• Time is Running Out on Colloquium Savings
• 2013 Annual Report
• ICSI Endorses AAP's ADHD Guideline
• Noteworthy Events
• Our Work: Progress Reports and Updates
• Call for Participation: Anticoagulation Control Meeting
• Member Spotlight: Member ACOs Recognized by CMS
• From IHI: Making Sense of Population Terminology
• Scientific Documents: Perioperative Protocol, ADHD

Time is Running Out on Colloquium Savings

Early Bird Registration Ends April 8!

Attend ICSI’s Colloquium on May 5-7 at the Saint Paul RiverCentre in St. Paul, MN and you’ll hear about more than 25 approaches plus practical tools you can implement to “Build a Sustainable Health System.” Register by April 8 and practice another key to sustainability—saving money (up to $80). Get all the details here. Download the complete program.

We’ve built this year’s Colloquium to deliver maximum value in what we know are tough times for clinicians to get away. Here are the top 10 reasons to attend:

1. Keynoters will provide system and patient insights to help you achieve the Triple Aim.
2. Four tracks cover the entire spectrum of your organization’s work.
3. A program focused on practical tools to provide a quick ROI.
4. Presentations designed to address individual, team and leadership skills.
5. Hands-on, pre-conference workshops—attend separately or as part of the Colloquium.
6. New! Tuesday reception to interact with peers, speakers and ICSI staff.
7. Posters of your peers’ work supporting sustainability.
8. Return of the mobile app to maximize your event experience.
9. A unique and inspiring closing session.
10. The hope that the Colloquium provides every year.

Note: There's still time to submit your poster abstracts! We've extended the deadline to Wednesday, April 9. Contact Jim Trevis with any questions.

2013 Annual Report Highlights our Collaboration

During 2013, ICSI concluded, continued and began new initiatives designed to help our members, sponsors and community target the Triple Aim. Check out how we collectively not only improved population health, the patient experience, including quality, and the cost of care, but also garnered national recognition for our work. NOTE: This year’s annual report is in electronic format with links to more information online. Access the annual report.

ICSI Endorses American Academy of Pediatrics ADHD Guideline

Important First Step in New Enhancements

Following a thorough review by the ADHD work group, on March 4, 2014, ICSI's Committee for Evidence-Based Practice (CEBP) endorsed with qualifications the American Academy of Pediatrics (AAP) guideline, ADHD: Clinical Practice Guideline, and Supplement. The CEBP also approved ICSI’s process for endorsement of external organizations’ clinical practice guidelines (CPGs). Find out more about the endorsement process.

The new endorsement process is one of several enhancements to our CPG development framework that were announced in January. Through the hard work of our members, ICSI has been developing evidence-based clinical guidelines and protocols to improve patient care since 1993. In order to continue providing the best value to our members and broaden the implementation of best practice guidelines, we are implementing the following changes:

• Ensure that ICSI’s guidelines posted on the National Guideline Clearinghouse are in full compliance with Institute of Medicine standards.
• Endorse guidelines from other respected organizations in addition to developing our own guidelines.
• Extend the revision cycle of some of our guidelines, without affecting the practice of best medicine.

By taking these actions, we can increase our efforts to enhance the implementation of guidelines in practice. To find out more about these changes, especially the new endorsement process, see the resources are available on our new endorsement webpage:

• Endorsement process document
• Endorsement process map
• FAQ document

Our Work: Progress Reports and Updates

PAC Seal of Approval Given to Choosing Wisely^® Minnesota, RARE Mental Health Collaborative

At its March 20 meeting, ICSI's Patient Advisory Council (PAC) unanimously approved the Choosing Wisely Minnesota initiative and the RARE Mental Health Collaborative for the PAC Seal of Approval.

The PAC also recognizes ICSI's partners in the Choosing Wisely Campaign: Minnesota Health Action Group and the Minnesota Medical Association, and in the RARE Mental Health Collaborative: Stratis Health and the Minnesota Hospital Association, who will also receive the award to recognize their support of patients and their families through these initiatives.

Each initiative submitted evidence that demonstrates how their efforts and activities meet the PAC Seal of Approval criteria. The seal has been added to the webpages of these initiatives and can be used in all materials to display their excellence in promoting patient- and family-centered care. Evidence documentation is also included.

ICSI initiatives and scientific document development utilize these criteria as a guide to integrate patient- and family-centered care into our work. ICSI members may also submit their initiatives and efforts for the PAC Seal of Approval. For more information, contact Carmen Hansen at 952-814-7096.

