l ast August, Johns Hopkins Community Physicians opened its first specialty practice in Virginia, extend-

ing a network of nearly 40 primary care and specialty outpatient sites that stretches across the Baltimore–Washington metro area.

The creation of the Johns Hopkins Community Physicians Ballston Medical Center in the Ballston neighborhood of Arlington, Virginia, is a boon for area patients, offering general and orthopaedic surgery, gastroenterology, and more. But a footprint in densely populated Northern Virginia also makes sense strategically for Johns Hopkins Medicine. A wider referring network benefits both its community and academic hospitals and specialists. And the Maryland Medicare waiver makes out-of-state business attrac-tive, because the resulting revenue is not capped as in-state revenue is.

The need to engage physician col-leagues throughout Johns Hopkins Medicine in supporting the organi-zation’s strategies at a time when the health care environment is rapidly changing is why the Office of Johns Hopkins Physicians was formed. Led by William Baumgartner, the office represents providers across the enterprise, at its core the full- and part-time faculty in the school of medicine, those employed by Johns Hopkins Community Physicians (JHCP) and those employed in Johns Hopkins Medicine hospitals and outpatient sites. Three years ago JHCP came together with the Clinical Practice Association (CPA) to create the Office of Johns Hopkins Physicians.

The CPA, formed in 1997 pri-marily to handle billing and other physician practice needs, represents some 2,000 faculty physicians and is led by Baumgartner. JHCP’s ori-gins date to 1982, but it took its current name in 2003 and includes some 360 primary care and special-ist providers.

integrating expertiseJHCP has benefited from the CPA’s expertise in billing, improving JHCP’s collection rates and helping its revenue cycle, says Steve Kravet, JHCP’s president and vice president of the Office of Johns Hopkins Physicians. The faculty physicians in the CPA have, in turn, learned from JHCP’s expertise in using Epic, the electronic medical record, and analytics to measure quality and efficiency.

At the same time, joining the CPA and JHCP under a common umbrella is a significant step toward health system integration, one of Johns Hopkins Medicine’s six strate-gic priorities.

Patients are the ultimate benefi-ciaries, says John Flynn, the Office of Johns Hopkins Physicians’ vice president and executive director of the CPA. Links between community physicians and faculty physicians strengthen and extend the continu-um of care. Common practice stan-dards increase quality. A shared elec-tronic medical record allows primary care providers in JHCP to schedule patients for appointments directly in many specialists’ schedules, improv-ing access by saving time and effort for patients, and boosting compli-ance with follow-up care. Improving access, Flynn notes, is a major focus of the Office of Johns Hopkins Physicians going forward, with tele-medicine offering new opportunities to care for patients both efficiently and effectively.

“There are many problems that patients come in for that can be handled remotely,” says Paul Scheel, director of the Division of Nephrology, who is heading up Johns Hopkins Medicine’s telemedi-cine efforts. “Telemedicine also gives primary care physicians the power to consult with specialists direct-ly—say, by sending an image of a patient’s rash—rather than sending the patient to a specialist. The pri-mary care physician stays in charge

of the patient’s care and coordinates it. That’s better for the patient and better for the physician.”

Working Together amid UncertaintyHealth care reform presents chal-lenges to Johns Hopkins Medicine and its individual providers. Although no one can predict pre-cisely how payment reform in particular will play out, all provid-ers will be affected. Because both the Affordable Care Act and the Maryland Medicare waiver financial-ly reward health systems for keep-ing patients healthy and out of the hospital, improving efficiency in the ambulatory setting has become an important strategic focus now for the Office of Johns Hopkins Physicians.

Having a shared electronic medi-cal record allows measurement of cancellation rates, number of patients seen in a day, resource use and other measures of efficiency.

“Being on Epic has given us the opportunity to develop common standards of practice across the ambulatory setting,” Kravet says.

—Christina DuVernay

Introducing the Office of Johns Hopkins Physicians

February 2015

For and about members of the Office of Johns Hopkins PhysiciansbestPractice

introducing Best Practice

welcome to the inaugural issue of Best Practice, from the Office of Johns Hopkins Physicians.

like CPA News, which it replaces, Best Practice will showcase excellent clinical work and issues of importance to clinicians in the Clinical Practice Association. but its scope will be wider, reflecting the role of the Office of Johns Hopkins Physicians in clinical integration. In this publication we will feature work done across the enterprise, including our colleagues in Johns Hopkins Community Physicians and all physicians who work in Johns Hopkins hospitals and ambulatory sites.

