Transcript Slide 1
Advancing PCMH Model with IPE/ICP Principles
IN-AHEC Network IPE Conference John Kunzer MD, MMM
• No conflicts to disclose
Objectives 1. Define a Patient Centered Medical Home (PCMH) and identify opportunities to advance PCMHs with IPE principles 2. Discuss examples of IPE within the clinical environment and lessons learned 3
Today’s Health Care Problems • We spend more but get less • U.S. ranks lowest in primary care orientation • Number of medical students going into primary care has dropped 52% since 1997 • Patients, staff, and physicians are not satisfied • Nonemergency ambulatory care visits to clinics of safety-net hospitals grew twice as fast as visits to non-safety-net hospitals from 2006 to 2009
“The current care systems cannot do the job. Trying harder will not work. Changing systems of care will.”
Crossing the Quality Chasm: A New Health System for the 21 st Century Institute of Medicine, 2001
A PCMH isn’t New . . .
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Wishard: A History of Building Patient-Centered Medical Homes • Medical and Dental Services • Mental Health • Pharmacy • Social Worker • Patient Navigator • Dietician • Financial Counselor • Lifestyle Coach • Medical Legal Partnership • Care Coordinators • Healthy Families • Women, Infant, and Children 7
A PCMH is Different . . . OLD
• One provider – One patient • Team Based Care • An Office Visit • A Passive Patient
NEW
• A Coordinated Experience • An Engaged Patient
PCMH: The Future of Primary Care • National Committee for Quality Assurance (NCQA) PCMH recognition program • Patient Centered Primary Care Collaborative has over 600 members • Pilot Programs have shown: – decreased staff burnout – increased patient satisfaction and quality – fewer emergency room visits – no difference in overall cost
The Patient-Centered Medical Home (PCMH)
• Personal physician for each patient • Team based care • Whole person orientation • Care is coordinated or integrated • Quality and safety • Enhanced access • Payment recognizes added value to patients 10
NCQA PCMH Standards
1. Enhance Access and Continuity 2. Identify and Manage Patient Populations 3. Plan and Manage Care 4. Provide Self-Care Support and Community Resources 5. Track and Coordinate Care 6. Measure and Improve Performance
Our Health Center Journey • Multidisciplinary Medical Home Implementation Team formed in 2009 • Champion Physician from each CHC • Gap analysis conducted from current performance and NCQA standards for PCMH • Pilot projects developed and best practices implemented • 105 Ezkenazi Medical Group providers recognized and 14 Wishard practices recognized
Our Health Center Journey • Standardized processes • Continuing education for all staff • Patient portal • Huddles • Increased same day appointments • Quality Champion Teams • Starting embedded RN care managers, electronic and telephone visits
• VSQ STUFF
Implications for IPE • Defining a common language and understanding is needed • Labeling actions helps make it understandable • Institutional support necessary • “Champions” at each site • Facilitate awareness of interdependence • Culture change takes time • Co-location does not equal collaboration • Professional development
PCMH and IPE: Potential to Create High Performing Teams 1+1 <2 PCMH+IPE <2 1+1 =2 PCMH+IPE =2 1+1 =3 PCMH+IPE =3