This issue of Colorado Medicine focuses on physician innovating – just a few examples of many around our state where physicians have identified an issue in health care delivery and took the lead to improve care for patients. Physicians are perfectly positioned to innovate and improve health care given the special relationship we have with our patients; our central role in the delivery and coordination of accessible and high-quality care; and our ability to apply scientific method to identify a problem, test solutions and implement change. We at the Colorado Medical Society support and encourage physician innovators like the following three and others in this issue, and will continue to advocate for physicians to be the recognized leaders in health care and the trusted source of guidance to improve care for patients and the health care delivery system.

Combating the opioid epidemic

Donald Stader, MD, an emergency physician, innovator and patient advocate who works for CarePoint Healthcare and practices at Swedish Medical Center in Englewood, Colo., is a renowned expert on the opioid epidemic and saw the tragedy of its effect on patients firsthand. In 2017, Stader and the Colorado chapter of the American College of Emergency Physicians launched one of the largest emergency-department-based opioid reduction pilots in the nation. As the physician lead, he developed and tested the opioid treatment guidelines that recommended the use of alternatives to opioids (ALTOs) that the piloting hospitals would use to target specific types of pain, and he trained physicians in 11 emergency departments across Colorado. The pilot returned remarkable results: a 36 percent reduction in opioid administrations when compared to the same time period in 2016, which amounted to 35,000 fewer individual opioid administrations between the 2017 pilot and the 2016 baseline period. He remains a leader in the effort to expand the pilot to other care settings like the primary care office, surgery center and dentist office through Colorado’s CURE initiative.

Reducing mortality and morbidity from sepsis

Gary Winfield, MD, division chief medical officer for HCA-HealthONE/Continental Division, leads clinical and quality initiatives supporting consistent high-quality clinical performance and practice standards across HealthONE hospitals in Denver and HCA hospitals in Wichita, Kan. He conceived the concept of obtaining a first-of-its-kind Joint Commission disease-specific certification for sepsis, implemented a reproducible model for sepsis early recognition and management at all facilities, educated other facilities outside HealthONE on this provider methodology to tackle sepsis and, as a member of the Coalition for Sepsis Survival Board of Directors, advocates for sepsis awareness and best practice treatment for the purpose of reducing sepsis mortality and morbidity.

Assuring value in health care for patients

Michael Pramenko, MD, a family physician leader with Primary Care Partners in Grand Junction, is a champion in value-based care. PCP is an independent, physician-owned practice and participant in the Comprehensive Primary Care Plus (CPC+) initiative whose providers offer pediatrics, family medicine with obstetrics, sports medicine and behavioral health care. Their ancillary services include laboratory services, X-ray, dexascan, ultrasound, mammogram, physical therapy and after-hours urgent care, and they developed an embedded behavioral health training program. PCP is a strategic partner and one of three founders of Monument Health, a clinically integrated network that brings together physician practices, St. Mary’s Medical Center and Rocky Mountain Health Plans. Together they collaborate with patients, coordinate as a team, and are accountable for accessible and more affordable care.

When physicians are allowed to be physicians – advocates for our patients, educators of the public and problem-solvers of the big issues in health care delivery – great things will happen. Let’s assure physicians can continue in this role and be recognized as leaders and innovators who are improving care for our patients.

Categories: Communications, Colorado Medicine, President's Letter, Resources, Initiatives, Physician Wellbeing Resource Center