JamesLHollyMD.com

	James L. Holly, M.D.

About SETMA Joint Commission Contact Information History Mission Statement Medical Home Scope of Services I-CARE Initiative Infusion Center The SETMA Way - What is it? SETMA's Model of Care Patient-Centered Medical Home The SETMA Approach to Patient Care	In The News Letters Vital Signs - Examiner Publication SETMA's Providers as of January, 2015 SETMA Knows - Abraham Lincoln and Healthcare Analytics SETMA – 1999 – Four Seminal Events PC-PCC Award January, 2015 Vital Signs Spring 2015 Vital Signs Q&A for PC-PCC Award Links to SETMA 2012 eHealth Innovator Award for LESS initiative Handout for Attendees eHealth Conference January 12, 2012 eHealth Initiative 2012 Award Program Application The eHealth Initiative's 2012 Award Letter 2012 National Quality Forum National Healthcare Improvement Award Effective prioritization of performance improvement goals Dashboard to Measure and Manage Whole System Performance Commitment to transparency Date-driven improvement of NQS priorities Demonstration of readiness to assume responsibilities of an ACO Demonstrated results on publicly reported performance measures Public Reporting Quality Metrics for 2009, 2010, 2011 Internally Tracked Reporting Quality Metrics for 2009, 2010, 2011 Complete Application in PDF Format SETMA's Medical Home Pilgrimage 2009 Medical Home Series I 2010 Medical Home Series II 2011 Medical Home Series Two 2009, 2010, 2011 Medical Home Miscellaneous Articles The Dr. and Mrs. James L. Holly Distinguished Professorship Universal American Letter of Transmittal for Support Dr. Holly's Acceptance Address for the 2012 Distinguished Alumnus Award CMS Medical Home Feedback Report Qualify & Cost SETMA questions Influenza Data SETMA I - October 2011 SETMA II - October 2011 Mark A. Wilson Clinic SETMA West - October 2011 SETMA and Fox 4 News - Healthy Living Videos SETMA Advertisements - Display and Video SETMA Announcements Featured Content Archive	Syllabus PC-MH Externship SETMA's MS4 Patient-Center Medical Home Selective Syllabus Introduction to SETMA's Senior Externship and Syllabus An Introduction to the Origins and Beginnings of Southeast Texas Medical Associates, LLP Patient-Centered Communication PC-MH Health Affairs August 15, 2013 Policy Brief -- Health Gap SETMA 8.20.13 Provider Training -- Health Affairs 2.14.13 -- Patient Engagement SETMA Provider Training 8.20.13 during First Senior Medical Student PC-MH Externship Medical Home Coordination Review Tutorial 2011 Medical Home Series Two Teaching Tool for PC-MH Course - Patient Care Activation, Engagement, Shared-Decision Making	Patient Information What Does Patient-Centered Medical Home Mean to You? What Does Patient-Centered Medical Home Mean to You? Health information exchange Patient Rights and Responsibilities Patient Directions Contact SETMA – Secure Texting What is HIPAA? Authorization To Release or Obtain Medical Records Complete Privacy Policy Website Privacy Policy	Presentations Invited Presentations SETMA Provider Training
Governance Board Governance Board Responsibilities Governance Board Leadership Training The SETMA Team and The SETMA Culture SETMA's Mission, Vision and Goals: Patient Safety and Quality Care Harassment, Neglect, Abuse, Exploitation - Role of HCAHPS & CAHPS Healthcare Provider Standards Providers Responsibility Medication Refills, Reconciliation and Maintenance Provider and Leadership Use of Data and Analytics Commitment To All Patients -- Ethnic Disparities Kaizen - Board Creates Culture of Safety and Quality SETMA's Policy and Practice for Advanced Directives SETMA's Policy on Completion of Medical Records Care Guidelines : Improve processes to evaluate and treat Integrated patient safety program (Sentinel Events) Effectively Manages all programs, services or sites Provides Patients with information about Primary-care Medical Home Organization-wide Planning to Maintain Focus on safety and quality Organization-wide Planning to Maintain Focus on safety and quality SETMA's Performance Quality & Safety Judged by CMS SETMA's Performance Quality & Safety Judged by CMS SETMA Awarded by HIMSS for Quality and Safety 2011 John M. Eisenberg Patient Safety and Quality Awards Application Healthcare Quality Award 2012 Principles of Quality and Metrics Principles Contacting SETMA & Secure Texting PC-MH Mission, Vision, Goal, Access, End-of-Life Communications and Public Reporting Change Existing Processes