"It was an innovation born of desperation, rather than inspiration."
East Bay Area
In an effort to provide superior quality of care, Dr. Whippy, then Assistant Physician-in-Chief, decided to focus on patients with diabetes in 2003.
“I knew we had to develop a system that was effective and efficient, and that also made life easier for the physicians,” she explains.
Dr. Whippy collaborated with Lolly Schiffman, MD, Medicine, and Deborah Rangel, Associate Medical Group Administrator, and other members of the Richmond Diabetic Team to create a pilot program using a facility-based Population Management Tool (PMT). The PMT is an electronic database from which customized worksheets are generated that identify patient-specific interventions to help prevent heart attack, stroke, and other complications of diabetes.
Once or twice a week, physicians used the worksheets to comprehensively review ten of their patients with diabetes. Management Assistants were hired to contact the patients to communicate and facilitate the physician’s instructions, which often involved laboratory studies and/or medication changes. The program resulted in improved patient compliance, leveraged physician time, and greatly improved quality scores.
PMT is now used in Richmond to target a population of patients who have had a coronary event or stroke, or have a “risk-equivalent” condition. And with Dr. Whippy as champion, the “Richmond model” for leveraged care outside the doctor’s office visit is being used throughout the region, and in several other KP regions. The PMT electronic data warehouse now contains a wide range of information on 3.3 million KP members, which can be used for facility-based identification and review of specific member populations.