Wisconsin Collaborative for Healthcare Quality

October 2019 Newsletter

WCHQ November 13 Assembly: “Growing Up Healthy”

President Chris Queram

Will delve into public health issues and patient care improvement models that are aimed at helping younger patients be their healthiest selves.

Vaping is a national public health issue. Megan Piper, PhD, from the UW Center for Tobacco Research and Intervention will describe the most current research and best clinical practices related to identifying and treating vaping-related diseases. Dr. Piper’s research focuses on understanding and treating tobacco dependence, with an additional interest in different populations of smokers who have more difficulty quitting, such as women and smokers with mental illness, and the growing use of electronic cigarettes.

National immunization expert Jon Temte, MD, PhD, will help clinicians find “Flu in the EHR.” Dr. Temte is associate dean for public health and community engagement at the UW School of Medicine and Public Health (UWSMPH) An expert on vaccines and immunization policy, Dr. Temte served on the US Advisory Committee on Immunization Practices (ACIP) and he was the first family physician to chair ACIP from 2012–2015.

Penny Funk, RN, MSN, will describe Marshfield Clinic Health System’s “Journey to Becoming a Certified Adolescent-Centered Environment.” Ms. Funk has 12 years of experience working as a pediatric nurse in an acute care setting, and many years of supervisory experience.

The PATCH (Providers and Teens Communicating for Health) Program is designed to help bridge the communication gap between teens and health care providers around topics related to sexual health, mental health, drug and alcohol use. PATCH Program Director Amy Olejniczak, MS, MPH, associate director of the Wisconsin Alliance for Women’s Health, will describe the program and provide examples of where this program is working in Wisconsin.

Dr. Michelle Kelly’s research focus is on leveraging tools and technology to engage families to improve the quality and safety of care of hospitalized children. She directed the implementation of American Family Children’s Hospital’s “MyChart Pediatric Bedside Project.” Dr. Kelly is an associate professor and pediatric hospitalist in the Department of Pediatrics at the University of Wisconsin School of Medicine and Public Health.

Registration is now open; view the agenda. This event will be held at Monona Terrace in Madison. For more information, contact Mary Kay Fahey at mkfahey@wchq.org.


Accelerating Value Theme Resonates Throughout WCHQ Board Retreat


John Toussaint, MD

The WCHQ Value Acceleration Initiative (VAI) had the full attention of the Board of Directors at their Annual Retreat September 10 in Madison.  The Board discussed both the current and future states of WCHQ as it relates to focusing on quality and accelerating value. Members offered suggestions and guidance for changes that would be required in governance, funding and work plans to successfully meet the Board-driven goals of the VAI.

John Toussaint, MD, was the guest speaker at the Retreat. He presented forward-looking suggestions to ensure the success of the VAI and commended WCHQ for keeping the flame of quality improvement lit because it is challenging to sustain improvement. Continuous improvement on a statewide level requires leadership and commitment, characteristics that are not present in health systems in other states but are in Wisconsin. He noted that measuring value will require even greater levels of leadership as WCHQ engages new partners, including payers and purchasers, in their work in novel ways.

Dr. Toussaint reminded the group that the foundation of WCHQ is built on measurement, which drives improvement. He emphasized that WCHQ should utilize this principle in the VAI work because is it not possible to attain value if actual cost is not available. As a measurement leader, Dr. Toussaint said WCHQ can guide this work as WCHQ members are transforming their business models to value-based health care.

Gabrielle Rude, PhD, WCHQ director of practice transformation, summarized the VAI work that has occurred over the past year. She reminded the Board that this work was developed in response to the 2017 Board Retreat that identified a use case for the integrated data asset between WCHQ and the Wisconsin Health Information Organization (WHIO), which seeks to combine clinical and claims data to improve the value of health care in Wisconsin.

The Board members divided into three groups to reevaluate and advise on three strategic issues tied to the value acceleration work that are related to governance, quality improvement and measurement. After discussing each topic, Board members reported out, coalescing on several points:

  • WCHQ must engage new partners for the value work to be successful
  • Variation in cost and quality exist; WCHQ’s measurement capabilities are important in addressing this issue; and,
  • Define the specific problem that is being addressed and address it strategically, so it is possible to measure the results.

For more information, visit WCHQ’s Value Acceleration Initiative.

