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THE EVER EVOLVING PATIENT CENTERED MEDICAL HOME

THE EVER EVOLVING PATIENT CENTERED MEDICAL HOME. Kathy Willis, MD Jay Besse. What is the PCMH?. Medical Home is not a place, but rather a theory and model for providing comprehensive primary care.

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THE EVER EVOLVING PATIENT CENTERED MEDICAL HOME

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  1. THE EVER EVOLVING PATIENT CENTERED MEDICAL HOME Kathy Willis, MD Jay Besse

  2. What is the PCMH? • Medical Home is not a place, but rather a theory and model for providing comprehensive primary care. • It creates and encourages partnerships between health care providers/teams and individual patients—and sometimes the patient’s significant others.

  3. LSU History HERE

  4. NCQA PPC-PCMHJoint Principles • Personal physician • Physician directed medical practice • Team of individuals who collectively take responsibility for ongoing care • Whole person orientation • Personal physician takes responsibility for all the patient’s health care needs

  5. NCQA PPC-PCMHStandards

  6. Continuing the LSU Medical Home • Accountable Care Organization agreement • Representatives from our partners will work with us • Important that a consistent concept is maintained across the LSU Medical Home locations

  7. Continuing The LSU Medical Home • Same patients • Same providers • Same staff • Same program • Same dedication

  8. What do we need to do now? • Address the challenges to meeting the NCQA requirements • Formalizing the requirements of the LSU Medical Home • Identify and adapt to system changes

  9. Defining the LSU Medical Home Standards • Two Perspectives • Providers • What do we expect from the patients? • What things should we are providers do to improve the patients experience? • What do we expect from our staff in the Medical Home? • Patients • What should a patient expect as a member of the LSU Medical Home? • Comprehensive • Multi-Domain • Flexible

  10. LSU Medical Home Measurement Domains • ACCESS • PROCESS • SCREENING & PREVENTION • OUTCOMES • PERCEPTION & SATISFACTION

  11. Domain 1: Access • Appointment Show Rate • Median Days to Appointment • Referrals * • Telephone Follow-up * • Assessing Electronic Access to patient records * * In Development

  12. Domain 2: Process • Documentation • Blood Pressure • Weight • Height • Smoking Status • Primary Care/Medical Home Verification • Verify patient-provider relationship • Medication Reconciliation

  13. Domain 3: Screening & Prevention • Cancer Screening • Breast – Mammogram in past 2 years, age 40-75 • Cervical – PAP test in past 3 years, age 21-65 • Prostate – PSA or PSA education in the past 2 years, age 50-75 • Colorectal – Colonoscopy in past 10 yrs, Flex Sig in past 5 years, or FOBT in past year • Tobacco Cessation • Depression Screening • Lipid Assessment • Lipid Profile in the past 2 years • Lipid Profile in the past 3 years • Routine Flu Immunization • Current flu shot • Pneumococcal Vaccination • Pneumovax administered ever • Abdominal Aortic Aneurysm (AAA) Screening * * In Development

  14. Domain 4: Outcomes • Blood Pressure Control • Last BP > 140/90 mmHg • Sustained BP > 140/90 mmHg • Lipid Management • Most recent LDL < 100 • Composite Lipid management • LDL <130, HDL>50, Trig <200 • Smoking Quit Rate

  15. Domain 5: Perceptions & Satisfaction • Pre-Visit Medical Home Perceptions • Post-Visit Medical Home Satisfaction

  16. Patient Perceptions • Focuses on capturing patient responses to domain related questions • Multiple Versions • Constant Refinement • Will identify areas for focus by the Medical Home

  17. Perception Results

  18. Patient Satisfaction • Will align with Medical Home domains • Focused on quick feedback to improve the patient experience • Will validate if improvements made through improved patient perceptions have improved patient satisfaction

  19. Why Measure the Medical Home? The Medical Home is fluid and requires constant review and refinement. There is no one model that fits the patient population, therefore, measurement helps to identify areas for improvement and action.

  20. Goals for the LSU Medical Home • Continued measure development through data dissemination • Identify areas for improvement • Participation in Medical Home-related improvement projects*

  21. LSU ICON - Medical Home Interest Group • Identifying areas of improvement to assist with meeting or exceeding the defined NCQA standards • Assist with the refinement of the currently identified measure set

  22. Thanks to the MH Standards Subcommittee • Kathy Willis, MD • Karen Applewhite, RN • Tena Turnage, RN • Pam Wright, RN • Jay Besse • Kris Like, RN • Julie Nevers, RN • Mary K Blackburn, RN

  23. Thanks

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