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The Art & Practice of HVC
  • About this Course
  • Course Details
  • Class Surveys
  • Week 1: Intro to Value-Based Care
    • Overview
    • Assignments Week 1
    • Orientation
    • Session 1
    • Session 2
  • Week 2: Value-Based Healthcare Delivery
    • Overview
    • Assignments Week 2
    • Session 3
    • Session 4
  • Week 3: Improving Value at the Bedside
    • Overview
    • Assignments Week 3
    • Session 5
    • Session 6
  • Week 4: Improving Value in Systems
    • Overview
    • Assignments Week 4
    • Session 7
    • Session 8
    • Final Project
  • Optional Deep Dives
    • Equity & HVC
    • Narrative Medicine & HVC
    • Hot Spotting & Value Stewardship
    • Pharma & HVC
    • Organizational Culture & HVC
    • Quality Control
    • Reality of Bundled Payments
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  • Syllabus
  • Required Readings (PDFs)
  • Further Instructions & Resources:

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  1. Week 2: Value-Based Healthcare Delivery

Assignments Week 2

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Last updated 4 years ago

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Syllabus

Monday

Tuesday

Wednesday

Thursday

Friday

VBHC: Mod 4 (1˚10')

Class (2 hrs)

VBHC: Mod 5 (1˚)

Class (2 hrs)

Mini-Reflection

Mini-Pres*: PCMH vs IPU

Learn more about the

Read about another affiliate clinic (PDF below)

Opt: Reflecting on Hotspotting and Value Stewardship

Required Readings (PDFs)

Further Instructions & Resources:

  • Mini-Pres: PCMH vs. IPU

    • All students (1˚): Please read the articles below and be prepared to discuss tomorrow. (Note: these are extra resources in the Dell Modules)

    • Student Discussion Leaders (2˚): You will be leading a short class discussion on PCMH vs IPUs. The articles in the Dell Modules are a few years behind, so you are tasked with finding updated information on these models. We have included some articles as a jumping off point and expect you to look for additional articles to prepare yourself to lead a discussion. To assist you, the course leaders can distribute some discussion questions to asked of the class.

  • Opt: Reflecting on Hotspotting and Value Stewardship

    • Optionally review the two other Atul Gawande pieces mentioned (and heavily critiqued) in the article, What the Healthcare Debate Still Gets Wrong. Facilitators can choose to assign all or some of these articles and decide whether to compare/contrast the arguments made by Gawande vs. Gaffney. Essentially, Gawande's articles discuss how "overdiagnosis and overtesting" (argued in OverKill & Cost Conundrum) and "super utilizers," (argued in The Hot Spotters) are huge contributors to healthcare waste and gross overspending in the U.S. whereas Gaffney, in review of Uwe Reinhardt's book, suggests that healthcare pricing and policy are principally responsible. By the way, a recent NYT piece (also included) highlights how recent research into hotspotting programs shows they are not as effective at reducing healthcare costs as everyone hoped.

  • Intro to the Choosing Wisely campaign:

    • Facilitators can decide which society guidelines to recommend to students. In the May 2020 elective's Thursday discussion section, UNC students heard from Dr. Alice Ma (renowned hematologist), so we chose hematology society guidelines (also because she contributed to their development). In her talk, she discussed the innovative, IPU-like Bleeding Disorders clinic that she helps run at UNC. It is an affiliate clinic with the Foundation for Women & Girls with Bleeding Disorders, and multiple institutions across the country boast such institutions. Further reading has been provided, as well as the link to Dr. Ma's talk.

* (2˚)

Click for May 2020 recorded talk with

ACP: (30')

Peruse website, (15')

CW Society Guidelines:

by Atul Gawande (1˚) (PDF below)

CW Society Guidelines:

(1˚) (PDF below)

(45')

(30')

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(30')

American Medical Home Runs
IPU, Part 1
IPU, Part 2
Association of High-Cost Health Care Utilization with Longitudinal Changes in PCMH Implementation
The PCMH: Expensive and in Need of Repair
2013 Review on PCMH
2017 Evaluation of PCMHs
American College of Physicians, page on PCMHs
2017 RCT on IPU
Intro to Choosing Wisely
here
Dr. Alice Ma
Eliminate Healthcare Waste
"WellMed"
TeamSTEPPS
American Society of Hematology
FWGBD
"Overkill"
American Society of Hematology-American Society of Pediatric Heme/Onc
"The Strategy that will Fix Healthcare"
"What the Healthcare Debate Still Gets Wrong"
2MB
OverKill - Atul Gawande.pdf
pdf
Monday Reading 1
218KB
The Strategy That Will Fix Health Care.pdf
pdf
Monday Reading 2
1MB
The Cost Conundrum _ The New Yorker.pdf
pdf
Cost Conundrum
3MB
Finding Medicine’s Hot Spots _ The New Yorker.pdf
pdf
Hotspotters - Who are the Pts?
5MB
These Patients Are Hard to Treat - The New York Times.pdf
pdf
Hotspotting
587KB
Multidiscp. Bleeding Disorders Clinic.pdf
pdf
More info on Bleeding Disorders Clinics