Altarum's Center for Implementation Science houses expert consultants and practice coaches who have worked with close to 1,500 ambulatory health care practices, gaining a deep understanding of the complex systems issues that face modern medical practice. These experts work with practices on myriad quality improvement endeavors, ranging from improving care for specific patient populations in line with the Centers for Disease Control and Prevention’s (CDC) Million Hearts Initiative, to leveraging health information technology (IT) to meet quality reporting requirements such as Meaningful Use or the Physician Quality Reporting System, to delivering a targeted quality improvement program designed to impact key processes with minimal resource expenditures.

Targeted Practice Optimization (TPO) was developed to untangle the complexity of medical practice by improving key clinical and administrative processes that interact to create the practice’s unique health care delivery system.

Targeted Practice Optimization is a rapid quality and process improvement solution for practices seeking to streamline key clinical and administrative processes and create a high-value experience for patients and providers alike. TPO leverages Lean and Six Sigma principles and tools, targeting specific practice workflows without incurring the time and expense of traditional practice redesign efforts. TPO solutions also leverage health IT investments that practices have already made by identifying underutilized EHR functions and suboptimal workarounds. TPO provides best practice strategies along with tailored policies, standard work instructions, and job aids for key processes:

  • Clinical information management (chart management/chart prep),
  • Orders tracking and follow-up,
  • Referrals management,
  • Clinic visit workflow, and
  • Population health management.

Our improvement recommendations are designed to accommodate and tie together the practice’s specific electronic health record and personnel resources as well as the goals and parameters of Meaningful Use, patient-centered medical home, and other practice-specific initiatives.

The key clinical processes interact to form the health care delivery system in an ambulatory practice. The functioning of this system affects a number of the practice’s outputs, which ultimately affect the health of patients and the population:

  • Productivity,
  • Patient access,
  • Patient satisfaction,
  • Quality of care,
  • Patient-centered medical home (PCMH) or Physician Quality Reporting System (PQRS) performance,
  • Organized Systems of Care (OSC) or Accountable Care Organization (ACO) performance,
  • Meaningful use,
  • Provider satisfaction, and
  • Staff retention.


Leveraging Health IT for Quality Improvement. The Center for Implementation Science is home to the Michigan Center for Effective IT Adoption (M-CEITA). M-CEITA is the state of Michigan’s Regional Extension Center (REC) for Health IT. It is part of a nationwide network formed to accelerate health IT adoption by primary care providers, Federally Qualified Health Centers, and Critical Access Hospitals. Under the M-CEITA program providers and practices receive direct technical assistance to adopt or optimize use of their health IT to meet Centers for Medicare & Medicaid (CMS) Meaningful Use criteria and realize related clinical quality improvements.

M-CEITA facilitates quality improvement through information strate­gies to integrate disparate data sources, generate real-time analytics, address privacy and security concerns, and offer technical and implementation support to improve care coordination, foster patient-centered care, and enhance the effectiveness of population health improvement efforts. 

This direct support of providers is critical to achieve the health, efficiency, and care improvements intended to result from meaningful use of health IT. Research demonstrates that health IT implementation alone does not improve patient care. According to a recent study of small physician offices conducted by Cornell University, at least nine months of EHR use coupled with eight or more technical assistance visits from a REC are required to yield statistical improvements in patient care quality.

Not only does M-CEITA guide and support providers through the journey to effectively use their health IT, we also keep them engaged and informed about national health care improvement priorities.


Contact us today to see if we can help you optimize your practice!