1. What differentiates your group from other groups in the area? For example, what do you consider to be some of the things you do better than other physician groups in the area? In other words, what do you consider to be your group’s strengths? Does your group plan to seek accreditation by NCQA?
2. What are some areas you are not as strong in as you would like to be? These might be areas in which you are at a disadvantage relative to other groups? These might be areas you are working on to improve?
3. At this point of time, what do you consider to be some of the opportunities that exist now and in the near future? (e.g., joint venture with hospitals, expand practice, financial improvement, improvement of patient care)
4. At this point in time and in coming year what threats does your group face? (e.g., reimbursement/payment, competition with other groups, relationships with health plans, internal group issues, changing demographics, legal issues)
5. We understand that in terms of care management practices, your group is doing the following:
for asthma __________________________________________________________________
for CHF ___________________________________________________________________
for depression _______________________________________________________________
for diabetes _________________________________________________________________
Are there any recent changes in these efforts that we should be aware of?
For CEO/CMO only: Do your CMPs incorporate health promotion activities, or if they do not, do you have other policies that encourage physicians to use health promotion activities?
6. Are there any other conditions for which your group has developed CMPs?
7. How is it you choose the conditions covered by CMPs and not others? How does your work in CMPs fit into your group’s overall strategy? Are there examples of CMPs that you discontinued using? Why?
8. What results have you received to date from use of these CMPs? (for example, in terms of quality of care processes, patient outcomes, patient satisfaction, utilization of resources, and financial impact on practice to date)? What has been the impact of CMPs on the physicians in your group? (for example, physician satisfaction with care, impact on other health professionals)?
9. From your perspective, what have been the primary motivators for undertaking your work on CMPs? Probe: What are some of the internal reasons? Probe: What are some of the external reasons?
10. As you consider the work you do in implementing CMP overall, what do you consider to be the primary barriers? What have you had to overcome?
11. What have been some of the primary facilitators that have helped you deal with some of the barriers and make progress in implementing CMPs? What is helping you? What are the facilitators? Probe: What would it take for you to do more?
Probe if have not covered federal and state regulations: What role, if any, have federal and state regulations played in the development and implementation of your CMPS?
Probe if have not covered corporate purchasers of health insurance: What role, if any, have corporate purchasers of health insurance played in development and implementation of your CMPS? Do they require quality data? Do they pay more for quality? Do they give quality data to their employees?
Probe if have not covered health plans: What role, if any, have health plans with which you contract played in the development and implementation of your CMPS?
Probe if have not covered electronic information technology: What role, if any, has electronic information technology (e.g., electronic medical record, e-health, automated patient reminders) played in development and implementation of your CMPS?
12. What are your immediate plans for the future in regard to CMPs? We are particularly interested in areas where you have made resource commitments or plan to make resource commitments?
13. Thank you very much for your time and insights. This has been very informative. Before we end, is there anything else that we have not covered that you think we should know about in order to understand your organization’s CMP efforts? Are there any lessons or better practices that you think would be useful to other organizations in their CMP efforts?
1. What differentiates your group from other groups in the area? For example, what do you consider to be some of the things you do better than other physician groups in the area? In other words, what do you consider to be your group’s strengths?
2. What are some areas you are not as strong in as you would like to be? These might be areas in which you are at a disadvantage relative to other groups? These might be areas you are working on to improve?
3. At this point of time, what do you consider to be some of the opportunities that exist now and in the near future? (e.g., joint venture with hospitals, expand practice, financial improvement, improvement of patient care)
4. A. At this point in time and in coming year what threats does your group face? (e.g., reimbursement/payment, competition with other groups, relationships with health plans, internal group issues, changing demographics, legal issues)
B. What do you see as the major challenge that governance confronts?
5. We understand that in terms of care management practices, your group is doing the following:
for asthma __________________________________________________________________
for CHF ___________________________________________________________________
for depression _______________________________________________________________
for diabetes _________________________________________________________________
Are there any recent changes in these efforts that we should be aware of?
