|
A
Sampling from Our History of Key Relationships, Projects
& Noteworthy Items...
Aetna,
Virginia Mason & Delfini
Delfini conducted a health care quality system assessment
of VM for Aetna. We are very impressed with the dedicated
staff at VM who are bringing evidence into daily practice.
Mike presented "Evidence-for Everybody" at a VM
health care conference. Collectively we are exploring other
initiatives to advance important work we are all engaged
in to create a synergistic approach to help others.
Alliance
Coal Group Health Plan
Purchasers can make a difference in health care. We are
pleased to have helped Alliance Coal's benefits administrator
to explore how evidence-based medicine could be incorporated
into their health care strategies. This group has created
an impressive cardiovascular risk reduction initiative to
improve outcomes for all of Alliance Coal's employees.
American
Academy of Family Physicians
From our American Academy of Performance Measures
Program — September 10-12, 2004
Performance Measures: A Practical Approach to
Improving the Quality of Clinical Care —
Overall Program Score 5.0 out of 5.0
AAFP hand-picked thirty-six physicians from the applicants
to receive training to represent the AAFP on national specialty
boards and consortiums charged with creating and evaluating
performance measures. We also gave them skills in doing
quality improvements in their own settings. The representative
for the AMA Physicians Consortium who was an observer at
the meeting, stated it was an outstanding program and incredibly
well organized.
From
the Director:
“I wanted to let you both know how much I appreciated
your willingness to adapt the program to our specific
needs. When you do something new, you always wonder how
it will be received by the attendees. This program exceeded
our high expectations! The family physicians who attended
were interested and engaged throughout the two and one-half
day program and I am sure the tools you shared will find
good use in the near future for many of them. Thank you
for devoting your energy and your professionalism to our
project."
Bruce
Bagley, M.D.
Medical Director for Quality Improvement
American Academy of Family Physicians
American
Academy of Neurology
We are embarking on a project with AAN to create
web modules to train residents and faculty.
Blue
Cross of Idaho
Idaho's variation in spinal care is significant.
Delfini is working with leadership at BC of Idaho to explore
how an evidence-based approach may improve care and reduce
this variation. An intensive four-day training program took
place in the summer of 2006. Now the group is exploring
ways to apply their new evidence- and value-based medicine
clinical improvement skills to improve patient care in Idaho.
Read more here.
Department
of Defense Pharmacoecononomic Center
Delfini
has provided training on effective meetings and effective
meetings in health care, along with training in critical
appraisal and evidence-based Pharmacy & Therapeutics
committee approaches.
DynaMed
Mike and Sheri are each associate directors for DynaMed.
DynaMed is a medical information database with nearly 2,00
clinical topic summaries, designed for use at the point
of care, with a goal of providing best available evidence
and daily updating. DynaMed was developed by Brian Alper,
MD, MSPH. You can read about DynaMed at http://www.ebscohost.com/dynamed/
Kaiser
Permanente Hawaii
Delfini
partnered with KP Hawaii on a 4-day EBM Conference —
"Talk Story, Talk Evidence" — that was highly
well received. We provided training in evidence-based medicine
topics. Featured were critical appraisal, guideline development
and special workshops for EBM committees such as P&T
committees and medical technology assessment committees,
plus performance measurement and pay-for-performance all
offered in structured segments to maximize benefit for specific
audiences. Delfini and KP Hawaii's collaborative work was
featured which you can read about here.
We
are currently working on developing another EBM initiative
with them. Conference information is here.
December
2005: Kaiser Permanente: Hawaii Nephrology EBM Guideline
Project 2005
Delfini was invited to work with Kaiser Permanente Hawaii
to help advance EBM within their organization. KP Hawaii
has a strong committment to evidence- and value-based
care. Their leaders are committted and support EBM. They
frequently sponsor outstanding EBM conferences and retreats
which are very well attended, and they have an impressive
and active EBM working group. They were desirous of taking
EBM to a new level and expanding and embedding evidence-based
clinical improvement skills and techniques more solidly
and more broadly into their culture. We came up with an
idea for a working project that would provide just-in-time
practical training, advance clinical care and help further
"seed" cultural change. Thus the Hawaii Nephrology
EBM Guideline Project 2005 was conceived. The guideline
has been completed and approved by their quality council.
