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404th MEETING OF THE MEDICAL SCHOOL COUNCIL
3 p.m., Wednesday, November 9, 2011
School of Medicine Administration, Board Room 103
PRESENT: Drs. Akpek, Barker, Bienvenu, Carroll, Chanmugam, Claypool, Comfort, Crino, Gonzalez-Fernandez, J. Green, James Herman, Joseph Herman, Ishii, Matunis, Molinaro, Nyhan, Puttgen, Tan, Taverna, Tufaro, Williams, Wolfgang, Messrs. Johnson and Rini, Ms. Foy
ABSENT: Drs. Ahn, Ahuja, Barone, Dlhosh, Fine, Gottesman, R. Green, Keefer, Pavlovich, Poynton, Resar, Shuler, Solomon, Tis, Wade, Zachara, Mr. Mandell Ms. Matthys
GUESTS: Dr. Dillon Jones, Mss. Campbell, Pollak, and Ungar
The minutes of the October 19, 2011 were approved.
II. Chair’s Report – Dr. Ishii
Dr. Ishii reported:
1) The Medical School Council name change to Faculty Senate was presented to the Advisory Board at the October meeting and was favorably received.
2) A committee has been formed to recommend changes in the MSC By-Laws. Dr. Jude Crino will chair the working group.
3) The Institute for Excellence in Education Peer Nominated and Peer Selected Education Awards were announced with a December 1, 2011 deadline for applications. A new award honoring Lisa Heiser was also announced. The award will recognize a junior faculty member’s contribution in education.
4) The Clinical Systems Advisory Committee will next meet on November 14th. Interested faculty should contact Steve Mandell.
III. Johns Hopkins Medicine 3.0 – Ms. Joanne Pollak, Senior Vice-President and General Counsel
As background, Ms. Pollak gave a brief history of her involvement in health care issues as a member of a private law firm prior to joining Johns Hopkins. As the landscape was rapidly changing due to the managed care frenzy in the early 1990’s, the University and Hospital were frequently on different sides of health care issues. It was in the best interest of both institutions to come together to speak as one in this rapidly changing environment. A virtual entity, Johns Hopkins Medicine (JHM) was created with certain powers delegated to JHM by both the Johns Hopkins Hospital (JHH) and the Johns Hopkins University Board of Trustees. In January 1996, JHM was created with Dr. Edward Miller as Dean of the Medical Faculty and CEO of JHM, followed by the appointment of Ronald Peterson as President of the JHH and Johns Hopkins Health Care System (JHHS). Over time additional hospitals were brought into the system with the expansion of the JHHS which today includes the JHH, Johns Hopkins Bayview Medical Center, Howard County General Hospital, Sibley, Suburban, and All Children’s Hospital in Florida. The JHHS also has limited affiliations with other local hospitals which over time might become full-fledged members of the health system.
The initial governance structure served the institutions well over the first ten to twelve years, but as the system expanded, the department directors felt more input into decision-making from the directors was required. Some 18 months ago, Dean Miller hired a consultant who studied the governance structure and met with some 40 institutional leaders. Two themes evolved from the consultant’s review: 1) JHH had not been as mindful as it should have been in decision-making and; 2) the current decision-making structure, a ten person Business Review Group, needed to expand to include additional stakeholders. The new JHM 3.0 structure creates seven operating committees: Research, Education, Managed Care and Population Health, Patient Safety and Quality, Office of Physicians, Community Division, and International Division. Each of these committees will have a working group that will make recommendations to a JHM Operating Committee which will consist of some 35 members including all Vice-Deans, 6 clinical chairs, 2 basic science chairs, MSC representation, as well as institutional leadership. Two new JHM entities; Brand Equity Committee and the Office for Transformation and Strategy have also been created.
The question of why make changes as the JHM leadership position will soon be changing was addressed. It was felt that health care reform legislation is driving payers into making reductions and JHM must be ready to respond with one voice in a complex marketplace.
The Operating Committee has met three times to date and has discussed IT initiatives (EPIC) and made the decision not to expand the JHHS at this time by acquiring another hospital.
In responding to questions it was noted that the new structure provides more faculty input than ever into decision-making and the new system can be changed if it doesn’t work.
Dr. Ishii thanked Ms. Pollak for her presentation.
IV. CPA PQRS Update- Ms. Nina Ungar, Associate Director, Contract Services and Ms. Michelle Campbell, Director Practice Management
Ms. Ungar described the Physician Quality Reporting System which allows participating physicians to receive financial incentives for reporting adherence to certain quality-related measures in treating Medicare patients. The CPA has provided assistance to faculty that compile data from multiple sources both electronic and non-electronic that generates the quality data required by the incentive program. Physicians must agree in writing to participate in the program before data is released to CMS. Hopkins received over $450,000 last year from the program. Over 540 CPA providers participated in 2010. At the present the pay for reporting program is optional but becomes mandatory in 2015, at which time Medicare payments will be reduced if physicians don’t participate. Eventually this program will merge into “pay for performance” and the earlier Hopkins gets into the program, the better we become at establishing quality measures. Dr. Baumgartner encouraged MSC members to bring this topic to faculty meetings and to encourage faculty to sign the PQRS participation form.
Ms. Campbell described the electronic prescribing initiative that began in 2009. The two approved systems at Johns Hopkins are Sunrise and Allscripts E-Prescribe. The systems provide outside medication history, formulary information, and checks for duplicate therapies and interactions. Medicare provides a combination of incentives and payment adjustments for e-prescribing. A timeline listing the incentives and penalties was presented. In order to get a Medicare credit the script must be sent electronically, it must be for a Medicare patient, and it must be in conjunction with an office visit.
Dr. Ishii thanked Ms Ungar and Ms. Campbell for their presentations.
V. Other Business
Dr. Ishii announced the following sentence will be added to the faculty appointment letter in 2012: “Would you like more information about your compensation plan”. MSC members were asked to encourage their departments to share compensation plans with faculty.
The issue of “training over-load” was brought up for discussion. Faculty feel there are too many online training requirements and there needs to be central control as to who can require online training. The MSC will seek information on the number of required courses to determine the scope of the problem.
There being no further business this meeting was adjourned at 4:55 p.m.
Mary E. Foy
Future Medical School Council meetings:
All meetings will be held in the School of Medicine Board Room (SOM 103), 3:00 to 5:00 p.m.
December 7, 2011
January 18, 2012
February 8, 2012
March 21, 2012
April 18, 2012
May 9, 2012
June 20, 2012