HCSD Update

1. HCSD Update Tuesday, April 17, 2012 Michael Kaiser, MD Chief Medical Officer LSU Health Care Services Division

3. Pelicanitis pel-i-kuhn-ahy-tis

4. Pelicanitis– a sense of being overwhelmed with too much to do with not enough resources and with uncertain future benefits. Severe cases occur in patients with immune system dysfunction.

5. Pelicanitis • The prognosis is excellent. • Patient usually regains function in 3-6 months and with continued therapy will regain capabilities above baseline with time. • One attack appears to confer lifelong immunity. (unless one moves to another hospital system)

6. Treatment • An understanding that initial goal is to maintain where we are. No capabilities lost. • No interruption in HCE measurement and reporting. • Some data currently in CLIQ will be moved to Pelican and used to populate a patient’s record. • The information currently in CLIQ will continue to be accessible for patient care. • The information currently in CLIQ will also continue to be accessible for quality improvement, evaluation and research purposes.

7. THERE IS A PLAN !!

8. Patient Our Vision Value Leader Our Mission Treat and Teach Our Values Tactics Teaching Revenue Resources Research Access Quality Safety Service Satisfaction Foundational Elements Medical Home Integrated Info Systems Disease Management Centers of Excellence Performance Improvement Low Cost Distributed Services High Quality LSU Health System Health Care Services Division “The (Strategic) Pyramid” THE BALANCED VALUE EQUATION VALUE = QUALITY + SERVICE COSTS Excellence Equity Execution Explainable Information Innovation Improvement Integrity Empathetic

9. The Triple Aim The Triple Aim simultaneously accomplishes these three critical objectives • Improve the health of the population served • Improve the experience of each individual • Affordability as measured by the total cost of care Improve the health of the population Improve the experience of the individual Improve Affordability

10. Patient Our Vision Value Leader Our Mission Treat and Teach Our Values Strategies Teaching Research Revenue Resources Access Quality Safety Service Satisfaction Low Cost High Quality Distributed Service LSU Health System Health Care Services Division “The (Strategic) Pyramid” Excellence Equity Execution Explainable Information Innovation Improvement Integrity Empathy Foundational Elements Medical Home Centers of Excellence Service Standards Integrated Info Systems Disease Management

11. Blue Shield of California • March 29 – April 25, 2011 • N = 1005: with family incomes < 200% FPL ($45,000 for a family of 4) • N = 1005: ages 19-64 • N = 1005: landline (n = 704) and cell phone (n = 301) • N = 1005: English (n = 705) and Spanish (n = 300) California ≠ Louisiana, but:

12. Blue Shield of California: Satisfaction • 48% rate their care as excellent or very good. • Courtesy of staff • Patient involvement in medical decisions • Cleanliness of facility • The amount of time the doctor spends with a patient • Having a highly regarded personal doctor

13. Blue Shield of California:Implications for Future Care • Interest in Alternatives: While a sustainable 58 percent express interest in changing facilities if they had the insurance do so, this goes higher in some groups – soaring to 86 percent, for example, among those who lack a personal doctor but want one.

17. Low Cost Distributed Services High Quality LSU Health System Health Care Services Division “The (Strategic) Pyramid” Patient Our Vision Value Leader Our Mission Treat and Teach Our Values Excellence Equity Execution Explainable Information Innovation Improvement Integrity Empathetic Tactics Teaching Research Revenue Resources Access Quality Safety Service Satisfaction Foundational Elements Medical Home Integrated Info Systems Disease Management Centers of Excellence Performance Improvement

18. Patient Our Vision Value Leader Our Mission Treat and Teach Our Values Tactics Teaching Research Revenue Resources Access Quality Service Satisfaction Foundational Elements Medical Home Integrated Info Systems Disease Management Centers of Excellence Performance Improvement Low Cost Distributed Services High Quality LSU Health System Health Care Services Division “The (Strategic) Pyramid” Excellence Equity Execution Explainable Information Innovation Improvement Integrity Empathetic Safety

19. Reporting

20. Patient Our Vision Value Leader Our Mission Treat and Teach Our Values Tactics Teaching Research Revenue Resources Satisfaction Access Quality Safety Service Low Cost Distributed Services High Quality LSU Health System Health Care Services Division “The (Strategic) Pyramid” Excellence Equity Execution Explainable Information Innovation Improvement Integrity Empathetic FoundationalElements Medical Home Integrated InfoSystems Disease Management Centers of Excellence Performance Improvement

21. Effect of Rapid Clinic Follow-up After Hospital Discharge on 30-day Heart Failure Readmission Lee Arcement, MD Appropriate Statin Therapy for Heart Failure Patients Lee Arcement, MD Diabetes Screening Protocols for Diabetes and Pre-Diabetes Ron Horswell, PhD Prospective Telemedicine Screening for Diabetes at High Risk for Retinopathy Jayne Weiss, MD

22. Patient Our Vision Value Leader Our Mission Treat and Teach Our Values Strategies Teaching Research Revenue Resources Quality Safety Service Satisfaction Low Cost High Quality Distributed Service LSU Health System Health Care Services Division “The (Strategic) Pyramid” Excellence Equity Execution Explainable Information Innovation Improvement Integrity Empathy Access Foundational Elements Medical Home Centers of Excellence Service Standards Integrated Info Systems Disease Management

23. Telemedicine Clinic

24. Distributed Services LSU Health System Health Care Services Division “The (Strategic) Pyramid” Patient Our Vision Value Leader Our Mission Treat and Teach Our Values Excellence Equity Execution Explainable Information Innovation Improvement Integrity Empathetic Tactics Teaching Revenue Resources Research Access Quality Safety Service Satisfaction Foundational Elements Medical Home Integrated Info Systems Disease Management Centers of Excellence Performance Improvement High Quality Low Cost

25. Prisoner Outpatient Clinics

26. Prisoner Costs

27. Low Cost Distributed Services High Quality LSU Health System Health Care Services Division “The (Strategic) Pyramid” Patient Our Vision Value Leader Our Mission Treat and Teach Our Values Excellence Equity Execution Explainable Information Innovation Improvement Integrity Empathetic Tactics Teaching Revenue Resources Research Access Quality Safety Service Satisfaction Foundational Elements Medical Home Integrated Info Systems Disease Management Centers of Excellence Performance Improvement

29. Patient Our Vision Value Leader Our Mission Treat and Teach Our Values Tactics Revenue Resources Research Access Quality Safety Service Satisfaction Foundational Elements Medical Home Integrated Info Systems Disease Management Centers of Excellence Performance Improvement Low Cost Distributed Services High Quality LSU Health System Health Care Services Division “The (Strategic) Pyramid” Excellence Equity Execution Explainable Information Innovation Improvement Integrity Empathetic Teaching