A Focus on Cardiometabolic Health

August 15, 2024
8:30 AM to 3:00 PM
DoubleTree by Hilton Madison East

Register for the upcoming chronic disease assembly, where healthcare professionals, policymakers, and community leaders will converge to tackle the most pressing issues facing our healthcare systems today.

Keynote Address by Dr. Mikhail Kosiborod
Renowned cardiologist Dr. Mikhail Kosiborod will present focusing on improving the quality of care and outcomes for patients with cardiometabolic disease. As Executive Director of the Cardiometabolic Center Alliance and Vice President of Research at Saint Luke's Mid America Heart Institute, Dr. Kosiborod's insights promise to be both informative and transformative. 

In-Person Sessions with Healthcare Experts
Dr. Samantha Pabich from the University of Wisconsin-Madison, will share lessons learned from our grandparents. Dr. Courtney Baechler, from the Minneapolis Heart Health Institute will lead a discussion about health equity and promotion. These sessions provide a unique opportunity to engage with experts in the field and explore innovative approaches to healthcare delivery.  

Additional sessions will include interactive breakout sessions led by industry experts with topics ranging from exploring the influence of social determinants on obesity to practical implementations of advances in chronic kidney disease treatment to a data presentation by health system leaders to inform decision-making and strategic planning in healthcare organizations and communities.

‍Final Remarks
Dr. Christopher Weber, Obesity Medicine Specialist with Ascension, will summarize the day's discussions and highlighting key takeaways. This is your chance to reflect on the insights gained and chart a course for action in your own healthcare practice or community initiative. 

Networking and Collaboration
Connect with peers, forge new partnerships, and exchange ideas to drive positive change in healthcare. The assembly provides ample opportunities for networking during breaks, lunch, and exhibitor visits. Whether you're a seasoned healthcare professional or a passionate advocate for community well-being, you'll find like-minded individuals eager to collaborate and make a difference. 

Register Today

Register now to secure your spot. WCHQ members can register at no cost, while non-members can register for a nominal fee of $80. Join us as we come together to shape the future of healthcare and build healthier communities for generations to come.

Partial funding provided by Bayer and Novo Nordisk.‍

As WCHQ celebrates its 20th anniversary, we review the results achieved over that time. This month we examine the adolescent and childhood immunization series measures. These measures are newer in comparison to some of the measures we’ve reviewed this year. They were publicly reported for the first time in 2015. WCHQ members decided to publish these results knowing that preventative immunizations not only protect the person receiving them, but also the people around them.

Childhood Immunization Series

From the end of 2015 through the end of 2019, WCHQ members’ childhood immunization rates increased annually by an average of 1.5% (increasing from 78.3% to 82.2%) despite patient populations also increasing during that timeframe (from 36,296 to 39,646 children seen by WCHQ members).

COVID-19 impeded the steady progress in part due to children missing well-child visits. A significant decrease in patient volumes was reported post-COVID with an average of 17.8% fewer children being seen across WCHQ health systems. Measure rates have also steadily declined back down to 79.1% in the third quarter of 2023, the lowest rates observed since 2015.

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‍Adolescent Immunization Series

The adolescent immunization series followed a similar pattern. From the end of 2015 to the end of 2019 reported patient volumes increased annually by an average of 4.5% (from 25,023 to 29,486 patients), while also increasing on time immunizations by an annual increase of 3% (78.7% to 88.22%). The impact of COVID hasn’t been quite as large for the adolescent population. There was a decrease in patient volumes by 7.8% across WCHQ health systems, while the measure rate declined through quarter two of 2023 to 86.8% (on par with 2018 rates).

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The downward trends are concerning. To help slow/reverse the effects of COVID on immunization rates, the WCHQ Immunization Improvement Team created an online toolkit of best practices for increasing immunization rates in children and adolescents, as well as addressing disparities. The toolkit includes evidence-based best practices shared by WCHQ members as well as easy to access published resources and interventions.

Margaret Hennessy, MD, a pediatrician at Ascension All Saints, led the recent toolkit launch webinar and explained the importance of building trust, message delivery, listening to patient/parent concerns and providing accurate resources as parents make immunization decisions. She highlighted the sections of the toolkit and provided examples of how they could be used by any person of the immunization care team.  The toolkit is a practical, usable tool for quick referencing and following standards of care.

The toolkit features information on:

• How to use the announcement approach to address vaccine hesitancy
• Immunization versus vaccination
• Clinical training and additional education
• Standard operating immunization procedures and resources
• Wisconsin specific resources
• Resources for patients and families

The new toolkit is available on the WCHQ website here.

If you would like to participate in WCHQ’s Child and Adolescent Immunization Improvement Team, contact Lori Bue at lbue@wchq.org.

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‍In recognition of the WCHQ 20th anniversary in 2024, we are planning a member profile each month. ‍

‍Member Name: ThedaCare

Member Background Both as a System and with WCHQ: For nearly 115 years, ThedaCare has been improving the health and well-being of the communities it serves in Northeast and Central Wisconsin. The organization delivers care to more than 650,000 residents in 17 counties, and employs approximately 7,000 providers and team members at 180 points of care, including eight hospitals. In 2024, ThedaCare and Froedtert Health combined to form one system to strengthen local health care and provide high-quality services for treatment and prevention in a coordinated manner.

