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WP physicians part of pilot program to improve medical care
  
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By Pat Hill
As politicians haggle over health-care reform and lines in the sand are drawn over such issues as the public option, two physicians in Woodland Park have raised the ante on a system that many agree is broken.
Part of a pilot program that measures patient progress for treating conditions such as diabetes, Greg Sharp and his wife, Heather, of Ideal Family Health Care, are among 17 test sites for the two-year program.
Sponsored by Colorado Clinical Guidelines, a nonprofit organization, the program is funded by Colorado Trust and the Commonwealth Fund.
In treating patients with diabetes, for instance, the physicians follow a set of guidelines that include following up on designated goals.
“We also use technology and have restructured the financial arrangement of our practice in order to give more time to patients,” Greg Sharp said. “Insurance pays us a monthly fee, per patient, for things like e-mail access and same-day scheduling. We try to slow things down a bit to provide better quality care.”
A successful test depends in part on the online registry of patient information. The registry tracks clinical results individually and as part of a larger population with the same illness. For instance, the registry records the percentage of how many diabetics have controlled their blood sugar.
“This is the first time physician practices have started looking at that kind of data,” Sharp said. “That has been a key tool for us to use to automatically update the information.”
In improving the delivery of health care, the Sharps are in the vanguard of physicians who eschew paperwork in favor of electronic records that can be uploaded to the online registry.
“At that point, the registry can be a tool that patients can interact with, as well,” Sharp said.
The collaboration of physicians, hospitals and emergency rooms removes redundancy.
“If you have a system that tracks quarterly blood tests and can share that data, then it cuts down on the reordering, the duplication of services,” Sharp said. “This is one of the areas they see technology saving money within the health-care system. That’s a lot of what’s happening in Colorado right now. I think we’re a forward-thinking state and are quite far along.”
The pilot program seeks results that reduce the cost of health care.
“The insurance companies hope that by paying us more to take better care of patients, they’ll see a decrease in emergency-room visits and hospitalization for diabetics,” Sharp said. “The program is actually looking at the quality side; fortunately, we’ve been able to find common ground for the work that’s being done.”
The test is designed to offer bonuses to physicians whose patients make improvements.
“That’s a very tricky area in terms of health care right now — what determines the health of the population and how should a physician be held responsible, or not, for what the patients do and how healthy they are?” he said. “How much is the result of the patients taking care of themselves and how much is the doctor not doing his job?”
In Colorado, the state’s medical society recognizes the downside of a bonus system and proposes that physicians have a voice in how the measurements are done and the data used, Sharp said.
“The goal is to encourage good care of patients and not unnecessarily penalize doctors who are taking care of a group of higher-needs patients because of socio-economic reasons or whatever. We want doctors to take care of those patients and not feel like they’re cherry-picking or avoiding those populations because they won’t get paid as well,” he said. “I think there’s progress to be made but it’s slow and probably for good reasons.”
In many ways, the test is a throwback to the old days when patient and doctor were a team that together tracked treatment results.
However, with today’s health care crises, skyrocketing costs and alarming rates of obesity, hypertension and diabetes in the United States, the relationship between doctor and patient has taken on a new tone.
“From a physician’s point of view, whose responsibility is a patient’s health, to what extent does a physician need to give the patient resources or to what extent does a patient need to step up and take ownership of these problems?” Sharp said.
In essence, the pilot program is about giving patients the resources they need to make decisions about setting goals for exercise and diet, for instance.
“How do you motivate people to bring up these issues and then follow through on them? It really becomes a collaborative relationship between patient and doctor, and no one person can own all of it,” Sharp said.
“Certainly patients have things happen that are outside of their control and physicians don’t have 100 percent control over what patients do, either. So there is this meeting in the middle, and how do you reflect that when it comes to payment?”
However, the registry is a tool for the physician, a more reliable barometer of understanding what the patient needs and doesn’t need, while cutting down on the redundancy of care, he said.
“Medical practices that get sued often have systems that break down in terms of keeping track of what’s been ordered, how the results have been communicated to patients,” Sharp said. “Technology systems that track that kind of information seemed like the right thing to do. You can see how technology really starts to get its fingers into the office in a good way. We’ve sort of been on the front end of these new measurements and systems of care. It’s been exciting, sometimes slow, sometimes frustrating, as new things can be.”
The Harvard School of Public Health measures the performance of the pilot program, which includes 17 physician sites and these insurance companies: Colorado Medicaid, Anthem Blue Cross/Blue Shield, Humana, Aetna, Cigna and United Healthcare.
Because only one company, United Healthcare, has paid the fees, the Sharps have taken a risk to be part of the pilot program.