6. Are there any other conditions for which your group has developed CMPs?
7. How is it you choose the conditions covered by CMPs and not others? How does your work in CMPs fit into your group’s overall strategy? Are there examples of CMPs that you discontinued using? Why?
8. What results have you received to date from use of these CMPs? (for example, in terms of quality of care processes, patient outcomes, patient satisfaction, utilization of resources, and financial impact on practice to date)? What has been the impact of CMPs on the physicians in your group? (for example, physician satisfaction with care, impact on other health professionals)?
Probe: Could you tell us a little bit about how the governing board of the group sees its role in regard to improving quality of care, outcomes of care, implementation of CMPs, and overall accountability?
Probe: What kinds of reports does the board receive about the quality and outcomes of care experienced by patients in the group?
9. From your perspective, what have been the primary motivators for undertaking your work on CMPs? Probe: What are some of the internal reasons? Probe: What are some of the external reasons?
10. As you consider the work you do in implementing CMP overall, what do you consider to be the primary barriers? What have you had to overcome?
11. What have been some of the primary facilitators that have helped you deal with some of the barriers and make progress in implementing CMPs? What is helping you? What are the facilitators? Probe: What would it take for you to do more?
12. What are your immediate plans for the future in regard to CMPs? We are particularly interested in areas where you have made resource commitments or plan to make resource commitments?
13. Thank you very much for your time and insights. This has been very informative. Before we end, is there anything else that we have not covered that you think we should know about in order to understand your organization’s CMP efforts? Are there any lessons or better practices that you think would be useful to other organizations in their CMP efforts?
1. A. From a financial perspective what has been the impact of your group's efforts to develop and implement CMPs? For example, is there any evidence that money has been saved from implementing CMPs? If so, in what areas? If not, why is this? If money is being saved by use of a CMP, who benefits – the group? the health plan(s)? the hospital(s)? What do you see as a realistic payback period for the group’s investment in CMP implementation?
B. Can you say a little bit about how much money the group has invested to date in developing and implementing CMPs? What have been the largest components of such investment? For example, educational activities, information systems, compensation incentives, etc.? How much money was required to meet one-time start-up costs? What is the annual operating budget for CMPs? Is this budget allocation considered permanent?
2. A. Could you describe for us the kinds of data that you use to prepare your various financial reports? (for example, cost, revenue, quality?)
B. To what extent, if any, do you use data related to the implementation of care management practices, quality, and outcomes of care in any of your reports? Specifically what data are reported to the group governing board - either financial or non-financial? What data do you feedback to individual doctors practicing in the group?
3. What are some of the major reasons that your group is working to develop and implement CMPs overall and in the four areas of asthma, congestive heart failure, depression, and diabetes?
4. From your perspective what have been some of the major barriers to developing and implementing CMPs? What have been some of the major facilitators, that is, things that have helped you overcome some of the barriers?
5. What role has the major health plans with whom your group contracts played in the development and implementation of CMP within your group? In what ways has their influence been helpful? In what ways has it hindered your group from making progress? To what extent do you see the group's relationship with its health plans changing in the future? In what ways and with what implications?
6. How are physicians in the group compensated? In what ways has this influenced either positively or negatively the development and implementation of CMPs within the group?
7. What future commitment has the group made to the further development and/or implementation of CMPs within the group? What specifically will you be doing this coming year? If a CMP does not save money, would you continue using it?
8. Is there anything else that you would like to share with us? For example, are there any more lessons based on your group's experience in developing and implementing CMPs that you would like to highlight? Any "better practices" that others might learn from?
1. A. Could you tell us a little bit about how the IT/IS function is organized within the group here?
B. How many people are associated with the IT/IS function? What is your annual capital budget? What is your annual operating budget?
