June 2021
President’s Column
This year’s WCHQ Statewide Improvement Event celebrated the dedication and perseverance that has been the hallmark of our health care providers throughout the pandemic. While the pandemic is not yet over, and as Deputy Secretary of Health, Julie Willems Van Dijk urged, we need to stay vigilant, it is also important that we stop and acknowledge the progress we have made to date. Pausing to recognize the incredible work we have accomplished is essential to provide needed motivation as we move into the next phase of this pandemic.
When the pandemic began and health care providers were asked to avoid or delay non-urgent health care, one could assume that work that was focused on improving the delivery of care and increasing health care value would also be deemed “non-essential.” This was not the case in Wisconsin as WCHQ’s member health systems were determined to manage through the pandemic while also continuing to improve and provide care for all their patient populations.
For example, WCHQ’s members recognized the pandemic would increase the demand on an already overloaded mental health system, and during the pandemic they released a depression screening toolkit. Members also participated in webinars on suicide prevention and alcohol screening. We launched an obesity workgroup to begin to tackle this root cause of so many chronic diseases, which was exacerbated by the fact, as stated by Dr. Dirk Steinert at the WCHQ Improvement, an average weight gain in the pandemic of 29 pounds. Our members worked with their communities on issues related to education by learning more about the safe operation of schools during the pandemic and shared strategies on how to increase childhood immunizations.
At our first in-person education event since 2019 this week, I asked each attendee to return to their organization and pause to reflect on the incredible accomplishments they and their teams have made to date. A momentary reflection and celebration of our accomplishments can provide the needed energy to take on the important work of addressing the impact of delayed and avoided care while simultaneously continuing to address the current pandemic. Thank you to each of you for the important work you do to care for the whole patient- we at WCHQ celebrate all that you do.
Governor Evers Addresses WCHQ Improvement Event; Woleske Delivers Keynote Address
Governor Tony Evers commended the staff at the Wisconsin Department of Health for their continued dedication to protecting the people of Wisconsin during the pandemic as he joined WCHQ Chair Kori Krueger, MD, in presenting a WCHQ recognition award to DHS. Julie Willems Van Dijk accepted the award on behalf of DHS. The awards were presented at the WCHQ Improvement Event June 29 at Monona Terrace.
Gov. Evers singled Willems Van Dijk out for special commendation and credited her with “crafting the state’s response to the pandemic.”
“I have had many great teachers in my life, Julie is certainly one of them,” according to Evers.
Willems Van Dijk urged the health care providers to stay vigilant, citing the fact that the Delta variant is in Wisconsin. She noted that hospitalizations now are almost entirely comprised of those who have not been vaccinated. About 50 percent of those eligible have been vaccinated.
WCHQ also presented an award to the Wisconsin Hospital Association for developing a dashboard that serves as a daily and reliable source of information for policymakers, the media, and the public. It tracks hospital admissions, hospital capacity, testing and deaths.
WCHQ Board Chair Kori Krueger, MD, presented the award to WHA President and CEO Eric Borgerding. In his acceptance, Borgerding noted that during a pandemic information is critically important. He thinks Wisconsin was in a better position to respond to the pandemic than most states because government and the health care community were better prepared.
Data and/or analytics teams or individuals from six WCHQ health systems were recognized for excellence in providing the data that was necessary to respond to the pandemic, reopen clinics and maintain normal data operations in a rapidly changing environment. To view the presentation, click here.
Bellin Health President and CEO Chris Woleske described Bellin as a “health care organization that is transforming into a population health organization.” She emphasized the importance of partnerships in achieving their mission to “enable every person and community in our region to achieve and maintain their full health and well-being potation through our relentless commitment to quality, experience and affordability.”
Gabrielle Rude, WCHQ president and CEO, presented her organization’s strategic approach to the future. WCHQ’s 2021 priorities, to improve health disparities, provide innovation tools and to improve health care value, were selected to align with its members goals.
Rude said the new WCHQ data platform offers a robust data visualization and can deliver detailed measurement information, be used to build cohorts and custom metrics, and offer members alternative forms of data submission, such as HL7.
Sharing data and best practices is the foundation for improvement, according to Rude. That will be particularly important as WCHQ expands its work even more deeply into addressing health care disparities.
Lastly, Rude said WCHQ will engage payers in the work with providers to continue to improve health care value and to make claims and clinical data available to members to identify opportunities for improvement.
Diabetes Summit Showcases Innovations in Education, Research, Patient Care
The rate of diabetes continues to climb in Wisconsin and around the world. Clinicians on the front lines are committed to helping patients live healthier lives with diabetes. It is for that reason that WCHQ was pleased to partner with Novo Nordisk to sponsor a Diabetes Summit June 29 at Monona Terrace in Madison. More than 80 representatives from nearly all the health systems in Wisconsin participated either in person or virtually to hear presentations from five diverse presenters.
