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FAQs

Is there a cost to me?

Only the cost of your time, which is kept to an absolute minimum. There are no hidden costs, no advertisers selling product, etc. Your name is not shared with anyone.

What exactly do I have to do to join this program?

You must first register complete the baseline practice assessment that will give you personal feedback about your practice performance and overhead compared to comparable practices nationwide. You will participate in conference calls with other practices so that you could make the most out of free tools, technologies and methods.

What is the free technology offered?

HowsYourHealth.org (for patients and practices) (HYH) is a family of tools that assesses patients? needs and provides them information based on their needs, summarizes their needs, and sends the information to the office. HYH also assists patients with problem solving for common problems and better self-management. and automatically populates a registry so that no office staff time is required. We also supply a phone coach program for patients. We provide great guidance (with video demonstrations) from other clinicians about best value technologies that they use.

How will this work with the EMR I currently use or I'm in the process of implementing?

These technologies do not depend on any EMR. The information can be imported if the practice wishes and if the EMR is able to import information from external sources.

Regarding HowsYourHealth?

Do I have to enter any demographic data?

No. the patient enters data. You and your staff enter nothing.

How will I be informed of the information my patients enter in howsyourhealth.org?

Your patient can bring you a paper copy of their report or email it to your practice.

I do not have time to tell my patients too much about this program. Will there be posters or flyers with a display of some sort to attract their attention for the waiting room?

Part of the project is to work through with practices how best to interest patients in using these technologies. We provide the materials practices may want to try such as newsletters, posters, and patient handouts about the practice that include information about the technology, etc.

Where has this been done before and what were the results?

There are approximately 100 physicians in the United States who have piloted this work. Practices who start doing this find that it is positively transforming many aspects of the way they care for patients. In particular, they and the patients are more often "on the same page", the practice and patient are much better at providing patient, self-management support, and the practice becomes more efficient.

Can I participate as part of a bigger organization?

Of course. Many practices, both big and small, have significant investments in the current way of doing business. The key change for any doctors office is to begin to reorganize the work using the concept of microsystems. The Ideal Medical Practices (IMP) Program is based on the business concept of "microsystems" popularized by Quinn and applied to medical practices by Batalden et al. This empiric work posits that the most successful models of business and health care occur in the "smallest replicable unit" of any organization. An SRU has: I) a group of people working together to serve a defined population of patient/customers, II) information flow between and among all of them for the benefit of the patient/customer III) relentless application of improvement and waste reduction methodologies to enhance reliability and replication.

Stripped of the jargon, SRU applies in any organization of any size. In solo practice, the SRU is easy to define. In larger practices or groups or organizations, the potential SRU sometimes has to be discovered. The advantage, if any, of using the "micropractice language" is to help doctors confront the implications of the three points listed above.

1. Practices (potential SRUs) seldom understand their population and how their team functions...hence the baseline work. At baseline we learn that most practices are driven by "symptom management" such as stress, "RVUitis" etc. without understanding root causes such as overhead and highly variable, ineffective, inefficient practice patterns. Our goal is to guide discovery of these root causes.
2. At baseline the data systems are found not to be information systems. The data systems merely push around data for administrative purposes or clinical data for very narrow purposes. At best, patient-based information is used to slightly modify the current way of doing business. Hence folding HYH, Vital Signs into everyday work as a method to inject some real patient-centered information...not just some more data.
3. Everyone now knows "PDSA" (plan do study act) but generally use it to focus on slight modifications of the current way of doing business. Or they use the chronic care model and PDSA to come up with grand schemes for "system redesign" that seldom reach nascent SRUs. The lack of effect is predictable.

In summary, IMP work is not just about small practices and small overhead. But it is about small manageable change that builds up to large replicable changes.

If I cannot participate in the conference calls, can my nurse/medical assistant participate in my behalf?

This is not recommended because the conference calls are very participatory and the doctors share information readily. However, we do use "blogs", and "podcasts" so that the best information can be shared with others in your office/organization.