C. About what percent of the group's annual operating budget is devoted to IT/IS in the most recent fiscal year? About what percent of the capital budget is devoted to IT/IS in the most recent fiscal year? About what percent of the IT/IS budget, both operational and capital, is committed to clinical activities such as clinical process improvement work, implementation of CMPs, quality improvement and outcomes reporting etc as opposed to financial, accounting, and administrative functions?
D. To whom do you directly report in the organization? What is the nature of your working relationships with the CEO, the Medical Director, the CAO, the CFO, and the Board of Directors in terms of the frequency of interaction and the kinds of issues that you work with them on?
2. A. Please describe for us the current state of information technology and information systems within the group? What specific functions are performed - for example, electronic patient records, any direct electronic exchange of information with patients, tests and procedures, drugs, diagnoses and treatment outcomes, health histories, etc; computerized scheduling; automated reminders; summary reports; insurance billing; payroll, etc. What decision-support tools are available to physicians in your group? To what extent and how is the Internet used in your group?
B. As you have developed your IT/IS, have you primarily purchased your system from a vendor/vendors, developed it yourself, or a mixture of both? What specific software, hardware, and interface systems do you currently use? What vendors do you use and what is the nature of your relationship with them in terms of length of contract, etc.?
3. We understand that in terms of care management practices, your group is doing the following:
for asthma __________________________________________________________________
for CHF ___________________________________________________________________
for depression _______________________________________________________________
for diabetes _________________________________________________________________
Are there any recent changes in these efforts that we should be aware of?
4. Please describe the role that IT/IS and information systems have played in the development and implementation of CMPs within your group?
5. What specific types of feedback reports, if any, do your physicians receive on their practice patterns within the group? How frequently do they receive these? What do they do with them? May we have examples of the types of reports physicians receive?
6. What have been some of the primary barriers to developing better IT/IS and information systems for the implementation of CMPs within the group? What have been some of the primary facilitators?
7. What role have the major health plans with which the group contracts played in the development and implementation of your IT/IS and information systems? In what ways have the health plans been helpful? In what ways have they hindered progress?
8. What resources do you plan to commit in the next 2-3 years to further the development and implementation of your IT/IS and information management systems within the group? What are you immediate plans this coming year?
9. What resources do you plan to commit in the next 2-3 years that are specific to the support of CMPs?
10. Is there anything else that you think is important for us to know in order to understand your group’s CMP efforts? For example, are there any major lessons that you wish to highlight or examples of "better practices" that others might learn from?
1. Could you please tell us a bit about the relationship between the hospital and the group?
2. With whom in the group do you interact? What is the nature of your working relationship with the group’s CEO, medical director, CAO, and CFO in terms of frequency and the kinds of issues that you work with them on?
3. From the perspective of the hospital, how important is the development and implementation of CMPs by the group? Why?
4. We understand that in terms of care management practices, the _____________ group is doing the following:
for asthma __________________________________________________________________
for CHF ___________________________________________________________________
for depression _______________________________________________________________
for diabetes _________________________________________________________________
Are you aware of these efforts?
5. Are there any other conditions for which your group has developed CMPs?
6. Please describe the role that the hospital has played in the development and implementation of CMPs within the group.
7. What have been the primary motivators for the group undertaking work on CMPs? Probe: What are some of the reasons internal to the group? Probe: What are some of the reasons external to the group?
8. In what ways has the hospital been a barrier to the development of CMPs in the group?
9. In what ways does the hospital help develop and implement the group’s CMPs? Probe: What could the hospital do that would allow the group to do more?
Probe if have not covered health plans: What role, if any, have health plans with whom the hospital contracts played in the development and implementation of the group’s CMPs?
Probe if have not covered electronic information technology: What role, if any, has the hospital’s electronic information technology (e.g., electronic medical record, e-health, automated patient reminders) played in development and implementation of the group’s CMPs? What kinds of data does the hospital report to the group? Who is given these data? What kinds of data and reports does the hospital receive from the group? What is done with this information? Does the hospital governing board receive a regular report on the group’s activity, and, if so, what is the content of this report?
