Wellforce Clinically Integrated Network (WCIN) Performance Briefing
Closing Quality Gaps: Tips from Wellforce CIN PCPs
10.26.21: Tips from WCIN PCPs l Colonoscopy Screenings l A1c Exams l Women's Health l Adolescent HPV Series l CPT Codes l COVID-19 Antibody Testing l Post-Acute Care Guide l Programs for our Network
October 26, 2021

A Message for WCIN PCPs, Practice Administrators, Board of Trustees, Network Leaders (Presidents, Administrators, and Medical Directors), and our WCIN All Staff (Braintree/Lowell)
Dear Colleagues,

As we focus on closing care gaps before the end of the calendar year, we wanted to share some helpful approaches that we have heard from some of you, along with a few clinical items (COVID-19 and non-COVID-19) and program announcements.

  • Mail out FIT tests or Cologuard with instructions for patients due for colorectal cancer screening who are unwilling or unable to schedule a colonoscopy before year-end, or who can’t be reached by phone.
  • Some groups have an order set in their EMR for Cologuard

  • Call patients due for screening (e.g. colonoscopy) directly to discuss (MD calls have a much higher yield than calls from staff).

  • Distribute disposable home fingerstick A1c machine for diabetic patients who are due for A1c and can’t or will not come to the lab.

  • For offices that have or are willing to get fingerstick A1c retinal exam machines, schedule diabetic patients to come in, creating additional convenient sessions (evenings or weekends).

  • Schedule a few women’s health sessions (perhaps on an evening or weekend) where Pap smears can be done and mammograms scheduled; can be shared across multiple practices or an LCO.

  • Make sure to start the adolescent HPV series early enough to complete by the 13th birthday (e.g. if 2nd dose is to be given the day before the 13th birthday, then the first dose must be given no later than 6 months prior to the 13th birthday). The CDC recommendation is to start at age 11 (or as early as age 9).

  • Make sure to use the correct CPT code for the specific rotavirus vaccine product you’re administering. There are two different products in use; Rotarix is a 2 dose series, and has a different CPT code than RotaTeq, which is a 3 dose series. Patients are being reported as non-compliant because the three-dose CPT code is being reported for patients receiving the two-dose vaccine, who then appear to be missing a dose.

As always, please make sure patients have their yearly flu shots, as well as COVID-19 vaccine primary series and COVID-19 booster for those patients for whom it is recommended.

Other important clinical items:
  • MHA recently published an excellent Post-Acute Care Guide, with separate sections directed at clinicians and patients.
  • Tufts Medical Center is able to see patients with suspected long-haul COVID-19. As of now, please refer these patients to the appropriate specialty for their most troubling symptom.
  • Pulmonary: Drs Ghamloush, Farber and Hon (617-636-6377)
  • Neuro: Drs. Querfurth, Albo and neuropsych Dr. Laudate (617-636-5848)
  • PM&R: Drs. Zaman and Bach (617-636-5631)
  • COVID-19 antibody testing continues to be unhelpful as a clinical tool, since we have no correlation between test results and actual protection against COVID-19 at an individual level. We urge you to refrain from ordering this test, even when patients request it. There was an excellent article in the Washington Post last week which may be helpful to provide to patients who are looking for this testing.

We appreciate all that you are doing to provide good care for patients! Please reach out to any of us with questions.
Wellforce Clinically Integrated Network
Medical Leadership Team
Megan Cardoso, MD
Ben Kruskal, MD
Frank Osborn, MD
Pratiksha Patel, MD
Mark Your Calendar: Programs for Our Network
Please visit the Wellforce Webinar Series Page for more details on upcoming events

  • Wednesday, October 27 (Noon-1 p.m.): Monthly EpicEdge Physician Town Hall
  • Click here to register.
  • Thursday, October 28 (5:30-6:30 p.m.): EpicEdge Community Info Session
  • Click here to register.
  • Wednesday, November 3 (7-8 p.m.): IEP for Home Seminar Series

ICYMI: Please visit the Wellforce Webinar Series Page for links to past recordings/presentations

The Wellforce Clinically Integrated Network is a distinctively different population health enterprise and value-based care contracting entity comprising 2,300 primary care and specialist providers, in private and employed practices, working in community and hospital settings. The Network’s purpose is to build healthier communities and to create healthy, rewarding experiences for its participating physicians. The Network was launched in July 2021 by building upon the legacies of two long-standing, high-performing organizations – Lowell General Physician Hospital Organization and New England Quality Care Alliance (NEQCA).