WILLIAM CONWAY, MD, CEO, Henry Ford Medical Group, Executive Vice President, Henry Ford Health System (Detroit)
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“The biggest challenge we face is how to support our patients in managing their own health behaviors. We must form a partnership with them, providing the guidance and support that will work given very individual and diverse needs. Henry Ford has made great strides in this arena by developing a range of tools as part of our population health management program. We believe these will have a significant impact on improving the quality and efficiency of patient care.
Examples include embedded case managers who are located in all Henry Ford Medical Group patient-centered medical homes, and the managers connect with all health plans that participate in the Michigan Primary Care Transformation Project. We have an ambulatory intensive care unit, an advanced care center to respond to the sickest 3 percent of the population, especially among the Dual Eligibles. And there’s panel managers, who proactively review patients identified by health plans as having “gaps in care” and conduct ongoing outreach by phone, mail and EMR reminders. The panel managers have delegated authority to make appointments, order and schedule preventive services tests for aligned patients.
Other tools include disease management for diabetes and heart failure patients; Health Risk Appraisal Outreach, which provides one-hour appointments to patients who have not been seen in the past year; and the Choosing Wisely Campaign, which manages patients more efficiently by implementing recommendations within specialty departments and incorporating prompts into Epic that remind physicians of the best options for certain conditions; advanced medication therapy management; and a Referring Wisely Initiative to decrease unnecessary specialty referrals.”
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