I welcome your story ideas and comments.

best regards,

william A. baumgartner, M.D.The vincent l. Gott Professor of Cardiac Surgeryvice Dean for Clinical AffairsPresident, Clinical Practice AssociationSr. vice President, Office of Johns Hopkins Physicians

Johns Hopkins Medicine • all children’s Hospital • Johns Hopkins Bayview medical center • Howard county General Hospital • The Johns Hopkins Hospital • Sibley memorial Hospital • Suburban Hospital • Johns Hopkins clinical Practice association • Johns Hopkins Community Physicians • Johns Hopkins medicine • All Children’s Hospital • Johns Hopkins Bayview medical center • Howard county General Hospital • The Johns Hopkins Hospital • Sibley memorial Hospital • Suburban Hospital • Johns Hopkins Clinical Practice Association • Johns Hopkins community Physicians • Johns Hopkins Medicine • all children’s Hospital • Johns Hopkins Bayview medical center • Howard county General Hospital • The Johns Hopkins Hospital • Sibley Memorial Hospital • Suburban Hospital • Johns Hopkins clinical Practice association • Johns Hopkins community Physicians • Johns Hopkins Medicine • all children’s Hospital • Johns Hopkins Bayview medical center • Howard county General Hospital • The Johns Hopkins Hospital • Sibley Memorial Hospital • Suburban Hospital • Johns Hopkins clinical Practice association • Johns Hopkins Community Physicians • Johns Hopkins medicine • all children’s Hospital • Johns Hopkins Bayview Medical Center • Howard county General Hospital • The Johns Hopkins Hospital • Sibley Memorial Hospital • Suburban Hospital • Johns Hopkins clinical Practice association • Johns Hopkins Community Physicians • Johns Hopkins Medicine • all children’s Hospital • Johns Hopkins Bayview medical center • Howard county General Hospital • The Johns Hopkins Hospital • Sibley memorial Hospital • Suburban Hospital • Johns Hopkins clinical Practice association • Johns Hopkins Community Physicians •

Sibley memorial HospitalSibley memorial Hospital • Suburban Hospital • • Suburban Hospital • Johns Hopkins Johns Hopkins clinical Practice associationclinical Practice association • Johns Hopkins Community Physicians • • Johns Hopkins Community Physicians • Johns Hopkins medicineJohns Hopkins medicine • All Children’s Hospital • • All Children’s Hospital • Johns Hopkins Bayview Johns Hopkins Bayview medical centermedical center • • medical centermedical center • medical centermedical center Howard county General HospitalHoward county General Hospital • The Johns Hopkins • The Johns Hopkins

Sibley memorial HospitalSibley memorial Hospital • • Suburban HospitalSuburban Hospital • Johns Hopkins • Johns Hopkins Clinical Practice Association • Clinical Practice Association • Johns Hopkins community Physicians Johns Hopkins community Physicians Johns Hopkins Medicine • Johns Hopkins Medicine • all children’s Hospitalall children’s Hospital • • Johns Hopkins Bayview Johns Hopkins Bayview medical centermedical center • • medical centermedical center • medical centermedical center Howard county General HospitalHoward county General Hospital • The Johns Hopkins • The Johns Hopkins Hospital • Sibley Memorial Hospital • Hospital • Sibley Memorial Hospital • Suburban HospitalSuburban Hospital • • Johns Hopkins Johns Hopkins clinical Practice associationclinical Practice association • • Johns Hopkins community PhysiciansJohns Hopkins community PhysiciansJohns Hopkins Medicine • Johns Hopkins Medicine • all children’s Hospitalall children’s Hospital • • Johns Hopkins Bayview Johns Hopkins Bayview medical centermedical center • • medical centermedical center • medical centermedical center Howard county General HospitalHoward county General Hospital • The Johns Hopkins • The Johns Hopkins Hospital • Sibley Memorial Hospital • Hospital • Sibley Memorial Hospital • Suburban HospitalSuburban Hospital • • Johns Hopkins Johns Hopkins clinical Practice association clinical Practice association • Johns Hopkins Community Physicians • • Johns Hopkins Community Physicians • Johns Hopkins medicineJohns Hopkins medicine • • all children’s Hospital all children’s Hospital • Johns Hopkins Bayview • Johns Hopkins Bayview Medical Center • Medical Center • Howard county General HospitalHoward county General Hospital • The Johns Hopkins • The Johns Hopkins Hospital • Sibley Memorial Hospital • Suburban Hospital • Hospital • Sibley Memorial Hospital • Suburban Hospital • Johns Hopkins Johns Hopkins clinical Practice associationclinical Practice association • Johns Hopkins Community Physicians • • Johns Hopkins Community Physicians • Johns Hopkins Medicine • Johns Hopkins Medicine • all children’s Hospitalall children’s Hospital • • Johns Hopkins Bayview Johns Hopkins Bayview medical centermedical center • • medical centermedical center • medical centermedical center Howard county General HospitalHoward county General Hospital • The Johns Hopkins • The Johns Hopkins

Sibley memorial HospitalSibley memorial Hospital • Suburban Hospital • • Suburban Hospital • Johns Hopkins Johns Hopkins clinical Practice associationclinical Practice association • Johns Hopkins Community Physicians • • Johns Hopkins Community Physicians •

This newsletter is published bimonthly for the Office of Johns Hopkins Physicians by Johns Hopkins Medicine Marketing and Communications. Send items to the editor at 901 S. Bond St., Suite 550, Baltimore, MD 21231. Phone: 410-502-8902

