President’s Corner

KAFP President’s Letter

Moving Forward with Change

Change is inevitable. Some changes we embrace, some changes we tolerate, and some changes…well, we have various ways of expressing our displeasure with some changes.

Regardless of all of the inevitable changes that occur, our focus on our patients remains front and center. Practice change is usually on the basis of real or purported benefit to our patients.  Although the transition to ICD 10 was a challenging change, one of the positives has been the EHR search option that evolved with implementation of ICD 10. I would not have been easily able to find the social determinants of health codes included in Group 1 with my ICD 9 search efforts. The changes that ICD 10 brought enables us to code in further detail the social challenges that are barriers to our patients’ health.

Comprehensive Primary Care Plus (CPC+), with the addition of a care coordinator to our team, has given our practice the opportunity to more directly address the social determinants of health that we all recognize impact our patients and our community’s health; but we struggle to find the time and the resources to address.

CPC+ feels like an extension of PCMH, but bigger, and with more potential return. It remains patient centered, but feels more all-encompassing. It extends beyond the individual patient, outwards to the concept of community and population health.

Questions, and opportunities to address with CPC+ include:

  • What changes do we make to benefit our health community as a whole?
  • What do our patients think about these changes?
  • What do our patients want us to focus on, to their benefit?
  • What are the impediments to successful transition from hospital to home?
  • What do our patients need beyond medications (and access to those medications) to improve their chronic disease management?
  • Do our patients go to their referrals?
  • What do the consultants advise?
  • Our practice has initiated quarterly Patient Representative meetings to listen to the “voice of the patient.”

Fortunately, these challenges and many others will be addressed over a 5-year time frame. Finally, the potential rewards of CPC+ feel greater. These rewards include reimbursement based on quality care rather than volume.

Hooray for care coordinators! Our practice and our patients are blessed with the addition of a care coordinator to our practice. She has been busy from day one. Changes our care coordinator has implemented include:

  • Helping our patients get their medications after discharge from the hospital.
  • Assisting patients get the equipment that they need (Example: Patients who could not afford CPAP supplies had gone without CPAP for 1 year, before the barrier was identified, and resolved).
  • Helping patients address transportation needs, and providing information regarding community resources to help families with their loved ones.

For those of you who work with care coordinators, this is old news.  For the rest of us, this is an exciting new addition to our team.  We now have another tool to address some of the social determinant needs that we have recognized; but for many reasons, were never able to quite address.

Then there are those changes that are too slow, too cumbersome, or ineffective. EHR changes to make our day easier are all of the above. Until the driving force for EHR change is consumer driven (us), rather than driven by regulation, we will continue to be frustrated in this arena. But EHR is not going away, so learning new ways to do old tricks seems to be the mantra. Please continue to share with us your challenges in working with your EHR system. We will share these concerns with the AAFP, where the volume of our voices will be amplified.

Speaking of learning new ways to do old tricks, the KAFP continues to chart the course toward 70 years as a chapter! Please save these dates, June 14-16, 2018, to attend the KAFP Annual Meeting. This conference will include educational CME regarding medical management for our patients, clinical topics, and opportunities to interact with your friends and peers. We will have breakfast round tables where we can share our successes and challenges with our individual practice EHR systems; learning how others on the same system have addressed similar challenges.

In January we start quarterly Wellness Wednesday Webinars: one-half hour lunch teleconference meetings. Mark your calendars for January 31 and April 4, 2018 from 12:15 – 12:45 p.m. These meetings will give us the opportunity to listen and share with experts and our peers regarding physician well-being. Dates for the summer and fall Wellness Wednesday Webinars will be set soon and promoted through the eNewsletter.

Throughout the 2018 Kansas Legislative session, the KAFP will send updates on issues of relevance. These issues can be positively impacted by your communication to your legislators.  Please take the time to share your voice. It will make a difference.

I hope that you were able to enjoy the holidays and have maintained the momentum after hitting the reset button at the first of the year. My wish for you in 2018 is positive change!

Stay in touch.  Please, please put the KAFP Annual Meeting on your schedule: June 14-16. 2018, Overland Park Marriott Hotel. Your attendance and participation will be rewarded in many ways.


Dr. John

John Feehan, MD, FAAFP
Olathe, KS