Meeting Minutes Population Health Workgroup 11/19/15 | 1:30-3:00 pm | CDPHE A4D
Discussion Items: Type of meeting Chair Co-Chair SIM Representative
Population Health Liz Whitley John Douglas Rachel Short
Members in Attendance: Barbara Becker, Tim Byers, Joshua Ewing, Jenn Fanning, Karen Koenemann, Jamie Morin, Neha Patel, Tyler Payne, Lenya Robinson, Kelley Vivian, Liz Whitley, Janie Dunckley, Jen Fanning Members of the Public: Don Sutton, Sara Davis, Tara Smith, Emily Haller
SIM Office Update Overview: Rachel substituting for Nicole, who is out working on SIM practice selection. Outreach Tour, engaged over 100 stakeholders We had good turn out from LPHA Directors. They expressed an interest to collaborate with us. For next year’s meeting we will reach out to additional organizations to align efforts. Over 175 practices applies to be a part of our first SIM cohort 4 CMHCs won a grant to be administered by CBHC. 100 practices will be funded in the first cohort of SIM. Pop health Plan Presented by Cambria Brown and Michele Coleman. Approach: o Used CDC template -- CDC will be reviewing the plan in addition to CMS. o Also utilized existing assessments and plans. o As well as engaging stakeholders. o 3 levels of care Framework Traditional clinical approaches. Innovative patient-centered care and funding models and or clinical community linkages. Community wide approaches. A: State Health Needs Assessment and Priority Setting. o Leveraging pop health assessments.
The Project described was supported by Funding Opportunity Number CMS -1G1-14-001 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Meeting Minutes Painted a picture for how there is alignment and synergy that helps encourage SIM. o Resources to determine areas of high burden and cost. Demonstrate (quantitatively) why this is important for CO. Addressed cost burden B: Existing Capacity an Efforts Aimed at Pop Health o Activities and capacities to be leveraged: highlights funding opportunities and other initiatives. o Pop health strategies and activities under SIM. o Additional opportunities to consider under SIM, moving forward. C&D: Roadmap o Drill down what was identified in A to behavioral health and put in goals, strategies and framework to establish SIM goals.
Questions Is this Draft? Yes o How are you going to vet this and how broadly will you continue to vet before submission? Need to put on Basecamp for review by WG. Tried really hard not to create new work- took from existing plans. Compilation of what is already out there. CDC format to appear this way- made it fit into there. Is this representative of this WG’s work? o This plan is a required deliverable that we are expected to turn in- doesn’t reflect the work of the committee per se but interested in their input before submission. Considered “draft” until CDC/CMS approve 100%. Will be available for public review after all revisions are made. Don Sutton First time he has been asked to publically talk about the plan. He would like reaction, input and feedback so he can provide a really robust plan. Don did not have a template- which is fine because now he can utilize what we can and develop what we need. 3 courses: pregnancy related depression, depression in men, obesity and depression in Year 2. Provider training plan for year 2-4 o Who? What? How will we get the knowledge out there? Develop on the evaluation plan for this education. Depression in men- create clinical guidance. Shannon
The Project described was supported by Funding Opportunity Number CMS -1G1-14-001 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Meeting Minutes
Clinical guidance is thought of in addition to screening- how do doctors recognize when they need to screen? What does that look like since men are different than women? o Taking the existing guidelines and expand and tailor to the adult male population.
Other emerging BH training How are those issues decided on? For instance, opioid epidemic is emerging and important topic in CO… o After implementing the three main areas, then part of the provider education plan will be to identify what other trainings are needed based on other areas. o The three course we are starting with are things we (CDPHE) have already been working on and are existing priorities identified that our team needs to work on- really easy wins for us. Depression in men is because our suicide rate is high in working age men. o Emerging issues is part of the info that Don has been collecting Opioid and heroin is something they are aware of and is very much something that will show up in the plan. Pregnancy-related depression (PRD) is in the MCH department, so Caitlin is reporting on that. o PRD is a MCH priority area o An education model around perinatal mood disorder has already been created. o Training unique from others because it was dev in a study format o Used a flyer- disseminated to over 500 people- to gain study sample o If people qualify for the study… Asked to complete a pretest- assess how you currently talk to and deal with perinatal mood and anxiety disorders Divided into intervention and control group Intervention group will receive module and then post-test to compare the data across groups and assess the effects of the module on provider education. End of January, the module will exposed to the intervention group. o Will the training be tweaked after the study is over? Yes, depending on the post-test o Does the control group get anything? Receive pre and post test What if you don’t see a difference? o That would be disappointing… The idea in having that 6 week gap between completion of the module and the post test is because we want to see what stuck with the providers.