“It’s a little disappointing but we’re not doing it for the money,” he said. “This is something that needs to happen, and we believe in what they’re doing. A lot of it is what we were already doing.”
Part of a pilot program that measures patient progress for treating conditions such as diabetes, Greg Sharp and his wife, Heather, of Ideal Family Health Care, are among 17 test sites for the two-year program.
Sponsored by Colorado Clinical Guidelines, a nonprofit organization, the program is funded by Colorado Trust and the Commonwealth Fund.
In treating patients with diabetes, for instance, the physicians follow a set of guidelines that include following up on designated goals.
“We also use technology and have restructured the financial arrangement of our practice in order to give more time to patients,” Greg Sharp said. “Insurance pays us a monthly fee, per patient, for things like e-mail access and same-day scheduling. We try to slow things down a bit to provide better quality care.”
A successful test depends in part on the online registry of patient information. The registry tracks clinical results individually and as part of a larger population with the same illness. For instance, the registry records the percentage of how many diabetics have controlled their blood sugar.
“This is the first time physician practices have started looking at that kind of data,” Sharp said. “That has been a key tool for us to use to automatically update the information.”
In improving the delivery of health care, the Sharps are in the vanguard of physicians who eschew paperwork in favor of electronic records that can be uploaded to the online registry.
“At that point, the registry can be a tool that patients can interact with, as well,” Sharp said.
The collaboration of physicians, hospitals and emergency rooms removes redundancy.
“If you have a system that tracks quarterly blood tests and can share that data, then it cuts down on the reordering, the duplication of services,” Sharp said. “This is one of the areas they see technology saving money within the health-care system. That’s a lot of what’s happening in Colorado right now. I think we’re a forward-thinking state and are quite far along.”
The pilot program seeks results that reduce the cost of health care.
“The insurance companies hope that by paying us more to take better care of patients, they’ll see a decrease in emergency-room visits and hospitalization for diabetics,” Sharp said. “The program is actually looking at the quality side; fortunately, we’ve been able to find common ground for the work that’s being done.”
The test is designed to offer bonuses to physicians whose patients make improvements.
“That’s a very tricky area in terms of health care right now — what determines the health of the population and how should a physician be held responsible, or not, for what the patients do and how healthy they are?” he said. “How much is the result of the patients taking care of themselves and how much is the doctor not doing his job?”
In Colorado, the state’s medical society recognizes the downside of a bonus system and proposes that physicians have a voice in how the measurements are done and the data used, Sharp said.
“The goal is to encourage good care of patients and not unnecessarily penalize doctors who are taking care of a group of higher-needs patients because of socio-economic reasons or whatever. We want doctors to take care of those patients and not feel like they’re cherry-picking or avoiding those populations because they won’t get paid as well,” he said. “I think there’s progress to be made but it’s slow and probably for good reasons.”
In many ways, the test is a throwback to the old days when patient and doctor were a team that together tracked treatment results.
However, with today’s health care crises, skyrocketing costs and alarming rates of obesity, hypertension and diabetes in the United States, the relationship between doctor and patient has taken on a new tone.
“From a physician’s point of view, whose responsibility is a patient’s health, to what extent does a physician need to give the patient resources or to what extent does a patient need to step up and take ownership of these problems?” Sharp said.
In essence, the pilot program is about giving patients the resources they need to make decisions about setting goals for exercise and diet, for instance.
“How do you motivate people to bring up these issues and then follow through on them? It really becomes a collaborative relationship between patient and doctor, and no one person can own all of it,” Sharp said.
“Certainly patients have things happen that are outside of their control and physicians don’t have 100 percent control over what patients do, either. So there is this meeting in the middle, and how do you reflect that when it comes to payment?”
However, the registry is a tool for the physician, a more reliable barometer of understanding what the patient needs and doesn’t need, while cutting down on the redundancy of care, he said.
“Medical practices that get sued often have systems that break down in terms of keeping track of what’s been ordered, how the results have been communicated to patients,” Sharp said. “Technology systems that track that kind of information seemed like the right thing to do. You can see how technology really starts to get its fingers into the office in a good way. We’ve sort of been on the front end of these new measurements and systems of care. It’s been exciting, sometimes slow, sometimes frustrating, as new things can be.”
The Harvard School of Public Health measures the performance of the pilot program, which includes 17 physician sites and these insurance companies: Colorado Medicaid, Anthem Blue Cross/Blue Shield, Humana, Aetna, Cigna and United Healthcare.
Because only one company, United Healthcare, has paid the fees, the Sharps have taken a risk to be part of the pilot program.
“It’s a little disappointing but we’re not doing it for the money,” he said. “This is something that needs to happen, and we believe in what they’re doing. A lot of it is what we were already doing.”
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