WCHQ-WHIO New Joint Venture Leverages Data Assets to Members’ Benefit

The Wisconsin Collaborative for Healthcare Quality (WCHQ) and the Wisconsin Health Information Organization (WHIO) announced that they have created a joint venture that leverages the data assets of the two organizations.

360ValuCounts combines clinical and claims data, WCHQ and WHIO can create a unique data asset that will provide actionable information to WCHQ members and WHIO data submitters.

When clinical and claims data is combined, it creates a comprehensive view of the care provided to patients in Wisconsin. 360ValuCounts data will allow WCHQ members to evaluate cost and quality in the health care sector in ways that are not currently possible. The combined data set offers innumerable opportunities to gain more information and greater insight into the patient populations that WCHQ members serve. There are strengths and limitations to both data sets, but together they are stronger and better positioned to know about all the care that a patient receives, regardless of where they may receive it.
WHIO and WCHQ plan to have the following deliverables available in 2020:

  • A series of two interactive reports focused on specific patient populations that are the focus of WCHQ’s Value Acceleration Initiative
  • Information for WCHQ member health systems on the quality of care and resources used for each population
  • Statewide benchmarks useful for comparison

Future products will be developed with the input of WCHQ and WHIO stakeholders.

WCHQ members will receive more information soon on how to access this member benefit. For more information contact Matt Gigot at mgigot@wchq.org.

Two New Depression Measures Slated for Public Reporting in 2020


The WCHQ Measurement Advisory Committee (MAC) met September 27 and discussed two behavioral health measures: PHQ-9 Utilization and Depression Remission. PHQ-9 Utilization is a companion measure to the Depression Remission measure and is new for Fall 2019 reporting. Both PHQ-9 Utilization and Depression Remission will be reported on Preview only (not publicly reported on WCHQ.org) in Fall 2019 and Spring 2020. Recognizing the importance of these behavioral health measures, including feedback from the WCHQ Behavioral Health Steering Team, there are several timeline goals determined by the MAC as follows:

  • PHQ-9 Utilization: Goal for public reporting on WCHQ.org is Fall 2020.
  • Depression Remission: Goal for public reporting on WCHQ.org is Fall 2021.

In an effort to ensure that members are acclimated to both of these measures and understand strategies to improve their measurement outcomes, we encourage anyone with questions or an interest in either of these measures to either join or sit in on the Behavioral Health Steering Team meetings. Contact Sarah Wright at swright@wchq.org if you are interested in either of these options for working with us on improvement strategies, to ask questions or to share what you have learned. If you have questions around data reporting requirements for either or both of these measures, contact Mary Gordon at mgordon@wchq.org.

WCHQ Disparities Report Creates Data Infrastructure to Reduce Variation


Following two years of work, WCHQ released its first Health Disparities Report at its largest ever Assembly meeting September 19 in Madison. WCHQ members, representatives from several key state agencies, insurers and prominent national experts all applauded the report, calling it the first and critical step in eliminating disparities in Wisconsin.

The “WCHQ Health Disparities Report” identifies where gaps in health outcomes and care exist in Wisconsin. The data is categorized based on race/ethnicity, payer and rural/urban geography. The data was submitted to WCHQ by 25 health systems and medical clinics and it represents the most complete and recent (2018) data available for this work.

“WCHQ has developed the data infrastructure that is necessary to create and support interventions and programs that will reduce health disparities,” according to report co-author Matt Gigot, WCHQ director of performance measurement and analysis. “This information makes it possible to benchmark current performance and measure progress over time. Reliable data that is collected in a standardized and consistent way is essential when the goal is improving performance.”

The report received excellent media mentions in the Milwaukee Journal, Wisconsin State Journal, Wisconsin Public Radio, WisBusiness, Wisconsin Health News, and several national outlets ran articles.

The WCHQ Health Disparities Report was developed in collaboration between WCHQ and the University of Wisconsin Health Innovation Program (HIP). Funding for the project was provided by the Wisconsin Partnership Program at the UW School of Medicine and Public Health (SMPH), which is committed to improving the health of Wisconsin residents and reducing health disparities through research, education and community partnerships.

“The Wisconsin Partnership Program recognizes that the most effective way to eliminate health disparities in our state is through collaboration among many partners and organizations,” according to Richard Moss, PhD, SMPH Senior Associate Dean. “This report provides a unique set of data that has not been gathered before. It’s a collaborative call to action and a resource that can be used by community partners to catalyze efforts to reduce health disparities.”

