Submitted by:
Marion Yerxa RN, MBA, CPHQ, Director of Quality
Management
Ray Sandoval, Midas Administrator
Aimee Miter, Statit PPR administrator
About Kaiser Permanente San Diego
Kaiser Permanente began serving San Diego in
1967 and currently provides care for nearly
500,000 members. Medical care is provided at
20 outpatient medical offices and at the Kaiser
Foundation Hospital San Diego. The hospital
averages over 2,700 hospital discharges a month.
The outpatient medical offices average over
115,000 physician outpatient visits a month.
Kaiser Permanente utilizes an electronic medical
record system which integrates inpatient and
ambulatory care received by members.
The Quality Management Department purchased
the Statit
Physician Profile & Review (PPR) solution
to address The Joint Commission requirement
for ongoing physician practice evaluation. We
quickly realized that Statit would also allow
us to capture key performance measures to assist
physician leaders in making decisions about
department management priorities based on physician
performance trends, visits, procedure details,
patient satisfaction scores and quality data.
With Statit, we were able to easily integrate
local data, data files from corporate offices
(HEDIS performance) and vendor data files.
Challenges?
We originally assumed most of our data would
come from hospital and outpatient coding information.
As we met with department physician leaders
to show them how to access their data with Statit
PPR, we learned from them about numerous other
department data sources they had which we could
incorporate in future reports to make the information
truly meaningful to physician leaders. We continue
to find that Statit PPR provides the flexibility
to capture different data sources from different
applications; from the MIDAS+ Care Management
System, to our Hospital Information System,
and from stand alone databases, we have been
able to capture key information that supports
the ability to assess physician performance
for peer review, Quality Committee and Credentialing
Committee use. With Statit PPR, we have been
able to address numerous heretofore hurdles,
including the ability to consolidate multiple
data sources, to efficiently and effectively
provide data updates, to ensure data accessibility
to users via secure password-protected web access,
and the critical analysis necessary through
the Statit PPR solution to provide statistical
control charts for trending variation and to
review performance comparative data among physician
peers. Statit PPR gives us a great deal of flexibility
in the type and form of data we receive and
our ability to integrate this data successfully
into the physician practice profile.
Types of Profiles?
We have fully populated profiles for 42 different
hospital and outpatient clinical specialties.
Each specialty has a common set of data elements
(department volumes and the six core competencies
specified by The Joint Commission Standards
for Ongoing Physician Practice Evaluation (OPPE).
Our physician profiles include peer review information,
medical-legal information, physician HEDIS scores
and patient satisfaction scores. Since our implementation
of Statit PPR in February 2009, we have developed
profiles for approximately 1,200 physicians
and are now working on adding profiles for our
450 Allied Health Professionals. With the help
from Statit, all this was possible!
Physician Acceptance?
Physician leadership acceptance of the profiling
data has been our greatest success! Physician
leaders cite their ability to track and trend
key department performance indicators as a very
positive enhancement to their work. Our initial
focus to consolidate existing, familiar data
sources was a key factor in gaining acceptance
within the leadership and our success. Another
successful strategy was that we met with each
chief to orient them to Statit PPR. We used
these sessions to obtain feedback regarding
the accuracy and validity of the information
and what additional performance measures would
be valuable to them. From these meetings we
have developed a robust list of recommendations
for future indicators and enhancements for users
of the Statit PPR profiles.
We are now finalizing our plans for providing
profile access to each physician, more than
1,100. In preparation for this phase, we asked
department physician chiefs to respond to a
survey about their confidence in the accuracy
of the data and if they had reservations in
releasing physician profiles access for each
physician. We were delighted that we received
unanimous support from all chiefs to release
access to all physicians.
Advice to Others?
There are many issues to decide including things
like attribution, data, which indicators to
include in the physician measurement, leadership
and physician acceptance, etc. Bringing everything
together in one secure portal, accessing data
and easily creating profiles and indicators
was made very easy by Statit PPR.
