Beyond the Textbook: Real-World Medicine and Case Studies Webinars

Welcome to MHCC’s Beyond the Textbook (BTT): Real-World Medicine and Case Studies Webinars. Innovative care delivery is focused on improving how care is coordinated, accessed, and delivered - especially for patients with complex, chronic, or serious health conditions. Shifting from traditional fee-for-service models may require providers to adjust payment structures, technology, workflows, staffing, and organizational culture. The presentations that follow feature a distinguished group of health care professionals discussing key opportunities and challenges in innovative care delivery.

Addressing Health Equity in Primary Care

Sarah Johnson Conway, MD
Interim SVP, Office of Johns Hopkins Physicians Chief Medical Officer, John Hopkins Clinical Alliance Assistant Professor of Medicine, Johns Hopkins School of Medicine

Dr. Conway discusses how primary care providers can promote health equity by addressing the social determinants of health, providing accessible and affordable care, and advocating for underserved populations.

Patient Experience Improvement

Amar Duggirala, DO, MPH, FAAFP
Owner, Poolesville Family Practice

Dr. Duggirala - recipient of the Maryland Primary Care Program’s CAHPS Performance Award - explains the process his practice uses to improve patient experience, reduce barriers to access, improve care coordination, and increase patient engagement.

Diabetic Care Pathway

Dr. Robin Motter-Mast, DO, MBA, DipACLM, FAAFP, CPE
Chief of Staff, Medical Director of Care Transformation, Greater Baltimore Medical Center

Dr. Motter-Mast explains the integrated care coordination team model that GBMC uses to improve the health outcomes and quality of life for diabetic patients.

How Should Practices Prepare for Value-Based Care?

Michael S. Barr., MD, MBA, MACP, FRCP
President & Founder, MEDIS, LLC

Dr. Barr highlights key areas where practices can focus their efforts to successfully transition into value-based care models. He also shares valuable frameworks, tools, and guides to prepare for this transition.

Case Study:Optimizing Medication Regimes for Congestive Heart Failure Ambulatory Patients

Scott Feeser, MD
Medical Director, Johns Hopkins Care Transformation Organization

Dr. Feeser presents a project to optimize the treatment regimen for congestive heart failure. Heart failure is a significant contributor to potentially avoidable hospitalizations and healthcare utilization. Dr. Feeser's project aims to improve patient outcomes and reduce costs associated with this condition.

Maryland Value-Based Care – What’s Next for Physicians?

Gene Ransom
CEO, MedChi, The Maryland State Medical Society

Mr. Ransom discusses current and planned value-based care models in Maryland for primary care and specialty practices. The models include the Maryland Primary Care Program, Primary Care AHEAD, and the Episode Quality Improvement Program.

CRISP’s Mission, Value, and Tools

Kevin Phillip
Communication Manager, CRISP

Mr. Phillip discusses CRISP’s mission, value, and tools as the State designated health information (HIE). CRISP offers clinicians access to shared data and reports. The data and reports include demographics, medications, encounters, labs, care team members, and health-related social needs providers.

Emerging Nicotine Products and Treatments

Niharika Khanna, MBBS,MD,DGO
Professor of Family and Community Medicine and Director of the Maryland Tobacco Control Resource Center, University of Maryland School of Medicine

Dr. Khanna provides an overview of trends in nicotine products and treatment options. She shows behavioral health associations with tobacco use, including adverse and positive childhood experiences, and presents current treatment options and contacts.

Use of an AI Scribe in a Community Health Center

Alireza Pirestani D.O.
Westside Family Healthcare

Dr. Pirestani discusses the implementation and use of an AI Scribe at Westside Family Healthcare, including the goals, challenges, and limitations of the project, as well as provider feedback, lessons learned, and next steps.

Incorporating eConsults as Part of Comprehensive Primary Care at Choptank Community Health Center

Elizabeth Buckshot, PA
Electronic Health Record Optimization and Clinical Onboarding Manager, Choptank Community Health Center

Elizabeth showcases how Choptank Community Health Center uses eConsults to address challenges, including limited specialists in the area and long wait times for patient appointments, as well as transportation, cost, language and health literacy.

The Pharmacist’s Role in the Health Care System

Magaly Rodriguez de Bittner, PharmD, MS, FAPhA, FNAP
Executive Director Center for Innovative Pharmacy Solutions
Associate Dean for Clinical Services and Practice Transformation
Department of Practice, Sciences, and Health Outcomes Research
University of Maryland School of Pharmacy

Dr. Rodriguez de Bittner highlights the role of pharmacists in team-based care, including the pharmacists’ role in chronic disease management, medication optimization, transitions of care and preventive services.