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The Healthcare Quality Equity and Action Forum
Designed by the Disparities Solutions Center at Massachusetts General Hospital

September 24 and 25, 2012
The Boston Seaport Hotel and World Trade Center, Boston, Massachusetts

Four sessions from The Healthcare Quality and Equity Action Forum have been recorded and made available on YouTube for public viewing. Please view the descriptions and click the links below to watch.

ACO's, PCMH's, VBP??: Integrating Equity into the New ABC's of Health Care Reform and Payment Reform

Thomas H. Lee, MD, Chief Executive Officer, Partners Community HealthCare, Inc., Network President, Partners HealthCare, Inc.

Brian Smedley, PhD, Vice President and Director, Health Policy Institute, Joint Center for Political and Economic Studies

Moderator: Joseph Betancourt, MD, MPH

As we aim to integrate equity into the new quality paradigm, we must learn the new ABC’s of payment reform and healthcare reform. Terms such as high-performing health care systems, accountable care organizations, value-based purchasing, and patient-centered medical homes, to name a few, have and will become the new language of quality and health care delivery. Success in this rapidly changing healthcare environment will be predicated on how fluent we can become about these forces of change, and how well we can position equity within these movements. Complex although it may seem, there are some basic concepts that will allow us to better understand where health care delivery is going, as well as the dimensions of the new field we’ll be playing on. This presentation will provide an overview of the key principles and ABC’s of payment reform and healthcare reform, and will be delivered by two experts who have both analyzed these movements in great detail, and are living their implementation. Not only will they share their thoughts about how the healthcare system is evolving, but they will provide some perspectives on how equity fits in.


Grounding Session III: Crossing the Digital Divide: HIT and the Promise of Equity

David Blumenthal, MD, MPP, Chief Health Information and Innovation Officer, Partners HealthCare, former National Coordinator for the Office the National Coordinator of Health Information Technology, US Department of Health and Human Services

Steven Atlas, MD, MPH,Director, Practice Based Research & Quality Improvement Network, Massachusetts General Hospital

Kamal Jethwani, MD, MPH, Corporate Manager, Research and Innovation, Center for Connected Health, Partners HealthCare

Moderator: Lenny López, MD, MDiv, MPH

Health information technology (HIT) has emerged as a cornerstone of health care reform, and as a crucial tool for payment reform. The march towards meaningful use is steadily advancing, and the promise of quality improvement, efficiency, and cost savings is driving the nation to solidify its health information infrastructure at a rapid pace. While there is excitement about the implementation and expansion of the capacities of the electronic medical record and decision support; the capacity to support population management as a vehicle for improving screening rates and manage chronic disease; and the use of innovative technologies such as remote monitoring, telemedicine, and text messaging—one pressing question remains. Will the digital divide once again emerge and will HIT be used to benefit all populations, not just a select few? In sum, how can HIT be deployed to improve the care of vulnerable populations? How can it be applied to assist in efforts to eliminate disparities? This panel presentation, delivered by the nation’s former Coordinator of the Office of Health Information Technology, as well as two innovators in the area of addressing disparities using HIT, will highlight promising and novel methods of deploying HIT to address disparities and achieve equity. They will also provide key perspectives on how to develop and focus HIT interventions at a health system level to eliminate disparities in both preventive and chronic care disease management.


Grounding Session IV: The Missing Pieces of the Puzzle: Oral Health and Mental Health in Chronic Disease Management

Brian Swann, DDS, MPH, Chief of Dental Medicine, Cambridge Health Alliance

Octavio Martinez, MD, MPH, MBA, Executive Director, Hogg Foundation for Mental Health

Tamarah Duperval-Brownlee, MD, MPH,Chief Executive Officer & Chief Medical Officer, Clinical Services, Lone Star Circle of Care

Moderator: Roderick King, MD, MPH

Chronic disease management and care coordination will benefit from heavy investments as part of health care reform and payment reform. The hope is that our nation will finally be able to devote the necessary resources to systematically focus interventions on those individuals and those conditions that are most prevalent, disabling, and costly. The obvious suspect conditions that seem to be emerging include congestive heart failure, diabetes, and asthma. A longstanding and growing area of research has indicated, however, how important mental health and oral health are as co-morbid conditions that significantly impact these chronic diseases. However, little attention and few resources have been devoted to better incorporating mental health and oral health interventions as part of chronic disease management. Going forward, successful chronic disease management cannot leave mental health and oral health by the wayside. Those that plan well will determine how to avoid missing these pieces of the puzzle, and strategically and systematically integrating mental health and oral health into these efforts. Led by two leaders in their respective fields, this presentation will highlight the key evidence on the impact of mental health and oral health on chronic disease, and present ideas and perspectives on how these areas can be integrated into chronic disease management and care coordination.


Action-Oriented Workshop B: Laying the Foundation: Building Measurement and Monitoring Infrastructure for Equity

Elizabeth Mort, MD, MPH, Associate Chief Medical Officer, Vice President of Quality and Safety, Massachusetts General Hospital

Wayne Rawlins, MD, MBA, National Medical Director, Racial and Ethnic Quality Initiatives, Aetna Inc.

Moderator: Lenny López, MD, MDiv, MPH

Population management, in addition to impending reporting requirements as part of health care reform and payment reform, will require not only the collection of REaL data, but the routine measurement of quality by patient demographics. This reporting will allow organizations to monitor equity, as well as develop disease management registries so interventions focusing on quality improvement and disparities reduction efforts can be created to meet the cultural, linguistic, literacy, or other needs of individual at-risk patients. Given forthcoming efforts to support the prevention of ambulatory care sensitive hospitalizations, disincentives for hospital readmissions, and compensation for patient experience, developing robust equity dashboards and reports will be an essential foundation for quality improvement and cost savings. But can this be done? If so, how? What are the key steps towards developing equity dashboards, reports, and registries? This workshop will highlight key lessons learned from two experts in the field who have led their organization’s efforts in this area. They will share lessons learned, key do’s and don’ts, as well as practical steps to both get started and advance ongoing initiatives in equity measurement and monitoring.


Support was provided by Aetna Life Insurance Company; Amgen, Inc.; Language Line Services; The California Healthcare Foundation; The Commonwealth Fund; American Cancer Society; DentaQuest Foundation; and a private donor.

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