AGENDA: POST CONFERENCE
Wednesday, March 19, 2014
(2 Tracks, Basic and Advanced (Select One)
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12:00 p.m. |
Post Conference Luncheon (For participants registered for Afternoon Post Conference Session)
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POST CONFERENCE: TECHNICAL ASSISTANCE FOR DEVELOPING SUPER-UTILIZER PROGRAMS
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The afternoon Post Conference is dedicated to providing technical assistance for super-utilizers has been divided into two tracks -- a basic and advanced.
The basic track is targeted at sites in the initial stages of planning and establishing a super-utilizer intervention. These sessions will focus on how to utilize the resources at your disposal to form an intervention that suits your community's needs.
The advanced track is for sites with existing programs. These sessions will explore strategies for refining and evaluating your intervention, and building long-term sustainability.
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TRACK 1: BASIC
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1:00 p.m. |
Screening and Targeting Patients for Interventions
Jeff Martin
Associate Director, Family and Community Medicine, Lancaster General Health, Lancaster, PA
Speaker Bio
Dr. Martin works in the Lancaster General Health Family Medicine Residency Program. He attended the University of Colorado, School of Medicine graduating with honors in 1993. He graduated from the family medicine residency at Lancaster General Hospital. He began and directed Lancaster General's Superutilizer Project from 2011-2013 with a belief that patients with complex medical conditions and numerous hospitalizations need help to break the cycle of repeat admissions. He provides clinical oversight and team leadership to LG's Care Connections Clinic, which treats the highest utilizing, most complex patients in our health system.
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Megan Williams, APRN, FNP
Nurse Practitioner, Beebe Medical Center, Population Health, Lewes, DE
Speaker Bio
As the Director of Population Health, Ms. Williams is responsible for providing leadership, management, and coordination for Beebe Population Health programs and directing Beebe's Community Outreach screening teams responsible for Health Promotion and Disease Prevention Education. In 2011, Ms. Williams began to develop and implement Beebe's first population care management program, with a focus on the care of high utilizer patients across the Beebe healthcare system. Ms. Williams oversees the team of care coordinators who are responsible for the work carried out through the clinically integrated organization, the Delmarva Health Network.
Presentation Material (Acrobat)
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John Wood, MD
Lancaster General Health, Lancaster, PA
Speaker Bio
Dr John C. Wood M.D. is Chair of Family and Community Medicine at Lancaster General Health. While a resident, he received the STFM resident teacher of the year award as well as serving as Chief Resident. Dr. Wood served as the inpatient medicine team lead for five years as Associate Director for the Residency. He is the Team Physician at J.P. McCaskey High School in Lancaster, PA and directs the musculoskeletal curriculum for the residency. As Chair, Dr. Wood serves as the Family Medicine eHealth Champion and focuses on transitions of care. Dr. Wood provides medical program direction and leadership to LGHealth's new high-risk, high intensity primary care clinic called Care Connections. His work with Care Connections focuses on innovative models of clinical delivery, patient risk stratification, transitions of care, novel payment methodologies and community/health system integration.
Presentation Material (Acrobat)
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Jason Turi
Clinical Manager, Camden Coalition of Healthcare Providers, Camden, NJ (Moderator)
Speaker Bio
Jason Turi is an Associate Clinical Director at the Camden Coalition of Healthcare Providers. He directs patient care activities and provides clinical oversight of the community-based multidisciplinary care management teams. Additionally he supports staff development and cross-site learning initiatives. Jason is a Registered Nurse, holds a Master of Public Health degree with a concentration in International Health, and speaks Spanish. He has served as a labor/community organizer, emergency/mental health nurse, and elementary school teacher. His interests lie in promoting healthcare equity as well as harm reduction approaches to public health.