to Improve Performance Team Members Focused on Safety and Quality	Your Life Your Health View Articles by Subject Aging Well Behavioral Health Cardiovascular Disease Risk Care Coordination Care Transitions Children's Health COGNOS Project Diabetes Exercise Healthcare Reform:Public Policy HIPAA & Security Labor Day Less Initiative Medical Home Medical Records Men's Health Mental Health Nutraceuticals Nutrition Smoking Cessation Thanksgiving Weight Management Women's Health All Articles	Public Reporting Public Reports by Year (2009-2017) Public Reports by Type Fall Risk, Pain, Functional, Wellness, Stress Assessment Fall Risk, Pain, Functional, Wellness, Stress Assessment for 2011 AND 2012 Core Measures: SETMA & Baptist Hospital Core Measures for January to December 2011 PQRS Diabetes Measures - Blood Pressure Diabetes Measures - Glyco and LDL Diabetes Measures - Nephropathy Screening, Foot Exam, and Eye Exam Preventive Measures - Screening (BMI, Colorectal Cancer, Mammography, Osteoporosis) Preventive Measures - Influenza, Pneumococcal, Urinary Incontinence Preventive Measures - Tobacco Use NQF Care for Older Adults Comprehensive CHF Care Diabetes Measures Diabetes Measures - Blood Pressure Control Diabetes Measures - Glyco and LDL Diabetes Measures - Smoking Cessation Female Measures General Health Measures Medication Measures Persistent Medications Medication Measures Pediatric Measures HEDIS (NCQA) Effectiveness of Acute Care Effectiveness of Chronic Care - Clinic/Hospital Effectiveness of Chronic Care - Clinic Only Effectiveness of Chronic Care - Diabetes (Smoking Cessation) Effectiveness of Chronic Care - Diabetes (Glyco and LDL) Effectiveness of Chronic Care - Diabetes (Blood Pressure Control) Effectiveness of Preventive Care Effectiveness of Preventive Care - Older Adults Effectiveness of Chronic Care - Diabetes Measures Effectiveness of Chronic Care - Persistent Medications (MPM) NCQA Diabetes Recognition Program Audit LESS Initiative PCPI PCPI Hypertension PCPI Diabetes PCPI Chronic Stable Angina PCPI Care Transitions PCPI CHF PCPI Weight Management PCPI CKD Stages IV V SETMA Lipid Audit Lipids Treatment Audit Tutorial Lipids Tutorial AQA COGNOS Project SETMA Audit for CKD Stages I III Patient Satisfaction Survey	Accreditations/Awards Achievements which have Advanced SETMA: The Time-line, Philosophy and Principles which Underlie that Advancement Awards	Diabetes Center of Excellence Education Diabetes Order Referral Form Seven Stations 2011 Advances in Diabetes Diabetes Tutorial Diabetes Prevention
EPM Tools Association of Medication and Diagnosis Automated Team Function Behavioral Health Adult Weight Management Tutorial Annual Questionnaires: Fall, Functional, Pain, Stress, Wellness Behavioral Health in SETMA's Patient-Centered Medical Home Model of Care Depression Tutorial Fall Risk Tutorial Health Insurance Portability and Accountability Act (HIPAA) Privacy Tutorial Intensive Behavioral Therapy (IBT) Obesity and Cardiovascular Disease Medicare Preventive LESS Initiative Tutorial Medical Home Transtheoretical Model Assessment Stages of Change Tutorial Pain Management Tutorial Reduction of Antipsychotic Medications Toolkit Smoking Cessation Tutorial Stratifying End-of-Life Risk for Hospice Services Tutorial Chronic Conditions Tutorial Chronic Renal Disease Management Tool Tutorial Calculating the Stages of Renal Disease Proteinuria Disease Management Tools Acute Coronary Syndrome Tutorial Adult Weight Management Tutorial Angina Tutorial Cardiometabolic Risk Syndrome Tutorial Chronic Renal Disease Tutorial Congestive Heart Failure Tutorial Diabetes Tutorial Hypertension Tutorial Lipids Tutorial Lipid Quality Audit Tutorial Primary Pulmonary Hypertension Tutorial Framingham Cardiovascular Risk Cardiometabolic Risk Assessment Framingham Heart Study Risk Calculators Tutorial Frederickson Classification of Dyslipidemia LDL Level Lipid Disease Management Risk Assessment General principles about ICD-9 Codes and HCC/RxHCC Codes Charge Posting Tutorial Coding to Ensure Accurate Health Risk Scoring E & M Codes Tutorial HCC & RxHCC Risk HCC/RxHCC Risk Tutorial ICD-9 Code Training Manual Hepatitis Screening Hospital Based Tools Hospital Care Summary and Post Hospital Plan of Care and Treatment Plan Tutorial Admission Orders Tutorial Daily Progress Notes Tutorial Care Transition Data Set from PCPI Tutorial Using The Clinic and Hospital Follow-up Call Templates Respiratory