News & Media
KLAS Research and MDHHS Headline MSMS Committee
On August 22nd, the MSMS Committee on Health Care Quality, Efficiency, and Economics (HCQE2), chaired by John E. Billi, MD, addressed several timely topics thanks to representatives from KLAS Research and the Michigan Department of Health and Human Services. Levels of physician satisfaction with electronic medical records (EMRs), Michigan’s Section 298 behavioral health integration initiative, and the proposed Medicare 2019 Physician Fee Schedule Rule topped the Committee’s agenda.
Taylor Davis, Executive Vice President of Strategy and Development for KLAS Research, started the meeting with an overview of the company’s efforts to use the voice of clinical users to turn EMR deployment and adoption into a consistently successful science.
“KLAS is a data-driven company on a mission to improve the world's health care by enabling provider and payer voices to be heard and counted. Working with thousands of health care professionals, KLAS collects insights on software, services, and medical equipment to deliver reports, trending data, and statistical overviews. KLAS data is accurate, honest, and impartial. The research directly reflects the voice of healthcare professionals and acts as a catalyst for improving vendor performance.”
The KLAS ARCH Collaborative is measuring physician satisfaction with EMRs, for which there is significant variation. Utilizing a common user satisfaction survey, benchmarks are established, drivers for successful EMR deployments are identified, and best practices from high performing organizations are developed and shared. Mr. Davis reported that more than 100 organizations in four countries have participated to date. An overarching goal is to get to a place where the EMR becomes a tool that clinicians enjoy using and view as a valuable component enabling high-quality care delivery. By analyzing survey responses and correlations among organizations whose users report high EMR satisfaction, KLAS has identified some basic keys to success when built on a foundation of teamwork and trust:
- Training – more than six hours of initial training is needed with at least three to four additional hours of training annually; the quality of training is important, including knowing and speaking to the clinical workflows of the people they are educating; peer-to-peer training can be very effective and simultaneously support culture change; and, training users on how to get data out of the EMR matters as much as training on how to put data into the EMR.
- Personalization – level of EMR personalization is the best predictor of organizational clinician EMR satisfaction, with personalization that help users get data out of the EMR helping the most.
- Dynamically Structure Governance – culture matters more than the EMR selected; and, successful organizations ensure the broader voice is heard, help users feel they have control over their own success, and respond quickly to small/critical optimizations.
An update on Michigan Medicaid’s efforts to develop an effective model for integration of behavioral and physical health services was provided by Phillip R. Kurdunowicz with MDHHS’s Policy and Strategic Initiatives Section. Currently, behavioral health services are carved out of Michigan’s Medicaid managed care structure. As a result, physical health services and mild to moderate mental health services are funded through contracts with licensed managed care organizations while specialty behavioral health services (e.g., services for the treatment of serious mental illness, substance use disorders, developmental disabilities, etc.) are managed by prepaid inpatient health plans contracting with community mental health agencies.
Budget boilerplate language was adopted (Section 298 of Public Act 107 of 2017) that requires the MDHHS to “…implement up to 3 pilot projects to achieve fully financially integrated Medicaid behavioral health and physical health benefit and financial integration demonstration models.” The stated goals of the pilot demonstrations are “…to test how the state may better integrate behavioral and physical health delivery systems in order to improve behavioral and physical health outcomes, maximize efficiencies, minimize unnecessary costs, and achieve material increases in behavioral health services with increases in overall Medicaid spending.”
To move forward, MDHHS established a workgroup, known as the “Leadership Group,” to guide the implementation of the pilot demonstrations. Mr. Kurdunowicz reported that the Leadership Group reached a consensus on the framework for the financing model and is working to finalize the structure for the payment model as well as other logistical details. The intent is to launch the pilots on October 1, 2018. The pilot sites for the Section 298 Initiative are:
- Pilot #1 – HealthWest and West Michigan Community Mental Health
- Pilot #2 – Genesee Health System
- Pilot #3 – Saginaw County Community Mental Health Authority
According to Mr. Kurdunowicz, MDHHS intends for this to be a very transparent process and has developed a website where you can find more information about the Section 298 Initiative.
Finally, the Committee received a legislative update from MSMS Director of State and Federal Government Relations, Christin Nohner, and a review of the proposed Medicare 2019 Physician Fee Schedule Rule by Stacey Hettiger, MSMS Director of Medical and Regulatory Policy. MSMS will comment on the proposed rule and is encouraging physician input as previously reported in Medigram.
MSMS members interested in serving on the Health Care Quality, Efficiency, and Economics Committee may contact Ms. Hettiger.