IU Methodist Family Medical Center and thePatient-Centered Medical Home Model Kaitlyn Aiello John D. Patton MHA Capstone April 23, 2011
IU Methodist Family Medicine Center (IUMFMC) Largest outpatient site in IU Family Medicine Department Training facility for IU School of Medicine Family Practice Residents Mission: Promote optimal health for individuals, families, and the global community and provide continuing and comprehensive patient care and deliver excellence in family medicine through innovative medical education and practice-based health services research. Vision: Provide accessible, cost-effective health care to all individuals and families through national and international participation in medical education and research that make a significant difference in the lives of people.
Project Goal Examine the operational, financial, and systems feasibility of the IU Methodist Family Medical Center achieving certification as a Patient Centered Medical Home.
Patient-Centered Medical Home A health care setting that facilitates partnerships between individual patients, their personal physicians, and the patient’s family.
Principles of the PCMH Personal Physician * Physician directed medical practice – Behavioral Health – Dental Whole Person Orientation – Acute, chronic, preventive, end of life Coordinated Care – Registries, information technology, health information exchange – Culturally competent – Linguistically appropriate
PCMH Standards Access and Communication Patient Tracking and Registry Functions Care Management Patient Self-Management Support Electronic Prescribing Test Tracking Referral Tracking Performance Reporting and Improvement Advanced Electronic Communications
Must Pass Elements PPC1A – Written standards for patient access and patient communication PPC1B – Use of data to show meeting this standard PPC2D – Use of paper or electronic-based charting tools to organize clinical information PPC2E – Use of data to identify important diagnoses and conditions in practice PPC3A – Adoption and implementation of evidence-based guidelines for three conditions PPC4B – Active support of patient self-management PPC6A – Tracking system for tests and to identify abnormal results PPC7A – Tracking referrals with paper-based or electronic system PPC8A – Measurement of clinical and/or service performance PPC8C – Performance reporting by physician or across the practice
Project Objectives1. Examine current process in place at IUMFMC through staff and management interviews to identify immediate noticeable barriers.2. Study and analyze NCQA PCMH certification process and compare to current IUMFMC practices.3. Offer recommendations on any PCMH elements where operational, personnnel, or information technology gaps exist.
PPC-PCMH ScoringLevel of Qualifying Points Must Pass Elements at 50%Level 3 75-100 10 of 10Level 2 50-74 10 of 10Level 1 25-49 5 of 10Not Recognized 0-24 <5
IUMFMC Gap Analysis Strategic Current Deficiency Action Plan Objective StandingPPC 1 A. 10 of 12 items Email consultations Add emailingProcesses Patient portal capabilities to current websitePPC 1 B. Email and website 1 A.Results response times PolicyPPC 2 A. 14 of 18 items Marital Status Upgrade June, 2011Basic System for Voluntary self-Managing Patient identified race/ethnicityData Email address Billing codes for services
IUMFMC Gap Analysis Strategic Current Deficiency Action Plan Objective StandingPPC 2 B. 9 of 10 items Status of age- Available if given atElectronic System appropriate preventive facility.for Clinical Data services Recommend (immunizations, requesting screenings, counseling) information from patient and scanning into record.PPC 3. Currently meetsCare Management or exceeds all elementsPPC 4 A. 1 of 2 items Identify and display in Language assistanceDocumenting the record the is available.Communication language preference ofNeeds the patient and family.
IUMFMC Gap Analysis Strategic Current Deficiency Action Plan Objective StandingPPC 4 B. 6 of 7 items Provides educational Provides resources,Self-Management resources in the language but not documented.Support or medium that the patient/family understands.PPC 5. Currently meets orElectronic exceeds all elementsPrescribingPPC 6 B. 5 of 6 items Retrieve imaging text IUMFMC already hasElectronic System reports directly from some imaging and labfor Managing Tests source services available onsite. Retrieve images directly Recommend an from the source upgrade to current HIS Flag duplicate tests with features that ordered address these missing Generate alerts for items. appropriateness of tests ordered
PPC 7 – Referral Tracking Must pass element Origin of the referral Clinical details Tracking status Administrative details
PPC 8 – Electronic Reporting – External Entities Transmit 10 or more nationally approved performance measures to an external entity Currently produces the reports – however, they are not transmitted to the public
PPC 9 – Availability of Interactive Website Request appointments Request referrals Request test results Request prescription refills See elements of their medical record Import elements of their medical record into a personal health recored
PPC 9 – Electronic Patient Identification Need clinical review or action Taking a particular medication Need preventive care Need specific tests Need follow up visits Might benefit from disease or case management support
PPC 9 – Electronic Care Management Support Communicate with disease or care managers Web-based educational modules for patients with three clinically important conditions
Recommendations Update Current Electronic Health Record – Include basic patient information such as marital status, race, language preference, – The ability to store age-appropriate preventive data – Test Tracking – Referral Tracking
Recommendations Interactive Website – Allow patients access to their medical records – Secure e-mail access to provide communication between patients and clinicians – Web-based educational modules – Report results on nationally approved measures to their patients and the public