The WCHQ Board Retreat September 13 at the Heidel House in Green Lake was successful on many levels. Board members networked with colleagues after having not been together in person for nearly two years. Board members contributed to a lively and productive dialogue with a goal of generating and operationalizing ideas that align with WCHQ’s mission. The general sessions centered on the current state of the health care environment. The breakout sessions focused on two areas: defining the role of employers in WCHQ’s work and determining the critical use cases for WCHQ data now and in the future.

WCHQ President and CEO Gabrielle Rude, PhD, started the day by recognizing the important role the WCHQ Board plays in shaping the future direction of the organization.

“My priority over the past year has been to meet members and learn firsthand how WCHQ can be a valuable partner in their improvement work,” Dr. Rude explained. “Another important aspect of my role with WCHQ is to build strong relationships with other organizations that represent health care. As ‘W’ organizations, we share a passion to do the best we can for our members. One way to do that is to be collaborative and look for opportunities to create greater value for our collective members.”

One organization that WCHQ shares a majority of its members with is the Wisconsin Hospital Association. Speaking at the Retreat, WHA President and CEO Eric Borgerding noted that Wisconsin is unique; it’s a highly integrated health care environment with many insurers and health plans, many of them provider owned.

Borgerding highlighted a new law that WHA helped pass that makes it a felony to threaten or attack health care workers. Wisconsin now has some of the strongest laws in the country protecting health care workers. He enumerated the challenges that the pandemic has had and will continue to have on health system finances over the coming year as patient volumes have not picked up yet.

Why Is WCHQ Important to Your Organization?

Several Board members were asked to share why they value WCHQ. Marilu Bintz, MD, Gundersen Health, said WCHQ data is used in their strategic planning process.

“We annually use not just WCHQ data, but we also integrate our community health needs assessment information into our strategic plan,’ according to Dr. Bintz. “WCHQ metrics are an integral part of our community health, and we use the WCHQ Disparities Report extensively in our efforts to reduce health care disparities because it is very actionable.”

Dr. Melms, Marshfield Clinic Health System, said quality programs are embedded into MCHS’s Institute for Patient Safety and Innovation. As a founding member of WCHQ, Dr. Melms said WCHQ has been a key promoter in the state of high-quality, safe care.

Julie Schuller, MD, is CEO of Sixteenth Street Community Heath Centers. Her interest in WCHQ is to ensure that the Medicaid and uninsured population “are not left out” of the WCHQ data.

Imran Andrabi, MD, ThedaCare, said they strive to be a population health organization, and without data, that will not be possible. They utilize WCHQ metrics and analytics to better understand where there are opportunities to improve.

People from within the Ascension system look to Wisconsin to learn about quality, according to Dirk Steinert, MD. With a mission to “care for the vulnerable, it is important that we take care of everyone in our community.” He said it is “incredible” how many people from the Ascension system come to Wisconsin to learn more about quality, and I credit WCHQ for that.”

Kori Krueger, MD, WCHQ Board Chair, explained how Marshfield Clinic Health System has quality conversations with residents, starting early to help them understand that quality is a shared responsibility.

“The Board retreat was an opportunity to engage deeper conversations on topics that are critical to our members,” Dr. Rude said. “Our Board is engaged, committed and forward-thinking. To remain a valuable partner with our members requires WCHQ staff to have a deeper understanding of the health care environment and to understand and anticipate our members’ needs. It is incumbent upon us to routinely ask our Board and our membership what we can do for them.”

In collaboration with WCHQ, Elizabeth Cox, MD, PhD, a pediatrician and health services researcher, and Meghan Brennan, MD, MS, an infectious disease physician and health services researcher, both at the University of Wisconsin; along with Melissa Gilkey, PhD, associate professor of health behavior at the University of North Carolina, are offering evidence-based communication workshops to improve HPV vaccination. This workshop has been shown to increase HPV vaccination by five percentage points and save time during clinic visits. Building on what the team learned in recent interviews about WCHQ member systems’ strategies for improving adolescent vaccination, the project team will build on systems’ strengths to increase capacity for HPV vaccine quality improvement.

WCHQ invites Wisconsin health care systems to join six-month project, which will start March 2023. Participating health systems will receive: (1) a 1-hour communication workshop for providers and clinical staff in six or more primary care clinics and (2) additional training and support for two or more health system vaccine champions.

Vaccine champions can be providers or clinical staff. The project team will provide training to health system champions, who will then deliver HPV vaccine communication workshops to half of the health system’s participating clinics. Trained experts from the project team will deliver workshops to the remaining clinics.

Other incentives include 1 hour of CME/CE, a $200 honorarium and travel reimbursement per workshop, and a $100 Amazon gift card for completing an exit interview for system vaccine champions (as allowable by system policy). Providers and clinic staff who attend the workshops will receive 1 hour of CME/CE and a $25 Amazon gift card for completing three brief surveys.

No data collection from patients or families is not necessary. Vaccination data to support the project’s evaluation will come from WCHQ. This project is funded by the National Cancer Institute.

Interested in participating or have questions? Contact the project team, prokids@pediatrics.wisc.edu or 608-263-1202, or Jen Koberstein at jkoberstein@wchq.org. The team will set up a brief meeting to describe the project and answer questions. Please share this information with others who may be interested.

Obesity

Obesity is not well understood. The WCHQ Obesity Advisory Group is well aware of that fact and they are focused on addressing the gaps in community education and understanding of this disease on many fronts.

