm birth
or short cervix• Declined progesterone• 17P or vag P• Continued after 4
weeks
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Need: Effective communication between
practice and MCPs to connect pregnant women at risk with
needed support: huddles
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“Huddle” with Medicaid Plans• Invite them to your meetings to partner on
patients• Get creative – think of new (better) ways to
do things• Talk about your whole population of patients
and individual needs, both met and unmet• Use Huddles for the “Study” part of PDSAs• Rotate weeks with different Plans• Have a “go to” person from each Plan• Keep it brief!
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Communication with Medicaid and Plans – what barriers are you having and how would you like return
info from the Skinny Form? (1 minute briefs)
• Center for Women’s Health, University of Cincinnati Medical Center
• Doctors Hospital Women's Health Center • Faculty Medical Center—OB Resident Clinic GSH (TriHealth)• Aultman Physician Center-OB/GYN Clinic• Five Rivers Health Centers, Center for Women's Health (Miami
Valley Hospital)• Mercy OB/GYN Associates Family Care Center/ MFM Clinic• MetroHealth Women's Clinic• Mount Carmel St. Ann’s OB/GYN Clinic• AGMC's Women's Health Clinic
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Communication with Medicaid and Plans – what barriers are you having and how would you like return
info from the Skinny Form? (1 minute briefs)
• Mt. Carmel West Outpatient Clinic• OSU McCampbell Clinic• OSU Martha Morehouse MFM• OSU East• Outpatient Care Center at Grant Medical Center• ProMedica Center for Health Services – Women’s Services
(ProMedica Toledo Hospital)• Riverside OB Community Care Clinic/ MFM Consultative Practice• St. Elizabeth Boardman’s Health Center• Tri-State Maternal Fetal Medicine Associates, Inc.• Women's Health Center at Summa Akron City Hospital
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What’s Next? Identify Primary and Secondary Contacts:
email names and contact info to: [email protected]• Let us know how you prefer to get
communication from the Plans: email, spreadsheet, fax, phone
Complete Monthly Progress Report by Nov. 5– The link will be sent to the OPQC OB
Progesterone Project Key Contact Be sure to open your Monthly Newsletters for
FAQ, success stories, upcoming calls and meetings!
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INPATIENT DATADr. Jay Iams
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Inpatient Data Collection
• Why Do We Want Inpatient Data?– Isn’t it too late? No, and It’s Important!
• We Need to Know: – The Fraction of ALL PTB’s that Our
OPQC Progesterone Project Can Affect.– Where Do Progesterone-Eligible Women
Come From? Hosps? Clinics? Zip Codes?
– How Can We Find More of Them?
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We Are Doing Well On ANCS Administration
And Documentation
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HOSPITAL DATA COLLECTED BY INPATIENT TEAMSNUMBER OF PRETERM BIRTHS / MONTH
PARTICIPATION INCREASED JANUARY AUGUSTBUT HAS DROPPED OFF SINCE THEN – WHY?
THIS DATA CREATES THEDENOMINATOR FOR THENEXT GRAPH
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HOSPITAL COLLECTED DATA % OF WOMEN WHO DELIVER PRETERM
WHO ARE ELIGIBLE FOR PROGESTERONEWHO ARE or ARE NOT RX’D
August Ratio of ALL PTBsTo ELIGIBLE PTBs:72 / 493 = 15%31 / 72 = 43%31 / 493 = 6% Really?
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Percent of FIRST SPONTANEOUS PTBs at OPQC Charter Sites
January October 2015Do We Need This Data?
YES WE DO !
AUGUST = 366 1ST TIME sPTB493 minus 366 = 97 2nd + PTBs72 / 97 = ~ 75% = ~ Right %31 / 72 = 43 % = About Right
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Distribution of GA for Inpatient Data
75% of Neonatal Mortality