Summit Medical Group, New Jersey’s largest multispecialty medical group, was selected by the American Medical Group Foundation (AMGF) to participate in a national collaborative dedicated to finding best practices in managing patients with rheumatoid arthritis (RA). Earlier this year, SMG received a $10,000 grant from AMGF and AbbVie to support their quality improvement efforts through participation in the collaborative. Working together with 17 other medical groups across the nation, SMG will facilitate the adoption, discovery, and spread of care processes that will improve the way in which RA patients experience the healthcare system.
A chronic disease with high morbidity, mortality and costs, rheumatoid arthritis (RA) affects approximately 1.3 million people in the U.S. In 2014, both the direct and indirect costs associated with RA were estimated to be $40 billion dollars, and could reach as high as $54 billion by 2030. The economic impact of RA is similar to, if not greater than, costs associated with more prevalent, chronic diseases such as diabetes.
Designed for organizations striving to improve the care of their RA patients, the collaborative is intended to leverage key learning and facilitate a “how-to” approach. Supported by an Advisory Committee of physicians and quality improvement experts, participants will gain mission-critical experience in engaging specialty departments such as rheumatology in performance measurement and improvement.
Medical Director for Population Health at SMG, Jamie Reedy, M.D., MPH, notes that the Group’s initiatives will focus on improving quality outcomes, access to timely care, and adherence to evidence-based guidelines. “We’re thrilled to have this opportunity to collaborate with other medical groups to improve the quality of care for RA patients. We look forward to engaging our RA patients in these improvements and partnering with them for better health outcomes,” she adds.
Through a yearlong series of activities, participating organizations will have the opportunity to test approaches and design care processes that are relevant to their clinical and operational models. As a result, best practices will be developed and shared around the work of the collaborative groups. The collaborative ends in August 2015.
Selected Podcast
Working Together for Better Health : SMG Participates in AMGF Rheumatoid Arthritis Collaborative
Featured Speaker:
In addition to her position with Summit Medical Group, Jamie L. Reedy, MD, MPH, is Medical Director of the Westfield Regional Health Department in Westfield, New Jersey.
She is Clinical Assistant Professor at the University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School in New Brunswick. She also precepts students in her clinical practice from UMDNJ.
Dr. Reedy is a member of the Overlook Hospital Medical Staff and the American Academy of Family Physicians.
She was Founder and Co-coordinator of the Homeless and Indigent Population Health Outreach Project that organizes health professional students to provide medical and preventive care as well as health education to underserved people.
Jamie Reedy, MD, MPH
Dr. Reedy is the Medical Director of Population Health at Summit Medical Group.In addition to her position with Summit Medical Group, Jamie L. Reedy, MD, MPH, is Medical Director of the Westfield Regional Health Department in Westfield, New Jersey.
She is Clinical Assistant Professor at the University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School in New Brunswick. She also precepts students in her clinical practice from UMDNJ.
Dr. Reedy is a member of the Overlook Hospital Medical Staff and the American Academy of Family Physicians.
She was Founder and Co-coordinator of the Homeless and Indigent Population Health Outreach Project that organizes health professional students to provide medical and preventive care as well as health education to underserved people.
Transcription:
Working Together for Better Health : SMG Participates in AMGF Rheumatoid Arthritis Collaborative
Melanie Cole (Host): Summit Medical Group was selected by the American Medical Group Foundation to participate in a national collaborative dedicated to finding best practices in managing patients with rheumatoid arthritis. My guest today is Dr. Jamie Reedy. She is the medical director of Population Health at Summit Medical Group. Welcome to the show, Dr. Reedy. Tell us a little bit about this collaborative, and what does it mean for patients at Summit Medical Group that are living with rheumatoid arthritis?
Dr. Jamie Reedy (Guest): Sure. Thank you for having me today, Melanie. The American Medical Group Foundation selected only 16 practices across the country that could prove that they had experience with quality improvement initiatives to participate in this learning collaborative and research project. We were thrilled to be selected because it gives us the ability to work with likeminded colleagues across the country to learn how to implement really best practices for caring for patients with rheumatoid arthritis. We know that rheumatoid arthritis is a chronic, life-long disease that can be very costly and lead to lots of disability for patients, so being able to focus on this and use the resources of the AMGF and our colleagues across the country is very exciting to us.
Melanie: Dr. Reedy, explain a little bit about the initiatives that are going to focus on improving this quality outcomes and access to timely care. What does that mean for patients?
