March 2023

President’s Report

Gabrielle Rude, PhD
President/CEO

At our March WCHQ Board of Directors meeting, the board participated in a strategic deep dive into Value Acceleration, one of our current strategic priorities. The discussion was led by Dr. Imran Andrabi, ThedaCare, who chairs the Value Acceleration Advisory Group. The group is planning for our next iteration of the WCHQ Value Report (a resource for members that allows comparison between health systems on drivers of healthcare costs in patients with diabetes).

Our January newsletter highlighted evidence that WCHQ members have saved Wisconsin more than $104 million in avoided healthcare costs by improving diabetes control. WCHQ’s next Value Report will continue to build on this evidence for patients with diabetes and add a more wholistic view of healthcare value - connecting quality interventions with health outcomes.

The board viewed options for the next iteration of the Value Report, utilizing the robust data available in WCHQ’s data repository, Data Voyager. One of our key strategic priorities, and the foundation for our other work, is leveraging our robust data repository to drive improvement. WCHQ transitioned to Data Voyager to be able to provide more actionable data to our members using the more than 10 years of data housed in Data Voyager. The board agreed WCHQ should leverage its own robust data (see article on Data Voyager), with Chris Elfner, Bellin, stating that it is “critical that WE take on this work.” The board was enthusiastic about ideas presented by the committee, with repeated comments praising the “wholistic” and “long-term” focus of the work.

Dr. Andrabi ended the conversation challenging WCHQ members to remain secure in our role as an improvement organization, noting that while the definition of value varies by perspective, WCHQ’s perspective is that of the patient.

WCHQ’s Data Voyager Gives Members Increased Data Potential

The theme for the WCHQ Statewide Improvement Event in June is “The Next Step in Healthcare Quality Improvement.” What does that mean? For health systems who are members of WCHQ, Data Voyager is the next step.

During the WCHQ Board of Directors meeting in March, Chief Operating Officer Carrie Blum and Director of Performance Measurement and Analytics Brian Slattery delivered an overview of the new Data Voyager tool and how it will be beneficial to WCHQ members.

Data Voyager is a dashboard that a member organization can use to “slice and dice” their own data, run reports for a single measure, or all the measures. The tool also gives members the ability to report on measure performance by clinic site, as well as individual providers.

“Data Voyager is a really powerful tool,” Brian said. “This system single-handedly allows members to use their own data, at their convenience, to view their performance on WCHQ’s entire portfolio of quality measures. It provides our members the visibility needed to drive processes and influence quality for the benefit of their staff and patients.”

What else do you need to know about Data Voyager?

  • Web-based, available 24/7
  • No limit to users
  • Data Voyager is more current than measure results on WCHQ.org
  • Members who submit data more frequently are updated more frequently

Brian Slattery is happy to train member organizations on how to use Data Voyager to its potential. He can be reached at bslattery@wchq.org.

Mark Your Calendar! WCHQ Education Event Dates

Specific event details, including registration information, will be shared soon.

Improving Colorectal Cancer Screening in Rural Wisconsin

April 11
Virtual education event

Agenda

Register

Importance of Biomarker Testing in Treatment Optimization for Patients with Advanced Non-Small Cell Cancer

April 20
Virtual education event

Agenda

Register

How to help patients with obesity in your primary care office

April 26
Virtual education event

Agenda

Register

WCHQ Statewide Quality Improvement Event

June 22
In-person and virtual attendance options

  • Immunization and Maternal Mortality webinars (virtual education events)
  • Afternoon Diabetes Seminar (in-person and virtual attendance options)

DoubleTree Madison East, 4402 E. Washington Ave., Madison, WI

Disparities Seminar

July 27
In-person and virtual attendance options

Antibiotics Webinar

August 31
Virtual education event

Obesity Seminar

September 13
Virtual education event

Chronic Kidney Disease Seminar

September 26
In-person and virtual attendance options

Behavioral Health Webinar

October 5
Virtual education event

Maternal Mortality Seminar

October 10
Virtual education event

Immunization Webinar

December 5
Virtual education event

Right Treatment Through Biomarker Testing for Lung Cancer

Webinar slated for April 20

The American Cancer Society states that lung cancer is the most common cause of cancer deaths in men and women in the United States and nearly 85% of lung cancer diagnoses are made when the disease is in the advanced stages.

