Monitoring Healthy People 2010 Outcome Objectives

1. University of Illinois Monitoring Healthy People 2010 Outcome Objectives Illinois Perspective on Medical Home National Survey Children With Special Health Care Needs

2. Outcome Objectives • 6 Core outcomes • 5 outcomes measured on survey…except • screening of all children for special health care needs. • Basis for monitoring progress over the coming decade • Criteria developed to meet each outcome • Questions on survey chosen to correlate with criteria

3. Outcome Objectives All children with special health care needs will receive coordinated ongoing comprehensive care within a medical home. Medical Home

4. Medical Home Criteria… 1. Child has a usual source of care for sick care and routine preventive care (Q37 and Q40/41). 2. Child has a personal doctor or nurse (Q42). 3. Family experiences no problems in obtaining referrals from specialists when needed (Q64).

5. Medical Home Criteria… 4 When needed, child's doctors and other health care providers do an excellent or very good job of communicating with each other (Q69). 5. When needed, child's doctors and other health care providers do an excellent or very good job of communicating with child's early intervention program, school, child care providers, or vocational rehabilitation program (Q70).

6. Medical Home Criteria… 6. Child's doctors and other health care providers usually or always spend enough time with the child (Q75), listen carefully (Q76), are sensitive to family's values and customs (Q77), provide needed information about child's care (Q78), and make family feel like a partner in child's care (Q79).

7. How will Illinois interpret… The Medical Home?

8. Medical Home …not an all or none phenomenon Degree of “Medical Homeness” 200 25 Some A lot 101.7 Mean score for pediatric practices Spectrum of Care W. Carl Cooley, M.D. – Medical Home Index – Nat’l Data

9. Medical Home …not an all or none phenomenon Degree of “Medical Homeness” 200 25 Some A lot 98 Median score for pediatric practices Spectrum of Care W. Carl Cooley, M.D. – Medical Home Index – Nat’l Data

10. The Medical Home Pyramid Low Priority Degree of Medical Homeness Elements Pillars Foundation High Priority

11. Foundation The Medical Home Pyramid Family-Professional Partnership – The primary care provider (PCP) and medical subspecialists share a trusting, collaborative relationship with the family. Parents are comfortable sharing concerns and questions with the PCP. The parents routinely communicate their child's needs and family priorities to the PCP, who facilitates communication between family and subspecialists when necessary. This relationship forms the foundation for the PCP's written Care Plan that is jointly developed and shared with the family. Short term and long-term goals are set, with detailed plans for follow-up and reassessment.

12. The Medical Home Pyramid • Will use this tier to report on the annual Block Grant • Qualitative measure • DSCC will reimburse MHPs for care coordination activities related to this tier of the pyramid Foundation

13. Medical Home Structure“Treatment Team” Cardiologist Primary Managing Care Physician Primary Managing Care Physician OT + Family + DSCC Care Coordinator + Urologist Orthopedist IEP-Related Services Family + DSCC Care Coordinator PT Speech Neurologist ENT Secondary Managing Care Physicians

14. Pillars The Medical Home Pyramid Critical Supporting Elements

15. Primary Managing Care Physician • Accessible • Family-Centered • Comprehensive • Continuous • Coordinated • Compassionate • Culturally-competent Care that is: Medical Home "Pillars" and for which the PCP: Shares Responsibility

16. Pillars The Medical Home Pyramid Other Essential Elements Foundation …taken from W. Carl Cooley’s Medical Home Index tools.

17. Other Essential Elements • Database designator • Senior volunteer program • Valet parking • Pre-visit survey • Bulletin board • Lending library • Special addition newsletter • Telephone consult • Review of care plan • Access to internet • DSCC referral • Additional reimbursement Medical Home involves the whole office staff

18. Additional ideas and suggestions • Build a team w/ parent input • Written materials are available in languages that rep. the comm. • Parents teach at brown bag lunch seminars • Develop a mission statement for the office • Chart identification • Designate staff to act as care coordinator • Use of email for information exchange • Contact person within the office

19. Thank you.... • Charles N. Onufer, M.D. • cnonufer@uic.edu • Robert J. Cook • Family Liaison Specialist • rjcook@uic.edu • Angela Pitts • ampitts@uic.edu • Shelly Roat • sgroat@uic.edu University of Illinois 217-793-2350 www.uic.edu/hsc/dscc