Failure Tutorial Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS): Tutorial for SETMA's Internal HCAHPS Survey Master GP Suite of Templates Master GP Suite of Templates Tutorial Medical Home Support Materials Department of Care Coordination, Director of Care Coordination and Care Coordination Referral Template Electronic Tickler File Electronic Tickler File Tutorial Follow-up Calls Intensive Behavioral Therapy (IBT) Obesity and Cardiovascular Disease Medicare Preventive Services Medical Home Coordination Review Tutorial Medical Home Plan of Care and Treatment Plan Medical Home Transtheoretical Model Assessment Stages of Change Tutorial Patient-Centered Medical Home Annual Questionnaires Patient-Centered Medical Home: SETMA's Medical Home Coordination Review (MHCR) Tutorial Patient Document for Coordination of Care Transitions of Care Management Coding (TCM Code) Tutorial Merit-Based Incentive Payment System (MIPS) Quality Metric Tool Tutorial Nursing Home Depression Tutorial Fall Risk Tutorial Hydration Assessment Tutorial Nursing Home Guidelines for Care Tutorial Nursing Home Principal Suite of Templates Nutrition Assessment Tutorial Reduction of Antipsychotic Medications Toolkit Skin Care Tutorial Outpatient Infusion Center for Intravenous Antibiotic Therapy and Other Meds Preventive Health Tools Adult Weight Management Tutorial CHF Exercise Tutorial Diabetic Exercise Tutorial Diabetes Prevention Tutorial Exercise Prescription Tutorial Hypertension Prevention Tutorial Intensive Behavioral Therapy (IBT) Obesity and Cardiovascular Disease Medicare Preventive Initial Preventive Physical Exam & Annual Wellness Visit Tutorial LESS Initiative Tutorial Progression to Type 2 Diabetes Smoking Cessation Tutorial Progression to Type 2 Diabetes Quality Metrics ACO and Medicare Advantage Stars HEDIS: NCQA, History, Quality, Safety, STARS, ACO ACO Quality Measures Performance Tool ACO Quality Measures Performance Tool Tutorial STARs - A Tutorial for Utilizing SETMA's Deployment of the STARS MA Program Specialized Tools Annual Questionnaires: Fall, Functional, Pain, Stress, Wellness Association of Medication & Diagnosis Chronic Conditions Tutorial Chronic Care Management Code (CCM) Tutorial Depression Tutorial Drug Interactions Tutorial Electronic Tickler File Tutorial Evaluation Lower Urinary Tract Symptoms in the Male Fall Risk Tutorial Future Labs Tutorial Hydration Assessment Tutorial HCC Risk Training Tool Hypertension: Fulfilling Quality Metrics for the PCPI Program Laboratory Results - Signing Off: Why and How Medication Module Tutorial Medication Reconciliation Tutorial Nutrition Tutorial Pain Management Tutorial Problem List Reconciliation Tutorial Progression to Type 2 Diabetes Referral Skin Care Tutorial SOAAP Opioid Risk Assessment Stratifying End-of-Life Risk for Hospice Services Tutorial Texas State Reportable Infectious Diseases Tutorial Transitions of Care Management Coding (TCM Code) Tutorial	Transforming Your Practice Library Introduction to SETMA's TCPI Library Transforming Your Practice (TCPI) Summary Document of TCPI CMS Quality 12.2015 TCPI Leadership and Governance Care Coordination HIPPA and Security Data Analytics Care Transitions LESS Initiative Medical Records Clinical Decision Support Hospital Care Tools Disease Management Tools Preventive Health Tools Behavioral Health Transformation Tools New Transformation Tools Patient-Centric Care Nursing Home Medical Home Display and Explanation of SETMA's Patient-Centered Medical Home Tools	Medical Home The Story and the Ideals Introduction to Preventive Health Tools PC-MH Patient Engagement & Alternative Payment Models Preventive Care: The Best Way to Treat Illness is Don’t Get it Coordination of Care Patient-Centric Care Population Health Transition of Care - One form of Care Coordination HCAHPS - Hospital Consumer Assessment Of Healthcare Providers and Systems CAHPS - Consumer Assessment of Health Care Provider and Systems Teaching Tool for PC-MH Course – Patient Care Activation, Engagement, Shared-Decision Making Display & Explanation of PC-MH Tools SETMA's Medical Home Pilgrimage Concierge Medicine not Medical Home Medical Neighborhood Security & HIPPA Referrals Patient Web Portal Health Information Exchange Medication Reconciliation The Automated Team Coordination of Care Medical Home Description & Standards AAAHC Joint Commission NCQA Planetree URAC NCQA Interview February 14, 2014	Facebook	Letters

