This past year, like every other organization, WCHQ was challenged to work innovatively during a time of unprecedented change and challenge. As an improvement organization, WCHQ has always embraced adaptability and innovation. Case in point, our strategic plan lays out a long-term vision of where we want to go; however, process steps are only detailed out over the next year and are updated regularly to allow us to react nimbly when things change. WCHQ’s practice led to some tough questions from our partners who were more accustomed to the traditional three- to- five -year detailed plan. This strategy was proven effective when the pandemic forced us to quickly change how and where we worked as well as rearrange and add priorities.
The workforce shortage is an example of a priority that was not on our radar in our pre-pandemic strategic plan. Staff layoffs led to delays in members submitting data and more intense requests for assistance from our staff. Staff burnout exacerbates the impact of staffing shortages, and we are seeing early signs that it will impact patient care outcomes and quality. In response, our improvement teams have added a focus on how to provide care virtually when patients and staff cannot physically be in the clinic. We also focused on renewing one’s purpose at our March Board meeting.
Wisconsin is fortunate to have dedicated health care leaders who have prioritized high quality care despite the pandemic, and WCHQ has added strategic priorities to ensure we can support our members and their staff in that mission.
The pandemic heaped a tremendous amount of stress on to health care employees working at every level of the organization. At the WCHQ March Board meeting, Clinical Professor Christine Whelan, PhD, at the University of Wisconsin – Madison, shared her knowledge of what works, and what does not, related to how people thrive.
Whelan described one response to ensuring that people stay true to themselves even in times of extreme duress and transition. It starts with identifying three core values, three key strengths and then apply those values and strengths to three groups that they want to impact.
Putting those three things together will, according to Whelan, help a person to fulfill their own purpose-based commitments. That, in turn, will help guide daily activities, such as caring for patients, family and self.
The Board also learned more about the WCHQ Obesity Advisory Group, a multi-stakeholder group with a goal of improving the care for those being treated for obesity. Christopher Weber, MD, Diplomate of the American Board of Obesity Medicine and Medical Director of Ascension Wisconsin and Advisory Group member, described the group’s activities to date. He said the focus has been to identify patients earlier to influence the progression of the disease. The group determined early in 2021 that education for both physician and patients would be a priority. The most recent WCHQ online seminar on obesity drew more than 150 attendees. Dr. Weber said payers have been participating in the discussions, which has led to dialogue around the costs to treat, employers’ perspectives on the disease, and measurement.
Jen Koberstein, WCHQ program manager to the project, said the group has made considerable progress in identifying measures that will provide the data necessary to inform the improvement work. WCHQ has developed two measures to date: obesity prevalence in the population and obesity pre-diabetes and diabetes HbA1c control. Koberstein said the Advisory Group will transition to an improvement team when WCHQ has the data on the above measures.
The obesity epidemic is driving up both the rate of other chronic diseases and the costs associated with treating them, according to Melanie Smith, MD, a Diplomate in obesity medicine at Advocate Aurora. Obesity, she said, is the greatest risk factor contributing to the burden of chronic disease and it is responsible for over $480 billion in direct health care costs.
Samantha Pabich MD, an assistant professor at the University of Wisconsin and endocrinologist at UW Health, joined Dr. Smith at the WCHQ March 23 webinar, “Obesity Treatment: A Pathway to a Healthier Wisconsin.” The webinar drew more than 150 registrations.
Dr. Smith noted that in New York City the second strongest predictor of COVID hospitalizations in the early months of the pandemic after advanced age was obesity. A patient being treated for COVID with a BMI over 35 was seven times more likely to be intubated than those with a normal BMI.
Pabich pointed out that modest weight loss can significantly improve a person’s health. She is pleased that Wisconsin has clinical trials in place for diabetes and obesity, which is an indicator that these diseases are important and that will lead to better care of patients with these conditions.
“When two-thirds of the population is carrying more weight than recommended, then it cannot possibly be just an individual problem,” according to Pabich.
