PHA lean tools help a rural, Southern Indiana FQHC surpass CMS Healthy People 2020 goals for diabetes management
Woodlawn Hospital earns Exemplary Practice status for successful TCM implementation
Lean Daily Improvement helps improve chronic care management enrollment at multiple sites
Five Indiana Critical Access Hospitals demonstrate competency to receive top lean designation from Purdue
Multi-specialty healthcare provider establishes protocol to assess opioid prescriptions for older adult patients
Northeast Indiana primary care applies practice transformation tools to hit MIPS metrics
History & Programs
|2005||The Healthcare Technical Assistance Program (H-TAP) was founded by Purdue University's Technical Assistance Program, the Regenstrief Center for Healthcare Engineering at Purdue, and the Indiana Hospital Association. Initially, the nonprofit program focused on lean training and population health assessments.|
|2010||With federal grant funding, HTAP established the Purdue Regional Extension Center (PurdueREC) to provide direct technical assistance to providers who were eligible to report to the CMS EHR Incentive Payment Program (see summary below). Associated health IT security reviews, scans and risk assessments were provided as well. HTAP continued to certify learners in Lean and Lean Six Sigma for healthcare.|
|2012||HTAP's name was changed to Purdue Healthcare Advisors (PHA).|
|2014||PHA was awarded funds to oversee technical assistance and consultation for four programs: the Indiana Medicaid Promoting Interoperability (PI) Program; the Lean Healthcare Transformation Initiative (LHTI); the Great Lakes Practice Transformation Network (see summary below); and Healthy Hearts in the Heartland (see summary below). The Lean First process improvement program was initiated.|
|2017||As a subcontractor for Altarum Institute, which was awarded CMS funds to implement the Quality Payment Program Resource Center (QPP-RC) for the Midwest, PHA staffed and maintained an Indiana QPP help desk.|
|2018||PHA's work with State of Indiana was expanded to address several clinical challenges impacting, smoking, long-term care and the opioids crisis. The LHTI added a second cohort of participating organizations, and funding for its first cohort was extended.|
PHA launched PHA Direct, an online platform for instruction, coaching and community building. PHA created an online version of its Lean Daily Improvement Facilitator Training & Certification course. Through the LHTI, five critical access hospitals were certified lean by PHA. PHA began work to help one rural Indiana community respond to prescription opioid abuse through the Empowered Communities grant, and two urban communities respond to the opioids crisis through the Small Care Neighborhood-Opioids Response grant funded by the state. Additional state funding allowed PHA to work with two Indiana cities through the Small Care Neighborhood-Long Term Care grant to improve transitions of care between hospitals and long-term care facilities.
|2020||PHA lean experts started work on the chronic care management of congestive heart failure at an Indiana hospital through the Quality Process for Health Improvement grant.|
Purdue Regional Extension Center (PurdueREC)
Purdue Healthcare Advisors was one of 62 Regional Extension Centers nationwide chosen by the Office of the National Coordinator for Health IT (ONC) to implement the 2010-2015 Health IT Regional Extension Center (REC) Cooperative Agreement Program authorized by the Health Information Technology for Economic and Clinical Health Act (HITECH).
Funded by a $13M grant from the ONC to support and accelerate the efforts of primary care providers to become meaningful users of electronic health records (EHR), PHA provided information, guidance, and technical assistance to 71 Indiana hospitals and assisted more than 3,200 provider-clients, the majority assisted through the grant and others through fee-for-service work. PHA helped majority of eligible providers in the State of Indiana navigate the EHR adoption process from vendor selection and workflow analysis to implementation and Meaningful Use (MU).