For and about members of the Office of Johns Hopkins Physicians

OFFICE OF JOHNS HOPKINS PHYSICIANSPresident: William Baumgartner, M.D. MARKETING AND COMMUNICATIONSSenior Vice President: Dalal Haldeman, Ph.D., M.B.A.Director of Communications and Design: Michael KeatingEditor: Christina DuVernayWriters: Karen Blum, Christina DuVernayDesign: David Dilworth

To read the newsletter online, please go to http://www.hopkinsmedicine.org/news/publications/_docs/best_practice.pdf

© 2015 The Johns Hopkins University and The Johns Hopkins Health System Corporation

Thrive After Go-LiveTHE TR AINING EMPHAS IzES qUICK wAYS TO NAvIGATE EPIC AND

ESTAblISH EFF ICIENT wORK FlOwS FOR DOCUMENTATION.

Robert Kass, medical director for Johns Hop-kins Community Physicians’ Westminster of-fice, received training for Epic when it rolled

out in 2013. But even though he and his colleagues were taught shortcuts to use the system’s various features, “if you don’t use them right away, you for-get them,” he says.

Now, after a dedicated “Thrive After Go-Live” educational session that reviewed Epic features, Kass built in these adaptations to more easily enter referrals and lab and radiology orders.

“We all could benefit from improving our effi-ciency,” he says. “Even if you walk away with two to three time-savers, it’s going to make a difference.”

Kass is one of 51 Johns Hopkins Community Physicians participants since May who have taken the trainings, adapted by Johns Hopkins Community Physicians directly from Epic to increase efficiency. “What we discovered was that physicians had gaps in their understanding of the system,” says Tiffani Freeman, Johns Hopkins Community Physicians’ assistant director of opera-tions training. Early Epic trainings highlighted specific features but didn’t necessarily explain how to fit them into daily work flow, she says. Some of the earliest Epic users missed out on train-ing enhancements added later, and some provid-ers wanted to achieve the comfort level they had with the prior electronic medical record system, says Cheryl Godsey, Johns Hopkins Community Physicians’ senior instructional design and develop-ment specialist.

In a six-hour, small-group class at the Wyman Park office, trainers and physician leaders explain quick ways to navigate Epic, establish efficient work flow for documentation, order labs, use the patient portal MyChart and get the most from communi-cation tools, such as Staff Messages and In Basket, which processes notes about items like prescription refill requests and lab results. The last two hours of class are allocated for hands-on time to customize

Epic, create templates for letters, and get one-on-one assistance.

Some sessions have been organized by spe-cialty and include a Johns Hopkins Community Physicians physician expert in Epic functions. This way, pediatricians can learn to use features specific to their specialty from another pediatri-cian, or a gyn/ob from another gyn/ob. “We also invite everyone to share best practices, to cre-ate a growing body of knowledge,” says Maura McGuire, Johns Hopkins Community Physicians’ director of education and training. “Even our toughest customers come out saying, ‘I learned something.’”

It’s been so successful that Johns Hopkins Medicine leaders have adapted the trainings too. Cystic Fibrosis Center Director Peter Mogayzel helped design a two-hour class for his department that focused on documentation efficiency.

“People have gotten the hang of using Epic, but I don’t think they’ve maximized its potential,” Mogayzel says. As physicians become more famil-iar with the system, there are more features to tap into, he says.

Ongoing training is “part of the Epic blue-print,” says John Flynn, director of clinical prac-tice improvement, but the question is timing. “You have to let people explore the system for a while and then learn to be more efficient.”

The Office of Johns Hopkins Physicians has developed two 2.5-hour courses focusing on doc-umentation efficiency and In Basket management (see box at right). Training sessions have been scheduled for each month through April. Anyone interested in attending may sign up through the ambulatory course catalog.

—Karen Blum

For more information, contact Chelsea Lange at clange9@jhmi.edu.

Epic trainer Cheryl Godsey shows physician Sujay Pathak a shortcut in documenting patient encounters.

Upcoming Training Sessions

DOcUmenTaTiOn eFFiciency

The Documentation Efficiency class will review using and customizing SmartTools, using SmartSets and Sticky Notes, adding orders to preference lists, and organizing the Meds and Orders and the Problem list sections.

Tuesday, Feb. 24, noon to 2:30 p.m. in the Johns Hopkins Outpatient Center, ll241

Tuesday, March 24, noon to 2:30 p.m. in the Johns Hopkins Outpatient Center, ll241b

Thursday, April 23, noon to 2:30 p.m. in the Johns Hopkins Outpatient Center, ll241b

in BaSkeT

The In basket class will review completing messages, searching completed messages and viewing another clinician’s In basket. Users also will learn how to create quickActions in order to handle In basket messages more efficiently.

wednesday, March 11, noon to 2:30 p.m. in the Johns Hopkins Outpatient Center, ll231D

Monday, April 6, noon to 2:30 p.m. in the Johns Hopkins Outpatient Center, ll231D

bestPractice

bPR141215 best Practice Feb 2015