Your Life Your Health - Patient-centered Medical Home SETMA's COGNOS Project

James L. Holly,M.D.

October 29, 2009

Your Life Your Health - The Examiner

The Your Life Your Health articles for February 19 to May 21st of this year examined the concept of a Patient-Centered Medical Home including what it expects of a medical practice and what it provides to patients. Those articles can be found on SETMA's website under the heading of your Life Your Health, by clicking on the icon entitled "Medical Home."

Perhaps the most important aspect of being recognized as a Patient-Centered Medical Home is the ability to examine patient-care data in order:

to change provider and patient behavior,
to change procedures and processes in the practice and
to provide patients with information about, and strategies for improving or preserving their health.

The organization and analysis of raw data obtained in the care of patients can produce information on the basis of which decisions, treatment plans, and plans of care can be provided to patients. These materials can help patients take charge of their own care and become actively involved in the management of their own health. In the coming three weeks, we will look at this process for three major conditions which are treated in SETMA's Patient-Centered Medical Home: Diabetes, Hypertension and Lipid Abnormalities.

The analysis of patient-encounter data may seem simple until is realized that SETMA's patients' electronic data base is huge and that it could take 36-hours to run the reports required for the above project. When it is realized that SETMA wishes to produce those reports daily, the potential problem is realized. If you want to report on something every 24 hours but it takes 36 hours to produce the reports, you can see that it is an impossible task.

COGNOS Project, Why?

This is one of the principle reasons for the COGNOS Project. By the time this article is published SETMA will be completing the fourth week of this project and expects to complete the project in seven more weeks. Here are some facts about the project.

COGNOS is an IBM computer program described as being for "Business Intelligence and Financial Performance Management." It is a data-mining software program which is elaborate, robust, complex and excellent. The use of COGNOS in healthcare is not new but it is not common place. In response to SETMA's desire and need to have real-time reporting capacity for quality measurement, and practice and provider performance, our Chief Information Officer, Richmond Holly, chose COGNOS. After one false start with another company, he chose LPA Systems (www.lpa.com) to consult and collaborate with SETMA on this project. While SETMA's entire IT team is involved in this project, Jon Owens is SETMA's principal liaison with LPA and the leader of this project for SETMA.

Changing Provider Behavior with Real-time Performance Reporting

There are multiple motivations for this project. The first is to change provider and patient behavior. Typically healthcare providers only receive delayed, retrospective reviews of their performance, which does not change behavior significantly, in our judgment. In the Old Testament, there is a verse which says that "because punishment against an evil deed is delayed, the hearts of men are set upon doing evil." The principle is that without immediacy between the consequences and/or evaluation of an action and the action itself, the potential for the consequence to effect positive change is diminished or eliminated. While auditing provider performance is never for punitive reasons, the principle is the same. If the reporting of the results is significantly removed in time from the events being audited, it will have little impact upon provider behavior.

In his book, The Fifth Discipline, Peter Senge of MIT used the classic metaphor of the Frog in Boiling Water to address the same issue from a different perspective. He explains, "If you put a frog into cool water; he will swim around. If you begin to heat that water, the change is so gradual that the frog will not recognize the danger until it is too late for the frog to escape." The same is true of patients and healthcare providers. Because the changes in patient health are generally very slow and without immediate consequences (symptoms), both provider and patient can become complacent.

