Hello
Have you looked into the schedule planner for AADE in Las Vegas this year? Seems like we are moving into new models of care. The Medical Home is one concept often mentioned. Neva White, MSN, CRNP, CDE of Thomas Jefferson University Hospital submitted this most recent blog. Please share how your practice is impacted by these new models.
Neva White MSN, CRNP, CDE
Thomas Jefferson University Hospital
Community Health Department
The American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics and the American Osteopathic Association define the medical home as a patient centered model of care. Primary care practices ensure that each patient has an ongoing relationship with a personal physician who leads a team that takes collective responsibility for coordinated medical care. It is a comprehensive approach to collaborative chronic disease management. Medical care is accessible, culturally appropriate, and continuous. The goal of the patient centered medical home is to provide individualized whole person services that yield efficient and effective patient outcomes.
National Committee on Quality Assurance (NCQA) has established the patient centered medical home recognition program. The recognition program uses principles of the evidence based Wagner Chronic Care Model as standards to recognize primary care practices that have incorporated a systematic process and structure to promote quality patient outcomes and improve health. Quality measures included in a medical home incorporate information technology with patient care through patient registries, tracking systems (referrals and lab results), and medical treatment alerts (medication interaction and allergy). Core performance measures are established as benchmark for evidence based practice. The patient experience includes self management support through the use of motivational interviewing, patient- provider goal setting, group visits and support. The American Academy of Family Physicians has created a checklist for the patient centered medical home that includes systematic quality improvement in practice organization, health information technology, quality measures and patient experience.
A patient centered medical home includes the following principles:
• A Personal physician
• Physician directed medical practice
• Whole person orientation
• Care is coordinated and/or integrated
The Affordable Care Act includes provisions for primary care practices that want to expand as recognized medical homes. The hope is that the medical home will assist physicians to provide cost effective, less fragmented care, with documented quality patient outcomes.
The NCQA patient centered medical home standards include:
• Enhance Access and Continuity of care
• Identify and Manage Patient Populations
• Plan and Manage Care using evidence based guidelines
• Provide self care support and community resources
• Track and Coordinate Care
• Measure and Improve Performance
“The Patient Centered Medical Home is a model of 21st century primary care that combines access, teamwork and technology to deliver quality care and improve health.” Margret E.O’Kane President , National Committee for Quality Assurance.
Resources for Further Information
• National Committee on Quality Assurance (NCQA)
http://ncqa.org
• American Academy of Family Physicians http://www.aafp.org/online/en/home/membership/initiatives/pcmh.html
• American College of Physicians
http://www.acponline.org/advocacy/where_we_stand/medical_home/
• American Osteopathic Association
http://www.osteopathic.org
• American Academy of Pediatrics
http://www.aap.org