Re: Proposing a series of articles

January 3, 2007

Hi Gordon,

How can we help? Do you have a definition of " ideal

micro-practice " ? Do you want to include any information, with

references, from the position papers of the AAFP (FOFM), AAP, and ACP,

regarding the medical home?

SP

Texas

Hi folks

Here's what I'm proposing as a series of articles about our work:

The IMP project is moving ahead and continuing to gather steam.

I'd like to propose the following:

A) Why this Series of Articles

1. There is a need for better care. My example was " IMP " . My example

shows that many are willing/able/needing to change.

2. The following series of articles will provide info from several

perspectives about IMP as an innovative, replicable and realistic

change model. Because the IMP change model is a win for clinicians,

we build each article around the perspective/experience of the

physician. But physicians are not the only winners. IMP has great

potential for patients so we will illustrate each article with info

from patients (we have lots of patient verbatims we can use). IMP

also has great potential for those who pay for care so each article

will include a commentary or example from the business community.

3. IMP is not an innovative model for solo clinicians only. Large

practices need to recognize how valuable IMP innovations are to all

types of practice. For this reason, each article also includes a

commentary about the implications for workforce within various types

of practice.

4. Finally, we recognize that transitions from the current financial

and practice model is not going to happen over night. " There is the

old joke that when you are up to your neck in alligators it is hard

to recall how to drain the swamp. " So we conclude each article with

some frequently asked questions.

The Origins and Direction of IMPs and IMP relationship to

Consensus Statements about Health Care Change.

IOM

CCM

Patient-centered, collaborative care

P4P

C) Brief Summary and topics for the series

24/7 access

Screening all patients

Measuring office practice and using the measurement to steer improvement

Getting paid for innovative modes of care delivery (e.g. Virtual

Office Visits, group visits)

I'd also like to suggest some position papers on office measurement

and changing the nature of how we finance health care (esp. primary

care) in the U.S.

I have a number of the articles in draft form (close to completion),

a cadre of other docs starting some companion pieces, and business

folks from the National Business Coalition on Health ready and

willing to provide their input.

Gordon

January 3, 2007

I would certainly agree with these articles, but I think they need to

be much more concrete. Quite honestly, I love when we talk about pay-

for-performance, Institute of medicine, yada yada yada..., however I

believe this type of stuff makes the rank and file physicians eyes

glaze over.

Not only do I believe that most of the external medical system is

sick, but I believe many offices are sick. Just as when you see in

the office someone who is taking care of their elderly parents who

have Alzheimer's disease and that someone is becoming ill herself by

giving this care. It is impossible for offices that are sick to

provide adequate patient care and do this new model. I believe

strongly that the idea is to heal the caregivers and the patient care

will follow. (Obviously many of you believe this also as you have

left dysfunctional situations). So, I suggest some of the topics

below as well that could be integrated into articles/podcasts and

eventually a " how-to " book:

Some suggestions for articles/podcasts:

How to survive in a low overhead/solo practice model-

Putting your patient's to work and they will love you for it:

1. How to have patients make their own appointments

2. Communication with patients that does not involve the telephone

3. How to set up and use patient entered information, both in the

office and on the Internet.

4. How to synchronize your patient entered information with your

electronic health record

5. How to put together all of your communication with patients into

electronic format. What tools does it take and how should it be done?

Help me, I'm scared-how do I bill for my services and make sure I get

paid?

1. How to efficiently bill for your services when you are the only

one doing it.

2. How do I use electronic billing?

3. How do I bill Medicare?

4. How do I effectively opt out of private insurance?

5. How do I opt out of Medicare and what are the consequences?

Help me to put together a useful and low cost health information

technology solution for my office.

1. Please tell me some low-cost, effective electronic health records

that I can use.

2. How do I connect these low-cost records with other electronic

forms of information such as billing system, laboratory systems and

hospital information systems?

3. How do I make my electronic health information technology system

seamless from one end to the other and bring in all necessary

information in digital format?

4. Do I need help in setting up my computers/network/system? If I

need help, who should I ask for help?

Help me do efficient workflow?

1. What do you mean by continuous common efficient office workflow

and where can I find out more about this?

2. Why does advanced access scheduling work so well with this

continuous workflow.?

3. I read that the Toyota production system can actually help

medical office workflow. Is anyone doing this stuff? Can anyone

give me more information?

regards

lou spikol

>

> Hi folks

> Here's what I'm proposing as a series of articles about our work:

>

> The IMP project is moving ahead and continuing to gather steam.

> I'd like to propose the following:

>

> A) Why this Series of Articles

> 1. There is a need for better care. My example was " IMP " . My

example

> shows that many are willing/able/needing to change.

>

> 2. The following series of articles will provide info from several

> perspectives about IMP as an innovative, replicable and realistic

> change model. Because the IMP change model is a win for clinicians,

> we build each article around the perspective/experience of the

> physician. But physicians are not the only winners. IMP has great

> potential for patients so we will illustrate each article with info

> from patients (we have lots of patient verbatims we can use). IMP

> also has great potential for those who pay for care so each article

> will include a commentary or example from the business community.