Here is information
in brief about this project.
McKesson
Collaboration
Delfini provided an EBM training intensive to McKesson
to help advance their application of evidence-based medicine
in their decision support work. McKesson embraced this training
by implementing an EBM initiative with a phased approach
to incorporating learnings into their products. Staff have
already commented on how the training has positively enhanced
their daily work. A post-test was immediately administered
folowing the training intensive, which resulted in high
scores of over 90 percent correct, reflecting good understanding
of basic EBM concepts such as bias, confounding and chance.
Update: Staff took a post-test about six months following
the training, and we understand that staff scores averaged
an impressive 94.7 percent correct answers on their test.
MD
Anderson, University of Texas
Delfini has worked as faculty for MD Anderson's
Clinical Safety & Effectiveness (CS&E) Training
Course which is based on Dr. Brent James' course for clinicians
at Intermountain Healthcare in Utah that offers skills to
make improvements in clinicians' care they deliver. MD Anderson
states that, "The CS&E Training Course will benefit
MD Anderson for years to come by developing a culture that
embraces healthcare quality improvements because the effort
will be led by individuals who have the most interest and
knowledge of what needs to be improved — the clinicians
providing the care."
Medtronic
Delfini has been selected to help start an EBM initiative
at Medtronic. Our work with them includes training in evidence-based
medicine and in economic analysis, plus how the two can
be combined to assess value.
Pharmacy
Benefits Manager (company name held in confidence)
We have done considerable work to help make groups
as efficient and effective as possible in doing evidence-
and value-based formulary management work. We have also
had the priviledge of working with some highly sophisticated
groups to help them advance further into greater practice
of evidence- and value-based formulary decision-making.
We have lots of new tools and process help available to
clients and participants of selected programs. We are also
preparing monographs for groups. Here's
more information about our work in this area.
February
2005 : National Pharmacy Benefit Management "Webinar!"
(company name in confidence)
No sooner do we get videocasting under our belt, but we
get invited to do a "Webinar." Broadcast live
from Sheri's Cajun Cottage in beautiful San Diego! It
was like hosting a radio show! The audience loved it and
felt they gained a lot.
Comments
from participants: "Really enjoyed the training...What
a great seminar!!!...Very worthwhile and learned a lot...Really
enjoyed...Very informative...Wonderful...Excellent training
program, most informative and enjoyable...Great presentation...LOVED
IT!"
Publications
(also see our publications
page)
Help
for Medical Leaders & Organizations
Our three-part series on "The Evidence-based Organization,"
published in the American College of Physician Executive's,
The Physician Executive, Journal of Medical Management
is now available on our website: Delfini
American College of Physician Executives Publication Page
»
Evidence-based
Pharmacotherapy
We authored a textbook chapter, publication date for which
is January 15, 2007. You can read about it here.
Performance
Measurement
Our
commentary in Modern Health, along with other resources
is available here.
Delfini
is mentioned in the highly praised, Overtreated:
Why Too Much Medicine Is Making Us Sicker and Poorer,
Bloomsbury USA; 1 edition (September 18, 2007), by Shannon
Brownlee, a Schwartz senior fellow at the New America
Foundation, and in an article in the Washington Monthly
adapted from the book. You can read the Washington Monthly
article here »
NBBJ
Although
it may, at first, seem surprising to those of us in the
health professions, evidence-based medicine has inspired
what is referred to as "evidence-based design"
(EvBD) in the field of archictecture. An evolving area,
EvBD is in its infancy. Medical architects, professors,
marketers and others from Seattle-based NBBJ, a leading
architectural firm, were interested in learning principles
of evidence-based practice and engaged Delfini to provide
training and consultation in October 2006. Of key interest
is how EvBD in a health care environment can create improvements
in areas such as health status outcomes, health care outcomes,
patient and provider satisfaction, efficiency and more.
Novartis
and Solara, a CommonHealth company
Delfini recently completed an update of the research on
antiotensin receptor blocker (ARBs) and ARB combinations.
Delfini will be working with Solara and Novartis to educate
clinicians on the research findings.
