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Delaware Cancer Consortium Quality Cancer Care Committee APPROVED – Minutes January 20, 2015 Delaware Technical Community College, Terry Campus - Dover, DE 10:00 AM – 11:30 AM Attendees Members Did Not Attend Attended Attended Did Not Attended Attend Attended Attended Did Not Attend Attended Did Not Attend Did Not Attend (was at ED&P) Attended Did Not Attend Attended Attended Christopher Frantz, MD, A.I. DuPont Hospital for Children Nicholas Petrelli, MD, Helen F. Graham Cancer Center Kathleen Burt, Nanticoke Hospital James Monihan, MD, Allied Diagnostic Pathology Consultants, PA Edward Sobel, DO , Quality Insights of Delaware Sean Hebbel, The Wellness Community – Delaware Michelle Sobczyk, Leukemia/Lymphoma Society Anna Maloney, Delaware 2-1-1 Judith Ramirez, Beebe Hospital - Tunnell Cancer Center Donna Stinson, Bayhealth Medical Center Janet Teixeira, Cancer Care Connection Laura Simonelli, Helen F. Graham Cancer Center Allison Gil, American Cancer Society Cathy Scott-Holloway, Delaware Breast Cancer Coalition Staff & Committee Liaisons Attended Katie Hughes, Division of Public Health – Comprehensive Cancer Control Program Ciera Lints, Division of Public Health - Comprehensive Cancer Control Program Attended Staff I. Call to Order: Review/Approve Minutes Dr. Christopher Frantz was unable to attend the meeting so in his absence Dr. Nicholas Petrelli convened the Delaware Cancer Consortium Quality Cancer Care Committee at 10:00 A.M. The committee reviewed and approved the minutes from the November 17, 2014 meeting with no changes. Dr. Petrelli announced he will have Dr. Scott Siegel present his perspective on Transition of Care at the March committee meeting. Dr. Petrelli reminded the committee of the Delaware Cancer Consortium Retreat on April 14 th and mentioned the topics of discussion will be Transition of Care following a Lung Screening Update in the afternoon. II. Animedix Inc. Presentation by Dr. Ashok Subramanian Dr. Petrelli introduced Dr. Ashok Subramanian, President of Animedix Inc who gave the committee a presentation on how his software works. Dr. Subramanian stated that Animedix Inc. has been working on a model for about 15 years that leverages the communication abilities of technology. Animedix Inc. has been able to translate complicated information whether it is scientific, clinical or regulatory issues to the people who need to know. Communications are core for collaboration for any type of success especially success with clinical outcomes and improved compliance. Dr. Subramanian said in the past 2 or 3 years Animedix Inc. has been working on a Coordinated Care/Transitional Care model that leverages technologies they have developed with ideas they have seen working in the marketplace and they feel they have a novel approach to issues that everyone is having in healthcare and they feel they can help with their software. Dr. Subramanian provided background information on what drove him to develop Animedix Inc. Dr. Subramanian said he has a background as an Emergency Room physician which he still practices today. Following his residency, Dr. Delaware Cancer Consortium Page 2 of 3 Subramanian did a fellowship in molecular medicine. He was very interested in basic science, and at the time 20 years ago molecular medicine was integrating with digital medicine and computers and the output and the amount of data that came through was immense and he had to decide if he was going to have a career focusing on 1 molecule and 1 disease or sit back and watch the amazing things that were happening in science and technology. Dr. Subramanian decided to be a spectator because he felt he had the ability to appreciate what was going on at a technical level and be able to communicate that to the people that were engaged in the clinical level and more importantly be able to communicate that information to those engaged with diseases and illnesses, or patients. While in fellowship, Dr. Subramanian said he developed an interest for animation, and felt animation was a way to communicate complex information to people. Dr. Subramanian stated that animations are worth millions of words that you can get across major ideas to someone very quickly. He also added that if you pair animation with contextual information you can efficiently communicate your ideas to physicians, scientists, patients or family members. Dr. Subramanian said patient education is a big component of Animedix Inc.’s work. The company has created animations for cancer, cardiovascular disease, and trainings for physicians to learn novel medicines. He reported that Animedix, Inc. has also done animation education for pharmaceutical companies as they developed new drugs, and trained investigators. Dr. Subramanian said that they use a platform called Lattice that allows them to take the content they or others have created and simulate it into contextually relevant presentations that can then be delivered to precise audiences securely which allows the presentations to be tracked to see if they are using the information, how much they are using it, and also there is a survey engine that allows feedback from the recipient which can determine how well the information was understood based on how the survey is answered. As a clinician, Dr. Subramanian said he is aware of many communication issues that clinicians deal with on a daily basis. With that knowledge and his background of IT, he felt there had to be an easier way to accomplish what is expected of a clinician and fix the communication issue. Dr. Subramanian stated that he learned of a company that has begun to thrive due to Meaningful Use Regulations and transitions to Electronic Medical Record called Scribe America. Scribe American trains individuals to be Medical Scribes. Medical Scribes are trained individuals