Maine Quality Counts Podcast

Sue Butts-Dion: Quality Improvement • What is one small change your practice has tested that has gone well? • What is one item your practice is struggling with or feel like you need more support for? Steve Meister, MD: ADHD, Attachment and Trauma

1. Communication Skills & Difficult Converstions/Behavioral Health Integration Review Trauma-Informed care Discuss integration strategies for behavioral health and chronic pain management Demonstrate responses to Choosing Wisely’s 5 Questions 2. Nonopioid & Nonpharm Treatments for Acute & Chronic Pain Evidence-based review of alternative treatments for acute & chronic pain Discuss comprehensive acute pain management plans & reduce surgical overprescribing This activity has been planned and implemented in accordance with the Essentials and Standards of the Maine Medical Association Committee on Continuing Medical Education and Accreditation through the partnership of Maine Medical Education Trust and the Maine Independent Clinical Information Service (MICIS). The Maine Medical Education Trust is accredited by the Maine Medical Association to provide Continuing Medical Education (CME) activities for physicians.

Alice Horowitz: UUsing Health Literacy to Improve Children’s Oral Health OBJECTIVES (3): 1. Provide background on oral health literacy and why health literacy is an important topic for engaging patients. 2. Discuss what a health literacy environmental scan is and how it fits into a health literate organization. 3. Highlight approaches to evaluating practices and health systems for being health literate/user friendly. 4. Discuss how we can use health literacy strategies to implement USPSTF recommendations around fluoride and engage families in this critical part of their health care. 5. Show examples of how to connect with pregnant moms and infants around oral health

1. Practice Transformation & QI for Opioids/Chronic Pain -Review best practices in practice transformation for opioid prescribing -Focus on team-based care including developing “CSI” (controlled substance initiative) teams 2. Harm reduction: diagnosis & treatment of opioid use disorder including MAT, naloxone prescribing, and risks of co-prescribing benzodiazepines -Appropriately diagnose opioid use disorder -Understand requirements and benefits of buprenorphine and naltrexone prescribing -Anticipate prescribing naloxone for all patients and families at risk Presented by the Maine Independent Clinical Information Service (MICIS). In 2017 MICIS has 6 clinical modules on Improving Opioid Prescribing and Patient Safety, with two modules covered in each webinar in this 3-webinar series. These modules are standalone topics and attendees can register for any or all of these webinars.

Dr. James Wiley and Dr. Jan Powell talk about the lessons learned in the previous National AAP ADHD Pilot and how we can apply these lessons to the CALM Project here in Maine. We will also learn more about ADHD medication management. Objectives: 1. Develop a deeper understanding of medication management for children with ADHD. (Dr. Wiley) 2. Highlight lessons learned from previous AAP ADHD project and coaching strategies (Jen Powell)

1. The Genesis of the Opioid Crisis: "How We Got Here." Trace the origin of the opioid crisis in America Review CDC opioid prescribing guidelines   2. Opioid Basics: MMEs & Tapering Calculate morphine milligram equivalents & evidence behind limits Discuss reduction strategies Elisabeth Fowlie Mock, MD, MPH, FAAFP From Holden, Maine, Elisabeth received her doctorate from Vanderbilt Medical School and a Master of Public Health in Health Policy and Administration from UNC-Chapel Hill. She attended Colby College and Emory University. She is Board Certified in Family Medicine and works part-time as a Hospitalist at EMMC. She is active in leadership of the Maine Academy of Family Physician

This webinar addressed how Vermont is building treatment capacity for substance use disorder including how the Hub and Spoke Model was built in Vermont including identifying priorities, policy and payment issues. It provided an overview on key lessons learned in Vermont that can be spread to other states looking to increase access to Medication Assisted Treatment

OBJECTIVES (3): Elevate the health of children by measurably improving the screening, diagnosis, and treatment for Attention Deficit and Hyperactivity Disorder (ADHD). To achieve improved care for children with ADHD, this learning collaborative Improving proper ADHD diagnosis and management so that patients are assessed for ADHD using a validated instrument across multiple major settings; parents of patients diagnosed with ADHD are given an educational ADHD booklet; and patients diagnosed with ADHD are prescribed behavior therapy.

Objectives: Describe the burden of HPV disease. Define the importance of HPV vaccination for cancer prevention. Explain the rationale for vaccinating youth at ages 11 or 12. List the updated recommendations for administering the HPV vaccine to girls and to boys. Provide useful and compelling information about HPV vaccine to parents to aid in making the decision to vaccinate. Locate resources relevant to current immunization practice.

The cost of ED utilization and the link to unnecessary ED utilization has often been addressed by trying to decrease the use of unnecessary ED visits. However, research has shown that attempts to lower ED utilization costs simply by diverting low acuity visits away from the ED may be misguided; that a focus on guiding a patient’s treatment course using risk stratification and best practice versus “risk reduction treatment” may be much more impactful.  Working to employ strategies to reduce utilization by high ED utilizers utilizing Complex Care Plans and Care Coordination also has the potential to create win-wins both in terms of reducing costs and improving patient care. This webinar will discuss these aspects of ED utilization and discuss the various ways to have the greatest impact on ED associated costs, while briefly touching on the positive effects treating patients in this way can have on provider and patient satisfaction.

Listen as Dr. Silk explains: What factors contribute to practice improvement in pediatric primary care oral health integration. Implement examples from Qualis Health and other states in terms of oral health care in the pediatric setting. Motivate and engage other team players for full buy-in of oral health integration for children in the medical setting.

On January 1, 2017, Psychiatric Collaborative Care Management Services(CoCM) were implemented by Medicare to support providers in the integration of behavioral health care with primary care. Join this webinar, hosted by Mary Jean Mork, LCSW, VP of Integrated Programming at Maine Behavioral Healthcare and MaineHealth, to explore the details of CoCM services and how this model of can enhance your practice of primary care by partnering with behavioral health services.