Kicking off the Summit was former NFL and Super Bowl standout Ottis Anderson. Anderson was honest with his audience; you must be straight with your patients. He found the best approach for him was for his doctor to tell him, “Ottis, you have to lose weight or your quality of life as you age will not be good.” That, he said, he understood.
When he learned he was diabetic, he saw his doctor as his partner, his coach. As an athlete, he had nutritionists guiding his diet and monitoring his health. When he retired, he slowly realized that he was the manager of his diet. Even with a family history of “sugar diabetes,” he didn’t think it would happen to him. But it did, and he had to adjust his lifestyle and eating accordingly. In his closing comments he asked the care providers to share this: “Take care of yourself. Be there for your grandchildren and for others.”
Kelly Charapata, RN, Bellin Health, described her health systems approach to diabetes education. Tim Nikolai from the American Health Association explained the Know Diabetes by Heart and Target: Type 2 Diabetes programs.
Carlos Mendez, MD, an associate professor of medicine at the Medical College of Wisconsin, presented research and information related to managing diabetes. Dr. Mendez described the evolution of antidiabetic medications.
Closing the Summit were Dirk Steinert, MD, and JoDeen Hettenbach from Ascension Wisconsin. Dr. Steinert quoted a statistic he had just heard that the average weight gain through the pandemic was 27 pounds before he shared that by 2030 fifty percent of the population in the US will be obese.
Hettenbach and Dr. Steinert said access to bariatric care has been limited by the number of clinicians, insurance coverage issues and cost. The discussion about obesity is difficult for both the clinician and the patient, but even modest weight loss can reduce the risk of disease.
Addressing the Impact of the Pandemic on Colorectal Cancer Rates
The pandemic has delayed preventive care. One area that has been adversely impacted is colorectal cancer screening rates. On July 30, WCHQ is partnering with Exact Sciences to several well-known experts on colorectal cancer screening together.
Register Flyer
Speakers and Topics
• Colorectal Cancer Screening in the Post-Pandemic Era
Durado Brooks, MD, MPH, Medical Director, Screening Business Unit,Exact Sciences
• Improving the Quality of Colorectal Cancer Screenings in Rural and Urban Wisconsin
Jennifer Weiss, MD, MS, Associate Professor, Gastroenterology & Hepatology Faculty, Medical Director, UW Health Gastroenterology GeneticsClinic
• Colorectal Cancer Screening Efforts in a Rural Health care System
Jennifer Strong, MD, Regional Medical Director, Marshfield Clinic Health System Institute for Quality, Innovation and Patient Safety
• An EHR-Based Solution toIdentify Colorectal Cancer Screening Gaps in Care
Ellen Bateman BS, MBA, Senior Director US Cancer Screening – Health System Marketing, Health Information Technology Program, Digital Collaborations, Exact Sciences
Pierce, Smelzer Join WCHQ Team
Sheryl Pierce, MBA, joined the WCHQ team 2021 as a quality improvement specialist. In her new position, Pierce will work with the Chronic Disease Learning Collaborative and will assist WCHQ members on improvement topics related to diabetes, hypertension, cholesterol, and team-based care.
Passionate about helping others maximize quality efforts, Pierce brings 14 years of experience understanding the complexities related to aging populations, health insurance, quality metrics, and various types of value-based payments. She brings a functional understanding of regulation and policy in addition to a comprehensive understanding of quality metrics associated with working with NCQA health plan metrics that have supported a local five-star Medicare Advantage plan.
Pierce holds a degree in marketing from the University of Wisconsin-La Crosse and an MBA with a health care emphasis from Viterbo University. She also has earned a Lean Six Sigma Yellow Belt Certificate from UW Madison for Professional and Executive Development and a Managed Healthcare Professional (MHP) designation from America’s Health Insurance Plans (AHIP).
Pierce serves on the Viterbo MBA/MSL Alumni Board and participates in the La Crosse Fall Prevention Coalition.
WCHQ also welcomed Tessa Smelzer to the team June 28 as executive assistant.
Before she joined WCHQ, Smelzer worked with Qualtim, Inc where she handled all executive management duties, including Board meetings, scheduling, and office responsibilities. Her experience also included acting as an information technology administrative specialist at TomoTherapy where she was responsible for managing vendor relationships, budgeting duties, and providing analytical and specialized administrative support to the COO.
“Tessa brings an incredible amount of experience and a high degree of professionalism to WCHQ,” according to WCHQ President and CEO Gabrielle Rude. “Her energy and passion for improvement will enable us to deliver an even greater level of service to our members going forward.”