ACC/AHA Assessment of Cardiovascular Risk Guideline and Estimator

There have been many questions about how ICSI plans to respond to the new lipid treatment recommendations from the American College of Cardiology (ACC) and American Heart Association (AHA). Decisions about treatment depend on the 2013 ACC/AHA Assessment of Cardiovascular Risk and Estimator, a five-year collaborative effort between a diverse set of expert reviewers who assessed evidence from randomized control trials (RCTs) as well as meta-analyses and systematic reviews of RCTs. The equations predict 10-year risk of stroke and myocardial infarction (MI) whereas former guidelines focused only on heart attacks. This guideline also highlights the large burden of disability from nonfatal events. The treatment threshold is 7.5 percent, which is lower than the former threshold of 20 percent risk of MI over 10 years or >10 percent with multiple risk factors, and also accounts for the impact of ethnicity, birth order, and sex.

The Centers for Disease Control and Prevention has not yet endorsed the new 2013 ACC/AHA Assessment of Cardiovascular Risk Guideline and Estimator. ICSI's cardiovascular guideline work groups are aware of this new guideline and estimator, are watching for commentary and endorsement, and will take all of that information into consideration and review again in the fall of 2014.

Two Quality Improvement Basics Presentations Now
Available to Members

ICSI's foundation is in creating clinical practice guidelines, but we have also trained leaders and staff in the art and science of quality improvement (QI). Members have requested tools and materials that they can use to train new staff or to refresh teams in QI basics, and we are happy to deliver.

Go to the Quality Improvement Basics page under Education and Services and log in as a member to access the new PDSA and Aims and Measures presentations, including slide notes. Now you can download and use these with your staff and get them practicing with the Rapid Cycle Workbook, which is also available. Watch for additional training tools in the future.

ICSI is also offering a QI Intensive pre-Colloquium workshop, which is another great opportunity for you to train staff in QI basics.

Keep in mind that ICSI can also provide practice coaches onsite to train your staff in QI within their current projects. Contact Pam Pietruszewski at 952-814-7078 to learn more.

New Website Promotes Shared Decision-Making Between Health Care Providers and Patients

The Minnesota Shared Decision-Making Collaborative (MSDMC) has launched an expanded website designed to serve as a resource to those interested in enhancing effective shared decision-making between patients and their health care teams. The site msdmc.org offers both an online and downloadable roadmap for researching and implementing methods to assure that medical decisions are informed by the best available evidence and are consistent with patient preferences. ICSI is one of many participants in MSDMC.

Automated Prescription Refill Problems? Uncovering Root Causes

Over the past few months, several provider groups contacted ICSI about concerns and confusion regarding automated prescription refills. ICSI convened two meetings to explore the issue, involving several provider groups, pharmacies, health plans, e-prescribing vendors and representatives from the Minnesota Department of Health’s (MDH’s) Office of Health Information Technology and the Minnesota Department of Human Services.

From in-depth discussion, it became clearer that the root cause of the problems is related to the process of notifying pharmacies about prescription changes or discontinuation. The group also identified the following concerns with the current medication prescribing systems:

1. Interoperability and better communication of electronic prescribing systems between provider organizations and pharmacies to send prescription update messages in more user-friendly ways, and
2. Standardization of medication prescribing language terms so that the same prescribing terminology is used by both provider groups and pharmacies.

Following the discussion, the group recommended involvement of the Minnesota e-Health Initiative Advisory Committee. Comprised of health care providers, hospitals, health plans, health care purchasers, consumers, state and public health agencies, and other community stakeholders, this committee is ultimately responsible for providing guidance to Minnesota provider groups and pharmacies on effective use of their electronic systems. The discussion participants convened by ICSI believed that this Committee would be an ideal venue to provide further understanding and guidance to the state’s health care and pharmacy community on the concerns raised.

If you would like to participate in these conversations going forward, please contact MDH's Karen Soderberg at 651-201-3576. If you have any questions for ICSI, please contact Senka Hadzic at 952-814-7065.

Making Sense of “Population” Terminology

The Institute for Healthcare Improvement (IHI) first introduced the concept of the Triple Aim in 2008. Since then, this ambitious ideal — improve the health of the population, enhance the patient experience of care, and reduce the per capita cost of care — has become something that more and more health care organizations and communities are trying to achieve. However, it’s become evident that new terminology can be confusing. For instance, what do we mean by "population," "population health," and "population management"?

In a new ihi.org blog post, IHI’s Director for the Triple Aim, Niñon Lewis, clarifies the meanings, drawing on both the guidance of experts such as David Kindig from the University of Wisconsin Population Health Institute, and IHI's experience working with nearly 150 organizations and coalitions around the world. Lewis also describes the evolution of the term “population medicine,” which is newly emerging as the best way to describe the design, delivery, coordination, and payment of high-quality health care services to manage the Triple Aim for a population. Learn more about the Triple Aim and other related resources from IHI.