Jen Koberstein, WCHQ program manager, leads the WCHQ Obesity Advisory Group with support from Novo Nordisk. Started in early 2021, the Obesity Advisory Group has helped design and develop content for an education series on obesity for employers aimed at building awareness of obesity as a chronic disease and the importance of including this coverage in their employee health plan. The group is also planning the statewide Obesity Summit October 13, 2022, in Fond du Lac.
The WCHQ Obesity Advisory Group is open to all WCHQ provider members. To learn more, contact Jen Koberstein.
Every April, the HHS Office of Minority Health (OMH) observes National Minority Health Month to highlight the importance of improving the health of racial and ethnic minorities and reducing health disparities.
The pandemic laid bare the health inequities that exist not only in Wisconsin, but around the globe. It has disproportionately affected communities of color. It also served to mobilize the leadership of Wisconsin’s health systems and clinics to not only identify where disparities are occurring, but to take action to eliminate them.
In late 2021, WCHQ gathered health care leaders at a Disparities Summit, co-chaired by Cathy Jacobson, president and CEO of Froedtert Health, and Dr. Susan Turney, president and CEO of Marshfield Clinic Health System. At the Summit, the health system leaders selected three WCHQ measures that would be the focus of improvement over the next two years: colorectal cancer screening, diabetes A1c control and hypertension control.
Baseline data on these three measures have been collected and will form the starting point for improvement. The WCHQ data is stratified by race/ethnicity, payer and geography.
The 2020 WCHQ Health Disparities Report found that rural underserved populations had much lower rates of colorectal cancer screening and blood sugar control in diabetes and hypertension are lower for urban.
The WCHQ data in this chart is from 2018 to provide a baseline that does not reflect the impact of the pandemic.
WCHQ will be collecting data from member health systems and analyzing trends in care gaps statewide across all WCHQ measures.
This data will be used to create reports that identify where disparities are occurring in Wisconsin, while the data above will support the work of the measure-specific improvement team.
Participation in the WCHQ Disparities Team is open to WCHQ members. If you are associated with a WCHQ provider member, contact Abbey Harburn. If you are corporate sponsor or annual partner and are interested in the disparities work, contact Mary Kay Fahey.
At its March meeting, the WCHQ Board of Directors approved a proposal that will return public reporting to the normal, pre-pandemic cadence. This will be accomplished by following the submission and attestation deadlines below:
Of note, this means WCHQ will not publicly report data from the Calendar Year 2020 and July 2020-June 2021 reporting periods. However, members are encouraged to submit data from those time periods and WCHQ will provide comparative, non-public reports this spring.
“This plan will allow us to get back on track and more consistently provide the timely, comparative information that our members need. We also want to be sensitive to the member resources necessary to validate multiple historic timeframes in the middle of a pandemic,” according to Brian Slattery, WCHQ Director of Performance Measurement and Analytics. “For these reasons we’re excited to get back to a regular and predictable reporting schedule.”
WCHQ also appreciates the dedicated data and IT managers and specialists working with its member health systems.
“I want to recognize the primary data contacts at each of our member health systems. We have asked a lot from them. Between the migration to a new platform and a global pandemic, we appreciate how challenging the past few years have been,” Slattery said. “Please know that our focus throughout this move has been to simplify data submission, make the work more routine and predictable and to increase the value of this data to our members.”
Direct questions about data submission and reporting to Brian Slattery.
As a data-driven organization serving Wisconsin’s health system, WCHQ is looking for a data analyst who can turn data into actionable insights for our members. In addition to providing member support to the measurement team, this role will be responsible for providing analytic solutions to support WCHQ’s strategic initiatives, improving organizational performance and using computer programming language to develop and run queries to assess and improve the quality and affordability of care in the state.
“This is an exciting new position at WCHQ” explained Brian Slattery, WCHQ’s Director of Performance Measurement and Analytics. “We have been able to perform some basic queries of the system, but given the rich dataset available, I think we have only begun to scratch the surface in terms of the types of analyses possible. We are anxious to bring in these additional skills to maximize the capabilities of the existing platform and provide greater value to our members, partners and grant organizations.”