WCHQ is excited to partner with Genentech, a biotechnology company based in San Francisco. Genentech has identified biomarkers associated with non-small cell lung cancer and when patients are tested for all biomarkers, treatment options and therapies for patients can be identified earlier. Biomarkers are specific molecular characteristics that can be found in tissues in the body as a response to the presence of cancer.  

The goal of the project is to establish a quality measure for our member health systems for patients diagnosed with metastatic or early diagnosis, non-small cell lung cancer that indicates appropriate biomarker testing was ordered and the results were used to drive a patient’s treatment plan.  

WCHQ Advisory Group work will start with developing a survey that will be distributed to health systems to better understand their biomarker testing processes.

WCHQ will host a webinar on Thursday, April 20, 2023, from 12:00 – 1:00pm. Recruitment for the Lung Cancer Advisory Group has begun. If your health system has medical oncology, surgical oncology providers and staff, quality personnel who would like to participate, please contact Lori Bue, Quality Improvement Specialist at lbue@wchq.org.

Recovery Stories:

Navigating health disparities, racism, and stigma to get mental health access

WCHQ partnered with the Medical College of Wisconsin on a project funded by Advancing a Healthier Wisconsin to increase access to behavioral health services for patients with Medicaid. As part of this project, patients tell the stories of their experience receiving services. WCHQ will feature these stories in upcoming newsletters. Welcome to the first in the series of recovery stories.  

These contemporary portraits of people living with mental illness provide brief glimpses into the experience of navigating the US health system as Medicaid recipients. They share their stories of seeking care, engagement with clinicians, therapeutic treatment, peer support, and recovery. The 3-minute personal vignettes point to the impact of social-cultural and institutional determinants on health, and the resilience it takes to access care and get better.  

 

Imani  - “Noncompliance” 

There is more than one way to be okay 

In this video, Imani candidly talks about the impacts that traditional treatments had on her self-understanding and identity. She explains how her therapeutic noncompliance labeled her as the problem rather than the treatment, and the lasting effects this had on her dignity and confidence. Imani speaks to the idea that there is “no one right or wrong way to recovery.”

Possible topics for discussion of this video, when sharing with staff and clinicians, include the biomedical model vs patient-centered care, evidence-based therapies, patient choice, multiple pathways to recovery and treatment non-adherence. 

Spotlight: Colorectal Cancer Awareness Month

This month we focus on Colorectal Cancer Screening and the importance of healthcare quality in the fight against colon cancer.

At WCHQ, we aim to help members improve colorectal cancer care by analyzing your data to reveal opportunities and by fostering collaboration among the membership. Below is the membership’s aggregated performance regarding colorectal cancer screening over the last few years:

Up until the COVID-19 pandemic, the membership had been on an upward trajectory approaching 80% on this measure. After 2019, however, we saw rates dip by over 2% in the most recent reporting period. Concerned about the impact that a shift like this can have on the health of the state's population, WCHQ members made this one of our improvement priorities.

Because we are keenly aware of the disparities in colorectal cancer diagnosis and mortality, WCHQ and Exact Sciences have partnered to work on an improvement project to address colorectal cancer screening in rural communities. In this improvement project, we will work with Wisconsin health systems serving rural communities to identify successes and barriers to colorectal cancer screening.

If you are interested in working on this project, please contact Quality Improvement Specialist Renee Sutkay. We will kick this project off with a webinar on April 11 and have a goal to start this team at the end of April.