10. What are the hospital’s immediate plans for the future in regard to CMPs? We are particularly interested in areas where the hospital has made resource commitments or plan to make resource commitments?
1. We understand that in terms of care management practices, your group is doing the following:
for asthma __________________________________________________________________
for CHF ___________________________________________________________________
for depression _______________________________________________________________
for diabetes _________________________________________________________________
Are there any recent changes in these efforts that we should be aware of?
Do your CMPs incorporate health promotion activities, or if they do not, do you have other policies that encourage physicians to use health promotion activities?
2. Are there any other conditions for which your group has developed CMPs?
3. How is it you chose the conditions covered by CMPs and not others? How does your work in CMPs fit into your group’s overall strategy? Are there examples of CMPs that you discontinued using? Why?
4. What results have you received to date from use of these CMPs? (for example, in terms of quality of care processes, patient outcomes, patient satisfaction, utilization of resources, and financial impact on practice to date)? How do you assess the impact of your CMPs? What has been the impact of CMPs on the physicians in your group? (for example, physician satisfaction with care, impact on other health professionals)? What has been the physician response to the CMP efforts?
5. From your perspective, what have been the primary motivators for undertaking your work on CMPs? Probe: What are some of the internal reasons? Probe: What are some of the external reasons?
6. As you consider the work you do in implementing CMP overall, what do you consider to be the primary barriers? What have you had to overcome?
7. What have been some of the primary facilitators that have helped you deal with some of the barriers and make progress in implementing CMPs? What is helping you? Probe: What would it take for you to do more?
Probe if have not covered health plans: What role, if any, have health plans with which you contract played in the development and implementation of your CMPs?
Probe if have not covered electronic information technology: What role, if any, has electronic information technology (e.g., electronic medical record, e-health, automated patient reminders) played in development and implementation of your CMPs?
8. What are your immediate plans for the future in regard to CMPs? We are particularly interested in areas where you have made resource commitments or plan to make resource commitments?
9. Thank you very much for your time and insights. This has been very informative. Before we end, is there anything else that we have not covered that you think we should know about in order to understand your organization’s CMP efforts? Are there any lessons or better practices that you think would be useful to other organizations in their CMP efforts?
1. We understand that in terms of care management practices, your group is doing the following:
For Asthma ___________________________________________________________
For CHF _____________________________________________________________
For Depression _______________________________________________________
For Diabetes __________________________________________________________
2. Could you say a little bit about how you work with the quality assurance director and the doctors and nurses in this group in regard to CMP development and implementation? Is there any one else in this group you work closely with in carrying out your responsibilities for implementing these care management practices?
3. As a result of your group’s implementation of CMPs, could you tell us a little bit about how your role as a nurse has changed in the last couple of years (Probe: giving advice to patients, participation in patient care teams, development of guidelines and pathways?)
4. To what extent do the nurses in your group who treat patients with asthma, CHF, depression and Diabetes use these CMPs?
For Asthma ___________________________________________________________
For CHF _____________________________________________________________
For Depression _______________________________________________________
For Diabetes __________________________________________________________
5. Do nurses in your group have the knowledge, skills, data, equipment, and support necessary to use these CMPs with their patients?
For Asthma ___________________________________________________________
For CHF _____________________________________________________________
For Depression _______________________________________________________
For Diabetes __________________________________________________________
6. From your perspective what have been some of the major barriers to the development and implementation of CMPs in your group? What have been some of the major facilitators - things that have helped you overcome some of the barriers? Are there physicians with certain characteristics that seem more likely to support CMPs?
7. Do you believe that using CMPs usually produces better patient outcomes? Do you or your group have any data to support your view?
8. Do you believe that using CMPs usually reduces the cost of care? Do you or your group have any data to support your view?