The medical literature addresses this complacency with the concept of "treatment inertia," the tendency on the part of healthcare providers to do nothing, even when something should have been done. Most of the research on "treatment inertia" has been done in the medical education arena where it is expected that "best practices" will always be present. There is no intent in this project of punishment, or of boiling anyone in hot water, but the intent is to find a way to change provider behavior and to overcome "treatment inertia." SETMA believes, as is also addressed by Senge, that the only effect way to change patient and provider conduct in the face of chronic conditions which cause no short-term discomfort but which have long-term devastating consequences, is to create discomfort in both in order to overcome "treatment inertia" and/or current apathy toward inevitable bad outcomes.

Aggregated-Provider-Performance Data for the Practice

Thus, we come to SETMA's COGNOS project. Through our electronic patient record (EMR), SETMA tracks multiple quality-measures sets from numerous sources such as HEDIS, NQF, PQRI, Physician Consortium and NCQA. These measures sets are available in SETMA's EMR in a "real time" format for providers to be able to review at the time of a patient encounter. Thus, each provider can review his/her own performance on each of these measures in the examination room. This ability has already resulted in improvement in provider performance.

However, we believe there is additional benefit to be gained from aggregated-provider-performance data which compares all providers in SETMA to other SETMA providers and comparing both against national standards of care. And, we believe that the reporting of that comparison immediately will provide great benefit to our patients. SETMA intends to begin reporting in January the results of our care of diabetes, hypertension and lipid management, as well as over 100 additional elements of quality measures related to preventive health, chronic health problems and risk stratification. We will report this on our website so that patients can not only see how they are doing - from the reports we give them during their clinic visits - but how all of our patients as a group are doing. In healthcare policy this is called "population management" and addresses the structure and processes of healthcare delivery which increases the probability of consistent and predicable quality care and outcomes in healthcare.

It is SETMA's opinion that when providers received information from hospitals, health plans or other sources about their performance from a year or more ago, that they review it and immediately forget it. Even when the data shows that their performance is substandard, its remoteness diminishes its impact. In addition, "benchmarks" - telling providers how their performance compares with an amorphous, unknown group does not have the impact as will the displaying of their performance along side their own colleagues, and particularly when it is done by name. SETMA also believes that the creation of a true and dynamic team will be encouraged by the public reporting of that performance data without the providers' names.

Unusual Requirements of NCQA Patient-Centered Medical Home

Many of the requirements for recognition by NCQA as a Patient-Centered Medical Home are procedures and/or processes which are a traditional part of the clinical practice of medicine. Some are not. It is these latter functions which are most challenging and for which our COGNOS project will be most helpful. Via the COGNOS function, it is SETMA's intent to report to all providers:

The day before a patient is to be seen - A report will be sent to each provider of what the patient needs during their visit the next day. This will include a list of what the patient needs in order for the patient's care to meet all quality measures which SETMA is tracking. This report will facilitate the ease of a provider and a provider's support staff making certain that every patient receives every element of care which they need and deserve. We expect to be able to do this by January, 2010.
The morning after the patient is seen -- The result of the providers' performances the previous day will be reported without the identity of the patient and that provider's performance will be measured against all SETMA providers. We expect to be able to do this by January, 2010. We believe that the immediacy of the report - less than 24 hours after the events - and the comparing of providers with one another will create the discomfort needed to effect change in providers' performance.
Monthly, without patient identification information or provider identification SETMA wide performance will be reported on our website www.jameslhollymd.com --SETMA believes that this will enable our patients to be confident that they are receiving excellent care from SETMA and it will be further motivation for our providers to raise the standard of SETMA's care. We expect to be able to start posting these results by February, 2010.
Quarterly SETMA will report de-identified (all patient identification removed) results to agencies to whom SETMA is accountable for quality measures -- As will be seen below, this is an NCQA requirement

A "Data Mart"

The second motivation for SETMA's COGNOS Project is that the aggregation of and the reporting on the amount of data tracked by SETMA is a major, daily undertaking and would be time and personnel intensive if it were not automated. Additionally, the size of the reports which SETMA envisions and the database from which these reports are being mined are such that without a data-mining tool, it could take longer than 24 hours to run the reports. In addition, the running of the reports could slow our system to the point that the usefulness of the EMR in patient encounters could be adversely affected. Through COGNOS, we are creating a "data mart" which will eliminate this problem. Simply put, a "data mart" is a repository for the data points required for the completion of the above described tracking. While SETMA's EMR has hundreds of thousands if not millions of data points, only about 200 are needed to evaluate he outcomes of our care. The "data mart" will create a secure folder for these data points and all queries will be pulled from the "data mart." These reports will take seconds rather than hours.

