Presentation to the Ohio State Society of Medical Assistant's annual convention about the Patient Centered Medical Home and the role of the medical assistant

1. The Healthcare Team as the Health Care Provider A Different Perspective on the Patient Centered Medical Home James Dom Dera, MD, FAAFP 23 April 2010

4. Preventive Medicine Behavioral Health Medical Assistants Medication Refills Acute Care Nursing Case Manager Test Results Chronic Disease Monitoring Physician

12. Preventing examples like this requires a fundamental change in how healthcare is delivered.

15. Huh???

26. Wellness Illness Health Risk Disease Impairment Treatment and Rehabilitation (Tertiary Prevention) Early Detection & Case Finding (Secondary Prevention) Health Promotion & Protection (Primary Prevention)

27. Health Care Costs Concentrated in Sick Few 1% 5% 10% 55% 69% 27% Source: A.C. Monheit, “Persistence in Health Expenditures in the Short Run: Prevalence and Consequences,” Medical Care 41, supplement 7 (2003): III53–III64. Distribution of Health Expenditures for the U.S. Population, By Magnitude of Expenditure, 1997 50% 97% $27,914 $7,995 $4,115 $351 Expenditure Threshold (1997 Dollars)

29. CMA Where does the CMA fit into this? Coordination of Care Enhanced Access Physician Directed Healthcare TEAM Whole Person Orientation Quality/Safety

34. Preventive Medicine Point of Care Testing Chronic Disease Monitoring Medication Refills Test Results Acute Care Behavioral Health Mid-Level Provider Acute Mental Health Complaint Chronic Disease Compliance Barriers Provider Physician Medical Assistant Preventive Medicine Behavioral Health Medical Assistants Medication Refills Acute Care Nursing Case Manager Test Results Chronic Disease Monitoring Physician

35. Preventive Medicine Point of Care Testing Chronic Disease Monitoring Medication Refills Test Results Acute Care Behavioral Health Mid-Level Provider Acute Mental Health Complaint Chronic Disease Compliance Barriers Provider Physician Medical Assistant

37. Thank-You!