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Improving Patient Care – Panel Management

There is no doubt you have a great deal of clinical data available within your office or practice, however, many providers aren’t using this data effectively to care for patients, especially those with chronic conditions. Panel management may be a tool your office can use to more effectively care for these patients. 

What is panel management?
Panel management groups patients with similar needs to improve their quality of care and health outcomes.1 By using a patient registry or other similar database, providers, administrators or non-medical staff members can help manage routine aspects of care.

Panel management creates a system where patients are systematically identified for gaps in care, preventive services or chronic condition management. These systems can flag suboptimal lab values, prescriptions that have not been renewed, needed vaccinations or referrals that have not been made.

Panel management-type approaches have been effective in helping improve delivery of preventive and chronic care for diabetes and cardiovascular disease.2 In an underserved population seeking care at federally supported health clinics, panel management significantly increased the number of patients who met clinical targets for LDL cholesterol after one year.3

Implementation
To start, you will need to use your available resources for clinical data – usually an electronic health record reporting feature or an existing registry – to identify a group of patients with certain conditions (e.g., diabetes or hypertension) or in a specific population (e.g., approaching one year of age for a childhood immunization program).

If you do not have these resources in place, don’t worry. Health Net Federal Services (HNFS) offers access to Provider Connect – Patient View, an online tool that provides civilian primary care managers (PCMs) and their staff data to help achieve cost and quality of care improvements.

Provider Connect – Patient View offers integrated outreach tools to alert PCMs gaps in patient care and provide patient-specific care recommendations.

Selecting a Target Population

Health Net Federal Services, LLC (HNFS) has several ongoing initiatives related to improving the quality of care for our beneficiaries. Of particular interest are the following targeted patient groups:

  • Patients, age 51–75, who have not had one or more appropriate screenings for colorectal cancer, such as: a fecal occult blood test within the last 12 months, a flexible sigmoidoscopy within the last 60 months, a colonoscopy within the last 120 months, a fecal DNA test within the last one or three years, or a computed tomography colonoscopy within the last five years.
  • Female patients, age 52–69, who have not had at least one mammogram in the previous 24 months.
  • Female patients, age 24–64, who have not had at least one Pap smear, also known as a Pap test, in the past 36 months.
  • Patients, with Type 1 or Type 2 diabetes, age 18–75, who have not had at least one HbA1c blood test within the past 12 months, at least one LDL-C blood test during the past 12 months and at least one retinal eye exam during the past 24 months.

Measuring Performance
Determine your practice’s current level of performance for each measure (for TRICARE beneficiaries, this data is available throughProvider Connect – Patient View ). Then decide which condition(s) or preventive measure(s) to address and establish a performance goal and target date. For example, 85 percent of beneficiaries with diabetes will receive an HbA1c and LDL-C blood test within 12 months, or 80 percent of age-appropriate women will receive a mammogram within the next eight months.

Improve the Quality of Care
Select an evidence-based intervention and work with your staff to engage them and assign responsibilities.

  • Recommend preventive screening and regular diabetes care to every appropriate patient according to accepted guidelines and your office policy. 
  • Create reminder systems for patients, and follow-up by phone or mail.
  • Offer a variety of resources, such as videos, social media or flyers. 
  • Make it easy for patients to schedule appointments by having convenient test locations, making phone calls to arrange services or allowing patients to make appointments via the Internet.

Panel management can be easily modified based on your practice size, patient needs and available resources. Take the first step today to begin improving patient care.

Stay Healthy with Health Net Federal Services

1. The New York City Department of Health and Mental Hygiene. (June 2011). Implementing Panel Management to Improve Patient Care. Vol. 30(2):9-14. Available from http://www.nyc.gov/html/doh/downloads/pdf/chi/chi30-2.pdf 
2. Neuwirth, E, Schmittdiel J, Tallman K, Bellows J. (Summer 2007). Understanding Panel Management: A Comparative Study of an Emerging Approach to Population Care. The Permanente Journal. 11(3): 12:20. Available from http://xnet.kp.org/permanentejournal/SUM07/panel-management.pdf 
3. Pollard C, Bailey KA, Petitte T, Baus A, Swim M, Hendryx M. (2009). Electronic patient registries improve diabetes care and clinical outcomes in rural community health centers. J Rural Health. 25(1):77-84. Available from http://onlinelibrary.wiley.com/doi/10.1111/j.1748-0361.2009.00202.x/pdf