>

> 3. IMP is not an innovative model for solo clinicians only. Large

> practices need to recognize how valuable IMP innovations are to all

> types of practice. For this reason, each article also includes a

> commentary about the implications for workforce within various

types

> of practice.

>

> 4. Finally, we recognize that transitions from the current

financial

> and practice model is not going to happen over night. " There is the

> old joke that when you are up to your neck in alligators it is hard

> to recall how to drain the swamp. " So we conclude each article with

> some frequently asked questions.

>

> The Origins and Direction of IMPs and IMP relationship to

> Consensus Statements about Health Care Change.

>

> IOM

> CCM

> Patient-centered, collaborative care

> P4P

>

> C) Brief Summary and topics for the series

> 24/7 access

> Screening all patients

> Measuring office practice and using the measurement to steer

improvement

> Getting paid for innovative modes of care delivery (e.g. Virtual

> Office Visits, group visits)

>

> I'd also like to suggest some position papers on office measurement

> and changing the nature of how we finance health care (esp. primary

> care) in the U.S.

>

> I have a number of the articles in draft form (close to

completion),

> a cadre of other docs starting some companion pieces, and business

> folks from the National Business Coalition on Health ready and

> willing to provide their input.

>

> Gordon

>

January 3, 2007

ditto. LLl_spikol wrote: I would certainly agree with these articles, but I think they need to be much more concrete. Quite honestly, I love when we talk about pay-for-performance, Institute of medicine, yada yada yada..., however I believe this type of stuff makes the rank and file physicians eyes glaze over.Not only do I believe that most of the external medical system is sick, but I believe many offices are sick. Just as when you see in the office

someone who is taking care of their elderly parents who have Alzheimer's disease and that someone is becoming ill herself by giving this care. It is impossible for offices that are sick to provide adequate patient care and do this new model. I believe strongly that the idea is to heal the caregivers and the patient care will follow. (Obviously many of you believe this also as you have left dysfunctional situations). So, I suggest some of the topics below as well that could be integrated into articles/podcasts and eventually a "how-to" book:Some suggestions for articles/podcasts:How to survive in a low overhead/solo practice model-Putting your patient's to work and they will love you for it:1. How to have patients make their own appointments2. Communication with patients that does not involve the telephone3. How to set up and use patient entered information, both in the office and on the Internet.4.

How to synchronize your patient entered information with your electronic health record5. How to put together all of your communication with patients into electronic format. What tools does it take and how should it be done?Help me, I'm scared-how do I bill for my services and make sure I get paid?1. How to efficiently bill for your services when you are the only one doing it.2. How do I use electronic billing?3. How do I bill Medicare?4. How do I effectively opt out of private insurance?5. How do I opt out of Medicare and what are the consequences?Help me to put together a useful and low cost health information technology solution for my office.1. Please tell me some low-cost, effective electronic health records that I can use.2. How do I connect these low-cost records with other electronic forms of information such as billing system, laboratory systems and hospital information

systems?3. How do I make my electronic health information technology system seamless from one end to the other and bring in all necessary information in digital format?4. Do I need help in setting up my computers/network/system? If I need help, who should I ask for help?Help me do efficient workflow?1. What do you mean by continuous common efficient office workflow and where can I find out more about this?2. Why does advanced access scheduling work so well with this continuous workflow.?3. I read that the Toyota production system can actually help medical office workflow. Is anyone doing this stuff? Can anyone give me more information?regardslou spikol>> Hi folks> Here's what I'm proposing as a series of

articles about our work:> > The IMP project is moving ahead and continuing to gather steam.> I'd like to propose the following:> > A) Why this Series of Articles> 1. There is a need for better care. My example was "IMP". My example > shows that many are willing/able/needing to change.> > 2. The following series of articles will provide info from several > perspectives about IMP as an innovative, replicable and realistic > change model. Because the IMP change model is a win for clinicians, > we build each article around the perspective/experience of the > physician. But physicians are not the only winners. IMP has great > potential for patients so we will illustrate each article with info > from patients (we have lots of patient verbatims we can use). IMP > also has great potential for those who pay for care so each article > will include a

commentary or example from the business community.> > 3. IMP is not an innovative model for solo clinicians only. Large > practices need to recognize how valuable IMP innovations are to all > types of practice. For this reason, each article also includes a > commentary about the implications for workforce within various types > of practice.> > 4. Finally, we recognize that transitions from the current financial > and practice model is not going to happen over night. "There is the > old joke that when you are up to your neck in alligators it is hard > to recall how to drain the swamp." So we conclude each article with > some frequently asked questions.> > The Origins and Direction of IMPs and IMP relationship to > Consensus Statements about Health Care Change.> > IOM> CCM> Patient-centered, collaborative care> P4P>

> C) Brief Summary and topics for the series> 24/7 access> Screening all patients> Measuring office practice and using the measurement to steer improvement> Getting paid for innovative modes of care delivery (e.g. Virtual > Office Visits, group visits)> > I'd also like to suggest some position papers on office measurement > and changing the nature of how we finance health care (esp. primary > care) in the U.S.> > I have a number of the articles in draft form (close to completion), > a cadre of other docs starting some companion pieces, and business > folks from the National Business Coalition on Health ready and > willing to provide their input.> > Gordon> __________________________________________________

January 3, 2007

I agree with Lou, much more concrete. I anxiously read everything in JFP even remotely related to this, but it's often too vague. Some of the article series/ or podcosts he details, I could certainly still use, despite being 3.5 yr into this.

