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February 2016

New ICSI Healthy Lifestyles Guideline, Endorsement of VA's COPD Guideline

ICSI is excited to announce that the revised Healthy Lifestyles guideline is now available. This document provides guidance to the clinician and team on how to address behavior issues including physical activity, tobacco, alcohol, nutrition, healthy thinking, and sleep. This new 2016 revision has been completely restructured and rewritten following the 5As framework - Assess, Advise, Agree, Assist, and Arrange, making it more concise and user-friendly. View the guideline.

ICSI also endorsed with qualifications the Veteran’s Affairs/Department of Defense (VA/DoD) Clinical Practice Guideline for the Management of Chronic Obstructive Pulmonary Disease (COPD). While acknowledging that this guideline was created for the VA/DoD system, we anticipate it can be used in various ways, depending on the needs and interests of the organization and/or practitioner. It includes a number of recommendations supported by the evidence for COPD, such as steps to confirming initial diagnosis, offering prevention and risk reduction in smoking and vaccination, and recommended medication(s). View the guideline.

ICSI Members Urgently Needed for Asthma Guideline Work Group

We urgently need members for our asthma guideline work group, especially a pulmonologist, allergist and primary care physician. If interested, please contact Georgette Susla as soon as possible. We also need members for our stroke and lipids guidelines. Learn more about our specific needs.

2016 ICSI Colloquium: A new approach to Value

Make your plans to join us at this annual gathering of Minnesota's health care community, taking place May 9 - 11 at the Minneapolis Marriott Northwest in Brooklyn Park. The theme expands our Triple Aim focus of the past few years to a more inclusive, outside-in approach to value, mindful that the health of all our patients and communities is the reason for the care we provide.

We've planned a great mix of engaging local and nationally known speakers; the preliminary program will be available online later this month. In the meantime, visit the Colloquium page and check out our new flyer for a sneak peek at some of the sessions sure to pique your interest. We look forward to seeing you in Brooklyn Park this spring! Get the details and register today.

Upcoming ICSI Events

Quality Improvement Basics

Thursday, February 11, 2016, 8 a.m. - 4 p.m., ICSI Office, Bloomington

HURRY! Registration closes February 4. The workshop includes practical basics such as Aims and Measures and the Plan, Do, Study, Act (PDSA) cycle, plus the adaptive work, communications and change management considerations needed for these improvements to remain embedded in your practice. This is a members-only session; sign in to your account to learn more and register. Call ICSI at 952-814-7060 with any questions.

Foundations of Motivational Interviewing Workshop

Friday, March 4 and Friday, April 15, 2016 Note date change!
8 a.m. - Noon, ICSI Office, Bloomington

Making lifestyle changes to support better health isn't easy. Motivational interviewing is a proven framework and set of skills used to help people work through ambiguity and change. Find out how you can better help your patients by learning and practicing these skills at the first 2016 offering of this popular two-part workshop. ICSI members pay a discounted rate of $45; the cost for nonmembers is just $125. Learn more and register by February 26, 2016.

Mental Health Community Partners Networking Event

Tuesday, April 12, 2016, 1 - 4 p.m., Maple Grove Community Center

Join us for another Mental Health Community Provider Network event, and continue to learn about bright spots and connect with colleagues toward improving care transitions for people with mental illness. Learn more and register by April 5, 2016.

Member and Sponsor Spotlight

HealthEast Care System: Going Beyond Clinical Walls with
Healing Hearts, Creating Hope Project

HealthEast Care System in St. Paul is excited to share an update about its partnership with the Center for Victims of Torture™ (CVT). Healing Hearts, Creating Hope is a multi-year collaborative project that provides onsite mental health services to Karen refugees from Burma. The primary location for these services is the HealthEast Clinic - Roselawn, which serves a large and diverse refugee population, including approximately 3,000 Karen. Seven clinic staff members are themselves Burmese refugees. Since 2010, the clinic has been working with CVT on its Healing in Partnership project to provide mental health screening for newly arrived refugees. Read more.

Community Care Network Program is Making a Difference for Chronic Patients

An article in the January 6, 2016 edition of the Winona Post describes a Winona Health program that focuses on patient-driven goals and partnering with coaches to help with social needs. Patients with chronic health conditions have seen an 85 percent decrease in hospitalizations and emergency room visits since the Community Care Network program began almost three years ago. Paula Philipps, a registered nurse, and Cassie Boddy, a social worker, were initially brought in to lead the Community Care Network after some Winona Health staff visited a similar facility in Pennsylvania and decided to bring the concept to Winona. Read the article.

Our Work: Progress Reports and Updates

ICSI Releases Report of Medication Utilization Management Work Group

In mid-2015, ICSI was asked, as a neutral convener, to bring together key stakeholders to address concerns about prior authorization for medications. The group’s charge was to analyze the key issues around medication utilization management/prior authorization in Minnesota and define opportunities for improvement, including creating recommendations and guiding principles for our efforts. Because prior authorization is only one component of medication utilization management, the work group also included step therapy, quantity limits, and medical necessity as they designed an improved process.

ICSI’s Board of Directors approved an executive summary of the work group’s efforts and recommendations in December 2015. Read the report.

Behavioral Health Integration: Lessons Learned from the Field

In a recent Network for Regional Healthcare Improvement (NRHI) Collaborative Health Network blog post, ICSI project manager and consultant Tani Hemmila talked about behavioral health integration, including lessons learned and challenges of this work. Read on for an excerpt. Connect with Tani and read the rest of her interview on the HealthDoers Platform. Not a member? Request an invitation.

"One theme that came up in [a recent] peer-to-peer meeting in Washington, D.C. is the detrimental impact of silos between organizations, departments, and even teams. This is not inherent to behavioral health integration efforts; it’s part of the structure of our society and health care in general. It’s what happens in the space between silos that will make the biggest impact in advancing integration efforts; interpretation and application of data, handoffs and communication between people and organizations, and patient care transitions inside a system and between systems. 

Another challenge is the discomfort and stigma that exists around addressing substance use in primary care. We have found that communities are looking to health care to help address substance use, yet healthcare often is not comfortable with it and may relegate it to a back burner. Yet many medical conditions cannot be effectively addressed unless substance use is part of the conversation between patient and clinician. Implementation efforts must meaningfully address not only new workflows but also people’s comfort level, misconceptions, and stigma that may exist."

New & Noteworthy

Small Health Care Provider Quality Improvement Program RFP Issued

The Federal Office of Rural Health Policy has issued a RFP for rural health care providers interested in implementing a quality improvement program to reduce emergency room visits due to chronic disease. The applicant must be a public or non‐profit health care provider or provider of health care services and must be located in an eligible rural area. For more information, view the funding announcement. The deadline to apply is March 4, 2016.

It is Time to Ask Patients What Outcomes are Important to Them

This research study, co-authored by HealthPartners' Leif Solberg, MD, was recently published online in the American Journal of Managed Care. The study's objective was to identify the outcomes desired by patients (and their family members) with abdominal or back pain and to compare patient and physician opinions regarding the importance of each outcome. It was conducted with patients in the Twin Cities area, and physicians were recruited with the help of co-investigator Cally Vinz, RN, an ICSI vice president. The researchers concluded that many outcomes are important to patients and their family mem­bers, but they mostly represent quality-of-life events rather than the symptom and function measures heretofore focused on by researchers. Physicians appear to rate most of these outcomes somewhat lower in importance. Read the article.