Identifying Bright Spots
The eight federally qualified health centers that comprise the Alameda Health Consortium share the goal of providing high-quality care to underserved communities in the East Bay. Their patients face obstacles to health care including poverty, lack of health coverage, immigration status, and language and cultural barriers. The health centers strive to provide affordable, comprehensive health and dental care to people of all ages, cultures, and health conditions.
In 1996, after California introduced new state managed care programs, the eight health centers in the Alameda Health Consortium created CHCN, a non-profit Medi-Cal organization, to help the centers navigate the new system so they could spend less time on administration and more on patient care.
Among other tasks, CHCN provides centralized support to help member health centers improve HEDIS outcomes. HEDIS measures how effectively health payers and providers provide patient services and care in a given year. HEDIS measures track information like whether a health center is providing timely immunizations for children, and regular colorectal screenings for patients over 50. How well health facilities do on HEDIS measures impacts reimbursement levels, as higher measures mean higher reimbursement.
CHCN and member clinics track many of the same HEDIS measurements. But different clinics consistently get better results in some areas than others. CHCN uses Tableau, a digital data visualization platform, and some health center staff use it too. Tableau takes data and turns it into visuals that are user friendly and accessible. Tableau enables health centers to monitor their progress on HEDIS measures; Tableau can let health center staff see which patients are due for which services, for example. But while a few staff members at each of the health centers were using Tableau, many were not.
CHCN decided to get representatives of all the clinics together in one place to give them an opportunity to:
- Receive hands-on Tableau training.
- Share best practices.
- Prototype solutions for improving HEDIS outcomes based on human-centered design methodologies.
In particular, CHCN staff wanted clinic representatives to share “Bright Spots,” that is, HEDIS improvement practices they found effective. CHCN also hoped to brainstorm new, innovative practices that clinic staff could take back and try out at their home sites.
With the support of our Technology Hub, CHCN organized a half-day interactive gathering that they dubbed, “HEDIS Palooza: A Quality Workshop.”
Completed Bright Spot Form
Planning a Palooza
CHCN staff created a planning committee which met regularly to prepare for the event. The HEDIS Palooza was scheduled and invitations were sent to representatives of all member health clinics.
The CHCN planning committee also solicited “Bright Spots” — innovative ideas or best practices — from member clinics before the Palooza. The CHCN planning committee sent Bright Spot Submission Forms to all member centers in advance of the Palooza. The forms were used to describe HEDIS best practices, and each center was asked to present at least one Bright Spot they’d tried and found effective.
The planning committee collected and consolidated Bright Spot forms and created an agenda for the HEDIS Palooza.
The HEDIS Palooza
The Palooza took place on July 17th, 2018. Participants were excited about the event, according to Samira Pingali, CHCN’s provider services manager. There were 53 total participants representing all eight health centers, including doctors, nurses, and clinical, administrative, data, and quality-control staff.
The CHCN planning committee made the meeting room festive with balloon clusters at each table; a musician played the fiddle during the lunch break. The event kicked off with introductions and an ice-breaker. Next there was a Tableau training that focused on using the digital tool to track HEDIS measures. Next, three health centers gave presentations about Bright Spots they’d implemented to improve HEDIS measures. (According to Pingali, CHCN received many Bright Spot submissions, but could only present three because of time constraints.)
The Axis Community Health, the Native American Health Center, and the Tri-City Health Center all made presentations. The presentations focused on ways to boost the number of patients screened for breast cancer, colorectal cancer, and cervical cancer to boost HEDIS measures in those areas.
“Bright Spot” presentation by Dr. Gemma Jamena from Tri-City Health Center, on colorectal cancer screening
After lunch and live music, there was a “Brainstorm, Innovation, and Design Session.” Individual health centers gathered to create prototypes of HEDIS innovations that would help improve outcomes at their own facilities. Center staff used human-centered design techniques, including brainstorming and journey mapping, to come up with ideas and create their prototypes. Each group had a box of materials (markers, Post-its, and other prototype tools) to work with.
Prototype for West Oakland Health Center
At the end of the session, Each health center presented their prototype to the entire group. Some Ideas included:
- Using text messages for follow-up appointment reminders.
- Creating incentives/morale boosters to increase the number of patient health screenings, for example, a staff pizza party or other celebration when a specific screening goal is reached.
At the end of the event, each health center was given materials to take home so they could continue using human-centered design techniques at their own facilities. Tech Hub support was used to pay for food and materials.
Results
While it’s difficult to evaluate the success of a half-day workshop, feedback from event participants was overwhelmingly positive, according to Samira Pingali. “I was pleasantly surprised about how responsive people were,” she said. “When we introduced specific skills and techniques, it took some people awhile to warm up to them at first. When you have a room full of doctors, it takes a while for them to warm up to the Post-its and the journey mapping. But everyone joined in. It was great to see health center staff all working together. “
Measuring Success
There were 53 event participants, and they were all asked to complete an evaluation form after the Palooza. The form was based on the Likert scale (rating 1-5) with 9 different metrics for participants to evaluate the value and effectiveness of the overall workshop session. The evaluation form also contained a free text section with “I like, I wish, I wonder”, allowing participants to qualitatively rate the workshop.
Palooza participants were very positive about the experience. In the “I like” section of the survey, most respondents said they appreciated the chance to get together with fellow clinic representatives, “to collaborate and network, learning from one another and sharing ideas, having time away from work to brainstorm in a creative manner,” say Pingali.
Other participants said they liked the Tableau tutorial, and appreciated learning more about how the tool can be used to improve quality measures. All of the “I wish” comments expressed regret that the workshop wasn’t longer.