9. In your opinion, what is the future of CMPs for patients with asthma, CHF, depression, and diabetes? Will the use of CMPs increase or decrease within your group? Will the number of medical groups in your region using CMPs increase or decrease? Why?
10. Is there anything else that you would like to share with us? For example, are there any more lessons based on your group’s experience in developing and implementing CMPs that you would like to highlight? Any “better practices” that you would pass on to others
1. We understand that in terms of care management practices, your group is doing the following:
For Asthma ___________________________________________________________
For CHF _____________________________________________________________
For Depression _______________________________________________________
For Diabetes __________________________________________________________
2. What is your relationship to the process of CMP development and implementation in this group? Do you think you have too little, too much, or about the right amount of responsibility for the development of these CMPs?
3. Could you say a little bit about how you work with the quality assurance director and the doctors and nurses in this group in regard to CMP development and implementation? Is there any one else in this group you work closely with in carrying out your responsibilities for implementing these care management practices?
4. Is the use of pharmaceuticals a part of the CMPs for patients with asthma, CHF, depression, and diabetes in this medical group?
5. As a result of your group’s implementation of CMPs, could you tell us a little bit about how your role as a pharmacist has changed in the last couple of years (Probe: giving advice to patients, participation in patient care teams, negotiation with health plans over formularies?)
6. How was the pharmaceutical component of each of these CMPs agreed to in this group? Specifically, how was the pharmaceutical component developed, and how was it made a formal part of the CMP?
7. Do pharmaceutical manufacturers develop “model” CMPs for asthma, CHF, diabetes, and depression? Has your group adopted any model CMPs (with or without revisions) proposed by pharmaceutical firms? If so, which ones? In what ways has this been helpful to your group. In what ways has this caused problems?
8. From your perspective what have been some of the major barriers to the development and implementation of CMPs in your group? What have been some of the major facilitators - things that have helped you overcome some of the barriers? Are there physicians with certain characteristics that seem more likely to support CMPs?
9. Do you believe that using CMPs usually produces better patient outcomes? Do you or your group have any data to support your view?
10. Do you believe that using CMPs usually reduces the cost of care? Do you or your group have any data to support your view?
11. In your opinion, what is the future of CMPs for patients with asthma, CHF, depression, and diabetes? Will the use of CMPs increase or decrease within your group? Will the number of medical groups in your region using CMPs increase or decrease? Why?
12. Is there anything else that you would like to share with us? For example, are there any more lessons based on your group’s experience in developing and implementing CMPs that you would like to highlight? Any “better practices” that you would pass on to others
(#9, #15, #16)
1. We understand that in terms of care management practices, your group is doing the following:
For Asthma _________________________________________________________
For CHF ___________________________________________________________
For Depression ______________________________________________________
For Diabetes _________________________________________________________
2. What specifically has been your role in the process of CMP development and implementation?
For Asthma __________________________________________________________
For CHF ____________________________________________________________
For Depression _______________________________________________________
For Diabetes __________________________________________________________
3. Could you say a little bit about how you work with the President of the Medical Group, the Medical Director, the Chief Information Officer, and individual doctors and nurses in regard to CMP development and implementation?
4. From a quality improvement perspective, what has been the impact of your group’s efforts to develop and implement CMPs? For example, is there any evidence that the quality of care has been improved from implementing CMPs? If so, in what way? If not, why is this?
5. Is there any evidence that the cost of care has been reduced or increased as a result of implementing CMPs? If so, in what way? If not, why is this?
6. Could you describe for us the kinds of data that you use to prepare your various reports on quality of care? Specifically, what reports go to the group’s governing body? Does your group use profiles of physician practices to assess their performance? Are any of these data used to assess whether physicians in this group are actually using CMPs to care for patients with asthma, CHF, depression, and diabetes?
7. Again, from your perspective what have been some of the major barriers to the development and implementation of CMPs in your group? What have been some of the major facilitators - things that have helped you overcome some of the barriers? Are there physicians with certain characteristics that seem more likely to support CMPs?
