wwppDiscuss News

WWPP Home page on 1/1/09 by Jack F. Mancilla

In Whatcom County, WA, providers, payers and patients are working together to design and build the system of care that patients want. Our vision. Here is a printable one page overview of the project and the partners.

Pursuing Perfection in Whatcom County, WA. is the current phase in our community's ongoing improvement of the healthcare system. Our efforts have been clarified by the Institute of Medicine's (IOM) Quality of Health Care in America Project and it's final pronouncement, Crossing the Quality Chasm Report, Our efforts have been accelerated by a two year, 1.9 million dollar grant from the Robert Wood Johnson Foundation; matched by the investment of more than three million dollars of local provider funds. We have as thought partners the staff of the Institute for Healthcare Improvement (IHI) and more than a dozen other organizations in the US and Europe who are working together toward very similar goals.

The Chasm Report documents how terribly broken the system is and it calls for revolutionary improvement in US Healthcare. The grant calls for nothing less than organizational transformation for all care providers and payers. Three necessary components for transformational improvement are 1) system (complex adaptive systems) improvements, not trying harder within the current system, 2) putting patients (one patient's story) at the center (QuickTime video of patient's view) of all system designs and in control of their own healthcare decisions; and finally 3) cooperation among clinicians both in the design/operation of the system and in support of individual patients needs.

We, in Whatcom County, WA, have chosen to improve the delivery of chronic disease care starting with diabetes and congestive heart failure. The care we provide will be based on the best scientific evidence and patient preference. We are also working to support patients and their teams of providers. There are clinical care specialists (nurses) to help patients navigate the current dysfunctional system and to help patients develop self management skills. We have developed a shared care plan that helps support the patient's efforts at self management as well as keeping all of the care team on the same page. (You may follow the link to the shared care plan and see the electronic version and you can download a paper version to begin using with your care team today.)

We are redesigning the way that clinic/office work is done so that it is much more responsive to patient needs through improved efficiency, fewer delays, use of e-mail, internet, and access to group visits. (HealthPartners in Minniapolis, MN have lead the way in office redesing. Here is a video clip explaining their views on "advanced access". And here is a link to other advanced access resources.)

We are making public promises to patients. We are measuring and documenting the outcomes including patient satisfaction. This Fall we begin reporting publicly our ourcomes and our performance on these promises.

Since the current payment system can work against any of these innovations, we are formally modeling the benefits and costs of this new way of providing care so that payers and providers can do "what if" scenarios and together develop rational payment policies to support a radically improved system of care without increasing overall costs. We have formally modeled the health care outcomes and the economic impact on all the stakeholders. You can read a paper on that work by following these links: paper and powerpoint.