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2:00 p.m. |
Selecting, Hiring, and Training Staff
Casey Chanton, LSW
IMPaCT Project Manager, Penn Center for Community Health Workers, Philadelphia, PA
Abby Letcher, MD
Family Practitioner, Allentown, PA
Nadia Ali
Director, Clinical Redesign, Camden Coalition of Healthcare Providers, Camden, NJ (Moderator)
Speaker Bio
Nadia Ali is the Director of Clinical Redesign at the Camden Coalition of Healthcare Providers. Through her role, she leads the design, development and expansion of primary care-based programming which involves multidisciplinary outreach teams, chronic disease education and quality improvement initiatives. Nadia oversees the program's various objectives and works closely with Camden's primary care practices. Prior to joining the Coalition, Nadia worked as Project Manager for NYU School of Medicine to help develop a plan for a regional health information network across emergency departments in the greater New York region, titled the New York Clinical Information Exchange (NYCLIX). In addition, Nadia has worked on health disparities research and outreach in immigrant communities. She is passionate about promoting healthy behaviors among populations that may not seek services due to cultural stigmas, and shifting the health care dialogue from treatment to prevention. Nadia's academic background includes studies in health policy and management, public health, and Spanish. Nadia is a graduate of New York University's Robert F. Wagner Graduate School of Public Service and Rutgers University.
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3:00 p.m. |
Networking Break
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3:30 p.m. |
Building Community Partnerships: Accessing the Resources in Your Community and Targeting Potential Coalition Members
Whitney Buchmann
Lead Community Organizer (Healthcare), Camden Churches Organized for People, Camden, NJ
Speaker Bio
Whitney Buchmann holds a B.A. in Spanish and International Studies with a Certificate in Conflict Resolution from Kansas State University. She is a bilingual Community Organizer leading Camden Churches Organized for People's work on issues impacting poverty and powerlessness, including healthcare and immigration reform. Since joining the PICO Network in May of 2010, she has worked with community leaders to reduce fear of reporting crimes in immigrant communities, address the overwhelming number of vacant and unkept properties in blighted neighborhoods, increase access to higher education for undocumented youth, amplify residents' voices in decisions to improve their healthcare and uncover injustices in medical transportation. Whitney believes community organizing is a form of worship and ministry that allows her to put her faith into action while working to create earth as it is in heaven.
Presentation Material (Acrobat)
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Josh Chisholm
Executive Director, Congregations United for Neighborhood Action, Philadelphia, PA
Speaker Bio
Joshua graduated from the University of Portland with a major in Spanish and a minor in Theology in 2000. Out of College, Joshua served as a Holy Cross Associate of Notre Dame, where he worked as a Youth Minister in Coachella, California. Following his year of service, Joshua began his career as a Faith Based Community Organizer in the PICO National Network. Along the way Joshua earned his Montessori Teaching credential through the American Montessori Society. Joshua currently works as the Executive Director of Congregations United for Neighborhood Action in Lehigh, Berks, and Northampton Counties in Pennsylvania.
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4:00 p.m. |
Building a Narrative: Making a Case for Your Program by Developing Patient Stories/Data Visualization
Patrick McCabe
GYMR Public Relations, Washington, DC
Speaker Bio
Patrick McCabe is a partner with GYMR Public Relations and has more than 25 years of communications experience, focusing almost solely on health and health policy issues. Having worked as a reporter, lobbyist, industry spokesperson and PR counselor, he has a full understanding for all sides of the communications business. His work has won awards from the Public Relations Society of America, the International Business Communicators Association, the Virginia Press Association, Women in Communications, and the Greater Washington Society of Association Executives. Prior to co-founding GYMR, Patrick was a vice president in the Washington health care practice of Fleishman-Hillard. He began his career as a reporter working in the Washington metropolitan area. Patrick graduated with honors from the University of Notre Dame.
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Haydn Bush
Account Supervisor, GYMR Public Relations, Washington, DC
Speaker Bio
Haydn Bush is an account supervisor with GYMR Public Relations, with over a decade of experience in health care quality communications. In his tenure at the American Hospital Association, he helped develop case studies on hospital quality improvement efforts, and researched and wrote primers on specific aspects of the Affordable Care Act -- from accountable care organizations to medical homes -- following the passage of the ACA. In his role with Hospitals & Health Networks magazine, his reporting on improving care and reducing costs for the patients with the highest health care costs received honors from the National Institute for Health Care Management Foundation and American Business Media. Haydn holds a bachelor's degree in English from the University of Wisconsin-Madison.