Gigot and Abbey Harburn from WCHQ worked closely with Maureen Smith, MD, MPH, PhD and her team from the Health Innovation Program (HIP)to analyze the data, write the report and create facility-level reports for WCHQ members. WCHQ and HIP will continue this work with additional tools and reports planned for release in 2020 that will be useful in measuring, monitoring and eliminating health disparities.

CMS Recognizes Two WCHQ Members for Quality Improvement, Leadership


Reedsburg Area Medical Center and Associated Physicians were recognized by the Centers for Medicare and Medicaid Services (CMS) for achieving Early Exemplar status through the Practice Transformation Network initiative. Their status demonstrates a commitment to patient and family engagement, optimizing health information technology, care coordination and team-based care.

Both practices received a Letter of Recognition from Robert Flemming, PhD, Director of the Transforming Clinical Practice Initiative at CMS.

“Achieving this recognition required strong quality improvement efforts from multidisciplinary staff to lead population health outcome improvements,” according to Sarah Wright, RN, MPH, WCHQ quality improvement specialist. “WCHQ members are consistently working to deliver better patient care, and once they achieve it, they share what they learn with other organizations. That willingness to collaborate is a hallmark of Wisconsin’s health care delivery system.”

To learn more about the Practice Transformation Network, contact Sarah Wright at swright@wchq.org.

Chronic Disease Funding Aligns with Value Acceleration Work


Improving care for patients with chronic disease has been a long-standing goal for WCHQ members. These patients are often medically-complex and may face personal, financial and other barriers to receiving the care they need to be as healthy as possible. WCHQ has been working with the Wisconsin Department of Health Services (DHS) since 2014 through a grant that supports its work to improve the quality of care, measure progress, evaluate the interventions and publicly report measure results.

WCHQ and DHS have recently completed their Scope of Work for year 2 of the current five-year project. The grant funding aligns with WCHQ’s Value Acceleration Initiative, which is aimed at improving care and reducing costs related to patients who have multiple chronic conditions including diabetes. Over the next 4 years, WCHQ staff will create new opportunities for members to collaborate within steering teams, at learning events and through the dissemination of best practices.

To join a steering team that is working on diabetes and hypertension, contact Cara Winsand, cwinsand@wchq.org or Gabrielle Rude, grude@wchq.org.

September 19 Assembly Take Home: To Eliminate Disparities, Start with Data


One of the largest Assemblies in the history of WCHQ focused on health disparities. The turnout reflects the level of concern and commitment that health care providers in Wisconsin haveJeanne Ayers, RN, MPH and Kimberlydawn Wisdom, MD on eliminating health disparities.

More than 200 people attended the September 19 WCHQ Assembly in Madison with Wisconsin State Health Officer Jeanne Ayers, RN, MPH. Ayers said overall, Wisconsin’s health ranking is falling. While the reasons for the decline are complex, health disparities are a contributor, which was illustrated later in the morning when the WCHQ Health Disparities Report was released.

Ayers defined “health equity” as achieving the conditions in which all people can realize their health potential—the highest level of health possible for that person – without limits imposed by structural inequities. Social determinants of health have the largest impact on equity in health and well-being.

Three practices can help to advance health equity, according to Ayers. The practices are: Expand the understanding of health; implement Health in All Policies with equity as the aim; and, strengthen community capacity.

Kimberlydawn Wisdom, MD, described Henry Ford Health System’s approach the three phrases they followed to address disparities: Raise awareness about health and disparities as they moved toward equity; implement tools to improve cross-cultural communication and collaboration, plan for review of quality metrics by race/ethnicity, and integrate into system processes to ensure sustainability and accountability, then continuously monitor quality metrics by care/ethnicity for intervention.

Dr. Wisdom’s presentation set the stage for the introduction of Matt Gigot, WCHQ, and Maureen Smith, MD, PhD, MPH to release the findings of the WCHQ Health Disparities Report.  (See article, " WCHQ Disparities Report Creates Data Infrastructure to Reduce Variation" in this issue.)

Three WCHQ members and a community-based program director presented in the afternoon: Cristy Garcia-Thomas, Advocate Aurora Health; Caroline Gomez Tom, Sixteenth Street Community Clinics; Aaron Perry, CEO/Founder of the Rebalanced-Life Wellness Association; and Greg Nycz, Family Health Center of Marshfield, Inc. Each of the speakers explained how their organizations are working to reduce health disparities in their communities.

A link to the video and the presentations will be available in November on WCHQ’s new Online Community.