Dr. Reedy: Sure. When patients have a flare of rheumatoid arthritis, or we believe that they may actually have the diagnosis, they need access to specialty care rapidly, in order to get the pain relief that they need. What we’re focusing on is making sure that our staff and our primary care physicians understand first and foremost how to diagnose the disease and how to do an appropriate laboratory or imaging workup so that we can detect those patients who really do need to be referred for specialty care sooner rather than later. Additionally, we are improving access in our rheumatology department for patients to be seen in a timely fashion when we do believe that they truly have this diagnosis. That includes changing our workflows in the office and putting processes in place to identify clearly who those patients are that need to be seen early on. We do know that early diagnosis and treatment of rheumatoid arthritis is absolutely critical in order to avoid the onset of irreversible joint damage that can result in disabling deformities for these patients. So, early care and appropriate care is absolutely critical.
Melanie: Now, what about adherence to evidence-based guidelines? How are you using this collaborative with patients to show that it’s going to work for them, that it can help them to live and manage their RA?
Dr. Reedy: Absolutely. The American College of Rheumatology nationally has published guidelines for treating patients with rheumatoid arthritis that include how to make the appropriate diagnosis, how to use imaging such as x-rays and other types of imaging appropriately, how to assess the severity of the disease. We are taking systematically those guidelines and assuring that our physicians and staff are educated on those guidelines and that we implement those as a regular part of our workflow. Let’s take the radiology guidelines for instance. There are clear guidelines for when to image the patients and joints to look for, erosions and signs of joint damage, but we don’t want to over-image and expose patients to unnecessary radiation. We’re assuring that those guidelines get implemented so that we can improve patient safety as well as patient outcomes. Additionally, there are clear guidelines for the medication treatment regimen that can be used to treat these patients, both early on and later in the disease. We are making sure that we put in place a medication treatment algorithm that is appropriate from the standpoint of evidence, that the medications have evidence that they will work, that they take into account cost, inconvenience to the patients such as whether the patients have to self-administer something at home or get an intravenous infusion. All of those factors are really important for the patient when thinking about managing a chronic illness. Oftentimes, these patients have other chronic illnesses they are managing at the same time. So, focusing on true evidence-based treatment guidelines really can help, from a patient’s safety and a cost standpoint as well.
Melanie: How were you measuring the performance and then thereby following up with improvement for the patients?
Dr. Reedy: We’re measuring performance in a number of ways. As I mentioned before, patients can have a significant severity of illness that can impact their quality of life. Every patient that comes in to the office with rheumatoid arthritis is assessed for their quality of life and how severe the disease is and how it’s impacting their day-to-day ability to function. They’re also assessed for the level of pain that they might have related to their joint disease. Those assessments are tracked in our electronic health record all the time, such that we hope to see improvement each time the patient comes in. If we are indeed doing our job and we are treating patients based on evidence, we hope to then see improvement in those disease severity and pain scores over time. In addition, we track use of medications and appropriate medications and the imaging that I talked about before. All of these data and these quality metrics are provided to our physicians on a monthly basis so they can review the data and determine next steps along that quality improvement pathway. We’re also very keen on looking at the cost of care and making sure that patients are getting care in less expensive settings like our office and we’re trying to keep them out of an urgent care center or the emergency department or the hospital. We do track their utilization of these more expensive settings of care and try to understand what more we can do in an outpatient setting to keep this patient out of the hospital.
Melanie: Dr. Reedy, if you were explaining this collaborative to a patient with RA, to have them involved in this initiative, how would you discuss the approaches in this design care process so that it would be relevant to what they’re going through?
Dr. Reedy: Absolutely great question. One of the attempts that we’re going to make in this collaborative is actually to convene a patient group, an RA patient advisory group, where we can bring together patients with this illness at all levels of the illness to actually advise what Summit Medical Group can do to provide better care for these patients. We want to understand, what is their experience of being cared for with RA at Summit Medical Group and how can we improve upon that? What I explain to patients and even to our clinical staff who are engaging with patients every day is that we are committed as an organization to improve the outcomes and the quality of care for these patients, and that requires a comprehensive look at everything from the time they present with joint pain until the time that they are appropriately treated and having a great quality of life. Every touch point along the way with our physicians and staff is really critical for us to understand. So, we want their feedback because without it, we can’t then figure out where in our workflows and where in our day-to-day patient care we need to improve to meet the needs of these patients.
Melanie: How are you collaborating with other medical groups to get all the information in one place so that you all have access to it and that it can help patients with RA all over the country?