8. In this group practice, were any CMPs for asthma, CHF, depression, or diabetic patients redesigned or substantially changed after initial implementation? Why were they changed?
9. Were any CMPs tried and then discontinued? Why?
10. Is the discontinuance of any other CMPs being considered? Why?
11. Does your group use CMPs for disease conditions other than asthma, CHF, depression, and diabetes? Which ones?
12. What role, if any, has electronic information technology (e.g. electronic medical record, e-health, automated patient reminders, etc.) played in the development and implementation of your CMPs?
13. In your opinion, what is the future of CMPs for patients with asthma, CHF, depression, and diabetes? Will the use of CMPs increase or decrease within your group? Will the number of medical groups in your region using CMPs increase or decrease? Why?
14. Is there anything else that you would like to share with us? For example, are there any more lessons based on your group’s experience in developing and implementing CMPs that you would like to highlight? Any “better practices” that you would pass on to others
Physician Interview: Physician Treating Patients With Asthma (#11)
1. To what extent do you use Practice Guidelines in your treatment of patients with asthma? Approximately for what percentage of your asthma patients do you use Practice Guidelines? What are the barriers preventing you and your group from more extensively using Practice Guidelines? What factors facilitate the use of Practice Guidelines by you and your group?
2. To what extent do you use Protocols or Clinical Pathways in your treatment of patients with asthma? Approximately for what percentage of your asthma patients do you use Protocols or Clinical Guidelines? What are the barriers preventing you and your group from more extensively using Protocols or Clinical Pathways? What factors facilitate the use of Protocols or Clinical Pathways by you and your group?
3. To what extent do you use Case Management in your treatment of patients with asthma? Approximately for what percentage of your asthma patients do you use Case Management? What are the barriers preventing you and your group from more extensively using Case Management? What factors facilitate the use of Case Management by you and your group? Do you find it difficult to link with community resources for Case Management of your asthma patients?
4. To what extent do you use Disease State Management in your treatment of patients with asthma? Approximately for what percentage of your asthma patients do you use Disease State Management? What are the barriers preventing you and your group from more extensively using Disease State Management? What factors facilitate the use of Disease State Management by you and your group? Do you find it difficult to link with community resources for Disease State Management of your asthma patients?
5. To what extent do you use Demand Management in your treatment of patients with asthma? Approximately for what percentage of your asthma patients do you use Demand Management? What are the barriers preventing you and your group from more extensively using Demand Management? What factors facilitate the use of Demand Management by you and your group? Do you find it difficult to link with community resources for Demand Management of your asthma patients?
6. To what extent do other physicians in your group who treat asthma patients use these CMPs?
7. Do physicians in your group have the knowledge, skills, data, equipment, and support necessary to use these CMPs?
8. In this group practice, were any CMPs for asthma patients redesigned or substantially changed after initial implementation? Why were they changed?
9. Were any CMPs for asthma patients tried and then discontinued? Why?
10. Is the discontinuance of any other CMPs being considered? Why?
11. Do you believe that using CMPs for asthma patients usually produces better patient outcomes? Do you or your group have any data to support your view?
12. Do you believe that using CMPs for asthma patients usually reduces the cost of care? Do you or your group have any data to support your view?
13. In your opinion, what is the future of CMPs for asthma patients? Will the use of CMPs increase or decrease within your group? Will the number of medical groups in your region using CMPs increase or decrease? Why?
14. Is there anything else that you would like to share with us? For example, are there any more lessons based on your group’s experience in developing and implementing CMPs that you would like to highlight? Any “better practices” that you would pass on to others?
Physician Interview Physician Treating Patients With CHF (#12)
1. To what extent do you use Practice Guidelines in your treatment of patients with CHF? Approximately for what percentage of your CHF patients do you use Practice Guidelines? What are the barriers preventing you and your group from more extensively using Practice Guidelines? What factors facilitate the use of Practice Guidelines by you and your group?
