For more than 15 years, Chris Queram has been at the helm of the Wisconsin Collaborative for Healthcare Quality

(WCHQ). Under his leadership, the organization advanced the science and art of health care measurement and improvement. Started by a small cadre of forwarding thinking health care leaders in 2003, Queram joined WCHQ in 2005. Since that time, membership has grown to include more than 30 health care, payer and dental systems and more than 25 business organizations that support WCHQ.

From the beginning, WCHQ was focused on building a set of ambulatory measures that enabled medical groups to collect and report data on all patients within their practice. WCHQ members have used these measures to drive improvement and reach across organizations to share their knowledge and learn from the highest performers.

In a recent interview with Sean Kirkby, a reporter with Wisconsin Health News, Queram said WCHQ has “created a community of organizations that are oriented to using data and analytics to improve care.”

Queram will continue to pursue his passion for health care measurement, accepting an appointment as interim CEO of the National Quality Forum (NQF). He will assume office shortly after the first of the year as NQF begins a nationwide search to find a successor.

Queram will bring a depth of knowledge and experience in health care quality measurement to his role in stewarding NQF forward. Before joining WCHQ, Queram was the CEO of The Alliance. In his early career, he served in positions at the former Methodist Hospital in Madison and at Froedtert in Milwaukee.

“In the face of an ongoing pandemic, quality measurement—and NQF’s role in it—is more critical than ever,” Queram said. “I am grateful for the opportunity to serve the organization in this capacity and look forward to working closely with the NQF Board of Directors and leadership to build on the strong foundation.”

Two new corporate members joined WCHQ in December, Genentech and Cerner. We appreciate their support and all our corporate and annual partners.

“These organizations complement our work with members by contributing ideas, presenting at our education events and by sharing new resources with our members,” according to WCHQ’s Mary Kay Fahey. “We look forward to developing innovative programming that anticipates and meets the needs of our providers and stakeholders.”

Watch for exciting news early next year as WCHQ announces several partnerships that will expand and enrich WCHQ’s improvement work with members and bring new education opportunities.

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Almost all the webinars in 2020 were focused on or included topics related to the pandemic. In 2021, WCHQ will continue to offer high-quality member education. While dates are not set, next year's topics will align with WCHQ improvement goals, which are: behavioral health, colorectal cancer screening, chronic disease management, and adolescent and child health. In addition, WCHQ will also direct resources to increasing immunization rates as members are concerned about the dramatic decline in the administration of life-saving vaccines.

While the in-person networking opportunities that are so highly valued by our members were lost due to the pandemic, WCHQ significantly increased its virtual education offerings in 2020. Overall, WCHQ nearly tripled the number of webinars in 2020 over previous years, drawing nearly 2,000 registrations.

The much-anticipated Statewide Quality Improvement Event is tentatively set as an in-person event on June 29 at Monona Terrace in Madison, 9 a.m. – 4 p.m.

WCHQ’s transition to the new Data Voyager platform continues toward its completion. Fall 2020 (Q3 2019 – Q2 2020) measure results for half of WCHQ members were generated over the Christmas holiday. Measure results for the remaining WCHQ members will be generated the week of January 4. WCHQ staff will be reaching out to members individually to ensure they are able to access the Data Voyager platform and view measure results once they are available.

The WCHQ Measurement Advisory Committee (MAC) recommended in December that public reporting of the Fall 2020 (Q3 2019 – Q2 2020) results be targeted for February 1. This will give members several weeks to identify issues with the results that need to be fixed. Results will be on the WCHQ.org preview site for members to review by January 18, with measure results publicly available on the website on or around February 1.

WCHQ very much appreciates the commitment and effort of its member organizations to submit data to WCHQ throughout 2020. The impact of COVID 19 on Wisconsin health systems and WCHQ’s transition to the Data Voyager platform made for a uniquely challenging year. WCHQ firmly believes that the transition to the Data Voyager platform in 2021 will deliver improved functionality and superior performance from the previous measurement system.

Adolescent and Child Health

In December, Rosa Kim, MD and Sara Herr of the Wisconsin Child Psychiatry Consultation Program (CPCP), joined the Adolescent and Child Health Improvement Team. Dr. Kim presented information on the program and the status of behavioral health services for children in the state of Wisconsin. The CPCP is designed to increase the capacity of primary care providers to support the behavioral health needs of Wisconsin children and their families. The CPCP offers education and training to PCPs, provides consultative support for screening, diagnosis, and management, and has a referral support network.

