This presentation explains the concept of the patient-centered medical home (PCMH), its function and its intended effects. A brief overview of the history of PCMH is also provided, as well as a discussion of its operational characteristics, its principles and outcomes, and what is expected in the future for the PCMH model.
2. W.H.
Introduction
⢠What is it?
⢠What does it do?
Patient-Centered Medical Home (PCMH) is an approach to
providing comprehensive primary care for children, youth
and adults.
The PCMH is a health care setting that facilitates
partnerships between individual patients, and their personal
physicians.
(Fisher, 2008)
4. www.scmao.com
History of the PCMH Concept
ďś Introduced by American Academy of Pediatrics
(AAP) in 1967
ď§ Initially referred to a central location for medical records.
ďś The PCMH model received formal recognition in
2007 by
ď§ American Academy of Family Physicians (AAFP),
ď§ American Academy of Pediatrics (AAP),
ď§ American College of Physicians (ACP),
ď§ American Osteopathic Association (AOA).
ďś Since then, they have been endorsed by more than
12 physician organizations.
(Homer, Cooley, & Strickland, 2009)
W.H.
7. Patient Personal Physician
ďŽ Trusted personal physician
ďŽ Physician who provides, manages and
facilitates care
ďŽ Care is coordinated or integrated across
healthcare system
ďŽ More accessible practice with increased hours
and easier scheduling
ďŽ Enhanced payment that recognizes the added
value of delivering care through the PCMH
model
ďŽ Assistance to practices seeking
transformation
ďŽ Support to practices adopting HIT for QI
The PCMH Model
W.H.
8. Family Medicine Foundation
Great
Outcomes
Heath
Information
Technology
Practice
Organization
Patient
Experience
Quality
Measures
The PCMH Model
ďś Practice Organization
ď§ Build a productive & supporting
environment
ď§ Put Finances In Order.
ďś Health Information Technology
ď§ Connect & communicate.
ď§ Depends on clinical decision
support tools.
ďś Quality Measures
ď§ Install a system to collect data.
ď§ Use the system to improve care.
ďś Patient Experience
ď§ Provide same-day appointments.
ď§ Free-up appointment slots
ď§ Educate and train staff.
(Backer, 2009)
W.H.
10. CEO OF New York-Presbyterian Hospital
ďśIn 2014: 32 million more Americans will have
health insurance and will need access to care.
ďśBaby boomers are reaching retirement age,
and facing the increased medical needs of old
age
ďśPhysicians shortage
ďś6,000 to 8,000 new physicians needed
annually on top of the 16,000 that are currently
produced each year
S.A.
11. PCMH Future
ďśThe PCMH has the potential to become an
important component of health reform
ďśTruly transforming the U.S. health care system
around personalized medical homes embedded in
highly functional medical neighborhoods will
require
ď§ better staffing models;
ď§ more robust electronic information tools;
ď§ aligned incentives for quality and efficiency within
payment and regulatory policies; and
ď§ a culture of greater engagement of patients, their
families, and communities.
S.A.
12. How to tell if you have a PCMH?
ďś Can you get an urgent appointment within 24 hours?
ďś Can you reach someone in the practice by phone at night or on
weekends?
ďś Can you get test results quickly via e-mail or telephone, or on-
line?
ďś If you have a chronic condition, is there a system for tracking how
youâre doing?
ďś Does the practice include non-MD staff members such as
nutritionists or nurse practitioners to help you manage your
medications or chronic conditions?
ďś Does your primary-care doctor keep track of your treatment by
specialists?
S.A.
14. Patient Expectations
ďś75% want the ability to interact with their
physician online (appointments, prescriptions,
test results).
ďś77% want to ask questions without a visit.
ďś75% want email access as part of their overall
care.
ďś62% of patients say access to these services
would influence their choice of physicians
M.Z.
16. www.scmao.com
PCMH Distribution
As of December 2010 there are 7,676 clinicians in 1,506
recognized PCMH practices in the US.
(National Committee for Quality Assurance [NCQA] , 2011)
M.Z.
17. Great Outcomes
Patients
⢠Enjoy better health
⢠Share in health care
decisions
Payers &
Employers
⢠Ensures quality & efficiency
⢠Avoids unnecessary costs.
Practices
⢠Team works
effectively together.
⢠Resources support
the delivery of excellent
patient care.
