Friday, June 1, 2012

Checking In On Our Strategic Plan

It may be warm outside and not typical “end of the year” weather, but our year-end from a business perspective is coming up in a few weeks, and as we come to the end of the first year of our three-year strategic plan to get to our vision, it’s time to reflect and see how we are doing and what accomplishments we have reached.

As I outlined last July in “New Year, New Vision, A Need for More and Faster Improvement” , our strategic goals are centered around the Triple Aim of Better Heath, Better Care, Less Waste --- and we added a fourth bullet of More Joy.  I stressed that in order to achieve this vision, we have to get better at executing change through the eyes of our patients, and I think we’ve been quite successful in doing so in Fiscal Year 2012.

The essence of our strategy lies in two parts – better coordination of care and a compact with our physicians for better care coordination. We have great doctors who work very hard but we need their help in redesigning systems so that everyone gets the care that we want for our own loved ones. We are also embracing physicians who want to remain in private practice as long as they will join us in pursuing our vision.

In order to coordinate care, we must have electronic records.  We’ve now fully implemented electronic health records in the 40+ offices of all our employed physicians (Greater Baltimore Medical Associates), both primary care and specialists.  This use of electronic health records is giving us the ability to create disease-specific patient registries so, for example, we can see how our diabetic patients are actually doing. This also gives us the opportunity to get messages about who has recently been discharged from the hospital so we can check-in with those patients and keep them on the road to recovery. We also now can make discharge summaries available within the electronic health record for employed physicians.

In the hospital we’ve fully implemented Computerized Physician Order Entry and have taken a lot of wasteful steps out of the processes that were created by having orders done on paper.

There’s been a lot of change with our GBMA practices on the Towson campus and locations across the region this year.  The GBMC at Joppa Road practice is brand new and started seeing patients last month, our GBMC at Perry Hall office moved to a new and larger location, and the GBMC at Hunt Manor practice was renovated. GBMC at Hunt Valley achieved NCGA Level 3 status as a patient centered medical home and is the model for our future and we opened the GBMC Gastroenerology group with several providers of GI services on the hospital campus.

We also launched Greater Baltimore Health Alliance and extended our primary care reach through Baltimore County.  To date, we have signed up providers in eight primary care private practice sites in the network: Chapel View Family Care (Perry Hall); Joseph T. Pallan, MD (Lutherville); Richard C. Habersat, MD (Hereford); Feirtag & Ramos PA (Lutherville); Alan Kimmel & Donald Weglein (GBMC Physicians Pavilion North); Jarrettsville Family Care (Jarrettsville); Josephs, Turner, O’Malley, PA (Towson); and Vincent P. Wroblewski, MD (Lutherville), all of whom have the same electronic health record that GBMC employed doctors have. These physicians are now in a better position to work with us in achieving  the Triple Aim, and its much easier for them to refer patients to specialists and to communicate with those physicians about how their patients are doing – again, a huge step in coordinating care.

GBMC has also enrolled in the Chesapeake Regional Information System for our Patients (CRISP) network, Maryland’s statewide health information exchange. Soon our providers will be able to access realtime messages about patients if they seek healthcare beyond the walls of the GBMC HealthCare system.  We are now beginning the dialogue with our private practice specialists about adopting our electronic record or linking their record to ours.

We’ve made a lot of progress in the area of informatics, but we’ve also made significant progress in care coordination doing things like freeing up primary care visits for emergency department patients who don’t have a primary care physician, extending office hours from 7 a.m. to 7 p.m. in many primary care offices, and launching the “myGBMC” patient portal to make it easier for patients to get lab results, schedule their next appointment and communicate with their doctor.  So far, 17,000 patients have registered at

In addition, we have gone a long way toward educating our staff about high reliability and patient safety issues, and are eagerly awaiting formal word of our application for the Medicare Shared Savings Plan through the Affordable Care Act.  For employees, we’ve made changes to the health insurance plan, lowering the out of pocket healthcare expense for many staff members and keeping their contributions at the same level as it was last fiscal year.

What I’ve highlighted here is only a small sample of all of the things that we have accomplished this year to get to better health, and better care with less waste and more joy for those providing the care. Thanks to all of my colleagues for all that you have done!

Have you benefited from any of our wonderful changes in the last year? What do you like the most in these improvements? What changes will you make to help us get to our vision faster? What other ideas do you have to improve the patient experience?

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