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Vanderbilt and affiliates receive $18.8 million innovation award to improve health care, reduce costs for chronic conditions

June 15, 2012

Vanderbilt University Medical Center and its affiliates have received preliminary notice of a three-year, $18.8 million grant to improve chronic disease management for patients with high blood pressure, heart failure and diabetes.

The Health Care Innovation Award from the Centers for Medicare and Medicaid Services (CMS) is one of the largest federal research grants awarded to VUMC investigators. The funding will support the implementation and evaluation of MyHealthTeam (MHT), a model of team-based care that couples collaborative health care teams with health information technology in order to improve control of chronic conditions.

“The receipt of this award brings to fruition years of thoughtful innovation, preparation and successful pilot programs in population-based disease management by our clinicians and Biomedical Informatics experts. They have been the architects for this exciting effort that, together with our affiliates, will provide carefully coordinated management for these costly and devastating chronic diseases,” said Jeff Balser, M.D., Ph. D., Vice Chancellor for Health Affairs for Vanderbilt University and Dean of the Vanderbilt University School of Medicine.

“The initiative will focus on management of these high-risk, high-cost conditions among patients from 18 rural and urban counties in Tennessee and Kentucky. The health care teams involved in this project will include Vanderbilt affiliate hospitals Maury Regional Medical Center, NorthCrest Medical Center and Williamson Medical Center,” said C. Wright Pinson, MBA, M.D., Deputy Vice Chancellor for Health Affairs and CEO of the Vanderbilt Health System.

Specifically, the initiative aims to help patients improve control of their blood pressure and blood glucose, reduce hospital re-admissions, emergency room visits and reduce the cost of care.

“This project will provide Vanderbilt and its partners an opportunity to implement and rigorously evaluate an innovative new model of inter-professional care that holds promise to improve the effectiveness, overall quality and efficiency of health care," said principal investigator Robert Dittus, M.D., MPH, Associate Vice Chancellor for Public Health and Health Care and the Albert and Bernard Werthan Chair in Medicine.

The care management model is based on best practices from Vanderbilt Affiliate hospitals and the MyHealthTeam@Vanderbilt initiative. The new technologies to support care management are derived from a range of Vanderbilt clinical technologies that have been successfully applied across a spectrum of in-patient, out-patient, and regional efforts designed to coordinate care.

“In this effort, we are bringing together the best care practices and the finest clinical skills from across our community,” said Mark Frisse, M.D., Project Management Officer and Director of Regional Informatics at Vanderbilt. “Technologies we at Vanderbilt have developed to manage medical information in our hospitals and clinics and to exchange information across entire communities will allow our regional clinical community to improve care using their own best practices and electronic medical record systems. We are excited to develop a collective approach to care management based on the best practices of our entire affiliate network.”

Pioneering national studies and Vanderbilt experience show that better care management improves the health of patients with a range of chronic illnesses. These improvements translate into fewer serious complications, including heart attack and stroke and fewer trips to the clinic, hospital and emergency room. This, in turn, lowers clinic waiting times and improves access for other patients in need of acute care.

Jim Jirjis, M.D., MBA, Chief Medical Information Officer and Medical Director of Adult Primary Care, predicts that this initiative will lower costs and demonstrably improve quality at every practice and facility participating in this regional effort.

“The key to this program is that care extends outside of the exam room into the patient’s realm,” Jirjis said. “It involves collaborative development of a clear plan of care with the patient, the provider and the care team.”

The investigators estimate that by achieving better control and reducing hospital visits, the project will result in health care savings of $38 million including a savings of $27 million to CMS.

Dittus is also the Senior Associate Dean for Population Health Sciences, Professor of Medicine, and Director of the Institute for Medicine and Public Health. Jirjis is an Assistant Professor of Medicine and of Biomedical Informatics and Chief Medical Information Officer. Frisse is the Accenture Professor of Biomedical Informatics and Professor of Management.

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