2. To what extent do you use Protocols or Clinical Pathways in your treatment of patients with CHF? Approximately for what percentage of your CHF patients do you use Protocols or Clinical Guidelines? What are the barriers preventing you and your group from more extensively using Protocols or Clinical Pathways? What factors facilitate the use of Protocols or Clinical Pathways by you and your group?
3. To what extent do you use Case Management in your treatment of patients with CHF? Approximately for what percentage of your CHF patients do you use Case Management? What are the barriers preventing you and your group from more extensively using Case Management? What factors facilitate the use of Case Management by you and your group? Do you find it difficult to link with community resources for Case Management of your CHF patients?
4. To what extent do you use Disease State Management in your treatment of patients with CHF? Approximately for what percentage of your CHF patients do you use Disease State Management? What are the barriers preventing you and your group from more extensively using Disease State Management? What factors facilitate the use of Disease State Management by you and your group? Do you find it difficult to link with community resources for Disease State Management of your CHF patients?
5. To what extent do you use Demand Management in your treatment of patients with CHF? Approximately for what percentage of your CHF patients do you use Demand Management? What are the barriers preventing you and your group from more extensively using Demand Management? What factors facilitate the use of Demand Management by you and your group? Do you find it difficult to link with community resources for Demand Management of your CHF patients?
6. To what extent do other physicians in your group who treat CHF patients use these CMPs?
7. Do physicians in your group have the knowledge, skills, data, equipment, and support necessary to use these CMPs?
8. In this group practice, were any CMPs for CHF patients redesigned or substantially changed after initial implementation? Why were they changed?
9. Were any CMPs for CHF patients tried and then discontinued? Why?
10. Is the discontinuance of any other CMPs being considered? Why?
11. Do you believe that using CMPs for CHF patients usually produces better patient outcomes? Do you or your group have any data to support your view?
12. Do you believe that using CMPs for CHF patients usually reduces the cost of care? Do you or your group have any data to support your view?
13. In your opinion, what is the future of CMPs for CHF patients? Will the use of CMPs increase or decrease within your group? Will the number of medical groups in your region using CMPs increase or decrease? Why?
14. Is there anything else that you would like to share with us? For example, are there any more lessons based on your group’s experience in developing and implementing CMPs that you would like to highlight? Any “better practices” that you would pass on to others?
Physician Interview: Physician Treating Depressed Patients (#13)
1. To what extent do you use Practice Guidelines in your treatment of patients with depression? Approximately for what percentage of your depressed patients do you use Practice Guidelines? What are the barriers preventing you and your group from more extensively using Practice Guidelines? What factors facilitate the use of Practice Guidelines by you and your group?
2. To what extent do you use Protocols or Clinical Pathways in your treatment of patients with depression? Approximately for what percentage of your depressed patients do you use Protocols or Clinical Guidelines? What are the barriers preventing you and your group from more extensively using Protocols or Clinical Pathways? What factors facilitate the use of Protocols or Clinical Pathways by you and your group?
3. To what extent do you use Case Management in your treatment of patients with depression? Approximately for what percentage of your depressed patients do you use Case Management? What are the barriers preventing you and your group from more extensively using Case Management? What factors facilitate the use of Case Management by you and your group? Do you find it difficult to link with community resources for Case Management of your depressed patients?
4. To what extent do you use Disease State Management in your treatment of patients with depression? Approximately for what percentage of your depressed patients do you use Disease State Management? What are the barriers preventing you and your group from more extensively using Disease State Management? What factors facilitate the use of Disease State Management by you and your group? Do you find it difficult to link with community resources for Disease State Management of your depressed patients?
