PROGRAM SUMMARY ARIZONA MEDICAL BOARD Contact: Timothy Miller, J.D., Executive Director Phone (480) 551-2791 MEA 0.0 A.R.S. §32-1421 to 31-1429, 32-1451 et.seq., 32-14 Mission: The mission of the agency is to protect public safety through the judicious licensing and regulation of physicians and physician assistants. Description: The agency staff supports two Boards – the Arizona Medical Board, which regulates the allopathic medical profession, and the Arizona Regulatory Board of Physician Assistants, which regulates physician assistants in the State of Arizona. Together, the Boards regulate over 18,000 licensees. The two boards determine and administer disciplinary action in the event of proven violations of the practice acts. The Agency processes application for licenses, handles public complaints against licensees, and disseminates information on healthcare delivery system. Strategic Issues: The strategic direction of the Arizona Medical Board and the Arizona Regulatory Board of Physician Assistants for the next two fiscal years, 2006 and 2007, is anchored in addressing the challenges that may beset public safety. Broadly, these issues include limited public access to timely and relevant information on healthcare delivery system; inadequate resources invested to process license applications and investigate consumer complaints; obsolete information technology; lack of communication among state agencies or other state medical boards that may result to untimely conduct of necessary action; and low level of accountability for system outcomes. The following agency goals address each of these issues by implementing a regulatory model that supports system accountability through the use of cutting edge technology. Goal 1: Educate the public to make informed healthcare decisions Objective 1: Increase access to relevant and a wide array of information on healthcare delivery system Action Steps: • Expand current consumer webpage to include geographic distribution of specialty doctors • Issue and distribute newsletter addressing topical healthcare delivery issues • Proactively offer Speaker’s Bureau services to universities, medical schools, centers & organizations Performance Measures: • Number of newsletter copies distributed (FY06 estimate: 40,000; FY07 estimate: 42,000) • Number of Speaker’s Bureau engagements (FY06 estimate: 32; FY07 estimate: 35) Objective 2: Disseminate information using effective communication media Action Steps: • Identify other communication media to effectively disseminate information • Allocate resources to test and explore various communication media • Develop a process to measure and receive consumer feedback on information dissemination Performance Measures: • Consumer satisfaction rating (FY06 estimate: 80%; FY07 estimate: 85%) • Percent of agency budget expended on information dissemination (FY06 estimate: 0.5%; FY07 estimate: 0.5%) Goal 2: Utilize available advanced technology in the regulation of licensees Objective 1: Streamline the licensing process Action Steps: • Implement e-licensing • Implement e-renewal • Implement on-line change of address • Implement on-line fee payment Performance Measures: • Percentage of license applications processed within standard time (FY06 estimate: 100%; FY07 estimate: 100%) • Percentage of renewal applications processed within standard time (FY06 estimate: 100%; FY07 estimate: 100%) • Percentage of license and renewal payments paid on-line (FY06 estimate: 30%; FY07 estimate: 35%) • Average time to issue a license from receipt of application (FY06 estimate: 60 days; FY07 estimate: 58 days) • Average time to renew license from receipt of application (FY06 estimate: 6 days; FY07 estimate: 5 days) • Licenses issued (M.D.) (FY06 estimate: 1345; FY07 estimate: 1412) • Licenses issued (P.A.) (FY06 estimate: 149; FY07 estimate: 152) • • • Resident Permits issued (FY06 estimate: 1243; FY07 estimate: 1293) Average number of days to process a medical doctor license upon receipt of completed application (FY06 estimate: 2 days; FY07 estimate: 2 days) Average number of days to process a medical doctor renewal upon receipt of completed application (FY06 estimate: 2 days; FY07 estimate: 2 days) Objective 2: Use cutting-edge technology in the judicious processing of complaints Action Steps: • Develop an automated milestone tracking system for case adjudication • Develop an automated case monitoring mechanism • Initiate paperless work environment • Develop virtual case review process Performance Measures: • Percentage of (investigation) cases conducted within set timeframes (FY06 estimate: 85%; FY07 estimate: 85%) • Percentage of cases reviewed by Board staff completely using electronic media (FY06 estimate: 85%; FY07 estimate: 85%) • Consumer satisfaction rating in the length of time for case adjudication (FY06 estimate: 80%; FY07 estimate: 80%) • Average number of days to complete a medical doctor investigation (FY06 estimate: 200 days; FY07 estimate: 180 days) • Average number of days to complete a physician assistant investigation (FY06 estimate: 200 days; FY07 estimate: 180 days) • Average number of days to resolve a medical doctor case (FY06 estimate: 280 days; FY07 estimate: 220 days) • Average number of days to resolve a physician assistant case (FY06 estimate: 280 days; FY07 estimate: 240 