Maybe we should start by reminding ourselves what UHA is for. Why did Stanford decide to build a community network of care, and why did the UHA medical groups and providers decide to joint that effort? There are multiple reasons, of course, but most important was our belief that by combining excellent community providers with the resources of a great academic medical center we could build something that would truly improve the care of our patients.

And so the past few years have involved a lot of hard work in building the infrastructure needed to fulfill that promise.   We have built a strong network of providers (now near 300 and still growing) across the Bay Area, we have implemented a common EMR platform (Epic) to enable coordination of care, and we are in the midst (with our Model Clinic rollout) of establishing a measure of efficiency and commonality in the essential care processes across our network. All of this puts us now in position to develop additional improvements that can be implemented with relatively minor modifications across all of our practices.

That’s a lot of work, a lot of disruption and change, and it’s been difficult – at times very difficult. Part of the challenge is that sometimes it seems like the work we’re doing is not directly improving patient care, and I’ve heard more than one person say “It’s about time we worked on quality!” I would argue that all of the work we’ve done so far is about quality, but OK, I get it; there’s a real hunger to get to the point where the work we do is directly improving care.

And it is about time. We are now planning a major UHA-wide quality initiative to be implemented over the next year. Based on conversations over the past few months with UHA medical group leaders, the primary focus will be cardiovascular health, where improvements can have the greatest impact on our patients’ health, but we will at the same time be building processes that can and will be deployed across the entire spectrum of population health measures.

We will be using the same methodology for this initiative that many of you are familiar with from our model clinic work. Define the scope, map the processes, collaborate with improvement professionals and front line clinical personnel to re-engineer these processes at a representative practice site, and then spread (with local modifications) to other sites.

As always, this process will respect the fact that both providers and staff are already working very hard; therefore, we will not be simply asking people to work harder but rather seeking ways to improve care without adding to the burdens of our people. We will be seeking out inefficiencies in current operations and will use the resources freed by elimination of waste to enable us to better address care gaps for our patients.  

Several UHA providers and staff are already engaged in these preparative discussions; others may be asked for input and at various stages of the initiative. Everybody will have an opportunity to contribute their ideas to this program as it spreads across all UHA sites.

Of course this program won’t be easy, any more than the foundational work that has preceded it has been easy. But this (finally!) is the fun part – now we will be able to see exactly how our work translates into better care for our patients. It’s about time that we have reached this point and I’m truly excited about working with you all and our SHC support team to save lives and improve the health of the patients we all serve.

Please share any thoughts by replying on this CMO blog, or contact me directly at:

bdbohman@stanford.edu
Office: 510-974-8274
Cell: 650-400-5704