NCQA Recognition as a Patient-Centered Medical Home

The third motivation for SETMA's COGNOS Project is that SETMA is preparing to apply for NCQA (National Committee for Quality Assurance) recognition as a Patient-Centered Medical Home. NCQA has published 9 Standards with 30 Elements and 189 Data Points for recognition as a Patient-Centered Medical Home. If you meet 25% of these Data-Points you will be a Tier I; if you meet 50%, you will be a Tier II and if you meet 75%, you will be a Tier III. SETMA's goal is to be a Tier III medical home and it is also our goal to meet all 189 Data Points.

Some of the 189 Data Points are reflective of actions which have traditionally been a part of medical practice and are easily met. Others are part of the electronic patient record and are easily met by any medical practice using a robust EMR. Others however, are not things which have traditionally been done. They are challenging and require significant changes to procedures and processes in a well-run medical practice. SETMA's COGNOS Project is intended to help us meet those unique new standards of care. Some of them are:

Pre-visit planning - Evaluating the patient's needs before they are seen and making certain everything is available in order to meet those needs. This is a complex problem in a multi-specialty group but the COGNOS functions will make this simple.
Post-visit review - Follow-up of patients has always been a part of patient care but the following up of every patient to see that they obtained their medications, followed through with their referrals, etc., is complex. COGNOS will make it possible for us to do this.
Reporting Performance on 10 National Quality Forum (NQA) endorsed quality measures -- SETMA has chosen to report on 32 NQA measures for 2009 and is adding another 20 NQA measures for 2010. We will report our performance on these to several external organizations as well as to the public. Of course, all patient identification information will be eliminated.
A written plan-of-care and treatment-plan which is personalized for each patient -- Due to SETMA's EMR, SETMA's disease management tools and SETMA's reports, we are already accomplishing this for diabetes, hypertension and the treatment of cholesterol and triglycerides. This was one of the most daunting of tasks but with the motivation of NCQA's requirements, SETMA has done it and found it to be an extremely valuable tool for our patients.
Calling Patients After a Visit - This NCQA requirement puzzled us for a while. The value was obvious but how to do it. In order to call ALL Patients seen at SETMA each day, it would require at least 8 full-time RNs, at a cost of over $600,000 a year. In addition, some patients would not benefit from such a call. Thus, SETMA has established a policy of calling all patients discharged from the hospital and/or emergency room and of calling clinic-visit patients whom the provider indicates would benefit from a call with the provider dictating when the call would be made and why the call would be made. Since we began this program over a month ago, this has already begun yielding benefit to our patients and providers.
Non-provider involvement in the patient's care - As aspects of health care become more and more precise, it is possible for someone without a medical degree to perform that function effectively and accurately. One of those areas is preventive healthcare. It does not take a physician or nurse practitioner to determine if a patient has or has not had a flu shot, is or is not allergic to eggs and to initiate the giving of a flu shot. The improving of the quality of care will be partially achieved by the involvement of many different people, at many different levels of care in the patient's healthcare experience. SETMA's COGNOS Project's pre-visit planning will allow nurses, within the scope of their licenses and skills, to perform unsupervised points of care.
There are many others elements of NCQA standards which our COGNOS Project will facilitate achieving; these lustrate the point.

COGNOS will allow SETMA to continue to move healthcare delivery forward and to improve the care all of our patients receive. Welcome to the future of medicine; welcome to SETMA.

Related Articles

	Transforming Healthcare: Public Reporting of Provider Performance on Quality Measures

About SETMA	In The News	Syllabus PC-MH Externship	Patient Information	Presentations
Governance Board	Your Life Your Health	Public Reporting	Accreditations/Awards	Diabetes Center of Excellence
EPM Tools	Transforming Your Practice Library	Medical Home	I-CARE Initiative	NextMD