Cote MD

Four Corners Family Medicine

-------------- Original message --------------

I would certainly agree with these articles, but I think they need to be much more concrete. Quite honestly, I love when we talk about pay-for-performance, Institute of medicine, yada yada yada..., however I believe this type of stuff makes the rank and file physicians eyes glaze over.Not only do I believe that most of the external medical system is sick, but I believe many offices are sick. Just as when you see in the office someone who is taking care of their elderly parents who have Alzheimer's disease and that someone is becoming ill herself by giving this care. It is impossible for offices that are sick to provide adequate patient care and do this new model. I believe strongly that the idea is to heal the caregivers and the patient care will follow. (Obviously many of you believe this also as you have left dysfunctional situations). So, I suggest some of the topics below as well that could be integrated into articl

es/podcasts and eventually a "how-to" book:Some suggestions for articles/podcasts:How to survive in a low overhead/solo practice model-Putting your patient's to work and they will love you for it:1. How to have patients make their own appointments2. Communication with patients that does not involve the telephone3. How to set up and use patient entered information, both in the office and on the Internet.4. How to synchronize your patient entered information with your electronic health record5. How to put together all of your communication with patients into electronic format. What tools does it take and how should it be done?Help me, I'm scared-how do I bill for my services and make sure I get paid?1. How to efficiently bill for your services when you are the only one doing it.2. How do I use electronic billing?3. How do I bill Medicare?4. How do I effectively opt out of private insurance

?5. How do I opt out of Medicare and what are the consequences?Help me to put together a useful and low cost health information technology solution for my office.1. Please tell me some low-cost, effective electronic health records that I can use.2. How do I connect these low-cost records with other electronic forms of information such as billing system, laboratory systems and hospital information systems?3. How do I make my electronic health information technology system seamless from one end to the other and bring in all necessary information in digital format?4. Do I need help in setting up my computers/network/system? If I need help, who should I ask for help?Help me do efficient workflow?1. What do you mean by continuous common efficient office workflow and where can I find out more about this?2. Why does advanced access scheduling work so well with this continuous workflow.?3. I re

ad that the Toyota production system can actually help medical office workflow. Is anyone doing this stuff? Can anyone give me more information?regardslou spikol>> Hi folks> Here's what I'm proposing as a series of articles about our work:> > The IMP project is moving ahead and continuing to gather steam.> I'd like to propose the following:> > A) Why this Series of Articles> 1. There is a need for better care. My example was "IMP". My example > shows that many are willing/able/needing to change.> > 2. The following series of articles will provide info from several > perspectives about IMP as an innovative, replicable and realistic > change model. Because the IMP change model is a win fo

r clinicians, > we build each article around the perspective/experience of the > physician. But physicians are not the only winners. IMP has great > potential for patients so we will illustrate each article with info > from patients (we have lots of patient verbatims we can use). IMP > also has great potential for those who pay for care so each article > will include a commentary or example from the business community.> > 3. IMP is not an innovative model for solo clinicians only. Large > practices need to recognize how valuable IMP innovations are to all > types of practice. For this reason, each article also includes a > commentary about the implications for workforce within various types > of practice.> > 4. Finally, we recognize that transitions from the current financial > and practice model is not going to happen over night. "There is the > old joke tha

t when you are up to your neck in alligators it is hard > to recall how to drain the swamp." So we conclude each article with > some frequently asked questions.> > The Origins and Direction of IMPs and IMP relationship to > Consensus Statements about Health Care Change.> > IOM> CCM> Patient-centered, collaborative care> P4P> > C) Brief Summary and topics for the series> 24/7 access> Screening all patients> Measuring office practice and using the measurement to steer improvement> Getting paid for innovative modes of care delivery (e.g. Virtual > Office Visits, group visits)> > I'd also like to suggest some position papers on office measurement > and changing the nature of how we finance health care (esp. primary > care) in the U.S.> > I have a number of the articles in draft form (close to completion), > a cadre of other docs starting some companion pieces, and business > folks from the National Business Coalition on Health ready and > willing to provide their input.> > Gordon>

January 5, 2007

Gordon,

I am glad to help write a piece or add my 2 cents. I have a file

full of patient testimonials which are quite impressive.

Let me know if ya need help...

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

www.idealmedicalpractice.org

>

> Hi folks

> Here's what I'm proposing as a series of articles about our work:

>

> The IMP project is moving ahead and continuing to gather steam.

> I'd like to propose the following:

>

> A) Why this Series of Articles

> 1. There is a need for better care. My example was " IMP " . My example