New Coordinated-Care Tools for High-Risk Asthma Patients Improving Health, Costs

Asthma is among the illnesses CHOC is focusing on as a component of its population health initiative. (Other acute care conditions of focus include: bronchiolitis, community acquired pneumonia, acute gastroenteritis, headache and acne.) As a prevalent health care problem in Southern California, asthma results in emergency (ED) visits, hospital admissions, school days missed and administration of complex medications to manage the condition.

In an effort to better coordinate care for these patients, CHOC recently reviewed the data on how frequently children with asthma go to the ED and what their physicians are doing to care for them.  After identifying the care gaps, CHOC provided physicians with clinical care guidelines and tools to help them implement the guidelines. CHOC has also created a patient registry, which helped identify patients who required an asthma action plan. CHOC demonstrated an 18% reduction in ED visits, year-over-year, for patients in their largest primary care practice, CHOC Clinics, which coordinates care for 27,000 of Orange County’s highest risk children.

CHOC Children's

CHOC also identified a subset of its highest-risk Medi-Cal patients with asthma (cohort of 178 children with frequent ED visits, hospitalizations, and/or use of oral steroids) and enrolled them in the CHOC Breathmobile program, a mobile asthma clinic. Over a 15-month period CHOC saw a reduction of:

  • ED visits from 104 to 12
  • Hospital admissions from 13 to 0

As part of CHOC’s comprehensive pediatric system of care, the organization has shifted its approach to become a “promoter of population health,” rather than focusing only on hospital care. To that end, CHOC is outreaching to practicing pediatricians to help them better coordinate care for their patients. The new guidelines and tools to coordinate care for high-risk asthma patients is just one example of how this shift is truly improving children’s health and lowering health care costs.

For more information, please contact Dr. Mike Weiss or Shahab Dadjou, CHOC’s division of population health, at 714-509-9229.

Pingmd, Secure Texting App: Q&A with Dr. Grant

CHOC Children’s has partnered with pingmd, a secure, HIPAA
compliant messaging app, which allows you to securely send text messages, videos and images to our specialists available within the network. We spoke with Dr. Kenneth Grant, pingmd physician champion and assistant division chief of gastroenterology/nutrition division at CHOC, to provide us with the latest on this new tool.

Dr. Kenneth Grant

Q: What are the main benefits of using pingmd?

A: Communication is much more efficient with this platform, and less likely to interfere with normal workflow. The triage of messages is also more efficient.

Q: What has your experience been so far with the new app?

A: Phenomenal. I can respond to a lot more requests in a more timely manner. I can use my smart phone, tablet or computer. The app has been working very consistently and speed has notably improved recently.

Q: Do community physicians have direct access to CHOC specialists with this tool?

A: Yes, once a community physician provides his/her email and practice affiliation to CHOC Business Development, the physician will then receive an invitation to pingmd. Once signed up, community physicians have access to the directory of CHOC specialists who are actively using pingmd. Messages are marked when sent and viewed. The app makes it clear when a user is offline. The CHOC specialists concierge is also available on pingmd, or by calling 714-509-4013.

Q: Is there a cost to sign up?

A: There is no cost for CHOC physicians or community physicians.

Q: Who should physicians contact to learn more or to sign up?

A: Please contact CHOC Business Development at 714-509-4329, or, provide your email, address and practice info to lcastelo@choc.org.

 

CHOC Children’s Network: An Update on Our Progress

CHOC Children’s has made tremendous progress on our strategic goal to create a comprehensive system of care for population health management.  Our efforts have centered, in large part, on building CHOC Children’s Network, a community of primary and specialty care pediatric providers who are dedicated to a new model of care designed to improve outcomes and enhance the patient and family experience.

Most recently, CHOC’s division of population health announced the first primary care practices to join CHOC Children’s Network:  Sea View Pediatrics, Southern Orange County Pediatric Associates, CHOC Primary Care Clinics and Pediatric & Adult Medicine, Inc. With 14 pediatricians and two nurse practitioners, Sea View Pediatrics has been serving children and families in four locations in south Orange County since 1973.  Southern Orange County Pediatric Associates, comprised of 12 pediatricians and four nurse practitioners in four offices, has been in practice since 1977. The CHOC Primary Care Clinics, with more than 15 pediatricians in four locations, have been serving the children and families of Orange County since 1965.  Pediatric & Adult Medicine, Inc., comprised of nine pediatricians in one location, has been serving the children and families of Orange County since 1978.

CHOC Children's Network

These practices will serve as the nidus for innovative care model redesign that includes care teams and enhanced clinical collaboration. CHOC looks forward to the new relationship with these providers and to advancing a coordinated pediatric system of care focused on proactive illness prevention, chronic, acute and post-acute care, as we continue to offer a broad range of opportunities for physicians to better align with CHOC.

In addition to the growing CHOC Children’s Network, the organization’s $17.8 million Centers for Medicare and Medicaid Innovation “Transforming Clinical Practice Initiative” population health award is progressing nicely. CHOC, in partnership with Rady Children’s Hospital-San Diego, has enrolled more than 100 percent of its targeted physicians (1,453); and collaborated with them to complete innovative practice assessments aimed at identifying opportunities to enhance clinical care, and built six evidence-based clinical care guidelines for common pediatric conditions. These guidelines are being embedded in EMR systems to help guide clinical best practices.


Check out the video below with Dr. Mike Weiss, physician executive lead, population health at CHOC;  Dr. James Korb, medical director, CHOC Primary Care Clinics; and Dr. Jan Johnson and Dr. Eric Ball, from Sea View and SOCPA respectively, on what this exciting initiative will mean for their patients and families.