Physicians
⢠Physicians focus
more on delivering
excellent medical care
PCMH
Outcomes
M.Z.
18. References
ďś Backer, L.. (2009). Building the case for the Patient-Centered
Medical Home. Family Practice Management, 16(1), 14-8.
ďś Fisher, E. (2008). âBuilding a Medical Neighborhood for the
Medical Home.â New England Journal of Medicine 359 (12):
1202-1205.
ďś Fischer, J. (2011). CEO OF NewYork-Presbyterian Hospital
Discusses Impact of Health Care Reform on American Medical
Centers and Medical Innovation. Retrieved from:
http://nyp.org/news/hospital/reform-medical-center.html
ďś Homer, C., Cooley, W., & Strickland, B.. (2009). Medical Home
2009: What It Is, Where We Were, and Where We Are Today.
Pediatric Annals, 38(9), 483-90.
ďś Landon, B. Gill, J. Antonelli R and Rich, E. (2010). Prospects for
rebuilding primary care using the patient-centered medical home.
PubMed
ďś National Committee for Quality Assurance [NCQA] (2011).
Retrieved April 15, 2011 from:
http://www.ncqa.org/LinkClick.aspx?fileticket=QKn%2BiVilJ9Q
%3D&tabid=631&mid=2435&forcedownload=true
19. References
ďś Patient-Centered Primary Care Collaborative. (2009). Proof in Practice: a
compilation of patient centered medical home pilot and demonstration
projects. Retrieved April 15, 2011 from:
http://pcpcc.net/files/Grumbach_et-al_Evidence-of-Quality_
%20101609_0.pdf
ďś Rosenthal, T. (2008). âThe Medical Home: Growing Evidence to Support
a New Approach to Primary Care.â Journal of the American Board of
Family Medicine 21 (5): 427-440.
ďś Rittenhouse, D. and Shortell, S. (2009). The Patient-Centered Medical
Home: Will It Stand the Test of Health Reform? PubMed.
ďś Rosenthal, M. Beckman, H. Forrest, D., Huang ,E, Landon, B and Lewis,
S. (2010). Will the patient-centered medical home improve efficiency and
reduce costs of care? A measurement and research agenda. PubMed
ďś Sinsky, C. (2011). The patient-centered medical home neighbor: A
primary care physician's view. PubMed
ďś Strickland, B., Jones, J., Ghandour, R., Kogan, M., and Newacheck, P.
(2011). The Medical Home: Health Care Access and Impact for Children
and Youth in the United States. Pediatrics, 127(4): 604 - 611.
20. That concludes our presentation
Speakers:
Wafa Hetany
Sara Abubotain
Marwah Zagzoug
Hinweis der Redaktion
Fisher, E. (2008). âBuilding a Medical Neighborhood for the Medical Home.â New England Journal of Medicine 359 (12): 1202-1205.
Fisher, E. (2008). âBuilding a Medical Neighborhood for the Medical Home.â New England Journal of Medicine 359 (12): 1202-1205.
In 2002, the medical home concept was expanded to include operational characteristics
A personal physician who coordinates all care for patients and leads the team.
Physician-directed medical practice â a coordinated team of professionals who work together to care for patients.
Whole person orientation â this approach is key to providing comprehensive care.
Coordinated care that incorporates all components of the complex health care system.
Quality and safety â medical practices voluntarily engage in quality improvement activities to ensure patient safety is always being met.
Enhanced access to care â such as through open-access scheduling and communication mechanisms.
Payment â a system of reimbursement reflective of the true value of coordinated care and innovation.
If you have all of these features, then congratulations you got yourself a Patient Centered Medical Home!
Patients today are savvy consumers of health care.
Patients expect to have online access to physicians and office staff, especially email
Access means 24/7âperhaps not to the physician or a real person but the ability to communicate via email or to set appointments
Convenience= same day appointments, setting up appointments on line, early morning and/or evening and weekend appointments
Coordination=obtaining lab results, films, referrals, should not rest on the patientsâ shoulders
Responsiveness=make sure the patient is the priority, return phone calls, emails, etc.
Many practices are now gaining official recognition by the NCQA as Patient Centered Medical Homes
As of December 2010 there are 7,676 clinicians in 1,506 recognized PCMH practices in the US. As health care reform gains momentum, the strength of the PCMH model is about to be tested