Electronic Access to Expert Medical Knowledge: Bringing Mayo’s Expert Medical Knowledge to the World Points of Contact: Lorraine Uthke, (507) 358-1671, uthke.lorraine@mayo.edu; Molly Cain, (507) 255-8455, cain.molly@mayo.edu Groups Involved in the Project: eHealth Care Delivery Platform, Affiliated Practice Network Submitted by LTJG Brooke Chumley 17 May 2013 Executive Summary: The Mayo Clinic has entered the healthcare consulting market with an innovative grouping of services that will differentiate them from the competition. With the goal of touching 200 million lives by 2020, the Mayo Clinic is reaching out to provide quality care, anytime, anywhere. The Mayo Clinic Care Network consists of 17 members in 2 countries, 12 states, and 1 territory. Through strategic partnerships alone Mayo has expanded its medical impact by more than one million patients since 2011 and the network is growing every month. Mayo’s healthcare consulting services along with access to the Mayo Clinic knowledge database and direct access to clinical experts provide members of the Mayo Clinic Care Network a one stop solution for process improvement, clinical queries and expert medical advise from Mayo physicians that is not available from any other consulting firm in the industry. Electronic Access 2 Objective of the Best Practice The Mayo Clinic has been looked to as the source for expert medical knowledge since the late 1800s when it became the world’s first not-for-profit integrated group practice. The Mayo brothers travelled the world to search out unique medical knowledge and find new surgical techniques. In Rochester, the Mayo Clinic opened its surgical suite for observation to any physician as a means to share the new knowledge and techniques learned through their travels (Mayo Clinic, 2013). Today, as it was then, Mayo’s culture is to provide the best care possible to patients through education, innovation, and sharing medical knowledge. The electronic age has brought forth a new means of information sharing and has allowed Mayo physicians to assist in providing care to patients around the world. Mayo physicians currently touch the lives of more than 20 million patients every year through its current operations. Mayo has set a goal to touch the lives of 200 million patients every year by 2020 (Mayo Clinic, 2013). Through the exploitation of technology and carefully chronicling the expert care provided at Mayo the goal is becoming reality. Background In 2010, Mayo began to expand their clinical reach by introducing the Mayo Clinic Care Network. The Mayo Clinic Care Network would be an ever-expanding group of affiliated medical centers and group practices in a non-ownership relationship with the Mayo Clinic. Each member site is able to use the Mayo Clinic Care Network brand and logo for marketing, publications and signage. Each site also has access the vast knowledge available from the Mayo Clinic through the use of provider-to-provider electronic secure messages, the AskMayoExpert online tool, and access to a team of healthcare and business consultants. After extensive vetting and internal reviews the first members were inducted in spring of 2011. Today there are 17 Mayo Clinic Care Network members. The first international Care Network member, Medica Sur, in Mexico, was inducted in May 2013 (Mayo Clinic, 2013). Figure 1, shows the locations of affiliate sites. The stars and areas in yellow represent the Mayoowned facilities; green designates a Care Network member. Figure 1. Electronic Access 3 All Mayo Clinic Care Network members receive the same core package of services with variations in volumes based on the size of the member’s organization. Use of the Mayo Clinic Care Network Brand and logo make up the largest part of the subscription fee. Members are provided unlimited access to AskMayoExpert and are provided limited eConsults and access to health care consultants. AskMayoExpert is an online resource that delivers Mayo Clinic expert vetted knowledge, expert contact information for Mayo sub-specialties, answers to common clinical questions, and more than 130 disease care process models that provide a selectable algorithm for clinical decision making at the point of care (Mayo Clinic, 2013). eConsults provide a means for external physicians to ask focused clinical questions regarding diagnosis, therapy, or second opinions to Mayo’s sub-specialty physicians. Members are provided 5, 10, or 20 eConsults across all specialties per month based on size. Health care consultants are availble across many specialty and administrative areas on a per-hour charge basis for members. Based on size, members are allocated consulting hours per month that can be used for this service. Additional hours may be purchased as needed based on the size of the project reuquest. Literature Review Many health systems provide external consulting services and the Mayo Clinic has joined that distinguished group. The