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5:00 p.m. |
Adjournment of Post Conference
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TRACK 2: ADVANCED
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1:00 p.m. |
Clinical Team Structure and Workflow
Lauran Hardin, MSN, RN CNL
Complex Care CNL, Mercy Health St. Mary's, Grand Rapids MI
Speaker Bio
Lauran Hardin MSN, RN CNL is the Complex Care Clinical Nurse Leader at Mercy Health Saint Mary's in Grand Rapids Michigan. She leads a Complex Care Portal Program serving more than 600 High Frequency patients cross continuum. She received her Masters in Nursing from the University of Detroit and certification in Palliative Care, Holistic Nursing and Elizabeth Kubler-Ross Center facilitator training. Her past experiences include creating the first Pain and Palliative Care service in West Michigan and facilitating complex care transitions for patients in 10 different hospitals in a 5 county region.
Presentation Material (Acrobat)
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Joan Orr, MCHES, MBA
Director Accountable Care, MaineGeneral Health, Augusta, ME
Speaker Bio
Ms. Orr is currently the Director Accountable Care for MaineGeneral Health and the Director of Operations for the Kennebec Valley Community Care Team. In her role she works with the Executive Vice President to execute changes to bring the system to greater integration—clinically and financially and greater accountability for both quality and costs. She provides management and operational support for strategic direction, execution and achievement.
From 2004 through 2009 she was Project Director for the Maine Youth Overweight Collaborative at the Maine Center for Public Health and other obesity projects and initiatives as part of the Maine Harvard Prevention Research Center.
Presentation Material (Acrobat)
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Victoria DeFiglio
Associate Clinical Director, Camden Coalition of Healthcare Providers, Camden, NJ (Moderator)
Speaker Bio
Victoria DeFiglio is an Associate Clinical Director at the Camden Coalition of Healthcare Providers. A registered nurse by training, Victoria partners with her "operational dyad," Nadia Ali, to oversee the design, development and expansion of the Coalition's clinical redesign programming. Her other buckets of work include organization-wide staff development, and sharing the Coalition's philosophy and methodologies through cross-site learning partnerships. She is a graduate of Simmons College and Goldfarb School of Nursing. She is currently pursuing her Masters in Nursing and Healthcare Administration at the University of Pennsylvania.
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2:00 p.m. |
Using Data: Patient Enrollment, Segmentation, Outcomes and Program Evaluation
Mary Ann Bates
Deputy Director, J-PAL North America, Department of Economics, Massachusetts Institute of Technology (MIT), Cambridge, MA
Speaker Bio
Mary Ann Bates is Deputy Director of J-PAL North America, which encourages the creation and use of evidence from randomized evaluations. J-PAL North America is housed at MIT's Economics Department and is a new regional office of J-PAL, whose network of 91 affiliated professors has conducted more than 460 randomized evaluations in 54 countries.
At J-PAL North America, she connects researchers and practitioners interested in conducting innovative randomized experiments and disseminates evidence from these evaluations to inform policy decisions.
She holds a Master of Public Policy from UC Berkeley and has conducted research as a Fulbright Scholar in Switzerland.
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Ken Coburn
Chief Executive Officer and Medical Director, Health Quality Partners, Augusta, ME
Speaker Bio
Ken Coburn, MD, MPH is CEO and Medical Director for Health Quality Partners (HQP), a non-profit R&D organization dedicated to designing and testing innovative models of care to improve the health of vulnerable populations. The system of community-based advanced preventive care pioneered by HQP has been rigorously tested in the Medicare Coordinated Care Demonstration and found to achieve better health at lower cost for high-risk chronically ill older adults. In partnership with Aetna, Inc. the same model has proven effective in higher-risk Medicare Advantage members.
Prior to founding HQP, Dr. Coburn served in leadership positions for quality and population health in a multi-hospital health system consortium (PennCARE), disease management division of the University of Pennsylvania Health System, Health Partners Plans, the AIDS Center at Montefiore Medical Center, and the outpatient AIDS Clinic at Jacobi Hospital.
He received his BA from Brown University, his MD from Columbia University College of Physicians & Surgeons, and did post-graduate training in internal medicine and infectious diseases. He earned his MPH from Columbia University's Mailman School of Public Health and is currently a doctoral candidate in public health (DrPH) at the UNC Gillings School of Global Public Health where he was awarded the Arthur B. Holzworth endowed scholarship in health leadership.