ThedaCare is one of the founding members of WCHQ, who shares a vision of statewide information that would help the Wisconsin’s health care systems make informed decisions about health care quality, cost and value.

Imran A. Andrabi, MD, FAAFM, president of Froedtert ThedaCare Health, Inc., is the current chair of the WCHQ Board of Directors.

‍Number of Providers: 1,100 providers within ThedaCare

Member of WCHQ Since: 2005

Current Quality Goals: “ThedaCare’s mission is to improve the health and well-being of the communities we serve,” said Mbonu Ikezuagu, MD, MHSA, FACP, CPE, Chief Quality Officer at ThedaCare. “As a not-for-profit health system, we are committed to providing the best possible care in every community we serve. We are here to support each of our patients throughout the entirety of their health journey, providing the information, expertise and care they need to be well, and stay well.”

In addition to our vision of being a proactive partner in health, our current quality goals align to provide the best health outcomes and dignity for our patients and community. Some of the metrics we are currently working on include:

• Preventative– Breast, cervical, colorectal cancer and depression screenings
• Immunization– Pneumonia, childhood and adolescence vaccinations
• Chronic disease– HTN, diabetes
• Safety/effectiveness– Mortality, readmission
• Dignity– Human Dignity Index – End-of-life

How WCHQ has impacted the care at ThedaCare: “WCHQ has positively impacted ThedaCare in many ways,” said Dr. Ikezuagu. “Through our partnership with WCHQ, ThedaCare has the ability to benchmark ourselves with other high-quality health systems in Wisconsin. We also have the opportunity to share best practices with member systems within WCHQ. These opportunities have been critical to our improvement and performance.”

WCHQ Assembly Provides Actionable Information to Attendees

Two heathcare topics in dire need of attention in our state were discussed at the latest WCHQ assembly on May 7 – immunizations and maternal health. WCHQ Quality Improvement Specialist Lori Bue set the stage for the day’s presentations. “Three in every five pregnancy deaths are preventable,” she said. “Every maternal death represents a life.” She shared additional maternal morbidity information, such as:

• Approximately 25 Wisconsin women die each year during or within one year of pregnancy.
• Pregnancy-related mortality for non-Hispanic black mothers is five times the rate for non-Hispanic white mothers.
• Of pregnancy-related maternal deaths, more than two out of three occur postpartum.
• Women who died in Wisconsin were more likely to have had less education, live in urban areas, and be enrolled in Medicaid at the time of death.

Regarding immunizations, Lori shared that, based upon WCHQ research data from December 2019 through June of 2023, childhood immunization rates for Black/African American children decreased by 11.8% and for Hispanic/Latino children decreased by 15.6%. In addition:

• Children within Medicaid program significantly lower rates of timely vaccination.
• Disparities with Black, American Indian/Alaskan Native notably lower rates.
• Children residing in underserved urban areas 12% less likely to receive immunizations compared to urban advantaged in Wisconsin.

The keynote speaker for the day was Dr. Paul Burstein. Dr. Burstein is Medical Director, Perinatal Safety and Quality at Ascension Columbia St. Mary’s Milwaukee & Ozaukee as well as a Clinical Professor at the Medical College of Wisconsin.

Dr. Burstein spoke about a variety of valuable tools Wisconsin caregivers can put into place to protect the lives of birthing people. For example:

• The advantages of using simulations to train for delivery complications, such as hypertension, hemorrhage, maternal cardiac arrest, and more.  
• Using identified systems that can be used in the case of an emergency, such as “Call Outs” and “CUS (Concerned, Uncomfortable, Safety Issue)," that empower staff to voice concerns during delivery. An Emergency Reporting System (ERS) allows any staff member to enter an event, even events that may not be recorded in the health record and allows for anonymity.

Dr. Burstein shared that, after putting such organized reporting structures into place at Ascension, a decrease was seen in important areas of care such as birth trauma event delays of treatment for fetal distress or shoulder dystocia.

Other speakers included:

• Stephanie Borchardt, PhD and Maddie Kemp, MPH, from the Wisconsin Immunization Program. Stephanie and Maddie shared maternal and infant RSV immunization rate statistics for the state of Wisconsin. In addition, they shared how to plan for the upcoming respiratory illness season, such as discussing RSV immunization with pregnant people at the 30-week gestation visit, issuing reminders to people who are past due for immunization and sharing information in a culturally relevant way.
• Melissa Gilkey, PhD, University of North Carolina. Dr. Gilkey demonstrated the importance of HPV vaccination. She stated, for example, that “on time” HPV vaccination (between the ages of 11 and 12) could prevent 90% of HPV cancers. She also shared that there is an increase in HPV vaccinations between May and August, and health systems can prepare now for those visits by sharing with staff effective communication strategies to use when speaking with parents about HPV vaccine.
• Sreevali Atluru, MD, University of Wisconsin-Madison School of Medicine and Public Health. Dr. Atluru shared strategies for caring for pregnant people who live with a substance use disorder. She advised to “give space and invite trust” and avoid stigmatizing language. In addition, she shared that, while we may not understand why a person is using a substance, we want them to be safe. Hospital Overdose Prevention Effort (HOPE) Kits may be given to patients, including sterile materials. In addition to fentanyl test strips and Narcan.  
• Lori Bue, WCHQ Quality Improvement Specialist and Ramona Curry, Lindsay Heights Community and Walnut Way Conservation Corp. Lori and Ramona shared videos that have been created to give patients a voice to advocate for equity in healthcare. Ramona stressed the importance of the community health worker and building relationships with the communities she serves. The videos and discussion guides will be loaded the WCHQ website in June for health systems to use for staff training.

