An annual research and education conference is a key component of the High Value Practice Academic Alliance, because of the importance of research in the transition to high value care. Best practice must be defined by data in conjunction with clinical expertise. Evaluation of outcomes ensures safety by confirming that cost-conscious care does not compromise our ability to diagnose and treat patients. Changing long-standing provider practice patterns has proven challenging, and we need to critically examine which interventions most effectively influence prescribing and ordering behavior. Patient acceptance of cost-conscious practice is another important area of investigation.
The inaugural National Research & Education Conference of the High Value Practice Academic Alliance, was held on October 8&9, 2017 in Baltimore, MD, sponsored by the Johns Hopkins School of Medicine. Peter Pronovost, MD, PhD, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins and Johns Hopkins Medicine’s senior vice president for patient safety and quality, delivered the keynote address. More than 200 faculty, house staff and administrators from 70 medical centers attended the meeting.
Five high value leaders spoke on their areas of expertise within high value care:
- Richard Duszak, MD, Professor and Vice Chair for Health Policy and Practice, Department of Radiology and Imaging Sciences, Emory University School of Medicine:
- High Value Imaging: Perspectives from a Contrarian Radiologist
- Douglas Hough, PhD, medical economist and author of Irrationality in Health Care: What Behavioral Economics Reveals About What We Do and Why:
- Physician Behavioral Modification
- Chris Moriates, MD, Assistant Dean for Healthcare Value at Dell Medical School, University of Texas at Austin
- Building High-Value Care Bridges
- Rita Redberg, MD, Msc, Professor of Cardiology at UCSF, Editor-in-Chief of JAMA Internal Medicine, who created the “Less is More” column to promote high value practice
- How Less Health Care Can be Better for You: Examples from Internal Medicine
- Vikas Saini, MD, President of the Lown Institute, who convened the first major academic national conference focused on the problem of unnecessary care and created the Right Care Alliance.
- Providing the Right Care: A Systematic Framework
Abstracts describing high value quality improvement initiatives were delivered by podium or poster presentation, including 22 podium presentations and 100 performance improvement posters from 44 medical centers in the US and Canada. Highlights included:
- Reduction of unnecessary labs, imaging, transfusions, medications, telemetry and procedures, including a health system blood management initiative that decreased institutional costs by more than $2 million per year
- Medical and surgical care quality pathways associated with cost of care reduction
- Medication transition algorithms to reduce length of stay
- Interventions to expedite sepsis diagnosis, reduce length of stay and decrease readmissions
- Discharge transition initiatives, including results from the groundbreaking Myocardial Infarction Combined-Device Recovery Enhancement (MICORE) study, which uses smart devices to educate patients for discharge throughout their hospitalization and to monitor vitals, medications and activity after discharge
The conference program can be viewed here.
Educational curricula for medical students, residents and fellows from multiple academic medical centers were also presented as posters. The award winning curricula were selected by a panel of judges:
- Vineet Arora, MD, Assistant Dean for Scholarship and Discovery, Director of GME Clinical Learning Environment Innovation at University of Chicago Medicine , Costs of Care director & co-author of Understanding Value Based Healthcare.
- Belinda Chen, MD, Director of Programs in Curriculum Development at Johns Hopkins School of Medicine
- Christopher Moriates, MD, Assistant Dean for Healthcare Value at University of Texas, Austin, Costs of Care director & co-author of Understanding Value Based Healthcare.
- Steven Rose, MD, Dean of the Mayo Clinic School of Graduate Medical Education
- Best Residency Initiative: $500 and award certificate
- Best Multi-specialty Initiative: $500 and award certification
- HVC Curriculum Educational Excellence Award: $500 and award certification
- Highest scoring abstract in each categories
- January 1, 2018 – Abstract submissions site opens
- April 1, 2018 – Deadline for abstract submissions by midnight PST
- June 15, 2018 – Abstract notifications sent
- September 21-23, 2018 – National research and education conference
- The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
- The Johns Hopkins University School of Medicine designates this live activity for a maximum of 8.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 8.25 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME’s Program and Activity Reporting System (PARS) for the purpose of granting ABIM MOC credit
- American Academy of Nurse Practitioners National Certification Program accepts AMA PRA Category 1 credit™ from organizations accredited by ACCME
- American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 CreditTM from organizations accredited by the ACCME.
- American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 credit™ from organizations accredited by ACCME. Physicians assistants may receive a maximum of 8.25 AAPA Category 1 CME credits for completing this course.
- It is the policy of the Johns Hopkins University School of Medicine that the speaker and provider globally disclose conflicts of interest. The Johns Hopkins University School of Medicine OCME has established policies in place that will identify and resolve all conflicts of interest prior to this educational activity. Detailed disclosure will be made in the instructional materials.
- Identify unnecessary tests, procedures and treatments to target for reduced utilization.
- Elucidate the most effective methods to refine provider ordering and prescribing behavior (education, clinical decision support and provider feedback).
- Evaluate safety outcomes of value-based improvement to ensure that cost-conscious care does not compromise providers’ ability to diagnose and treat patients.