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Practice Transformation

Practice Transformation. Thriving in a Time of Change Stephen Weeg. Transformation. A fundamental redesign of the organization’s: Mission, vision, and strategic goals Organizational responsibilities and roles Policies and procedures Care processes Use of data

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Practice Transformation

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  1. Practice Transformation Thriving in a Time of Change Stephen Weeg

  2. Transformation • A fundamental redesign of the organization’s: • Mission, vision, and strategic goals • Organizational responsibilities and roles • Policies and procedures • Care processes • Use of data • Relationships with patients and community

  3. Health West Background • Six clinics (1 urban, 5 rural) in southeast Idaho located within a 50 mile radius • 5 of the 6 have a single medical provider each day; Pocatello has 3-4 providers per day. • 9,000 patients with 31,000 visits annually • 45% Uninsured • Annual budget: $3.5 million • Migrant and community health center; 2 sites serve over 60% Hispanic patients

  4. Why PCMH • Strategic Position • Patient Care • Staff Satisfaction & Empowerment • Financial Advantage

  5. Challenges • Meeting HRSA Program Requirements • UDS Clinical and Financial Indicators • Seeing patients • Fiscal stability • Meaningful Use, Affordable Care Act & politics • Changing healthcare environment • Tyranny of NOW

  6. Before PCMH

  7. Health West Journey • Safety Net Medical Home Initiative: July 2009 • Team-based care & huddles: 2009 • EMR: December 2009 • Empanelment, Data, Position redefinition: 2011 • New mission: 2011 • NCQA Site Recognition: March – July 2012 • Embed and strengthen roles: 2012 • Meaningful Use Incentive: 2012

  8. After PCMH

  9. Patient Impact • 56 yodiabetic female suffering from obesity and depression. She had a poor self imageand lacked motivationto make changes. Her primary care provider reviewed with her all aspects of her current situation including her current lab work, medications, goals, feelings towards her current health, and more…”

  10. Patient Impact • Over the next two months, and with a little encouragement, she was able to do the following: • Meet with our health educator and mental health counselor • Adjust to a better medication regimen • Begin a regular exercise program and improve her diet, helping her shed 6 pounds, have more energy throughout the day, have longer, more restful sleep, and improve her mood • Move forward in her life with help of the counselor

  11. Provider Impact • “The very best part of the Patient Centered Medical Home is that the patient gets, better, more effective care than ever before, and the provider, because everyone is working as a team, can deliver this care with even less effort than before.  More for less—you can’t beat that!” • Mark Horrocks, MD, Medical Director

  12. Staff Impact • “With Team-based care, we can better anticipate our patients’ needs when it comes to medication refills, scheduling lab work, and setting up for an office visit, etc. Plus, our patients’ needs are better served. I also feel that I can work more comfortably with my provider.” • RH, LPN • “Team-based care helps our patients by giving them a support group and the exceptional care they need. They are always followed up with and have a medical team they can count on to help with their needs. “ • MP, Receptionist

  13. Elements of Success • Vision • Focus • Team Focus • Technical Assistance & Support • Humor • Organizational Engagement & Leadership • Passion • Persistence • Data

  14. Why Become a Patient Centered Medical Home? This is the kind of care that wewouldwant for ourselves and for the persons we know and love. It is the right way to care for the whole person.

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