Omni
Medical Group and St. John Medical Center
Since Delfini's inception, we go twice yearly to work with
the Omni Medical Group in Tulsa, Oklahoma, at St. John Medical
Center. The dedicated leadership of this group is intent
upon training all OMNI physicians to be evidence-based medicine
practitioners. The training programs are open to others
well, and OMNI is active in broadening EBM skills in the
community including working to provide this training to
local residencies which now sponsor the events. See the
program announcements here.
Regence
Blue Cross/Blue Shield
Delfini has a long standing affliation with Regence, providing
training and tools, assisting with modifications to their
monograph process and templates, and Delfini directly participates
in their work including evidence reviews for monographs.
This group has great dedication to operating in an evidence-
and value-based way and is among the best we've ever seen.
We showcase them here.
State
of California
Administrative
Law Judges — Office of Administrative Hearings for
the State of California: December 2004
We conducted a program on Law and Medical
Evidence for the Administrative Law Judges (ALJs)
for the State of California. Many of the judges expressed
that the information we presented will be useful in their
work and even most of those, for whom this information
is not directly related to their work, found the information
to be very interesting. There was a strong sentiment that
this kind of information is deeply needed by malpractice
attorneys, medical boards and medical "experts,"
which we will be pursuing.
State
of Washington
Department
of Social and Health Services (DSHS) chose Delfini
to train their staff and clinicians who conduct medical
necessity and other reviews. Other state employees involved
with improving Washington State’s plan for improving
health care, such as from the Health Care Authority, were
also invited. Testimonial below:
Mike
and Sheri, I just wanted to thank you once again for
the great job you did today, teaching our staff EBM
assessment for validity and usefulness. You were inspiring
to our staff. I just loved to see how attentive they
were and to hear the great questions that were asked.
They were getting your messages! Fantastic.
People
are raving about your training. I just heard how professional
that it was, that HRSA and the other agencies were presented
in style and the staff really appreciated that. I believe
they recognized that we brought the very best to them,
showing that we value EBM and their work in this area.
Again,
thanks so much. It was such a pleasure to work with
you to make this day so special for our staff.
Siri
Siri
Childs, Pharm D
Pharmacy Policy Office Chief
Department of Social & Health Services
Health & Recovery Services Administration
Division of Medical Benefits & Care Management
Medical Consulting & Pharmacy Policy Units
State of Washington
King
County Healthcare Advisory Task Force:
September
2004
Mike
was invited to do a health care quality system assessment
for the task force, reviewing Aetna. The review was structured,
in part, on the Delfini
Health Care Quality System Assessment Tool
[PDF]
and online tool [WORD
Doc]. Caroline Whalen, Deputy County Administrative
Officer, is reportedly very pleased with the quality of
Mike's work.
In the News June 15, 2004
The task force (and Mike) makes the news for completing
their work. For those of you who have registered (free)
with the Seattle Times, here's the link
to the news story. The website for HATF is here: http://www.metrokc.gov/exec/hatf/.
Background
Mike served on a task force of some of the country's
top experts in health care and cost management who
are working on a plan to accomplish both goals for
King County government in Washington State, in partnership
with some of the area's biggest employers. Mike's
expertise and knowledge was certainly felt. County
Executive Rom Sims is quoted as saying, "The
task force's work is stunning because they are raising
issues with us that we never would have thought about.
It's a breathtaking change. I don't think anyone thought
you could get a higher quality of care and lower your
costs." Mike, who served as the luminary for
evidence-based medicine, was one of the panel members
interviewed
for the Seattle PI.
University
of California, San Diego School of Medicine: 2004
- 2005
A federal grant supported Sheri's developing an
educational program for 4th year medical students on rotation
in Family Medicine at the University of California, San
Diego.
"Sheri,
I very much appreciate...the incredible job you have done
with the curriculum for 426....Your boundless enthusiasm
for teaching and your passion for evidence-based approach
to care is unparalleled and will certainly lead to continued
success."
Kirsten
Searfus, MD
Pre-docorate Program Director
UCSD Family Medicine
San Diego CA
University
of Texas (see
MD Anderson above)
University
of Washington
Mike annually teaches the evidence based medicine module
in a Medical Management course targeting midcareer medical
leaders who are seeking additional certification.
Mike
provides annual teaching to family medicine residents at
Group Health Cooperative, a part of the University of Washington's
family medicine residency network.
|
