WHA Physician Leaders Council Discusses PDMP, AHCA

Council provides feedback on WHA members’ integrated physician enterprise needs

May 19, 2017

The WHA Physician Leaders Council met May 11 and discussed a range of topics impacting physicians and physician practice within WHA’s member hospitals and health systems, including:

  • Latest developments on the American Health Care Act (AHCA), including WHA policy priorities and advocacy strategies;
  • Prescription Drug Monitoring Program (PDMP) functionality and efforts to expedite interoperability of PDMP data with EHRs;
  • A continued dialogue on how WHA can best support its members’ integrated physician enterprise now and in the future;
  • Building on the WHA Physician Engagement and Retention Toolkit, identifying additional resources to help physician leaders and organizations engage and retain their physicians;
  • WHA budget advocacy to expand graduate medical education (GME) program funding; and,
  • Rulemaking on standards for level III and IV trauma facilities.

AHCA Update

WHA President/CEO Eric Borgerding and Jenny Boese, WHA vice president, federal affairs and advocacy, provided a report to the Council on the latest developments related to the AHCA in both Washington, DC and Madison, including WHA policy priorities and advocacy strategies. WHA along with hospital and health system leaders were in Washington, DC May 9 and met with both of Wisconsin’s U.S. senators. The key message of those meetings was the need to make key improvements to the AHCA in the Senate to protect Wisconsin’s coverage gains.

For more information about the AHCA and WHA’s discussions with Wisconsin’s U.S. senators, click here..

PDMP Functionality and Interoperability

Matthew Stanford, WHA general council, provided the Council with an update on ongoing discussions with state officials regarding the Prescription Drug Monitoring Program (PDMP), including efforts to expedite interoperability of the PDMP data with electronic health records (EHRs), clarify requirements and address delegation issues.

Stanford discussed the WHA letter signed by WHA Physician Leaders Council Chair Steve Kulick, MD, requesting additional clarity regarding physician discipline related to the PDMP mandate, and the subsequent resolution by the Controlled Substances Board that provided additional clarity regarding that Board’s intent to use discretion in making referrals to licensing boards for non-compliance with the mandate (see story here).

Stanford also shared joint efforts by WHA and the Wisconsin Medical Society to clarify the ability of physicians to satisfy the PDMP review mandate by delegating the review to another individual as permitted by existing principles of medical delegation, as well as other clarifying language intended to create additional options for EHR connections to the PDMP data. (See story on the joint memo submitted by WHA and the Wisconsin Medical Society to the Controlled Substances Board and the Board’s action below.) Additionally, during the meeting, the Joint Finance Committee unanimously approved a recommendation to amend the state budget bill to include that clarifying change in statute regarding medical delegation (see story here).

Council members continued to talk about the benefits of having access to the PDMP database, but also raised concerns about the length of time the web-based PDMP can take to use as well as the utility and effectiveness of some of the alerts provided by the PDMP. For example, one member said for an average child psychiatrist seeing 25 patients per day, the total time that it takes to access the web-based PDMP adds up to around an hour of extra time in the physician’s work day. Others noted that especially for physicians in a multi-specialty clinic setting, some of the ePDMP alerts were not useful or created false positives. By moving to a flexible approach to interoperability with EHRs that focuses on the sharing of data and enabling providers to choose what analytics are most relevant to their practice, some of these concerns could be addressed.

Council members also expressed interest in learning more about newly available PDMP functionality for medical coordinators and supervisors. WHA staff said it would work with the Department of Safety and Professional Services (DSPS) to organize a WHA webinar for physician leaders that can better introduce and explain the new PDMP functionality.

WHA activities supporting members’ integrated physician enterprise

The Council continued a dialogue from its last meeting on how WHA can best support its members’ integrated physician enterprise now and in the future. The Council is a key component of WHA’s efforts to continuously define and identify how best WHA can meet members’ needs in support of members’ integrated physician enterprise.

"As WHA’s members’ focus has evolved beyond the traditional ‘walls’ of the hospital to a presence as local and regional integrated health systems, WHA’s focus has similarly evolved," said WHA Chief Medical Officer Chuck Shabino, MD. "The physician component of our members’ enterprise is significantly larger, and WHA has been evolving to respond to those changes by enhancing WHA activities to incorporate, from the system prospective, physician issues, opportunities and initiatives."

Physician retention and engagement

Building upon the 2016 WHA Physician Engagement and Retention Toolkit, the Council discussed the need for additional education or resources to help physician leaders and their organizations further engage and retain their physicians. Staff presented and sought feedback on potential options WHA could develop and provide to help physician leaders and their organizations regarding engagement and retention. In the coming weeks, look for additional announcements from WHA on new engagement and retention resources for physician leaders.

Legislative and regulatory update

WHA staff provided an overview of several additional current WHA legislative and regulatory advocacy efforts impacting physicians and physician practice within WHA’s member hospitals and health systems.

One of WHA’s budget advocacy efforts is to increase Wisconsin’s investment in the state’s GME matching grant program to help expand access to GME programs in Wisconsin.

"Wisconsin’s aging physician workforce and aging patient population is creating challenges for the state’s health care delivery system. Data shows Wisconsin needs between 2,000 and 4,000 additional physicians by 2035," said Shabino. "We know that graduate medical education is a key factor in where physicians end up practicing, and funding GME is a successful model to recruit and retain physicians in Wisconsin."

Andrew Brenton, WHA assistant general counsel, provided an update to the Council on developing rulemaking that would impact level III and IV trauma centers, and in particular sought input from the Council regarding draft proposed standards that would place specific responsibilities on physicians. Brenton told the Council WHA staff has been working with the Department of Health Services (DHS) since DHS first proposed the development of a new rule in 2016 and that the rule has several more steps to go, including a public hearing, before the rule is finalized. Brenton said WHA will keep the Council informed as the rule further progresses.

This story originally appeared in the May 19, 2017 edition of WHA Newsletter