March 2020

President's Column

Chris Queram

No amount of emergency planning could have fully prepared the world for this pandemic; however, in a crisis of this magnitude, health care providers and those who support them become the nation’s heroes.

Let me take a moment to offer a humble yet heartfelt “thanks” for all that you and your colleagues are doing to meet the needs of our communities across the state. These extraordinary circumstances require strength and courage, the hallmarks of individuals in health care. You have our gratitude and prayers in the days and months ahead.

Over the past few days, I have received feedback on WCHQ from several members who believe that “there is no other organization in the state better positioned to assist health systems and clinics with sharing best practices and approaches to manage the impact of this crisis on ambulatory operations.”

WCHQ has more than a decade in benchmarking clinical performance and facilitating quality improvement. As we pivot to incorporate the clinical and operational challenges posed by the pandemic into the work of our current steering teams, we are also looking at setting up new resources for our members focused on specific topics related to COVID-19.
Your feedback will inform our work over the next few months.

As we pursue this rapid response to the pandemic, here are a few of the items we continue to work on:
The transition of WCHQ’s measurement and analytics value stream to the SymphonyCare platform is in full swing (see related article in this issue);

  • We will release a new Behavioral Health Toolkit within the next few weeks;
  • We are adapting our upcoming education events (see related article); and
  • Steering Teams are adjusting their work to include a specific focus on supporting quality of care during the coronavirus pandemic.

Thank you for doing what you do every day under the most trying of circumstances. We look forward to better, healthier days ahead.

Chris Queram

WCHQ Names Rude President/CEO-designee

Gabrielle Rude, PhD

The WCHQ Board of Directors named Gabrielle Rude, Ph.D., successor to President/CEO Chris Queram, effective January 2021. Queram, who announced he will step aside at the end of the year, has led WCHQ since 2005.

Rude has directed clinical practice transformation at WCHQ for the past four years. Over that time, she has elevated WCHQ’s profile as a partner and leader in quality improvement, helped establish WCHQ as a statewide health care data resource, and designed and implemented novel initiatives to improve health care value.

“We are excited for Gabrielle to step into this position. She will play a key role to ensure WCHQ is relevant to members and engaged in the work to improve health and make health care in our region better, safer and more affordable,” according to WCHQ Board Chair Dave Rushlow, MD, Chair of Family Medicine, Mayo Clinic.

Rude received her bachelor’s degree in health promotion/wellness and Spanish from the University of Wisconsin-Stevens Point and master’s and a doctoral degree in population health sciences from the University of Wisconsin. She is a certified professional in health care quality.

“I am looking forward to the opportunity to work with our members to continue to improve the quality and value of health care in Wisconsin. This organization has been on the cutting edge of health care quality improvement and innovation in the state and, over time, we’ve seen the quality of care in this state rank among the best in the nation,” Rude said. “As we help our members find new ways to improve health and the quality of care, we will also work with them to increase the value of health care, which is an economic development asset for our state.

Queram will continue to lead WCHQ in 2020 while assisting Rude as she transitions to her new role.

Transition to SymphonyCare Data Platform Advances

The WCHQ measurement team continues to advance several ongoing initiatives, including spring public reporting and the transition to the SymphonyCare IT platform. From a public reporting standpoint, the vast majority of WCHQ members have uploaded data to the system and WCHQ will be ready to begin a preview period at end of the April, with publication to occur in mid-May. There are several notable developments in the IT transition. SymphonyCare has started to incorporate historical data into the new platform. This data is being used to support the development of both the quality measures and user interface into the new application. Additionally, a data submission guide has been provided to the WCHQ members for the new platform, and several members have begun to upload data to the SymphonyCare platform using the new data submission requirements.

WCHQ measurement staff has found that there is variation in available IT resources across the WCHQ membership due to the ongoing COVID-19 outbreak and they are working with members individually to determine when it makes sense to begin a conversion to the SymphonyCare standards.

Spring Measure Results Publication on Schedule
In preparation for the transition from WCHQ’s current RBS system to the new SymphonyCare platform WCHQ moved up and extended the public reporting preview period for Spring 2020. Originally preview was planned to start on May 4 through May 15. Because access to our current measurement platform, RBS, will end on May 31. Now, WCHQ plans to have the preview period begin April 20 and go through May 15. The rationale for this change is to ensure that WCHQ can get all members’ measures run and validation completed in a timely manner in case there are any issues found prior to publication. Changes to results can be made during the preview period in cases where data issues are found, which has been allowed in past reporting periods. Publication of measure results to is still on schedule for the week of May 18.

WCHQ Transformation Team Update: Incorporating COVID-19 into Steering Team Work

The Practice Transformation team at WCHQ has adjusted its work to include a specific focus on supporting quality of care during the coronavirus pandemic. Our goal is to help members continue to provide quality care for all patients. Specifically, the Quality Planning Committee has modified its April meeting to be an opportunity for members to share and ask questions of each other and the WCHQ team regarding their needs during this time. Our steering teams have been modified to include relevant discussions on coronavirus preparations related to each clinical topic. To date, we have had requests for topics including: caring for chronic disease patients, procedures for child and adolescent vaccinations, health disparities, and the impact on health care quality during a pandemic.