“Novel Approaches in Behavioral Health”
April 21, 2022
9 AM - 12 PM CST
A live, virtual WCHQ education event
Concern for the wellbeing of the health care workforce has never been higher. Myra West, PsyD from Marshfield Clinic Health System will describe the actions that health system has taken to check in with staff and then develop support programs for employees that promote psychological wellness.
The integration of behavioral health into primary care is aimed at improving care and creating better access to behavioral health services while reducing unnecessary cost. Martha Saucedo from Access Community Health Center will explain the balance required to successfully implement this model.
There is high interest in the new research center at UW-Madison that is studying the potential for therapeutic use of psychoactive substances. Christopher Nicholas, PhD, is an assistant professor in the UW Department of Family Medicine and Community Health. Dr. Nicholas will describe his research into the clinical efficacy and therapeutic mechanisms of psychedelic and other psychoactive compounds for addiction, trauma, depression and chronic pain.
This Assembly is of interest to those working in behavioral health, primary care, pharmacy, human resources and the team members who support front line staff.
Contact Mary Kay Fahey for information.
May 5, 2022
12 PM – 1 PM CST
A live, virtual education event
Katharine A. R. Price, MD.,
Associate Professor of Oncology
Co-Chair of the Head and Neck Cancer Disease Group
Mayo Clinic, Rochester, MN
The HPV vaccination targets the HPV-related cancers, such as head and neck cancers, cervical cancer and others common to men and women. Dr. Katharine Price is a surgeon and she sees cancers in her practice every day that could have been prevented by the HPV vaccination.
Dr. Price is passionate about the importance of the HPV vaccination. At this webinar, she will:
Direct questions to Mary Kay Fahey.
May 19, 2022
12 Noon – 1 PM
A live, virtual education event
Precision medicine is one of the fastest growing fields in science. The ability to evaluate a person’s genes, environment and lifestyle to determine the best approach for both disease prevention and treatment is now a reality.
This WCHQ education event will increase awareness of diagnostic testing and biomarkers to understand the impact of this testing on patient care. It will provide an overview of biomarker testing, how it is used in cancer care and how it can be applicable in the primary care setting.
This webinar will be of interest to clinicians working in the primary care setting and those that support them. Direct questions to Mary Kay Fahey.
June 22, 2022
9 AM – 3:30 PM
In person and virtual attendance options
Monona Terrace Convention Center, Madison, WI
Keynote Address By:
Angela Fitch, MD
Weight-management and obesity medicine specialist
Co-director, Massachusetts General Hospital Weight Center
Registration materials will be available soon
September 20, 2022
9 AM – Noon
October 13, 2022
9 AM – 4 PM
The Hotel Retlaw, Fond du Lac
November 10, 2022
WDA, WCHQ Formalize Collaboration
The WCHQ and the Wisconsin Dental Association are both committed to improving the health of the people living in our state. The WCHQ’s advocacy and education efforts complement the WCHQ Oral Health Collaborative’s goal of integrating medical and dental care by creating opportunities for members to share information.
WCHQ and WDA recently agreed to a more formal approach to the relationship. Both organizations committed to collaborating on education events that help bridge the gap between the medical and dental communities and lead to better, more holistic patient care. WDA will participate in and present at the annual WCHQ Oral Health Summit and attend WCHQ’s monthly Oral Health Collaborative meetings.
Through the agreement, WCHQ will be able to submit professional papers for consideration to publish in the WCHQ Journal and attend appropriate meetings and education events sponsored by the WDA.
“WCHQ and WDA are both committed to improving the health of the people in Wisconsin. We cannot improve medical care without considering a patient’s oral health history,” according to WCHQ President and CEO Gabrielle Rude, PhD. “By increasing our opportunities to collaborate with WDA, we learn more about the dental environment and can incorporate that perspective into our work at WCHQ.”
