By Patricia Dennis
For my final project on the Leadership Program in Integrative Healthcare at Duke, I wanted to leverage the assets of my organization to build a transformative initiative by collaborating with others from across our enterprise for the benefit of our patients, members and community.
HealthPartners is the largest consumer governed nonprofit health care organization in the nation – serving more than 1.5 million medical and dental health plan members nationwide. Our care system includes a multi-specialty group practice of more than 1,700 physicians, 50 primary care clinics, 55+ specialties, seven hospitals, 22 dental clinics, a 24 hour on-line clinic, plus several pharmacies and an institute for education and research. HealthPartners employs over 22,500 people, all working together to deliver the HealthPartners mission.
When I started the business plan process, I tapped several potential champions across HealthPartners who were already engaged in Integrative Healthcare practices, and looked to them for guidance in identifying the best opportunities for transformational change.
I held interviews with the leadership to understand the pain points in the delivery system and posed these questions: What things are we doing now in complementary care or integrative medicine? Are there places in the organization that are already delivering this type of care?
Talking to the people who were already delivering such care was also helpful. With this group, I asked: If you were part of the Duke Program and had the opportunity to pick one meaningful project, what would it be? They highlighted their successes and where they saw a need.
We soon identified reducing the likelihood of Chronic Pain Syndrome as having great potential.
The opportunity to see the topic of Chronic Pain Syndrome from the standpoint of the patient, the primary care provider and from the health plan allowed us to approach the Triple Aim of Health, Experience and Affordability from each of those perspectives. Tackling this issue from several perspectives while acting within our organization’s mission and vision provided a powerful focus and call to action.
DEFINITION OF CHRONIC PAIN SYNDROME
We defined Chronic Pain Syndrome as pain lasting more than 12 weeks accompanied by adverse impacts on coping with aspects of work, relationships and leisure, and in which emotional responses ranged from hopelessness to relentless searching for relief.
In addition to the support from the HealthPartners CEO and executive leadership, the working team consisted of myself plus the:
We began to evaluate data and put together a plan that would identify potential patients, and connect them with care services in our health system to improve their health. We wanted to demonstrate that usual care combined with a comprehensive, person-centered model could reduce the likelihood of Chronic Pain Syndrome.
The idea of creating an intervention to reduce the likelihood of Chronic Pain Syndrome, rather than treating it after the fact, quickly took root as a prime method to impact change, not only for patients, but also for providers and for our health system overall. We began to evaluate data and put together a plan that would identify potential participants through clinician referral or through claims identification, and connect them with care services in the system to improve their health and well-being.
We identified the following steps as being within our scope of work:
The key transformational elements in our model were:
The resources for complementary care available for outpatients in the PCP setting through our system included modalities such as:
We determined that the care coordination process would be best handled by licensed behavioral health (BH) professionals who had received chronic pain training.
To be eligible, patients needed to be:
Our objectives for the pilot were to:
We established the following timeline:
MEASURES OF SUCCESS
Being able to measure success is an important aspect of any pilot. We identified three areas where we could have a measurable impact.
Care Delivery Outcomes
Measurement will be done through surveys, scoring tools and claims data.
In the process of setting up the pilot, we identified several barriers:
While there have been challenges along the way, our team has been able to continue to refine and improve our approach ahead of the pilot launch which is currently underway. And while there are several important outcomes, most significantly, we believe we have a concrete plan that will identify and engage patients who are at risk for Chronic Pain Syndrome early on in their journey, altering their course to improve their health and well-being.
Patricia Dennis is the Senior Vice President, Health and Care Engagement at
HealthPartners in Minneapolis, Minnesota.
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