The Michigan Value Collaborative

Helping Michigan hospitals achieve their best possible patient outcomes at the lowest reasonable cost

Month: September 2017 (page 1 of 2)

Why I’m excited for the November 3rd Semi-annual collaborative meeting

Jim Dupree

Jim Dupree, M.D., M.P.H. is the Director of MVC

The next MVC collaborative-wide meeting is coming up soon, November 3rd at Schoolcraft College http://www.schoolcraft.edu/vistatech/maps-parking

I wanted to take a minute to explain why I’m particularly excited for this fall’s meeting. In the six months since our last collaborative-wide meeting, the coordinating center has been hard at work across several fronts:

  • We have expanded our peer-to-peer workgroups program to offer more hospitals a platform for learning from and teaching each other about best practices for improving care. This has included new workgroups about optimizing skilled nursing facility/extended care facility use for patients with congestive heart failure. We have also expanded these workgroups to cover topics such as palliative care and how to establish a heart failure clinic. For more information about joining these workgroups, please contact Abeer Yassine at abeery@med.umich.edu
  • We have added two new services lines: Atrial Fibrillation and Nephrolithiasis. Atrial Fibrillation represents a common reason for inpatient admission and the service line data expands our ability to provide actionable data about medial admissions. Nephrolithiasis is a high-volume surgery, and we now have a window into emergency department (ED) visits and/or hospital admissions that occur after this outpatient procedure.
  • In response to your comments, we have made several improvements to the registry website and its underlying data. For example, we have improved the accuracy of the National Provider Identification (NPI) number available on Blue Cross Blue Shield of Michigan (BCBSM) claims. In addition, we added patient age, gender and comorbidities (COPD, diabetes and ESRD) filters to the BCBSM claims. Finally, in response to your suggestions, we have added an index place of service indicator that allows users to identify episodes beginning in the hospital inpatient, outpatient, or ED settings.

On November 3rd, we will discuss the next opportunities for value improvement in Michigan.  These include:

  1. A focus on the emergency department as a location for improving healthcare value. We will learn from Donna Fox from Michigan Medicine about their program that leverages social and medical supports to reduce ED visits and readmissions. We will also learn from Lauran Hardin about a population-based intervention to reduce ED utilization and cost for high-need patients.
  2. A special presentation from Dr. Keith Kocher Program Director for the Michigan Emergency Department Improvement Collaborative (MEDIC). MVC members have asked previously for increased collaboration with other BCBSM collaborative quality initiatives, and Dr. Kocher will introduce the PATH initiative to prevent avoidable hospitalizations after ED visit.
  3. The launch of an important new initiative aimed at improving safe births in Michigan. Many hospitals are working to reduce the use of C-section for low-risk births, and we now have new tools to assist in those efforts. Dr. Dan Morgan will discuss this initiative at the collaborative-wide meeting and seek your feedback.

The November 3rd meeting will offer the Collaborative a chance to decide how we, collectively, want to improve the value of health care in Michigan.  We look forward to seeing you at Schoolcraft College (http://www.schoolcraft.edu/vistatech/maps-parking) on November 3rd . Please be sure to register by clicking here.  And as always, contact us at shiyuan@med.umich.edu with any suggestions or questions.

 

 

Pain Management Efforts: Addressing the Opioid Epidemic

Abeer Yassine

Abeer Yassine, is the MVC Hospital Engagement Associate

Drug overdoses are a leading cause of accidental death in the U.S., with as many as 20,000 of these deaths in 2015 related to prescription pain relievers.1 Various studies have also drawn relationships between opioid usage and higher hospital costs (ex: 30-day readmissions). 2,3 Since the opioid epidemic does not come only at a cost to patient lives, but also to hospital systems across the country, pain management interventions have become widespread as a primary focus for hospitals. With hopes of helping address the Opioid Epidemic, there have been several promising interventions across the U.S. that are focused on different facets of pain management.

Straith Hospital, Southfield, Michigan

The original Straith Hospital focused on plastic and reconstructive surgery but over the past twenty-five years has branched out into other realms of heath care. In a recently published Crain’s Detroit article, Straith Hospital was highlighted for their new Interventional Pain Center in Southfield, Michigan.4 This new Interventional Pain Center is focused on comprehensive procedural interventions using multi-modal approaches to help limit and reduce the use of opioids in Michigan. Examples of procedural interventions include physical therapy and steroid injections. Straith decided to take this approach to pain management rather than medication management based on the needs of the population that they treat. To learn more about the variety of services at Straith’s Interventional Pain Center and the procedures they hope to offer click here.

Eliminating Medications Through Patient Ownership of End Results (EMPOWER) Study

For a variety of reasons opioids are often the drug of choice for treating patients with chronic non-cancer related pain. However, with limited knowledge on the effectiveness of these medications and scarce availability of alternative pain relief treatment options, a study is being conducted to elicit information about an online tool to help chronic pain patients. The EMPOWER study is a federally funded study focused on pain management through an online program for non-cancer patients. This $2.5 million study will examine the impact of an online tool, Goalistics Chronic Pain Management Program, over the course of five years. Goalistics offers daily activity trackers, planning, and relaxation tools and exercises to help individuals better manage their pain without the use of medication.

This online program was created by psychologists and offers patients easy-to-use tools to manage their chronic pain and has been shown to be effective in pain management in small samples. With investigators from University of Cincinnati College of Medicine and Washington State University College of Nursing, the EMPOWER study will expand the sample size to further examine the impact of online, holistic pain-management. For more information on the EMPOWER study, click here and here.

1 American Society of Addiction Medicine (2016). Opioid Addiction 2016 Facts & Figures. Google Scholar

2 Rogal, S., Mankaney, G., Udawatta, V., Good, C.B., Chinman, M., Zickmund, S., Bielefeldt, K., Jonassaint, N., Jazwinski, A., Shaikh, O., Hughes, C., Humar, A., DiMartini, A. and Fine, M.J. (2016), Association between opioid use and readmission following liver transplantation. Clinical Transplantation, 30: 1222–1229.  Google Scholar

3 Waljee J.F., Cron, D.C., Steiger, R.M., Zhong, L., Englesbe, M.J., and Brummett, C.M. (2017), Effect of Preoperative Opioid Exposure on Healthcare Utilization and Expenditures Following Elective Abdominal Surgery. Annals of Surgery, 265: 715-721.Google Scholar

4 Green, Jay (2017). Straith Hospital expands into interventional pain center program. Crain’s Detroit Business

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