During the programmatic years, PHA helped its PurdueREC-registered providers secure more than $200M in MU incentive payments from the Center for Medicare and Medicaid EHR Incentive Payment Plan, which is now called the Medicare Promoting Interoperability Program. The PurdueREC guided more than 25% of the state's primary care providers to MU compliance, and 25 Critical Access Hospitals (CAHs) and 5 rural hospitals to MU compliance; and helped more than 89% of Federally Qualified Health Clinics throughout the state. All of the PurdueREC's rural and CAHs implemented an EHR, and 83% achieved the MU standard, while 98% achieved the first milestone. In addition, the PurdueREC was recognized nationally for excellence with regard to grant sustainability efforts, most notably around the areas of Health IT privacy and security.
Three milestones marked the progress of healthcare providers along the Stage 1 MU compliance timeline:
- Eligible providers reached Milestone 1 when they enrolled in the program. 2,937 providers enrolled, which exceeded the goal of 2,200 providers, including 30 CAHs.
- Eligible providers reached Milestone 2 when they implemented this reporting. 2,686 providers implemented this reporting, which exceeded the goal of 2,200, including 30 CAHs.
- Eligible providers reached Milestone 3 when they successfully attested to MU by demonstrating their EHR usage met specific thresholds for key objectives. 2,201 providers successfully attested, which stands at 100% of the goal.
Healthy Hearts in the Heartland (H3)
Purdue Healthcare Advisors was one of seven universities and healthcare-industry partners that participated in Healthy Hearts in the Heartland (H3), a research program from 2015-2017 that focused on quality improvement and the prevention of strokes and heart attacks. Funded by a $15 million grant ($1.4M to PHA) from the Agency for Healthcare Research and Quality (AHRQ) and led by the Northwestern University Feinberg School of Medicine, H3 aimed to help providers in three states to use population-based tools and implement performance-measurement software in order to improve the overall health of their patient population.
As an H3 partner, PHA provided provide hands-on coaching to 60 small practices in Indiana on point-of-care support for Million Hearts© cardiovascular measures as well as support geared toward optimizing EHR clinical decision functionality, such as clinical decision support rules, and preparation for the coming changes to quality reporting and financial-incentive programs. PHA provided participating practices with direct assistance focused on six targeted specific heart-health measures required by the EvidenceNOW project and aligned with the Million Hearts initiative. These measures also fall within the scope of clinical quality measures associated with Meaningful Use (MU) and the Physician Quality Reporting System (PQRS).
Principal Investigator: Abel Kho, MD
IRB# STU00201720, AHRQ# HS 023921-01
Northwestern University Center for Health Information Partnerships
Great Lakes Practice Transformation Network (GLPTN)
Purdue University was among 32 partners (three Regional Extension Centers; seven other universities; three State Departments of Health; and five regional Health Information Exchanges) in the Great Lakes Practice Transformation Network (GLPTN) led by the Indiana University School of Medicine, which was awarded $46.4M in September of 2015 by the U.S. Department of Health and Human Services to implement the CMS Transforming Clinical Practice Initiative (TCPi).
From 2016 to 2020, GLPTN's lead organization in Indiana ― Purdue Healthcare Advisors ― guided more than 3,000 of the 15,000+ GLPTN-participating clinicians through the CMS-identified phases of patient-centric practice transformation necessary to effectively participate in value-based payment systems. Faculty experts from Purdue University and seven other schools partnered with PHA's Quality Improvement Advisors (QIAs) to help 50+ clinics, health centers and practices meet associated TCPi milestones as well as self-identified clinical and operational goals. QIAs worked on the providers' schedules to enhance clinician participation in the Physician Quality Reporting System; establish chronic care management programs within practices and leverage new Medicare billing code changes; provide clarity on Quality Payment Program reimbursement adjustments; and provide exclusive access to CMEs and other opportunities through Support & Alignment Networks.
In the 20-page 2019 GLPTN Indiana Program Summary, Purdue Healthcare Advisors offers a programmatic overview and areas where the network impacted transformation; quality; TCM and CCM; and innovation. It also lists the network's CMS Indiana Exemplary Practices, organizations that transitioned to an APM, and individuals who received lean training certification.
Principal Investigator: Malaz Boustani, MD
Indiana University School of Medicine
Funding Opportunity Number CMS-1L1-15-003 U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services