The Project described was supported by Funding Opportunity Number CMS -1G1-14-001 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Meeting Minutes
Partnering with the Depression Center to develop content and work on getting a webinar up and running for January- will be recorded for later viewing. o That is the immediate goal (in the grant therefore it needs to be developed and deployed). o Concern: since webinars are not ideal for learning, it would make more sense for the modules to step away from that model because that model isn’t going to take us very far. Breathe life into learning… better to use live, bi-directional video training. Developed originally out of NM and currently across the world. Support from CHF to launch ambitious set of 18 different topics (PH and clinical) all will be launched by 3 months from now) Primary care (both clinical and PH) 3 month series on one topic. Every 3 weeks for an hour you will hear facts about the topic Then you go around and hear cases (locally?) Built on existing ECHO Platform and will expand Not a lot of the platform right now Existing topics not anything for mental health o Challenge- How to bring these modules to life as a stepping stone to the larger ECHO platform. Could be used as a larger consolidation of all subtopics. o ECHO and SIM Working with other groups to use ECHO for communication and training to be used with other aspects of SIM (RHC, facilitators, etc.) Don Sutton o Lots of people/agencies/groups working on courses o Decided it would be a better use of funds to be sure that we are not duplicating what already existed or what someone else has already committed to working on
Conducting Environmental Scan on: Content Integration process needs- set around integration. o Developing that kind of global scan/environmental scan. Survey of stakeholders BH & PCP Training and education providers ( in CO and nationwide) Added 3 questions to pre-survey at WF Summit o What’s already out there and what has been helpful? o What do you need to be successful?
The Project described was supported by Funding Opportunity Number CMS -1G1-14-001 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Meeting Minutes
Will be administering a wider survey to statewide PCPs Would like to convene a meeting with anyone in the state doing education with integration… o The more we can clearly identify what is being done and wat needs are unmet the better we can determine where we should put the dollar in the remaining years of SIM. Where is this all going to go? Collectively, we want to identify a host and platform. Best of all worlds… all this material could be housed somewhereone place and search for terms and come up with what you need Collaborative and creative Online assessment tools whether people will fit in integration practices as providers. Also, a whole way to do virtual interaction o Create a virtual exam room and then you as the person in the interaction go in and greet the patient and get scored In the end you can tell if you interaction was successful. SAMHSA interactive online tools webinar. Don welcomes anything you have to help him learn. Do you envision any practical advice for how to bill for screening or caring BH? o Why not, if that is something that is identified as useful information? Won’t have a clear sense of that until we are working with the practices. What have they already done and still need to know? o This is part of the pregnancy-related depression module. o Essential component o We need to think about how best to get this information out there. CO-train- system of courses o Not universally agreed upon. o Why it not universally agreed upon? o What could we do to improve it? To have this course catalog you will need to incent to push the providers there and it is useful. Targeting training on the health systems of integration o There are enough experts around and clinical systems that really want to do this dance that it would be good to have trainings on the health systems aspects of integration. o How can you make the business model work to bring these two systems together? Maintenance of Certification o CO Association of Family Physicians or CMS resource for Don. Denver Foundation grant review is well underway.
The Project described was supported by Funding Opportunity Number CMS -1G1-14-001 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services.
Meeting Minutes o Just a couple weeks away for completing the process for the collaborative grants. Denver Foundation still has some work to do with who they fund o Info by January meeting.
Outstanding Questions:
What is the best method of delivering training modules? What strategy will be employed to get differing health systems to work together on delivering training models? How will additional needs be identified and additional training series be developed?
Action Items: Topic
Responsible Party
Put Population Health Plan on Basecamp for review Report out on the Pop Health Plan at Steering Committee Schedule 2016 meetings
Nicole King
Deadline
12/01/2015
Nicole King
12/16/2015
SIM Office
12/31/2015
The Project described was supported by Funding Opportunity Number CMS -1G1-14-001 from the US Department of Health and Human Services, Centers for Medicare and Medicaid Services.
