San Mateo Medical Center: A County System of Healthcare (Text Version)

Slide Presentation from the AHRQ 2008 Annual Conference

On September 9, 2008, Jagruti Shukla, MD, MPH, made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (1.5 MB).

Slide 1

San Mateo Medical Center: A County System of Healthcare

Jagruti Shukla, MD, MPH
Medical Director
September 9, 2008

Slide 2

San Mateo Medical Center Main Campus Primary Care Clinic

The colored photograph shows the entrance to the San Mateo Medical Center.

• 11 San Mateo County Clinics, Federally Qualified Health Center (FQHC)
• 9 Physicians = 6 full-time-equivalent (FTE), Approx. 20,000 visits/year
• Patient Population

Slide 3

Chronic Care Model—Past Experience

• One Provider Team in Safety Net Institute (SNI) Collaborative in 2004
• Introduction of Chronic Disease Electronic Management System (CDEMS) Registry
• Chronic Disease Management (CDM)
• Improvements in Clinical and Process Measures
• Success working as a team

Slide 4

Toolkit Intervention

• Introduced by Administration
• Random division of providers into Intervention and Control Groups
• Formation of MD-MA-Clerk teams
• Jointly set goals—10 parameters total
• Data transfer for all Diabetic patients into CDEMS

Slide 5

The colored photograph shows a group of medical staff.

Slide 6

Major Accomplishments

• Working together as teams
• CDEMS data sheet used as the Progress Note
• Chronic disease education at each visit
• Monthly group visits for all providers
• Some Population Management (No labs 1 yr)
• Improvements seen in both process and outcome measures

Slide 7

Reflections: What worked well

• Experience of our pioneer team with CDM
• Formal structure, timelines, reporting
• Coaching Support
• Weekly meetings—time allocation for brainstorming and reporting
• Toolkit references
• Targeted Interventions: Pneumovax

Slide 8

Reflections: Challenges

• Time commitment for data input, reports, and meetings
• Integration of CDM into usual workflow
• Significant amount of front-end work prior to seeing benefits
• Active communication with staff not involved
• Sustaining and spreading successful ideas
• Interpretation of the variation seen in the MD's data reports

Slide 9

Next Steps

• Establish patient care teams for all providers
• Identify all clinic patients with DM and populate CDEMS Registry
• Further develop role of MA, Clerk, and RN
• Monthly group visits for all providers
• Add Pharmacist and LSW into the clinic
• Continue to monitor and discuss measures

Slide 10

San Mateo Medical Center Main Campus Primary Care Clinic

• Questions?