April is Minority Health Month

The HHS Office of Minority Health (OMH) is teaming up with the Office of Disease Prevention and Health Promotion (ODPHP) Move Your Way campaign for National Minority Health Month in April. The theme is Active and Healthy, and they will be promoting activities to incorporate small amounts of activity into daily life. Check out their website for more information.

WCHQ will host conversations and share resources on the Wisconsin Heart Health Community of Practice throughout the month of April. To join our conversations and access the resources, you will need to become a member of the Wisconsin Heart Health Community of Practice. Join the Community of Practice here. If you prefer to have a personal invitation sent directly to your email, please contact Cara Winsand.

WCHQ Education On Hold, Tentative 2020 Calendar

WCHQ has built a strong reputation for providing excellent education opportunities for our members. We will continue to provide relevant and quality education in 2020, but depending on the circumstances, content might be delivered differently.

Cancelled: April 21 Assembly on behavioral health. WCHQ appreciates the presenters’ willingness to share their projects and best practices. This Assembly will either be rescheduled as an in-person meeting later this year, or the presentations will be recorded and posted to WCHQ’s Online Community.

Tentative: WHQ Statewide Quality Improvement Event June 16. This event has not been cancelled. A decision will be made by mid-April with member feedback and advice.

Still On: September 17 Assembly on health disparities; and November 12 Assembly on Adolescent and Child Health.

WCHQ knows our members value opportunities to meet in-person to network with their colleagues across the state. In these times of social distancing and extremely busy times for health care providers, if you are not registered for WCHQ’s Online Community, I would encourage you to take a minute to do it now. By registering now, you can access member-only areas of the site and it will allow you to register for online or in-person education in a few steps. Click here to join.

WCHQ Oral Health Collaborative Members Share Measurement, Integration Strategies

Amit Acharya, BDS, MS, PhD, executive director of the Marshfield Clinic Research Institute, presented their work to map and understand the workflow of dentists and how that information can be used to integrate medical and dental health records. The research was focused on gaining insights into what is important for health care providers to know about dental visits and adapting the EHR to highlight these items. He also discussed the Marshfield Clinic integrated care model using a patient with diabetes as an example, stressing the importance of dental and medical providers working together to address this population and other patients with multiple chronic health conditions. WCHQ hosted the third annual Oral Health Summit in Wausau March 3. The Summit brought thought leaders in the industry together to discuss innovations in delivering oral health, approaches for measuring quality in dental health settings, and strategies related to integrating dental and medical care in primary care settings.

Fred Eichmiller, DDS, BSME, vice president and science officer at Delta Dental of Wisconsin, is providing expert input on dental measurement nationally through the Dental Quality Alliance at the American Dental Association and Delta Dental. He discussed the work that is under way to determine the best tools for reporting patient-reported outcomes and he will continue to update the group as they close the loop on that project. Dr. Eichmiller also discussed current and past DQA measures for the group to consider.

HealthPartners’ Todd Thierer, DDS MPH, associate dental director of primary and pediatric dentistry, presented about the triple aim in providing care; health, experience, and affordability. He shared the unique position of HealthPartners with more than 70 dental providers who are integrated across their health system. He discussed HealthPartners’ emphasis on disease management, risk assessment, and risk reduction. Dr. Thierer shared the unique pay incentives that drive the dentists to provide preventive services for patients while providing incentives for quality.

Children’s Health Alliance of Wisconsin is leading the Medical-Dental Integration Project in Wisconsin. CHA’s Dana Fischer and Jenna Linden described the project that embeds dental hygienists in pediatric clinics to provide screening, education, fluoride application, and referrals. The discussion about their model was robust with members brainstorming about how to implement the model within their respective systems.

Gabrielle Rude, PhD, WCHQ director of practice transformation, led a discussion focused on value and measurement. As she shared examples of WCHQ’s current improvement activities, summit members expressed interest in joining these projects along with their medical colleagues. Participants brainstormed a list of potential measures that WCHQ staff will explore further. The group agreed the focus should be on the development of new, cross-cutting dental/medical measures

The group expressed excited about unifying dental professionals and leader organizations to improve access to and improve the quality of dental care regionally. The group is committed to advancing the integration of medical and dental services in all settings to improve population health.

In addition to the presenters, participants included: Jesley Ruff, DDS, ForwardDental; Charles Huntley HealthPartners; John Zweig, DMD, and Charles Lernarduzzi, DDS, Dental Associates; Harshad Hegde, Marshfield Clinic Research Institute; Greg Theis, DDS and Doug Ballweg, Delta Dental; Tom Raimann, DDS and Matthew Rossetto, Wisconsin Dental Association; Karen Ordinans and Matt Crespin, The Children’s Health Alliance of Wisconsin; and, Elizabeth Rydell, DDS, Midwest Dental.

For information about the WCHQ Oral Health Collaborative, contact Jen Koberstein.