days) • Medical doctor cases referred to formal hearing (FY06 estimate: 10 days; FY07 estimate: 10 days) Objective 3: Promote the use of advanced technology in the practice of medical profession Action Steps: • Promote use of advanced technology in the health profession • Procure and implement a new information technology software solution for the Arizona Medical Board • Develop intranet and extranet to decrease time of data/information exchange with key stakeholders and medical consultants • Partner with the federal government in encouraging broader use of health information technology Performance Measures: • Number of agency-sponsored seminars on topic of advanced technology (FY06 estimate: 1; FY07 estimate: 1) • Number of external stakeholders issued limited access to Board data and information (FY06 estimate: 1; FY07 estimate: 2) • Percentage of stakeholders with limited on-line access to Board data (FY06 estimate: 20; FY07 estimate: 22) Goal 3: Strengthen collaboration with stakeholders, other state agency Boards, and other state Medical Boards Objective 1: Develop a system of communication among state agencies, state Boards, other state medical boards for case referral, adjudication and compliance monitoring Action Steps: • Increase participation in multi-stakeholder groups and committees • Attend/present at relevant national conferences on Board activities • Develop a process for stakeholder participation in rule making • Co-sponsor conferences, seminars & similar events with other parties • Initiate dialogue with other state medical boards regarding compliance monitoring of licensees Performance Measures: • Representation on committees (FY06 estimate: 4; FY07 estimate: 6) • Co-sponsorship of conferences, seminars, etc. (FY06 estimate: 1; FY07 estimate: 2) • Attendance/presentation at national conferences relevant to regulation, licensing, & medical practice. (FY06 estimate: 2; FY07 estimate: 3) • Number of states engaged in dialogue with AMB (FY06 estimate: 8; FY07 estimate: 10) Objective 2: Improve awareness of licensees on statutory requirements Proposed Action Step(s): • Develop a webpage for “Ask AMBy” • Sponsor education seminars addressing Arizona statutory & rule requirements • Review consistency of AMB rules with other state Board rules on topics with overlapping jurisdiction Performance Measures: • Number of questions received and answered through “Ask AMBy” webpage. (FY06 estimate: 50; FY07 estimate: 75) • Number of seminars sponsored addressing Arizona statutory & rule requirements. (FY06 estimate: 1; FY07 estimate: 1) Objective 3: Promote the physical and mental health of licensees Action Steps: • Implement the Physician Health Program. • Increase awareness of the Board’s Physician Health Program. • Allocate resources to support the Physician Health Program. Performance Measures: • Number of self-report or voluntary participation in the Board’s Physician Health Program (FY06 estimate: 15; FY07 estimate: 25) • Participation success (completion) rate (FY06 estimate: 80%; FY07 estimate: 82%) • Relapse rate (FY06 estimate: 5%; FY07 estimate: 4%) • Non-compliance rate. (FY06 estimate: 5%; FY07 estimate: 4%) • Percentage of participants with practice restriction and/or limitation (FY06 estimate: 20%; FY07 estimate: 20%) • Recidivism rate for MAP participants (FY06 estimate: 5%; FY07 estimate: 4%) Goal 4: Increase accountability through adoption of a system of performance measurement Objective 1: Improve efficiency of the adjudication process Action Steps: • Develop and administer a consumer satisfaction survey to a randomly selected statistically valid number of licensees with open investigations • Develop a process to analyze and use survey results and other data for quality improvement • Evaluate workflow processes for quality improvement Performance Measures: • Overall consumer satisfaction rating (FY06 estimate: 80%; FY07 estimate: 80%) • Average cost of investigation to the Board (FY06: set baseline) • Average cost of investigation to licensee (FY06: set baseline) Objective 2: Improve efficiency of the licensing process Action Steps: • Develop and administer a consumer satisfaction survey to a randomly selected statistically valid number of licensees • Develop a process to analyze and use survey results and other data for quality improvement • Evaluate workflow processes for quality improvement Performance Measures: • Overall consumer satisfaction rating (FY06 estimate: 99%; FY07 estimate: 99%) • Average cost of issuing a license (FY06: set baseline) Objective 3: Disseminate Board data and statistics Action Steps: • Utilize Geographic Information System (GIS) to report distribution of Physicians & Physician Assistants statewide. • Partner with educational institutions for data analysis and dissemination • Utilize data analysis for continuous quality improvement and agency administration Performance Measures: • Frequency of statistical report publication (FY06 estimate: 4; FY07 estimate: 4) • Number of quality improvement initiatives adopted to address issues or problems identified from data analysis (FY06 estimate: 2; FY07 estimate: 2) • Number of days to respond to a data request (FY06 estimate: 10 days; FY07 estimate: 10 days) • Average score of agency-wide customer service satisfaction surveys (FY06 estimate: 7.7; FY07 estimate: 7.8)