who have been educated on medical terminology and coding who can take the burden of the documentation largely away from the clinician so the clinician can focus on patient care. The use of medical scribes also saves money as scribes are paid significantly less than a clinician. The documentation and coding improves because that is the Scribes primary function. The Scribe is directly supervised by a physician or practitioner. Dr. Subramanian pointed out that this allows the physician to spend more time with their patients and even increase their patient volume. Scribes can also focus on learning various electronic medical record systems which prevents the physician from having to devote time to learn and perfect a new system. Scribes can also assist physicians with patients. Dr. Subramanian stated that once trained Scribes can get patients drinks or blankets and take down any questions the patient or family members of the patient may have for the practitioner. Scribes can assist patients with giving them more education on what they are being seen for and ensure the patient takes their satisfaction survey which also allows for the physician to address any issues with the patient that left them unsatisfied before they leave. Dr. Subramanian has also developed a concept that’s called a Patient Champion which is a trained Medical Scribe whose job it is to take responsibility under direct supervision of parallel workflows or a “checks and balances” workflow system. Patient Champions are responsible for post discharge follow up such as contacting the patient and ensuring they carry out what was asked on their follow up plan such as following up with their Primary Care Physician, coming back to the Emergency Room if necessary, address side effects with the physician from medications if the patient is having them or even assisting with scheduling an appointment for the patient. The Patient Champion completes these follow up assessments through the parallel workflow system which is very scripted and algorithmic. The parallel workflow system allows Patient Champions to easily take over where the other has left off during shift exchanges. Patient Champions are also cross-trained as Scribes and are familiar with entering information into the Electronic Medical Record which gets approved by the physician since the physician is ultimately accountable for the information entered into the system. A Patient Champion can be considered as an extension to a Care Coordinator or Nurse Navigator without needing the knowledge of a Care Coordinator or Nurse Navigator. Scribe America is the largest provider of Scribes in the country, working in 43 different States in hundreds of hospitals with over 6,000 employees. Due to how much Scribe America has emerged educational opportunities at colleges may become available in the future however at this time Scribe America employs and trains all of their employees and contracts them out through hospitals. Dr. Ashok Subramanian has created a way for patients to take a survey that uses animations and allows the patient to see a picture of all of the practitioners that saw them with a description of their job title and a survey to rate the physician and ensure their accommodations where met. Delaware Cancer Consortium Page 3 of 3 Dr. Subramanian believes that humans need to be responsible for communication between each other, not technology. He said you can use whatever technology you want to use but without people you just have a bunch of information in several different places. When there is a network of people that know how to use systems and databases and are able to pull information out of those systems then they need to communicate it. The problem is clinicians do not have enough time to filter through DHIN or other databases. With a network of Patient Champions this information can be pulled, centralized and communicated and Patient Champions are employed to have the time to be responsible for pulling this together. Dr. Subramanian’s vision is to have a network of Patient Champions, or a Patient Champion team, whose responsibility it is to pull this information and communicate it hospital to hospital provider to provider. Dr. Nicholas Petrelli asked if Dr. Ashok Subramanian had these workflow systems in a software package. Dr. Subramanian responded with No, it’s not in a software package but it is all web based system with people using the technology already available and connecting it to Scribe Plus. Ms. Janet Teixeira asked if this program would need to be funded and piloted. Dr. Ashok Subramanian answered yes; it will be about $40,000 to pilot this program. Dr, Sobel asked who else can see the patient information? Could he link all other providers that are caring for each specific patient? Dr. Subramanian responded that they can link in the provider even if they do not use the software since that specific provider will be linked as caring for the patient. Dr. Petrelli asked to note that the pilot will be $40,000 and this may be something that is taken in front of the Advisory Council. Dr. Nicolas Petrelli adjourned the Quality Cancer Care meeting at 11:30 am. . III. Public Comment No members of the public attended the meeting. IV. Future Meetings 2015 The Delaware Cancer Consortium Retreat will be held at the Dover Downs Hotel and Casino on April 14, 2015. Delaware Cancer Consortium meetings for 2015 will be held at Delaware Technical and Community College’s Terry Campus from 10:00 a.m. - 11:30 a.m. Below is the list of meeting dates for 2015. If you have any questions or concerns please contact Ms. Katie Hughes at [email protected] or Ms. Ciera Lints at [email protected]. Delaware Cancer Consortium Quality Cancer Care Committee 2015 Future Meetings March 23 April 14: Delaware Cancer Consortium Retreat May 11 July 20 September 28 November 16