Smelzer holds a bachelor’s degree in business administration from California State University, Northridge.
Harburn Named WCHQ Quality Improvement Specialist
WCHQ is pleased to announce the promotion of Abbey Harburn, MPH, to the position of Quality Improvement Specialist. Abbey joined WCHQ in 2017 and has most recently served in the position of Project Analyst. Abbey will be partnering with members on improvements related to adolescent and child health and disparities.
This promotion recognizes the contributions Abbey has made to WCHQ during her tenure with the organization and is effective in July. Please join us in congratulating Abbey as she takes on these new responsibilities.
Improvement Teams
Obesity
Variation in Obesity Service Coverage
The WCHQ Obesity Advisory Group met in June to discuss the financial impacts of obesity on health systems. The group discussed the differences in coverage between obesity and other chronic diseases and the inequitable benefit structures. They also discussed the lack of uniform coverage among insurers that further complicates treating patients. The group went on to discuss the difficulties they encounter when coding a visit for a patient with obesity. These considerations led to agreement within the group to invite insurers to the next meeting to identify and eliminate barriers. Several insurer representatives will attend the July meeting to meet with the Obesity Advisory Group members.
If you would like to join this group and work on issues related to obesity, contact Jen Koberstein.
Chronic Disease
DHS Funding Opportunity for Clinics to Work on Disparities
The Wisconsin Department of Health Services (DHS) has invited medical clinics to apply for grants and participate in a project to prevent chronic disease. The project will be focused on reducing chronic disease disparities through electronic health record/health information technology and team-based care. The grant will provide up to $20,000 to three health care clinics engaging in this work. The submission to DHS is due July 12, 2021 and details can be found here.
Adolescent and Child Health
Catching Up on Well Child Visits and Recommended Vaccines
Well-child visits begin in the first weeks of life and continue through adolescence. These visits are a prime opportunity for pediatric care providers to assess physical and mental health, screen for appropriate development, and provide guidance to children and parents. It is during these visits that immunizations are given, and children are screened for things like lead exposure, vision, and depression. Families are given guidance on diet and activity, dental care, and a wide variety of topics important to the health of kids and families.
WCHQ’s Adolescent and Child Health Improvement Team continues to focus on measuring and improving rates of annual well-child visits for children and teens.
Throughout the COVID-19 pandemic, many families delayed well-child visits to avoid exposure. In the early months of the pandemic, vaccination rates and blood lead level testing for children decreased significantly. View Report. Now, health systems are strategizing how to bring children in to catch up on any missed screenings or vaccinations. A recent call to action from CDC senior officials highlighted the importance of improving vaccination rates to ensure a safe return to in-person learning for Fall 2021. When compared to 2019, public sector vaccine ordering data showed a 14 percent drop, with the measles vaccine showing a drop of more than 20 percent. The CDC has developed guidance and resources for catching up on well child visits and recommended vaccines. More information is available here.
Well-child visits begin in the first weeks of life and continue through adolescence. These visits are a prime opportunity for pediatric care providers to assess physical and mental health, screen for appropriate development, and provide guidance to children and parents. It is during these visits that immunizations are given, and children are screened for things like lead exposure, vision, and depression. Families are given guidance on diet and activity, dental care, and a wide variety of topics important to the health of kids and families. For more information on WCHQ’s Adolescent and Child Health Improvement team, contact Abbey Harburn.
Behavioral Health
Health Systems Focus on Behavioral Health Demand, Depression Remission
The pandemic has significantly increased requests for behavioral health services across Wisconsin and depression is one of the main concerns. The Behavioral Health Improvement Team discussed integrated behavioral health and the positive impact it has on depression remission. Payment for this service, however, is a challenge. The next behavioral health improvement team meeting will identify the payment barriers and describe what other states have done to overcome those barriers.
The team continues to discuss how depression screening and referrals work within their systems. Health system members shared their internal efforts to impact depression remission and response rates that included changing EMR alerts, using My Chart to send out screening tools, and setting internal goals.
To learn more about the WCHQ Behavioral Health Improvement Team contact Jen Koberstein.
Oral Health
Taking Care of Your Own Smile by Cultivating Well-being During the Pandemic:
A Presentation for Dentists
WCHQ Oral Health Collaborative members are invited to register for a webinar focused on self-care for dentists in partnership with the Wisconsin Dental Association and training MinnesotaDental Association. Dr. Shilagh Mirgain will talk to dentists about the consequences of burnout and how to avoid it at a July 14 webinar from 6:30-8 PM.
Members of the WCHQ Oral Health Collaborative can register through their state association using this link.