The CPCP was formed through a collaboration between the Wisconsin Department of Health Services, the Medical College of Wisconsin, and Children’s Wisconsin in response to the shortage of psychiatric providers for children and teens throughout the state. Once enrolled in the CPCP, providers have access to consultations via phone and email. They can also access online and in-person trainings addressing topics ranging from screening and assessment to treatment and psychopharmacology for mental health and psychiatric disorders.  For more information or learn about enrollment in the CPCP.

Behavioral Health

Individual Placement and Support (IPS) is an evidence-based practice that supports people, with mental illness and substance use disorders, by helping them find and keep meaningful jobs in the community. The program is based on the philosophy that work helps people be an integral part of their community while it improves self-esteem and satisfaction with life. IPS is a proven part of assisting people in recovery and is backed by rigorous research and evidence. During the December Behavioral Health meeting, Lalena Lampe and Stacey Teegardin, IPS state trainers from the Wisconsin Department of Health Services/ UW Department of Psychiatry, presented on IPS and shared that people who have access to IPS services are two to three times more likely to obtain and keep a job.

IPS provides unique benefits to both employers and people looking for work. Participating employers are viewed as partners who share a goal of giving back to their communities as well as gaining qualified and motivated staff. Job seekers are given a new opportunity after overcoming adversity in their lives. When people help people, everyone benefits.
The principals of IPS are competitive employment, integrated services, zero exclusion, worker preferences, benefits counseling, rapid job search, systematic job development, and time-unlimited support.

IPS is currently available in 21 Wisconsin counties [https://www.dhs.wisconsin.gov/ips/sites.htm].

If you would like more information on IPS please send an email request to DHSDCTSIPS@dhs.wisconsin.gov.

Chronic Disease
Managing chronic disease is one of WCHQ’s improvement priorities. The WCHQ Chronic Disease Learning Collaborative staff found a new report from the U.S. Surgeon General could be a useful resource for clinicians who are treating patients with hypertension.

The report, “A Call to Action to Control Hypertension,” identifies evidence-based interventions that can be implemented, adapted and expanded in diverse settings. The recommendations include the following:

• Implement protocols to standardize patient care. Treatment protocols can help identify patients eligible for clinical management, reduce variations in care, prompt medication initiation and intensification, standardize timely patient follow-up, and reinforce lifestyle counseling and referrals. They can also empower all members of the clinical team to engage in patient management.
• Refer all patients with high blood pressure to lifestyle change resources to help them control their blood pressure and improve their overall cardiovascular health. Examples include dietitians, exercise physiologists and specialists, community-based programs and resources, and the National Diabetes Prevention Program. Ensure follow-up with patients after referrals.
• When possible, prescribe in a way that lowers patient costs, reduces barriers to getting medications, and simplifies regimens to improve adherence. Examples include selecting generic drugs covered by the patient’s insurance, longer-duration prescriptions (90 vs. 30 days), fixed-dose combination pills, and lower dosing frequency (once per day).
• Prescribe medications electronically and synchronize medication regimens to reduce the chance that patients will lose or not fill their prescriptions.
• Use self-measured blood pressure monitoring with clinical support for patients with high blood pressure.
• Use data from clinician dashboards and patient registries to highlight gaps in care so they can be addressed through quality improvement efforts.
• Encourage the use of multidisciplinary care teams to help patients manage their blood pressure. Support shared decision-making and effective communication between teams and patients.

For more information on these actions and to review additional resources, visit this one-pager for health care professionals.
If you are interested in joining the Chronic Disease Learning Collaborative, contact Sarah Sky.

Oral Health

The WCHQ Oral Health Collaborative (OHC) continues to receive inquiries related to the publication of the first oral health measures on the WCHQ website. WCHQ fielded inquiries from dental practices and local and national health care organizations that are interested in the collaborative development of oral health measures and improvement.

A recent article by OHC member HealthPartners was published in the Journal of Public Health Dentistry that addresses their mission to provide value-based care that aligns with the triple-aim; improving the health of a population while providing great service and doing so at a lower overall cost.1 The authors discuss the importance of integration of the medical and dental record, risk assessment tools and quality measurement as keys to achieving the triple-aim and value-based care.

The OHC will hold a Summit in 2021 that focuses on the oral-systemic link, the development of relevant new metrics and the identification of opportunities for improvement. The group will continue to share and discuss new processes that were developed in response to the pandemic.

For information or to get involved with oral health measurement, contact Jen Koberstein.

1Berwick DM, Nolan TW, Whittington J. The Triple Aim; care, health, and cost. Health AFf. 2008;27(3):759-69