Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Health Care Quality topic
No spam. Unsubscribe anytime.
San Joaquin Health Centers reports large QIP gains, credits standing orders and 'gap' clinics
Summary
San Joaquin Health Centers officials said preliminary 2024 quality incentive program results show marked improvement versus prior years and that standing orders, targeted outreach and new dashboards drove gains; final audit is due in August.
San Joaquin Health Centers reported a sharp rise in quality-incentive performance over the last three years, and preliminarily said its 2024 results exceed the measure set by the QIP program.
John Diuglio, chief medical officer for San Joaquin Health Centers, told the Health Care Services Review Project Committee on Oct. 15 that the system went from roughly 58% in 2021 to 78% in 2022, 88% in 2023, and is “preliminarily scoring 43 out of 40 measures” for 2024. He said the 2024 results are projected to link about $78,000,000 to the county health system pending a final audit in August.
Diuglio said the improvements were driven by new dashboards that show performance at system, clinic and individual clinician levels, extensive quality-led outreach to patients with care gaps, standing orders that allow trained clinical staff to initiate certain preventive services, and “gap clinics” that exclusively schedule patients with outstanding care needs.
The standing-order model began in October 2022 with colorectal cancer screening, Diuglio said, allowing staff to counsel patients, place Cologuard orders under the primary care provider’s name, mail kits and record completed screening results in the EHR. “Once this worked ... it went down to mammograms, hemoglobin A1c for diabetes, etcetera,” he said. Diuglio described the approach as an effort to “decrease the burden for their clinical staff” and to address measures outside of a routine visit.
Diuglio also reviewed recent recruitment: an internal medicine physician from the San Joaquin General Hospital residency, two family medicine physicians arriving this month, two family nurse practitioners who started last month, two hybrid pediatricians (hospital rounds plus clinic), two certified nurse midwives added for obstetrics, and an OB-GYN joining clinic services in October. He said recruitment is ongoing and that he conducts “probably conservatively 5 to 10 interviews a week.”
Committee members asked about the speed of the Cologuard improvement. Diuglio said the colorectal screening standing order went into effect in October and the clinics met the measure within about a year, and “in about a year and a half, we went from not meeting it to overperforming.”
Diuglio added that the program is “outcome driven” and “patient centered,” emphasizing early detection for cancer screenings as the primary objective rather than chasing metrics.
The committee did not take a formal action on the presentation; Diuglio said the final QIP audit is due next month.