Dr. Reedy: The collaborative has been wonderful about setting up a central repository on the internet for all of the groups to communicate with each other in an open forum and to share materials, to share best practices, to share evidence-based guidelines, to share what we’re learning when we do quality improvement projects in the office, and to share tools for engaging patients in their own care and in that shared decision making that has to happen with patients when they have a chronic illness. We’ve been able to share our tools as well as adopt materials and tools from other organizations across the country and network again with likeminded colleagues. That has been really invaluable. We’re also looking at how we can utilize better our patient portal. Summit Medical Group rolled out a brand new patient portal about six months ago, which is an online way of engaging patients in their care, in reviewing their medical records, in communicating with Summit Medical Group. We have the ability to push out through the portal patient education materials and engagement materials for patients with chronic illness. We are looking at the best ways of doing that, knowing that many of our patients are online every day and looking for high-quality patient education materials. We want to be able to provide that to them through that forum.
Melanie: Dr. Reedy, in just the last minute or two, explain to the listeners the most important bit of information from this collaborative and the national collaborative for rheumatoid arthritis patients and what you really want them to take away from this message.
Dr. Reedy: I want patients to understand that Summit Medical Group is absolutely committed to improving the quality and cost outcomes of care for our patients with rheumatoid arthritis. We want to hear from our patients, we want to understand their experience, and we want to use that information to improve the processes of care here at Summit Medical Group. So, we invite the patients to provide feedback to us in the context of their office visit, or through our patient portal, and we want them to know that through our new electronic health record and the patient portal and the adoption of the evidence-based guidelines, that we are assuring that we’re doing the best we can to help them manage a very difficult and disabling chronic disease.
Melanie: Thank you very much for such great information, Dr. Reedy. You’re listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.
Working Together for Better Health : SMG Participates in AMGF Rheumatoid Arthritis Collaborative
Melanie Cole (Host): Summit Medical Group was selected by the American Medical Group Foundation to participate in a national collaborative dedicated to finding best practices in managing patients with rheumatoid arthritis. My guest today is Dr. Jamie Reedy. She is the medical director of Population Health at Summit Medical Group. Welcome to the show, Dr. Reedy. Tell us a little bit about this collaborative, and what does it mean for patients at Summit Medical Group that are living with rheumatoid arthritis?
Dr. Jamie Reedy (Guest): Sure. Thank you for having me today, Melanie. The American Medical Group Foundation selected only 16 practices across the country that could prove that they had experience with quality improvement initiatives to participate in this learning collaborative and research project. We were thrilled to be selected because it gives us the ability to work with likeminded colleagues across the country to learn how to implement really best practices for caring for patients with rheumatoid arthritis. We know that rheumatoid arthritis is a chronic, life-long disease that can be very costly and lead to lots of disability for patients, so being able to focus on this and use the resources of the AMGF and our colleagues across the country is very exciting to us.
Melanie: Dr. Reedy, explain a little bit about the initiatives that are going to focus on improving this quality outcomes and access to timely care. What does that mean for patients?
Dr. Reedy: Sure. When patients have a flare of rheumatoid arthritis, or we believe that they may actually have the diagnosis, they need access to specialty care rapidly, in order to get the pain relief that they need. What we’re focusing on is making sure that our staff and our primary care physicians understand first and foremost how to diagnose the disease and how to do an appropriate laboratory or imaging workup so that we can detect those patients who really do need to be referred for specialty care sooner rather than later. Additionally, we are improving access in our rheumatology department for patients to be seen in a timely fashion when we do believe that they truly have this diagnosis. That includes changing our workflows in the office and putting processes in place to identify clearly who those patients are that need to be seen early on. We do know that early diagnosis and treatment of rheumatoid arthritis is absolutely critical in order to avoid the onset of irreversible joint damage that can result in disabling deformities for these patients. So, early care and appropriate care is absolutely critical.
Melanie: Now, what about adherence to evidence-based guidelines? How are you using this collaborative with patients to show that it’s going to work for them, that it can help them to live and manage their RA?
Dr. Reedy: Absolutely. The American College of Rheumatology nationally has published guidelines for treating patients with rheumatoid arthritis that include how to make the appropriate diagnosis, how to use imaging such as x-rays and other types of imaging appropriately, how to assess the severity of the disease. We are taking systematically those guidelines and assuring that our physicians and staff are educated on those guidelines and that we implement those as a regular part of our workflow. Let’s take the radiology guidelines for instance. There are clear guidelines for when to image the patients and joints to look for, erosions and signs of joint damage, but we don’t want to over-image and expose patients to unnecessary radiation. We’re assuring that those guidelines get implemented so that we can improve patient safety as well as patient outcomes. Additionally, there are clear guidelines for the medication treatment regimen that can be used to treat these patients, both early on and later in the disease. We are making sure that we put in place a medication treatment algorithm that is appropriate from the standpoint of evidence, that the medications have evidence that they will work, that they take into account cost, inconvenience to the patients such as whether the patients have to self-administer something at home or get an intravenous infusion. All of those factors are really important for the patient when thinking about managing a chronic illness. Oftentimes, these patients have other chronic illnesses they are managing at the same time. So, focusing on true evidence-based treatment guidelines really can help, from a patient’s safety and a cost standpoint as well.