Over the past year, the Advisory Group has emphasized the importance of treatment and support for those with obesity. Earlier in the year, WCHQ Advisory Group members participated in an education session that invited employers to learn more about the consequences on their workforce of not providing supportive treatment for those with obesity. More than 100 representatives from employers across the state attended the virtual webinar; a signal that there is a high level of interest in helping their employees, and their families, with obesity.

At their September meeting, the Advisory Group discussed how education could be made more available across Wisconsin. Members of the group agreed to reach out to employers in their area and invite them to the Obesity Summit scheduled October 13 in Fond du Lac. The Obesity Summit is open to WCHQ provider members, employers and annual partners and corporate sponsors. Registration information is here.

For more information, contact Jen Koberstein.

‍Chronic Disease

Chronic Kidney Disease

“You improve what you measure”

National claims data point to potential gaps in screening, diagnosing and treatment, all of which are important components to reversing or slowing the progression of chronic kidney disease (CKD). To help better inform quality initiatives in Wisconsin, the WCHQ Chronic Kidney Disease (CKD) Advisory Group is tasked with supporting efforts towards early detection and treatment of chronic kidney disease (CKD) in patients with diabetes and hypertension.

If “you improve what you measure,” the CKD Advisory Group is moving in the right direction. Currently, the group is in the process of developing meaningful measures to help inform clinical decisions and support educational opportunities related to diabetes and CKD. The first measures will focus on screening and the second measure is in development.

There is a lot of important work ahead. To find out more about WCHQ’s CKD initiative, contact Sheryl Pierce.

Chronic Disease Learning Collaborative (CDLC), Hypertension Workgroup

A recent workgroup survey revealed that many WCHQ members are engaged in Self-Monitored Blood Pressure (SMBP) programs. In addition, many responded with interest in gaining insight around providing devices and integrating results into EHRs.

To further explore this topic, the CDLC Hypertension workgroup welcomed Dr. Amanpreet Sethi, a practicing family physician and ACO medical director at Advocate Aurora Health (AAH) to share some insights at the September meeting. She presented a unique AAH pilot program combining a multidisciplinary approach to care with technology to help priority populations manage hypertension. Through the process, the blood pressure monitoring program has evolved into a team-based care approach encompassing primary care, pharmacy, care management, and remote patient monitoring resulting in improved medication adherence and blood pressure control.

To find out more or to join the Chronic Disease Learning Collaborative, please reach out to Sheryl Pierce.

‍Behavioral Health

The WCHQ Behavioral Health Improvement Team members met with NAMI Wisconsin Public Policy and Advocacy Director Sita Diehl and volunteer psychiatrist Richard Immler, MD from Wausau, Wisconsin, to learn more about and to provide their input into a new statewide behavioral health system change initiative. The project, which is being led by NAMI Wisconsin, is called the Wisconsin Mental Health Action Partnership (MHAP). The goal of the project is to collaborate with stakeholders throughout Wisconsin to develop a plan to improve the quality of and access to behavioral health services. This will include input from stakeholders including county staff, the Wisconsin Hospital Association, health systems and advocates. WCHQ members shared their experience with and concern for populations that are often not considered as systems of care are in development.

WCHQ will continue to work with NAMI as a stakeholder throughout the process.

If you are interested in learning more about this initiative or other issues related to behavioral health, contact Jen Koberstein.

Adolescent and Child Health

Understanding and responding to the concerns of parents and care givers of children who are vaccine hesitant requires patience and practice. At the Adolescent and Child Health Assembly September 20, Amy Nicholas, PharmD, and Morgan Anderson, PharmD, from Sanofi presented the national perspective on vaccination rates and explained the AIMS method. The AIMS method is an approach to opening a dialogue with patients and parents of patients who are vaccine hesitant. AIMS, which is an acronym for Announce, Inquire, Mirror and Secure Trust, is a non-defensive way to have a conversation with parents. The approach is patient-focused and based on behavioral science that builds trust.

Melissa Gilkey, PhD from the Gillings school of Global Public Health at the University of North Carolina studies individual, interpersonal and organizational approaches to improving the delivery of adolescent vaccine, including HPV. Dr. Gilkey noted that the pandemic has set back vaccination schedules, especially HPV. Similar to Drs. Nicholas and Anderson, Dr. Gilkey offered a communications process for providers to follow that has been successful in helping care givers distinguish fact from fiction as it relates to the HPV vaccination.

Fort Health Care’s Stacy Kutz and Kati Wetzel shared how they have used WCHQ’s data to align their internal goals to the measure results they receive from WCHQ. They described the structure they created to deliver better results and shared their tracking system.

Resources, including videos, spreadsheets and a recording of this webinar are available by contacting Abbey Harburn. 

Oral Health

WCHQ Oral Health Collaborative Work Will Incorporate Disparities        

Disparities in oral health are well known and a source of concern for dental and medical providers. The WCHQ oral health member practices have been submitting data to WCHQ on a small set of measures. WCHQ is working with members on how the data can be stratified to identify disparities. WCHQ has been collecting and reporting disparities data on medical measures for several year. This work is being closely followed by the oral health collaborative members as a model for setting goals and sharing strategies on how the gaps in oral health care can be closed.

At their September meeting, members of the group shared final plans for the WCHQ Oral Health Summit, which will be held in La Crosse October 7, 2022. CareQuest Institute, Jill Boylston Herndon, the American Dental Association and WCHQ, will present information related to disparities in oral health. Several presentations will focus on value-based care and its applicability to oral health.

Health system members interested in oral health can contact Jen Koberstein for information.