5. To what extent do you use Demand Management in your treatment of patients with depression? Approximately for what percentage of your depressed patients do you use Demand Management? What are the barriers preventing you and your group from more extensively using Demand Management? What factors facilitate the use of Demand Management by you and your group? Do you find it difficult to link with community resources for Demand Management of your depressed patients?
6. To what extent do other physicians in your group who treat depression in patients use these CMPs?
7. Do physicians in your group have the knowledge, skills, data, equipment, and support necessary to use these CMPs?
8. In this group practice, were any CMPs for depressed patients redesigned or substantially changed after initial implementation? Why were they changed?
9. Were any CMPs for depressed patients tried and then discontinued? Why?
10. Is the discontinuance of any other CMPs being considered? Why?
11. Do you believe that using CMPs for depressed patients usually produces better patient outcomes? Do you or your group have any data to support your view?
12. Do you believe that using CMPs for depressed patients usually reduces the cost of care? Do you or your group have any data to support your view?
13. In your opinion, what is the future of CMPs for depressed patients? Will the use of CMPs increase or decrease within your group? Will the number of medical groups in your region using CMPs increase or decrease? Why?
14. Is there anything else that you would like to share with us? For example, are there any more lessons based on your group’s experience in developing and implementing CMPs that you would like to highlight? Any “better practices” that you would pass on to others?
Physician Interview: Physician Treating Diabetic Patients (#14)
1. To what extent do you use Practice Guidelines in your treatment of patients with diabetes? Approximately for what percentage of your diabetes patients do you use Practice Guidelines? What are the barriers preventing you and your group from more extensively using Practice Guidelines? What factors facilitate the use of Practice Guidelines by you and your group?
2. To what extent do you use Protocols or Clinical Pathways in your treatment of patients with diabetes? Approximately for what percentage of your diabetes patients do you use Protocols or Clinical Guidelines? What are the barriers preventing you and your group from more extensively using Protocols or Clinical Pathways? What factors facilitate the use of Protocols or Clinical Pathways by you and your group?
3. To what extent do you use Case Management in your treatment of patients with diabetes? Approximately for what percentage of your diabetes patients do you use Case Management? What are the barriers preventing you and your group from more extensively using Case Management? What factors facilitate the use of Case Management by you and your group? Do you find it difficult to link with community resources for Case Management of your diabetes patients?
4. To what extent do you use Disease State Management in your treatment of patients with diabetes? Approximately for what percentage of your diabetes patients do you use Disease State Management? What are the barriers preventing you and your group from more extensively using Disease State Management? What factors facilitate the use of Disease State Management by you and your group? Do you find it difficult to link with community resources for Disease State Management of your diabetes patients?
5. To what extent do you use Demand Management in your treatment of patients with diabetes? Approximately for what percentage of your diabetes patients do you use Demand Management? What are the barriers preventing you and your group from more extensively using Demand Management? What factors facilitate the use of Demand Management by you and your group? Do you find it difficult to link with community resources for Demand Management of your diabetes patients?
6. To what extent do other physicians in your group who treat diabetes patients use these CMPs?
7. Do physicians in your group have the knowledge, skills, data, equipment, and support necessary to use these CMPs?
8. In this group practice, were any CMPs for diabetes patients redesigned or substantially changed after initial implementation? Why were they changed?
9. Were any CMPs for diabetes patients tried and then discontinued? Why?
10. Is the discontinuance of any other CMPs being considered? Why?
11. Do you believe that using CMPs for diabetes patients usually produces better patient outcomes? Do you or your group have any data to support your view?
12. Do you believe that using CMPs for diabetes patients usually reduces the cost of care? Do you or your group have any data to support your view?
13. In your opinion, what is the future of CMPs for diabetes patients? Will the use of CMPs increase or decrease within your group? Will the number of medical groups in your region using CMPs increase or decrease? Why?
14. Is there anything else that you would like to share with us? For example, are there any more lessons based on your group’s experience in developing and implementing CMPs that you would like to highlight? Any “better practices” that you would pass on to others?