Opinion

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Supporting Patients and Primary Care Providers

Panelists discuss how supporting primary care providers requires moving beyond passive quality measures to peer-to-peer education, transparent performance feedback, multidisciplinary team resources, and creative care delivery models that address the "27-hour day" problem.

UPMC's Systematic Approach

UPMC has developed a comprehensive systematic approach to multidisciplinary diabetes and obesity care through their integrated delivery and financing system. As one of the largest IDF systems with 40 hospitals, UPMC coordinates care between hospitals, clinicians, and payer divisions to improve patient outcomes while decreasing total cost of care. This integration provides significant advantages for implementing coordinated care strategies.

The system employs three key strategies: e-consults that provide specialist recommendations to primary care physicians before patient appointments, proactive outreach using EMR data to identify patients who would benefit from GLP-1 receptor agonists, and simplified referral processes through Epic order sets. Care managers play crucial roles by coordinating appointments for newly diagnosed diabetes patients and connecting them with diabetes educators and lifestyle programs.

Telemedicine has become integral to their care model, reducing friction and making it easier for patients and PCPs to access specialty care. The success of this approach requires multiple stakeholders including PCPs, specialists, and insurance divisions to collaborate toward common goals. While challenging to implement, this coordinated approach demonstrates high return on investment and serves as a model for other healthcare systems.

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