Jeremy Hoffman, DDS, a WDA Trustee from Weston, will represent the group on the WCHQ Oral Health Collaborative. Dr. Hoffman will bring his experience and knowledge of organized dentistry to the group and act as a liaison between WDA and WCHQ.
One of the best ways to stop the progression of kidney disease is to identify it early. As a disease that often has no symptoms, many patients do not learn they have kidney disease until they are in a late stage of the disease.
The newest WCHQ improvement team is focused on early identification and treatment of patients who have kidney damage. At its inaugural meeting March 29, members of the Chronic Kidney Disease Advisory Group heard from Dr. Vesta Valuckaite, MD, health systems medical director at Bayer and Tricia Barrett, executive director of quality and population health strategy at Bayer. Both presenters emphasized the importance of early and reliable testing of patients who are diabetic. New measures have been developed that call for running both eGFR and UARC. Not all health systems are currently running both tests, but to meet the measure, both are required. Studies have shown that people with diabetes and macroalbuminuria are 19 times more likely to see a rapid decline in renal function compared with those without albuminuria.
The members of the Advisory Group have diverse backgrounds but a common desire to improve the care for those with CKD. To join the Advisory Group, contact Sheryl Pierce.
Nearly 47 percent of U.S. adults have high blood pressure with the majority of those patients requiring lifestyle modification and medication, according to the Centers for Disease Control and Prevention (CDC). The Surgeon General’s report, “A Call-to-Action to Control Hypertension” provides solutions to avoid complications related to cardiovascular disease. A recent publication in the American Journal of Hypertension to Control Hypertension, summarizes the cost effectiveness behind hypertension management strategies. Various team-based care approaches and self-measured blood pressure programs are noted within this publication to support managing hypertension.
If your health system is developing strategies to help patients control their blood pressure, consider joining the WCHQ Chronic Disease Learning Collaborative Workgroup to network with other health systems on this topic. Contact Sheryl Pierce for more information.
Improvement Team Holds Focus Groups on Interventions to Address Health Equity
How health systems identify quality improvement strategies and interventions for the general patient population and for specific populations experiencing health disparities was the subject of a focus group hosted by WCHQ, the University of Wisconsin Health Innovation Program (HIP), and the Medical College of Wisconsin (MCW). Disparities Improvement Team members participated in the exercise during their March meeting.
Researchers at HIP and MCW will compile these results and share blinded information with participants. The results will identify best practices for designing interventions to improve health equity. WCHQ will hold additional focus groups for participants who were unable to join the Improvement Team meeting.
To participate in a future focus group or join this improvement team, contact Abbey Harburn.
WCHQ members selected immunizations as a priority improvement area in 2022. Organization-wide, WCHQ selected a target of 83.6 percent for childhood immunizations and 90 percent for adolescent immunizations. This action set the stage for the Adolescent and Child Health Improvement Team’s work, which started with a review and understanding of the improvement targets to determine the strategies that would be required to meet each goal.
Vaccine hesitancy was identified as a significant barrier to improving these measures, an issue that was exacerbated by the recent pandemic. The Improvement Team members discussed the various spheres of influence that impact health care decision-making for patients and families and the need for increased guidance and education on addressing vaccine hesitancy in their patient populations. As the Improvement Team works toward these goals, they will continue to share best practices and provide education related to vaccine compliance. Strategies to improve vaccination rates will be shared throughout the year and addressed at the 2022 Adolescent and Child Health Assembly September 20, 2022.
For more information on the Adolescent and Child Health Improvement Team, contact Abbey Harburn.
Screening New Mothers for Depression
More than half of new mothers experience the “baby blues,” with 15 percent of those developing more serious post-partum depression. One health system member said it is their practice to screen new moms for depression when they bring their infants in for their initial checkup following delivery. Others said they are starting to incorporate that into their patient visits as well.
Depression is on the increase – that is why the Behavioral Health Improvement Team continues to focus on screening. This topic will be discussed in more detail at the next meeting when the members share more best practices .
To join the Behavioral Health Improvement Team, contact Jen Koberstein.