Improvement Teams

Asthma Improvement Team Update:

Helping patients control their asthma through patient screening tools

At the last meeting, members of the Asthma Improvement Team shared information on what their health systems are currently doing to capture the Asthma Control Testing (ACT) patient questionnaire and how it is recorded in the EMR.  

During the next meeting on Tuesday, March 28, noon – 1:00pm, we will have a presentation by Dr. Karen Pletta, Director of Quality Improvement in General Pediatrics & Adolescent Medicine at UW Health, about their roll out of the ACT screening initiative across all pediatric clinics.

The Asthma Improvement Team is made up of clinicians and medical professionals representing pediatric allergy, pulmonology and primary care. If you would like to join the work of the Asthma Improvement Team, please contact Lori Bue at lbue@wchq.org.   

Chronic Disease Learning Collaborative Update:

Associated Physicians Increase Access to Primary Care Visits

The Chronic Disease Learning Collaborative met on January 30, 2023, to share their improvement goals and outcomes in a poster presentation format. Aspirus, Associated Physicians, Gundersen, Marshfield Clinic (3), Prevea and Primary Care Associates of Appleton shared their improvement goals and the work they are doing in their health systems. One year ago, each team member set a chronic disease improvement goal unique to their health system.

To provide additional assistance to their patients living with chronic illnesses, especially those with Medicare, Associated Physicians has re-introduced Registered-Nurse Led Annual Wellness Visits (AWV). More often, Medicare patients are being seen for problem-based visits, which are solution focused. AWVs are more general, supportive, and focused on prevention. “Primarily, this is to screen the patient for high-risk conditions and provide an opportunity for the patient to share details about themselves,” says Theresa Whittington, RN, MSN, Associated Physicians, who is leading this project. AWVs are 60-minute appointments, with 25 slots available each week. Patients see a physician when they are first enrolled in Medicare, but subsequently see an RN for AWVs.

Staff are contacting patients who have not been seen for their annual wellness visits, or need follow up from a problem-focused visit, to take advantage of AWVs. There are many goals within this initiative:

  • screening for high-risk conditions
  • working with the patient on overall health and wellness goals
  • referrals to specialty providers and community resources

Effective and efficient RN to physician communication after the AWV is also a priority.

Please contact Renee Sutkay, Quality Improvement Specialist, rsutkay@wchq.org for more information.

Chronic Kidney Disease Advisory Group Update:

CKD Members Discuss Overcoming Payment Struggles for Patients      

WCHQ CKD members met on March 2 and discussed including payers in the work they are doing to increase access, early detection, and treatment of CKD. Members also discussed:

  • the evidence that shows SGLT2 inhibitors and nonsteroidal MRAs2 are key medications in preventing the progression of CKD1, yet insurance companies either do not cover them, or they are cost prohibitive for most patients.  
  • engaging payers and employers in the work we are doing to prevent the progression of CKD.
  • inviting pharmacists who are part of specialized CKD teams and team-based care to join this work.

If you are interested in learning more about the work WCHQ members are doing on CKD contact Jen Koberstein.

Check out the articles below for further reference.

Healthy Mom and Baby at Time of Delivery

WCHQ’s Maternal Health Improvement Team is seeking involvement from midwives or doulas who have interest in bringing their expertise to the WCHQ Maternal Morbidity Improvement Team. This team meets on the first Friday of each month from noon – 1pm. The intent of this team is to look at chronic disease measures such as hypertension, diabetes, depression screening and obesity and apply them to the pregnant population. The data will then be stratified by age, race, payor, ethnicity, and location, to further identify the disparities amongst this population. If interested in participation in this group please contact Lori Bue at lbue@wchq.org.

Enhancing Care for Children with Asthma

Our friends at the Wisconsin Department of Health Services shared this information with us. They are working with the American Lung Association (ALA) on a clinic-based quality improvement program and are recruiting clinics to participate. Please notify the ALA contact on the flyer for more information or to participate.