The day ended on a positive note, with attendees learning about the Baskets of Hope Food Security Initiative. Amanda Prusak and Helen Osborn-Senatus of The River Food Pantry joined Nikeya Agwoeme and Joanne Johnson from SSM Health to discuss their partnership securing food resources for new parents in need. SSM Health began screening for social determinants of health in January of 2023, covering six categories, including food insecurity. New moms were determined to be an ideal population for this initiative, as mothers and expectant mothers experiencing food insecurity have an increased risk of physical, mental and oral health problems. Over the last 9 months, over 100 bags of food items have been delivered.

Asthma continues to be a chronic illness that affects many people in Wisconsin and there is an increased asthma burden in underserved areas of our state. This carries not only a heavy burden medically, but socially as well. On May 15, WCHQ hosted the webinar, “Asthma Efforts Across Wisconsin,” focused on asthma care improvement.

Our presenters shared valuable asthma-related information with webinar attendees:

• Carissa Hoium, MPH, Environmental Health Program Leader, Children’s Health Alliance of Wisconsin, Wisconsin Asthma Coalition, reminded us that although asthma is a deadly disease that affects many people across the state, there is hope for improved outcomes with all of the work and resources shared today. The Wisconsin Asthma Coalition works to improve asthma management, enhance quality of life, reduce disparities, and prevent asthma related deaths across the state.
• Molly Zemke, MPH, Program Manager and Meridith Mueller, MPH, Evaluation Specialist with the Wisconsin Department of Health Services, reported that 192 participants completed the Asthma-Safe Home program in the first year. The program provides in-home asthma education and at times, home remediation services. This service improves home air quality, inherently improving asthma symptoms, emergency room visits, and provides patient education about asthma symptoms and early intervention in those symptoms and triggers. The Asthma-Safe Home Program works closely with the Pharmacy Society of Wisconsin to support the integration of community pharmacy teams into the patient’s asthma plan.
• Kari Trapskin, PharmD and Senior Vice President, Practice Transformation at the Pharmacy Society of Wisconsin explained their work to “build sustainable programs that can provide more access to asthma education across the state.” The outcomes have increased patients’ understanding of their asthma; when patients understand how to manage their chronic disease, their outcomes are better.
• Jill Heins, Nationwide Senior Director, Health Systems Improvement for the American Lung Association, shared with the participants the broad resources that the American Lung Association can provide. The American Lung Association provides the Asthma Education Institute, bringing important education and preparation for the national exam for Asthma Educator Certification.

WCHQ’s asthma improvement work brings healthcare partners from across the state together to increase guideline-driven interventions and improve patient outcomes. This work is important and takes a team to support a patient’s asthma plan. These holistic patient asthma plans not only focus on medication adherence, they include regular health care visits and education about environmental factors and other asthma triggers.

If you interested in joining this work, connect with Lori Bue, Quality Improvement Specialist, lbue@wchq.org.

The Obesity Medicine Association (OMA) recently announced the appointment of Christopher Weber, MD, FAAP, FACP, CSCS, DABOM, FOMA, to its Board of Trustees. Dr. Weber, an esteemed physician and leader in the field of obesity medicine, brings a wealth of expertise and dedication to this new role.

As a board-certified physician in Pediatrics, Internal Medicine, and Obesity Medicine, Dr. Weber has demonstrated a lifelong commitment to advancing the understanding and treatment of obesity. He currently serves as an internal medicine physician at Ascension Wisconsin, where he specializes in obesity medicine and serves as the Medical Director for Ascension Wisconsin Bariatric Services.

Dr. Weber’s professional achievements and accolades underscore his qualifications for this important position within the Obesity Medicine Association. He is a Fellow of the American Academy of Pediatrics (FAAP), a Fellow of the American College of Physicians (FACP), a Certified Strength and Conditioning Specialist (CSCS), and Diplomate of the American Board of Obesity Medicine (DABOM) and a fellow of the Obesity Medicine Association (FOMA).  Dr. Weber was one of the founding members of the WCHQ Obesity Advisory Group and has led that group in developing obesity measures, educational efforts, and development of tools for primary care providers.  

His insights and contributions will undoubtedly strengthen the mission of the Obesity Medicine Association in its efforts to promote evidence-based approaches to obesity treatment and prevention.

If you would like to learn more about the work WCHQ is doing on obesity, contact Jen Koberstein at JKoberstein@wchq.org.

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