Heart Health NOW! (HHN)
Frequently Asked Questions (FAQ)
Q: How are practices selected for participation in Heart Health NOW (HHN)?|
A: Statewide, 300 small practices will be chosen that:
- Serve adults
- Have an electronic-health-record (EHR) system
- Are not currently receiving intense quality-improvement (QI) support
- Are Carolina Access II providers, and/or paid participants in the Medicaid “Meaningful Use” incentive program
Q: How do practices benefit from HHN participation?
A: A multidisciplinary team of experts will provide participating practices with QI services focused on cardiovascular health, including:
- Onsite practice facilitation and coaching
- Access to specialized disease registries
- Consultation with AHEC (Area Health Education Centers) practice coaches
- Shared learning opportunities
- EHR support
Q: How much time will AHEC spend at participating practices?
A: An AHEC practice coach will provide QI support up to 80 hours per month during the 12-month “intervention period,” depending on practice availability and needs. More facilitation hours may be available if desired.
Q: What will participating practices be doing during the 12-month intervention period?
A: Practices will receive ongoing coaching and informatics support to:
- Implement evidence-based approaches for the prevention of cardiovascular disease (CVD)
- Regularly review the HHN dashboard, a specific informatics resource for this project, and track practice progress on ABCS measures
- Carry out small tests of change (Plan-Do-Study-Act, or PDSA cycles), as needed
- Participate in webinars and collaborative educational meetings that share best-practices regionally and across the state
- Complete surveys and interviews, as requested
Q: What are the interventions, and who will they be geared to?
A: Interventions will be driven by the data, practice staff, and workflows, and will be supported by the experience of the AHEC coach, with the goal to improve CVD clinical outcomes related to ABCS measures. Any changes made during the intervention period will depend on what a participating practice wants, and how that practice currently functions.
Examples of interventions might include:
- Using data/tools in the Informatics Center (IC), a Community Care of North Carolina (CCNC) web application, to assist practices in deciding where to focus their work – for example, are there patients who need more services or medication changes?
- Embedding protocols for clinical care into a practice’s clinical workflows and EHR. Participating practices will work with an AHEC coach to choose or develop the protocols they want to implement, and the best method of doing so
- Applying PDSAs with the help of an AHEC practice coach, to see how any implemented changes are working for a practice
- Enhancing a practice’s use of patient self-management support, care planning, etc., whether internal to the practice or through referrals to outside programs (QuitlineNC, for example)
Q: What if a practice is already receiving onsite QI support services with a local AHEC, or a CCNC network like Community Care Plan of Eastern Carolina (CCPEC)?
A: A practice’s participation in HHN will not impact its current engagement with a local AHEC or CCNC network on QI-related initiatives (for example, Meaningful Use, Patient Centered Medical Home/PCMH, etc.). Instead, HHN participation will complement existing efforts, which will continue as usual.
Q: How many collaborative educational meetings and webinars should practices expect to participate in?
A: Annually, there will be three collaborative educational meetings (of roughly 1.5-2 hours in duration apiece). Each AHEC region will determine by consensus whether meetings are held face-to-face or via webinar and, if in-person, the best locations and times.
Q: Who from a practice is expected to participate in collaborative meetings and webinars?
A: The team that attends should include at least a clinical leader plus someone else in the practice who is familiar with front-end-to-back-end workflows, though attendees are often determined by early interactions between the practice and its AHEC coach.
Q: What surveys will be conducted throughout the program?
A: A designated clinical leader, and up to four additional staff members, will participate in:
- A 15-minute phone survey prior to the start-date of a practice’s intervention
- A second survey at the end of the 12-month intervention period
- A third survey at six months post-intervention
Unless the practice specifies otherwise, individual participants will receive $30 for each completed survey.
Q: How many interviews will be conducted throughout the program?
A: The designated clinical leader will be interviewed four different times:
- Prior to a practice’s intervention start date, for 30-45 minutes
- Once during the 12-month intervention period
- At the end of the 12-month intervention period
- At six months post-intervention
Unless the practice specifies otherwise, the clinical leader will receive $50 for each completed interview.
Q: Who from a practice will be surveyed and/or interviewed?
A: A clinical leader in the practice will complete surveys and interviews for the program. This “Key Informant” can be a physician or, when appropriate, a nurse practitioner or PA. If a practice employs five or more people, then four additional staff members (to include physicians, practice managers, nurses, medical assistants, or front-desk personnel) will participate in the surveys
Q: Are there financial incentives for participating?
A: As indicated earlier, $30 will be paid for each completed survey, and $50 for each completed interview. Also, financial assistance is available to cover fees incurred between the HHN enrollment date and April 2018 for establishing and/or maintaining a practice’s connection to the CCNC IC.
Q: What happens if a practice encounters technical or other issues that impede HHN participation or progress?
A: A CCNC practice facilitator will help resolve or mitigate these issues as needed, and ensure any additional follow-up. It is CCNC’s responsibility to establish and maintain connectivity between a practice’s EHR and CCNC’s IC, in order to facilitate the exchange of patient information to support this project.
Q: Will Continuing Medical Education (CME) credits be available for HHN participation; if so, will CME credits be Category 1 or Category 2?
A: The American Medical Association (AMA) and other CME-accrediting bodies have determined that:
- Physician participation in initiating a QI project earns five Category 1 CME credits
- Performing the QI project (measurement plus PDSA cycles): five more credits
- Completing a project and showing improvement: five more credits
- Involvement in all three previous steps: five extra-credits
So, for example, if a physician measures his/her BP control panel, participates in a plan to improve the BP control, and then measures and refines the plan and improvement occurs, his/her efforts will add up to 20 total CME credits.