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PCMH and a solo practice

Objectives. Understand the NCQA PCMH Certification CriteriaPractical office re-engineering to qualify for the NCQA PCMH Certification. Becoming a Level 3 PCMH. Practice transformationImplementing the electronic medical recordFacing rising expenses as percentage of annual gross incomeAchieving N

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PCMH and a solo practice

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    1. PCMH and a solo practice Salvatore Volpe MD FAAP FACP CHCQM www.svolpemd.com http://ehrphrpatientportal.blogspot.com/

    2. Objectives Understand the NCQA PCMH Certification Criteria Practical office re-engineering to qualify for the NCQA PCMH Certification

    3. Becoming a Level 3 PCMH Practice transformation Implementing the electronic medical record Facing rising expenses as percentage of annual gross income Achieving NCQA Certification Decision to pursue recognition at Level 3 Cost to the practice vs. potential reimbursement Utilized PCIP QI coaching (Facilitator) for technical assistance The future of PCMH for Primary Care Physicians

    4. PPC-PCMH Content and Scoring

    5. PPC-PCMH Content and Scoring

    6. Preparation Self-assess- identify current processes and workflows Collect data – perform initial analysis and routine reassessment Identify opportunities for improving efficiencies and health outcomes Solicit input from patients and office team about ways to improve care delivery Develop workflows, assign roles and implement processes Submit documentation to NCQA

    7. Practice Transformation • Access – Evening/weekend hours, after-hours care • Coordination of care – Information shared with specialists, information shared with patient, updating of care plan • Team-based care – Defined roles and responsibilities, training, communication • Role of medical home – Discussion of roles/expectations for medical home and for patients • Community involvement – Assessment of community needs, matching services to needs, involvement of community organizations • Addressing special population needs/risks • Evaluating patient experiences – enhanced role of patient in care

    8. 1 A: ACCESS & COMMUNICATION PROCESSES

    9. 1 B: ACCESS & COMMUNICATION RESULTS

    10. 2 D: ORGANIZING CLINICAL DATA

    11. 2 E: IDENTIFYING IMPORTANT CONDITIONS

    12. 4B: SELF-MANAGEMENT SUPPORT

    13. 6A: TEST TRACKING

    14. Conclusions PCMH is a good guide for office transformation, but practices have to buy into the concept first Sometimes, the transformation is the easiest part. Proving it is the challenge Care coordination efforts are rarely documented EMRs not yet ready to facilitate capture of that information Hard to get aggregate look (many fields are not queriable/no reports available) How do you prove something was given or printed? Some features desired for the future Notification if patient is in the ER or hospitalized Referral system that alerts you if preauthorization is necessary Patient education materials available in all languages

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