Fostering Collaboration in Lean for Clinical Redesign

The Patient Centered Medical Home (PCMH) is a model for transforming both the delivery and financing of primary patient care. Its basic tenets include a whole person orientation to health care that involves the coordination of community resources beyond the physician office. Additionally, increased patient responsibility for his /her own health is an important precept of the model. The University of Michigan Health System (UMHS) has been working with physician organizations (P.O.s) and their primary care practices to help them restructure their patient care delivery in accordance with PCMH principles. Working primarily with P.O.s in Michigan, UMHS has been leading multi-day, face-to-face workshops to help medical practices apply the tools and methods of Lean Thinking to their transformation as a PCMH. Since 2008, more than 100 practices from 18 P.O.s have participated in ‘Lean for Clinical Redesign' workshops. As a multi-year pilot project, the University of Michigan School of Public Health (UM SPH) is leading an effort to support shared learning among participants in the Lean for Clinical Redesign Collaborative by creating a portal for web-based tools and training. To inform the design of the portal, likely users were surveyed regarding their exposure to both Lean Thinking and PCMH concepts and their experience with the Internet and certain web-based tools. Using these survey results, the eCollaborative was designed to provide a virtual worksite based on distance learning principles. It also allows for networking between practices attempting to become designated as PCMH. The purpose of the eCollaborative is to foster communication and learning within and between the participating physician organizations and their practices. The site provides resources to answer common questions, profiles of other participants, examples of tools developed and implemented, and stories reflecting the opportunities for organizational change. It was designed to supplement and reinforce, rather than supplant, the face-to-face sessions that comprise the Learning Collaborative training provided to P.O.s by UMHS. Providing an online portal for resources and networking which is readily accessible (with sufficient Internet access) aligns with the Lean concept of meeting learning needs just-in-time. This presentation will chronicle the efforts of, and lessons learned from this pilot to improve exchanges between the participating P.O.s, their primary care teams and the Lean Coordinating Center at UMHS. Models of distance learning that assist in advancing clinical redesign throughout the United States should be explored further.