leap into the healthcare consulting landscape was done in a way that is uniquely Mayo. Instead of providing a standalone consulting service to member organizations, Mayo maintains its tradition of education and knowledge sharing. By providing direct access to its vast clinical knowledge and expert physician staff Mayo has taken the next step in knowledge management and knowledge sharing. There was no evidence of any other health system or independent firm providing a list of services similar to those provided by the Mayo Clinic. Johns Hopkins Applied Physics Lab, Geisinger Consulting Group, Cleveland Clinic Healthcare Solutions, and Kaiser Innovation Consultancy are all external consulting services provided by leaders in the health care field. Apart from the names, there are few differences in the services offered by these groups (Campbell, P, 2012; Cleveland Clinic, 2013; Geisinger, 2013; Innovation Cosultancy, 2013). Similarly, industry consulting groups who focus on health care are readily available to share information and best practices, at a price. Customers are looking for a partner organization that align with their culture, goals, and is able to complement services provided or provide service in an area that is currently lacking. Affiliation, with or without ownership, between practices increased 10 of the 12 HEDIS measures (Friedberg, 2007). Mayo provides the reputation, infrastructure, knowledge, and services that would benefit affiliates, large and small alike. Implementation Methods Mayo utilizes a proactive and reactive approach in its efforts to expand the Care Network. Potential members either request to become an affiliate or Mayo’s Affiliated Practice Network staff identify organizations to approach. No matter the method of introduction, all potential members are required to be available for a due diligence screening completed by Mayo staff. The due diligence process is an exhaustive review of the potential member’s organization to ensure the organizational culture and practice standards are in-line with Mayo. Screening for potential members includes evidentiary reporting, audits, and on-site visits by Mayo staff. No part of the organization is off limits. Thorough evaluation is done on the Electronic Access 4 organizational profile, value, safety, service, outcomes, compliance, education, governance, finance, operations, and facilities. Not all potential members successfully pass the due diligence process. Initial goals for membership are set at the beginning of each fiscal year, however, organizational culture is one of the most important factors used to determine fit. Having affiliates with a similar organizational culture is more important than reaching a numeric goal for membership. Results This type of effort has worked as an excellent marketing and brand management campaign for Mayo as it has spread the brand into states where Mayo had not previously had a presence. While this does not actually bring the Mayo Clinic practice into the market where the affiliate is located, it does provide better clinical information to the affiliate organization, improve the quality of care provided at the affiliate site, and provide a means of education and knowledge sharing that was not available before the partnership. The Mayo Clinic Care Network has worked to strengthen the Mayo brand and expand Mayo’s reputation. Through the 17 affiliate sites, Mayo has been able to reach more than one million additional patients this year. Expansion of the Mayo Clinic Care Network brings the organization one step closer to reaching the goal of 200 Million patients per year. Conclusion Implementation of this initiative has allowed Mayo to increase the quality of care provided at affiliate practices and provides benefit to Mayo through brand expansion. Increasing the core package of services over the typical consulting firm allows Mayo to better market the product and to be more selective in the organizations it chooses to affiliate with. Remaining true to tradition the Mayo Clinic has and will continue to share advances in medical practice and expand the patient population it has the ability to influence. References Campbell, P. (2012). Johns Hopkins applied physics lab partners with Hopkins medicine on $8.9 million program to improve patient safety. www.jhuapl.edu/newscenter/pressreleases/2012 Cleveland Clinic. (2013). Cleveland Clinic Healthcare Solutions. http://my.clevelandclinic.org/professionals/healthcare-solutions Friedberg, M.W., Coltin, K.L., Pearson, S.D., et.al. (2007). Does affiliation of physician groups with one another produce higher quality primary care? Journal of General Internal Medicine. 22(10): 1385-1392. Geisinger. (2013). Geisinger Consulting Group. www.geisinger.org/professionals/consulting Innovation Cosultancy (2013). Innovation Consultancy Kaiser Permanente. http://xnet.kp.org/innovationconsultancy Mayo Clinic. (2013). The Mayo Clinic. www.mayo.edu