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Launching a Core Strategy: Strengthening Primary Care

Doctors and Nurses

Being trained in family medicine and working as a primary care doctor is a privilege. One of my mentors, Dr. Marc Babitz, used to say, “Family physicians can take care of 90 percent of what walks through the door, and we know what to do with the other 10 percent.” Making sure excellent care is delivered, documented, reimbursed and that patients get a satisfying medical home requires you to have a team behind you.

Since our inception, HealthInsight has been committed to understanding and impacting levers for better quality in health care. We recognize our primary care delivery system as critical for delivering the best health care. We are committed that practices of all sizes develop an agile, team-based delivery model that maximizes outcomes and ensures staff satisfaction while it sustains revenues. That’s why we’re launching our core strategy of Strengthening Primary Care.

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Innovation through Collaboration

Professionals Meeting

Several years ago I wrote about how technology can help support innovation and recognized that it can also be a “disruptive force” for processes and communication. That hasn’t changed. I’m now beginning to witness and directly experience how collaboration supports innovation.

With the recent merger of HealthInsight and Qualis Health, the Information Services Team is going through another period of explosive growth with new infrastructure, new staff with new skills and tools, and even new technologies. We’re entrenched in efforts to look at and compare what works and what could be improved. We’ve begun recognizing and supporting new collaborative opportunities, both within our own team and more broadly with the newly combined staff. We’re helping to set, support and develop the new “norms” for this organization as it begins to define itself.

Along the way, our staff will explore new opportunities and spend time and effort getting to know each other – where our strengths lie and where we can help each other to improve together. To facilitate that process, we’ll continue to look for potential areas where we can become even more nimble as a larger organization. I’ve watched as the individuals who make up this new organization embrace the differences that make people unique. They’re genuinely interested in working toward the best outcomes – not only for internal needs, but for everyone we work with, too.

So what does all of that mean, really? I believe that in helping to support all of these collaborative efforts, we’ll strengthen our relationships and help create a workplace of continual improvement, initiative and innovation. Innovation may be as simple as a new process or as big as a new opportunity that we haven’t yet explored. Nonetheless, having collaborative opportunities – whether at the team level or even between individuals – will support and encourage innovative thinking, sharing and change.

But it will take all of us working toward a shared vision to get there. In a way the efforts, challenges and progress of our merger mirror our work with you – our partners – in working through the challenges in health care and striving toward our shared vision of an improved, efficient, safe and cost-effective system for all of us.

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"Ukuphosa Itshe Esivivaneni" – Throw Your Stone upon the Pile

Safari

Recently I had the opportunity to visit Zimbabwe and South Africa to observe a close friend and colleague work with local health leaders to improve HIV treatment. I was able to attend the last day of a learning session where awards were given to teams. It was an invigorating experience for me to observe the pure joy and exuberance the teams showed as they were acknowledged for their efforts to improve care in their communities. The celebration honored a collective experience, rather than individual accomplishments.

While in South Africa, I went on a short safari. Since I was the only person on the 12-hour adventure, I quickly bonded with Ndu, a Zulu safari guide. Ndu was very interested and intrigued with American culture and asked me about Utah food. After sharing the recipe for funeral potatoes, I asked Ndu questions about Zulu culture in South Africa.

I learned about many Zulu traditions that day. One I will never forget is, “Ukuphosa itshe esivivaneni,” which translates to “Throw your stone upon the pile.” During our safari, he stopped at a pile of stones and explained to me that long ago when someone died, people paid their respects by adding a stone to the pile. The result is a unique monument created by individuals. The practice was used in ancient times to mark places of spiritual, astronomical and historical significance. Ordinary people were expected to contribute to great works. Ndu explained that the idea is what we create collectively is better than what we can create individually. The diversity of participation lends to a shared vision of the future where everyone does their part to realize that vision.

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Love You to the Moon and Back

Women Walking

On Jan. 12 of this year, my mother Donna celebrated her 80th birthday. Frankly, she didn’t think she was going to make it. Not because she suffers from a chronic disease or because she has been ill recently. Her mother, Helen, passed away at 79 after falling and breaking her hip. Grandma Helen was hospitalized after her fall and, well, she never left that hospital bed, until she left that hospital bed. My mother just assumed she would suffer a similar fate.

So, when it came time to schedule her six-month check-up in January with her primary care physician, she put it off. After all, what was the point?

When asked about when her next visit with her doctor was, her story always changed: “Oh, they called and rescheduled it for next month.” “Your aunt and uncle are visiting from Colorado that day, so I moved it.” “Oh, your Dad and I forgot about it, so we had to reschedule again.”

Three months passed, and still no appointment. Only now, she wasn’t feeling so hot. She and my dad had both had their flu shots, but over a period of about four weeks, she battled a chronic cough, stomach viruses and sleepless nights. She spent days on end in her pajamas wrapped up in the blanket I got her for her birthday, adorned with the photographs of her 14 great-grandchildren in the shape of a crescent moon with the phrase “love you to the moon and back” scrawled next to it. (“Guess How Much I Love You,” from which that line came, was the story I asked her to read to me over and over again.)

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New Mexico Medicaid is changing: are you ready?

Doctors

Here at HealthInsight, no matter what our titles may be, we each have a role in helping those in our community to understand changes in health care. This came to mind recently in my “off-hours” while I was getting my nails done. The manicurist asked me what I did for a living, and my answer opened up an interesting conversation about her mom.

She explained that although her mom works, she would like to qualify for Medicaid so she can have access to health care. I was glad to provide her with some ideas and resources for additional information. I also let her know that Medicaid in New Mexico is changing.

The current program is called Centennial Care and two of the four Medicaid managed care organizations (MCOs) that contract with the State to provide health care coverage for New Mexico Medicaid beneficiaries are changing. The new MCOs will be:

  • Blue Cross and Blue Shield of New Mexico (BCBS)
  • Presbyterian Health Plan, Inc. (PHP)
  • Western Sky (Centene)
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