Collaborating with leaders across Vanderbilt to address important Pop Health initiatives, the Population Health Project Management Office (PMO) team helps the Vanderbilt Medical Group (VMG) proactively reach out to patients, communicate best clinical practices and equip patients to close gaps in their care. In calendar year 2021, the team focused on wellness visits, standard assessments, immunizations, disease management and cancer screenings—and hit its reach goal. Of the 25 total measures on the pillar plan, the team met target in 19.
In pediatrics, the team did well in measures for asthma medication, immunization, depression screening and well visits; for women’s health, scores were favorable for cancer screenings, preventive visits, HPV immunization and depression screening; for adult primary care, goals were reached in cancer screenings, diabetes A1c control, Annual Wellness Visits and depression screenings.
The team’s 2022 quality preventive care pillar measures are similar to 2021, with many of the same measures being the focus of expanded focus clinics. Five new active measures were added, including a study of COVID-19 in pregnancy.
"We are working with health IT and marketing to build tools to empower patients to act on preventive care," explains Jeremey Whitaker, Manager of the VMG PMO. "At least once a year, we want to send patients their health care checklists so they know what to focus on and give them the tools to self-schedule for screenings. We want to empower patients to own and act on this information more easily."