*Pediatric & Adult Medicine, Inc. joined CHOC Children’s Network shortly after this video was created.


For more information about CHOC Children’s Network, please contact Dr. Mike Weiss or Shahab Dadjou, CHOC’s division of population health, at 714-509-9229.

Join us May 21 for Orthopaedic Medicine: What Every Pediatrician Should Know

Education on performing routine exams on knees, back and hips; diagnosing common upper and lower extremity issues; and ways to improve the patient referral process from PCP to orthopaedic specialists are among the topics featured at an upcoming conference hosted by CHOC Children’s. We spoke with Dr. Afshin Aminian, medical director of the CHOC Children’s Orthopaedic Institute, about what guests can expect on May 21.

Q: What is the importance of the “Orthopaedic Medicine: What Every Pediatrician Should Know” conference?  

A: Orthopaedic injuries and musculoskeletal problems are common problems that our general practitioners see on a routine basis. They range from newborn hip screening exams to diagnosis of overuse athletic inures and scoliosis screening exams, among other common issues. We hope that we can partner with our attendees to provide them some valuable, interactive education so that they feel confident when facing these issues with their patients.

Q: What will attendees be able to take away from your presentation on the management of back pain and scoliosis?

A: The incidence of back pain is on the rise in adolescents, and scoliosis is very prevalent in adolescent females. Our attendees will develop an algorithm for diagnosis and management of back pain in children and be able to succesfully perform a scoliosis screening exam.

Q: What can attendees expect at the breakout sessions?

A: The break out sessions will feature hands-on training on performing musculoskeletal exams and a chance for one-on-one tutorials with the expert group leaders.

Q: When should a pediatrician refer a patient to a pediatric orthopaedic specialist? 

A: Referral guidelines will be discussed in an open forum style with audience participation and input. The referral guidelines currently on the CHOC website, will then be updated for ease of access to our referring physicians.


An internationally-recognized and sought-after expert in pediatric orthopaedics, Dr. Aminian has presented at numerous conferences and meetings in the United States and abroad. His clinical interests include scoliosis surgery, treating spinal deformities in children, and assessing surgical correction in relationship to patient outcome in radiographic parameters. Dr. Aminian is board certified in orthopaedic surgery, and is affiliated with the Pediatric Orthopedic Society of North America, the American Academy of Orthopedic Surgery and the Scoliosis Research Society.


“Orthopaedic Medicine: What Every Pediatrician Should Know” will be held on May 21, from 8 a.m. to 5 p.m., at CHOC Children’s Hospital, in the Harold Wade Education Center.

CHOC designates this live activity for a maximum of 7.25 AMA PRA Category 1 Credit™. 

Click here to register and learn more.   

Why You Should be on Doximity

Often called the “Linkedin for doctors,” Doximity is considered the premier online professional network for physicians.  Doximity has created online CVs for each physician in the country, for which physicians just need to claim their profiles, verify/correct their credentials and add additional professional information.  The entire process is free and takes about 15 minutes.

Member Benefits

Physicians interested in their professional online reputations will find being Doximity members particularly helpful.  The network’s data powers the US News and World Report Doctor Finder, which is the most visited site—other than choc.org—for consumers looking up information about their physicians.

Doximity members are also invited to participate in the “Best Hospitals” reputation survey.  In fact, physicians who became members by Dec. 11, 2015 received online surveys for US News’ “Best Children’s Hospitals” in February 2016.  (Note, CHOC is listed as Children’s Hospital of Orange County and the Mission Viejo campus is listed as CHOC at Mission Hospital.)

Other benefits of being on Doximity include:

  • researching and connecting with other physicians;
  • keeping up with the latest medical literature. (Doximity provides members access to several hundred peer-reviewed medical journals and high-quality consumer media sources, including NPR, Wall Street Journal and New York Times. Articles appear in members’ feeds based on selected interests, reading habits and specialties.);
  • communicating with other members via a HIPAA-compliant messaging platform that is integrated with a free fax line that allows users to receive, sign and send faxes from their desktops or mobile devices;
  • earning free CME;
  • reviewing residency information;
  • and evaluating salary information by specialty and geographic area in the US.

Colleague Connect

CHOC is partnering with Doximity’s Colleague Connect, a physician marketing program designed to enhance the hospital’s brand reputation—and its doctors’ reputations— among the physician community. The program’s key element is having physicians serve as brand ambassadors (physicians prefer hearing from colleagues rather than hospitals).  CHOC’s marketing and communications department is partnering with physician leaders to create personal messages targeted to carefully chosen physician audiences.  The goal is to introduce the physicians and CHOC, and have the recipients add the physicians as colleagues on Doximity.

When physicians are added as colleagues, they are essentially placed in a physician’s personal network.  This means the physician and CHOC have preferred placement in that physician’s search, and information about the physician and CHOC are more likely to be viewed by the physicians with whom they are connecting.  According to Doximity, this can lead to enhanced reputation and increased referrals.

Taking an Active Role

If you’re interested in partnering with CHOC’s Marketing and Communications Department on the Colleague Connect program, please contact Mellisa Henry, marketing director, at mhenry@choc.org.  The program doesn’t require much of your time.  You do need to permit CHOC to send colleague requests on your behalf, and either review or—if so inclined—write the colleague introduction messages.  If you have additional questions, please contact Mellisa, who can also put you in touch with a practicing physician who leads the hospital partnership program at Doximity.