Melanie: How were you measuring the performance and then thereby following up with improvement for the patients?
Dr. Reedy: We’re measuring performance in a number of ways. As I mentioned before, patients can have a significant severity of illness that can impact their quality of life. Every patient that comes in to the office with rheumatoid arthritis is assessed for their quality of life and how severe the disease is and how it’s impacting their day-to-day ability to function. They’re also assessed for the level of pain that they might have related to their joint disease. Those assessments are tracked in our electronic health record all the time, such that we hope to see improvement each time the patient comes in. If we are indeed doing our job and we are treating patients based on evidence, we hope to then see improvement in those disease severity and pain scores over time. In addition, we track use of medications and appropriate medications and the imaging that I talked about before. All of these data and these quality metrics are provided to our physicians on a monthly basis so they can review the data and determine next steps along that quality improvement pathway. We’re also very keen on looking at the cost of care and making sure that patients are getting care in less expensive settings like our office and we’re trying to keep them out of an urgent care center or the emergency department or the hospital. We do track their utilization of these more expensive settings of care and try to understand what more we can do in an outpatient setting to keep this patient out of the hospital.
Melanie: Dr. Reedy, if you were explaining this collaborative to a patient with RA, to have them involved in this initiative, how would you discuss the approaches in this design care process so that it would be relevant to what they’re going through?
Dr. Reedy: Absolutely great question. One of the attempts that we’re going to make in this collaborative is actually to convene a patient group, an RA patient advisory group, where we can bring together patients with this illness at all levels of the illness to actually advise what Summit Medical Group can do to provide better care for these patients. We want to understand, what is their experience of being cared for with RA at Summit Medical Group and how can we improve upon that? What I explain to patients and even to our clinical staff who are engaging with patients every day is that we are committed as an organization to improve the outcomes and the quality of care for these patients, and that requires a comprehensive look at everything from the time they present with joint pain until the time that they are appropriately treated and having a great quality of life. Every touch point along the way with our physicians and staff is really critical for us to understand. So, we want their feedback because without it, we can’t then figure out where in our workflows and where in our day-to-day patient care we need to improve to meet the needs of these patients.
Melanie: How are you collaborating with other medical groups to get all the information in one place so that you all have access to it and that it can help patients with RA all over the country?
Dr. Reedy: The collaborative has been wonderful about setting up a central repository on the internet for all of the groups to communicate with each other in an open forum and to share materials, to share best practices, to share evidence-based guidelines, to share what we’re learning when we do quality improvement projects in the office, and to share tools for engaging patients in their own care and in that shared decision making that has to happen with patients when they have a chronic illness. We’ve been able to share our tools as well as adopt materials and tools from other organizations across the country and network again with likeminded colleagues. That has been really invaluable. We’re also looking at how we can utilize better our patient portal. Summit Medical Group rolled out a brand new patient portal about six months ago, which is an online way of engaging patients in their care, in reviewing their medical records, in communicating with Summit Medical Group. We have the ability to push out through the portal patient education materials and engagement materials for patients with chronic illness. We are looking at the best ways of doing that, knowing that many of our patients are online every day and looking for high-quality patient education materials. We want to be able to provide that to them through that forum.
Melanie: Dr. Reedy, in just the last minute or two, explain to the listeners the most important bit of information from this collaborative and the national collaborative for rheumatoid arthritis patients and what you really want them to take away from this message.
Dr. Reedy: I want patients to understand that Summit Medical Group is absolutely committed to improving the quality and cost outcomes of care for our patients with rheumatoid arthritis. We want to hear from our patients, we want to understand their experience, and we want to use that information to improve the processes of care here at Summit Medical Group. So, we invite the patients to provide feedback to us in the context of their office visit, or through our patient portal, and we want them to know that through our new electronic health record and the patient portal and the adoption of the evidence-based guidelines, that we are assuring that we’re doing the best we can to help them manage a very difficult and disabling chronic disease.
Melanie: Thank you very much for such great information, Dr. Reedy. You’re listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.