Local healthcare reform implements treatment processes

Findlay, Ohio is one of the first communities in the United States to establish a partnership between area businesses, physicians and the local hospital to initiate healthcare reform at the community level. The program, called the Employer Data Project (EDOC), is overseen by Blanchard Valley Health System (BVHS). Its goal is to reduce variation in care and improve treatment processes while lowering health care costs.

The EDOC program studies medical claims data for employees of 10 participating area businesses, including Cooper Tire & Rubber, Marathon Oil Company and Whirlpool Corporation, and compares variations in the treatment of common medical problems. These variations are then reviewed to determine where physicians can implement a more consistent treatment process.

“In order to make this project successful, we needed collaboration by physician leaders, local companies and BVHS,” says Scott Malaney, president and CEO of Blanchard Valley Health System. “Physicians had to understand this was the right thing to do and be willing to follow the data. Ten local companies had to understand that we were working with sensitive data and that we needed to treat it collaboratively. BVHS had to invest time and resources. Everyone had to do something, and the result has been a transparent, collegial process that has already produced meaningful results and holds great promise for reducing variation and improving quality in the future.”

Since this collaboration began in 2005, EDOC has found that chronic diseases and the complications that come with poor control of these diseases cause a significant increase in healthcare costs for employers. By physicians using consistent treatments of nationally accepted best practices and through employee education, EDOC has demonstrated improvement in quality of care and a decrease in health care costs.

BVHS has 314 physicians on its medical staff, with 168 physicians on the active medical staff. The Health System also has 80 ancillary medical staff members.

“We did have some physicians who didn’t want to be told what to do, so we didn’t tell them,” says Malaney. “We simply tracked and reported the data and let the numbers change their mind. That, combined with the direction of key medical staff who led their colleagues to understand the importance of the program, made this collaboration possible.”

“Physicians have not seen this program as being told how to treat their patients, instead we have seen it as a way to improve,” says Dr. Stephen Orr, an ophthalmologist and EDOC committee member. “The EDOC program was introduced by Blanchard Valley Health System in a very gradual way to ensure everyone was on board, then BVHS held a series of continuing medical education (CME) events that collaborated with the phase-in of the project and gave doctors time to understand and adapt to the program.”

Part of that phase-in included finding “physician champions” to invite participation from area physicians to get them on board, says Pat Beham, EDOC program director.

“The way we went about the system helped create collaboration,” says Dr. LeRoy Schroeder, endocrinologist and EDOC committee chair. “First, we formed a committee of a wide range of specialists and subspecialists to decide what conditions to begin reviewing. The committee then looked at evidence-based guidelines for the management of these conditions and this data was reviewed against recorded data for each physician. The findings were then discussed with each physician on a quarterly basis and educational sessions were provided to help improve standards of care.”

The EDOC has helped alert physicians to best practices for treating diabetes, and increase the number of patients with controlled blood pressure from 50% to 64%. According to Beham, the program has also led to additional initiatives to improve local health care, including working with Whirlpool Corporation to be the pilot site for a patient-centered medical home program.