In January of each year, SETMA reviews the goals which we established the previous year and sets goals for the coming year.  In January, 2015, SETMA partners, executive management and colleagues set the following goals:

1. Expanding our service to Southeast Texas by inviting ten physicians to join SETMA’s healthcare team, including psychiatry, and other greatly needed services.  Achievement:  we actually have added 13 healthcare providers to SETMA’s staff in the past year, including three behavioral health professionals.  Because we did this without borrowing any money are assuming any debt, it was a challenging year financially.  However, we finished the year with a balanced budget and with our hourly-employees receiving their annual bonus.


2. Expanding our mental health services to all of our patients who need help in coping with complex healthcare challenges.  Achievement:  As a part of our Patient-Centered Medical Home (PC-MH), SETMA has expanded our Behavioral Health department.  This achievement has only magnified the need for these services in a primary care setting.  We expect to consolidate this department in 2016 and to continue to expand it going forward.


3. To deepen our understanding of and practice of Patient-Centered Medical Home particularly in the areas of patient-centered conversations, shared decision making and patient activation and engagement.  Achievement:  SETMA has continued to learn and expand the tools and services of our patient-centric care.  In 2015, SETMA designed and deployed a tool for the performance and documentation of Chronic Care Management of patients who quality for that program.  As noted below, in 2016, we will cycle back through the accreditation processes for NCQA Diabetes Recognition Program, first achieved in 2010, for NCQA Stroke/Heart Recognition first achieved in 2013; NCQA PC-MH, first achieved in 2010.  In the period from June, 2016 through June, 2017, SETMA will also renew our PC-MH and Ambulatory Care accreditations with the Accreditation Association for Ambulatory Healthcare (AAAHC), first achieved in 2010 and up for renewal in June 2017, and, in February and March of 2017, we will renew our accreditations for PC-MH and Ambulatory Care with URAC and the Joint Commission.


4. Expanding our laboratory services to include patient safety in managing pain and pain treatment and in expanding our services to include genomics.  Achievement:  SETMA designed and deployed laboratory services to comply with the Texas Medical Board requirements for the management and auditing of the chronic use of controlled substances.  SETMA has also expanded the electronic prescribing of controlled substances (also referred to as ePCS) to increase the safety and quality in the use of these medications.  SETMA also designed and deployed a tool for the Texas Department of Aging and Disability Services' Reduction of Antipsychotic Medications Toolkit.  SETMA has also participated in the Texas e-Prescribing of Controlled Substances (EPCS) Outreach Planning Group initiated by the Medicaid- CHIP Health Information Technology section of the Texas Health and Human Services Commission.


5. Continuing to support each member of SETMA’s healthcare team by meeting their needs for a safe, secure and stable work environment free from discrimination, harassment or unnecessary stress.  Achievement:  SETMA has continued our zero-tolerance for breaches in these areas of our team work. 


6. Renewing our commitment to SETMA’s mission statement:  To build a multi-specialty clinic in Southeast Texas which is worthy of the trust of every patient who seeks our help with their health, and to promote excellence in healthcare delivery by example.  Achievement:  Professionally, publicly and practice-wide, SETMA continues to pursue this mission statement, keeping it in the forefront of all of our efforts to expand excellence in our work.  In 2015, SETMA was invited to participate in the Centers for Medicare and Medicaid’s (CMS) Transitioning Clinical Practice Initiative (TCPI).  As SETMA’s “offer” to CMS, a section of www.jameslhollymd.com was redesigned and can be reviewed at:  Introduction to SETMA’s TCPI Library.


7. To renew our commitment to SETMA’s Community Council which allows patients to have a direct input into SETMA to which input SETMA is committed to respond.  Achievement:  While scheduling of regular meetings has continued to be a challenge, in March, 2015, eleven members of this council participated in the 7th Annual Medical Home Summit in Philadelphia:  see Report on 7th Annual Medical Home Summit.  We have renewed our commitment to this program for 2016.


8. To continue to invite medical students and residents, and healthcare groups to visit SETMA’s Medical Home, giving us the opportunity to share our innovations with them and for us to learn from them.  The next group to visit SETMA is a delegation from Australia in March, 2015.  Achievement:  In addition to the visitors from Australia in 2015, SETMA has a second visit from a delegation from China.  SETMA’s materials are being translated into Chinese and in March of 2016 a visit by SETMA to China is being scheduled.  The group from China is actively and aggressively translating SETMA’s model of care, clinical decision support and disease management tools into Chinese.


9. To continue to participate in educational opportunities to share SETMA’s vision, passion and principles with others.  In March, 10 members of SETMA’s Accreditation Team, SETMA’s PC-MH and SETMA’s Community Council will present a national conference in Philadelphia. This group includes three SETMA patients who will attend the conference to give their perspective of 21st Century healthcare.  Achievement:  This was a success.  Through the weekly Your Life Your Health columns, SETMA’s website, invited presentations and correspondence, SETMA continues to address critical healthcare issues.  SETMA’s participation in local and regional healthcare discussions continues.  These discussions can be found under In-The-News/Letters at www.jameslhollymd.com.  One of the most important of these discussions can be reviewed at: The Value and the Power of the Healthcare Team: Answering Dr. Amy Townsend’s Imperative


10. To improve SETMA’s provider education process with our monthly four-hour meeting for training, which process will focus on SETMA’s 2014 achievements and SETMA’s goals for 2015.  Achievement:  These sessions were help 11 times in 2015 and provided opportunity for introducing new initiatives and to continue in the process of strengthening SETMA teamwork.

In our next column, January 14, 2016, Looking Back as a Foundation for Envisioning the Future Part II, we will publish our goals for 2016.  In August, 2016, we begin our 22nd year at SETMA and our 42nd year of service to Southeast Texas.  As always, we look to the future by remembering the past, and by establishing and maintaining a continuity of growth and development.  We also renew our commitment to the lessons of the seminal events (see: May, 1999 -- Four Seminal Events in SETMA’s History) and understandings which we learned in May, 1999 which were:

• The commitment to excellence in healthcare through electronic patient management.
• The commitment to quality and safety marked by a celebratory spirit allowing us to recognize what we have achieved while acknowledging where we need to improve.

We continue to be challenged by Abraham Lincoln’s 1856 “House Divided” speech in which he said:  ‘If we could first know where we are, and whither we are tending, we could better judge what to do, and how to do it,”  It is SETMA’s goal to always “know what to do and how to do it.”
We renew our commitment to following the principles enunciated in SETMA’s May, 1999 white paper:  More Than a Transcription Service: Revolutionizing the Practice of Medicine With Electronic Health Records which Evolves into Electronic Patient Management.  And, to following the ten principles derived from Peter Senge’s The Fifth Discipline, which guided both our development of an EHR and our practice transformation. They are:

1. Pursue Electronic Patient Management rather than Electronic Patient Records
2. Bring to every patient encounter what is known, not what a particular provider knows
3. Make it easier to do “it” right than not to do it at all
4. Continually challenge providers to improve their performance
5. Infuse new knowledge and decision-making tools throughout an organization instantly
6. Promote continuity of care with patient education, information and plans of care
7. Enlist patients as partners and collaborators in their own health improvement
8. Evaluate the care of patients and populations of patients longitudinally
9. Audit provider performance based on endorsed quality measurement sets
10. Integrate electronic tools in an intuitive fashion giving patients the benefit of expert knowledge about specific conditions

A successful future is always founded upon the vision of the past.