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Maggie Hawthorne
Senior Manager, Research and Evaluation, Camden Coalition of Healthcare Providers, Camden, NJ (Co-Moderator)
Speaker Bio
Margaret Hawthorne serves as the Senior Manager for Research & Evaluation for the Coalition. Here she manages the CCHP efforts to use a mix of qualitative and quantitative methods inform, evaluate and improve programs. Prior to joining the Coalition, Maggie worked as a Program Officer at the Institute of Medicine; here she served as the data manager for the Evaluation of PEPFAR study, a congressionally mandated mix methods evaluation of U.S. global HIV/AIDS programs. Prior to this Maggie worked as an epidemiologist at the Texas Department of State Health Services and served as the HIV Incidence and Viral Resistance Surveillance Coordinator for the state-overseeing the surveillance systems used to track the leading edge of the HIV epidemic in Texas.
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Aaron Truchil
Manager of Research, Camden Coalition of Healthcare Providers, Camden, NJ (Co-Moderator)
Presentation Material (Acrobat)
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3:00 p.m. |
Networking Break
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3:30 p.m. |
Getting and Negotiating Contracts: Building Sustainability for Your Program
Susan Mende
Senior Program Officer, Robert Wood Johnson Foundation, Princeton, NJ
Speaker Bio
Susan Mende is a Senior Program Officer at the Robert Wood Johnson Foundation (RWJF) where she helps to manage the Aligning Forces for Quality (AF4Q) initiative, RWJF's signature effort to lift the overall quality and value of health care in targeted communities. Susan's special focus areas include: consumer and community engagement; ambulatory and hospital quality improvement; primary care and complex populations.
Susan was formerly the Chief Operating Officer for Tsao Foundation, Singapore where she focused on community based care of older people, professional and caregiver training and regional and international aging issues for WHO and the UN . While living in Australia, she consulted with national and international organizations on successful aging and inclusion of older people. Trained as a nurse, she received her MPH from Hunter College of The City University of New York.
Presentation Material (Acrobat)
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Corey Waller
Director, Spectrum Health Medical Group Center for Integrative Medicine, Grand Rapids, MI
Speaker Bio
R. Corey Waller MD, MS is an addiction, pain, and emergency medicine specialist. He is the Medical Director of the Spectrum Health Medical Group Center for Integrative Medicine, the Medical Staff Chief of pain medicine to the Spectrum Health Hospital System, as well as SUD Medical Director at Network 180. Dr. Waller earned a master's degree in neuromolecular biology at Southwest Texas State University and earned his medical degree at the University of Texas Medical School in San Antonio. Dr. Waller completed his Emergency Medicine residency at Thomas Jefferson University in Philadelphia.
Dr. Waller's special interests include understanding the biopsychosocial and financial impact on society of emergency department super utilizers, pregnant patients with a substance use disorder, and the complex interaction of pain and addiction.
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Mark Humowiecki
Legal Counsel and Director of Governmental Affairs, Camden Coalition of Healthcare Providers, Camden, NJ (Moderator)
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4:00 p.m. |
Building a Narrative: Making a Case for Your Program by Developing Patient Stories/Data Visualization
Patrick McCabe
GYMR Public Relations, Washington, DC
Speaker Bio
Patrick McCabe is a partner with GYMR Public Relations and has more than 25 years of communications experience, focusing almost solely on health and health policy issues. Having worked as a reporter, lobbyist, industry spokesperson and PR counselor, he has a full understanding for all sides of the communications business. His work has won awards from the Public Relations Society of America, the International Business Communicators Association, the Virginia Press Association, Women in Communications, and the Greater Washington Society of Association Executives. Prior to co-founding GYMR, Patrick was a vice president in the Washington health care practice of Fleishman-Hillard. He began his career as a reporter working in the Washington metropolitan area. Patrick graduated with honors from the University of Notre Dame.
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Haydn Bush
Account Supervisor, GYMR Public Relations, Washington, DC
Speaker Bio
Haydn Bush is an account supervisor with GYMR Public Relations, with over a decade of experience in health care quality communications. In his tenure at the American Hospital Association, he helped develop case studies on hospital quality improvement efforts, and researched and wrote primers on specific aspects of the Affordable Care Act -- from accountable care organizations to medical homes -- following the passage of the ACA. In his role with Hospitals & Health Networks magazine, his reporting on improving care and reducing costs for the patients with the highest health care costs received honors from the National Institute for Health Care Management Foundation and American Business Media. Haydn holds a bachelor's degree in English from the University of Wisconsin-Madison.
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5:00 p.m. |
Adjournment of Post Conference
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