explaining how the Patient Centered Medical Home (PCMH) platform for healthcare deliver is more likely to support domestic violence prevention and creat a safer environment than the FFS episode of care system we are in now. The medical Home is a home for the data where the all the data goes and is held accountable this idea was first articulated by Dr. Calvin C.J. Sia, a Honolulu-based pediatrician in 1967.
This concept of the medical home was integrated with Ed Wagners Chronic disease Model and Thomas Bodenheimer Kevin Grumbach advanced/proactive primary care at the request of the Patient Centered Primary care Collaborative into a set of principles Know as the Joint principles of the Patient centered medical home.
The patient-centered medical home (PCMH), is a team based health care delivery set of principles led by a physician that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. It is "an approach to providing comprehensive primary care for children, youth and adults" The provision PCMH medical homes allow better access to health care, increase satisfaction with care, and improve health. Joint principles that define a PCMH have been established through the cohesive efforts of the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Physicians (ACP), and American Osteopathic Association (AOA).[10] Care coordination is an essential component of the PCMH. Care coordination requires additional resources such as health information technology, and appropriately trained staff to provide coordinated care through team-based models. Additionally, payment models that compensate PCMHs for their effort devoted to care coordination activities and patient-centered care management that fall outside the face-to-face patient encounter may help encourage coordination.
Patient-centered medical homes (PCMHs) are intended to actively provide effective care by physician-led teams, Where patients take a leading role and responsibility. Objective: To determine whether the Walter Reed PCMH has reduced costs while at least maintaining if not improving access to and quality of care, and to determine
whether access, quality, and cost impacts differ by chronic condition status. Design, setting, and patients: This study
conducted a retrospective analysis using a patient-level utilization database to determine the impact of the Walter Reed PCMH on utilization and cost metrics, and a survey of enrollees in the Walter Reed PCMH to address access to care and quality of care. Outcome measures: Inpatient and outpatient utilization, per member per quarter costs, Healthcare Effectiveness Data and Information Set metrics, and composite measures for access, patient satisfaction, provider communication, and customer service are included. Results: Costs were 11% lower for those with chronic conditions compared to 7% lower for those without. Since treating patients with chronic conditions is 4 times more costly than treating patients without such conditions, the vast majority of dollar savings are attributable to chronic care.
The Patient-Centered Medical Home in the Transformation From Healthcare to He...Paul Grundy
Surgeon General of the Navy VADM Matthew L. Nathan, MC USN
Fortunately, we have a way to address this crisis—the
Patient-Centered Medical Home (PCMH) model launched at Naval Hospital Pensacola and Walter Reed National Military Medical Center, Bethesda, Maryland (formerly the National Naval Medical Center) in 2008. It is now being implemented throughout the Military Health System (MHS) and carries great promise. It provides the clinical framework we need to meet our strategic objectives in terms of quality of care, impact on costs, population health, and readiness. One of the most significant benefits of the team-based, collaborative approach is that it allows us to embed within a primary care environment the psychologists, nutritionists, tobacco cessation specialists, mind-body medicine therapists, and health educators our patients need in order to develop and maintain mindful, healthy behaviors—along with the “mental armor,” our active duty military personnel need to increase their operational effectiveness and their resiliency in bouncing back from stressful situations. As we move ahead with this more comprehensive approach to health, we can begin to better address so many of our patients for whom we can find no specific reason for pain and discomfort. The PCMH model also provides a positive impact on our costs. Early data reporting from the PCMH clinics at Bethesda show reduced visits to the emergency room, lowered pharmacy costs, and significant per beneficiary per year savings and improved Healthcare Effectiveness Data and Information Set metrics, access, and patient satisfaction and trust. These positive impacts on the bottom line can be applied directly to improved costs or toward the reallocation of resources from reimbursing those who are sick to the population health-based programs that can make and keep our patients healthy.More significant, however, the PCMH environment allows us to go beyond mere collaboration and to a much more proactive approach to managing our patient populations. It is within the context of the medical home that we can begin to surround our patients with the tools and resources they need to move them from health care to health.
This infographic speaks to the challenges Emergency Departments face in caring and following up with the growing population of patients they see, and demonstrates how some EDs are seeing measurable improvements in care, patient satisfaction and efficiency.
Partnering with Patients, Families and Communities for Health: A Global Imper...EngagingPatients
Engagement is an essential tool to improving global health. This report introduces a new framework for engagement to help countries assess current programs and think strategically about future engagement opportunities. It spotlights barriers to engagement and offers concrete examples of effective engagement from around the globe.
Building Patient-Centeredness in the Real World: The Engaged Patient and the ...EngagingPatients
This paper examines the separate but intertwined ethical, economic and clinical concepts of patientcenteredness and how ACOs provide a structure for turning those concepts into a functioning reality.
Patients and their loved ones often hold critical knowledge that informs diagnosis. This toolkit from the Institute of Medicine offers patients, families and clinicians guidance on how they can collaborate to improve diagnosis.
Patient-centered medical homes (PCMHs) are intended to actively provide effective care by physician-led teams, Where patients take a leading role and responsibility. Objective: To determine whether the Walter Reed PCMH has reduced costs while at least maintaining if not improving access to and quality of care, and to determine
whether access, quality, and cost impacts differ by chronic condition status. Design, setting, and patients: This study
conducted a retrospective analysis using a patient-level utilization database to determine the impact of the Walter Reed PCMH on utilization and cost metrics, and a survey of enrollees in the Walter Reed PCMH to address access to care and quality of care. Outcome measures: Inpatient and outpatient utilization, per member per quarter costs, Healthcare Effectiveness Data and Information Set metrics, and composite measures for access, patient satisfaction, provider communication, and customer service are included. Results: Costs were 11% lower for those with chronic conditions compared to 7% lower for those without. Since treating patients with chronic conditions is 4 times more costly than treating patients without such conditions, the vast majority of dollar savings are attributable to chronic care.
The Patient-Centered Medical Home in the Transformation From Healthcare to He...Paul Grundy
Surgeon General of the Navy VADM Matthew L. Nathan, MC USN
Fortunately, we have a way to address this crisis—the
Patient-Centered Medical Home (PCMH) model launched at Naval Hospital Pensacola and Walter Reed National Military Medical Center, Bethesda, Maryland (formerly the National Naval Medical Center) in 2008. It is now being implemented throughout the Military Health System (MHS) and carries great promise. It provides the clinical framework we need to meet our strategic objectives in terms of quality of care, impact on costs, population health, and readiness. One of the most significant benefits of the team-based, collaborative approach is that it allows us to embed within a primary care environment the psychologists, nutritionists, tobacco cessation specialists, mind-body medicine therapists, and health educators our patients need in order to develop and maintain mindful, healthy behaviors—along with the “mental armor,” our active duty military personnel need to increase their operational effectiveness and their resiliency in bouncing back from stressful situations. As we move ahead with this more comprehensive approach to health, we can begin to better address so many of our patients for whom we can find no specific reason for pain and discomfort. The PCMH model also provides a positive impact on our costs. Early data reporting from the PCMH clinics at Bethesda show reduced visits to the emergency room, lowered pharmacy costs, and significant per beneficiary per year savings and improved Healthcare Effectiveness Data and Information Set metrics, access, and patient satisfaction and trust. These positive impacts on the bottom line can be applied directly to improved costs or toward the reallocation of resources from reimbursing those who are sick to the population health-based programs that can make and keep our patients healthy.More significant, however, the PCMH environment allows us to go beyond mere collaboration and to a much more proactive approach to managing our patient populations. It is within the context of the medical home that we can begin to surround our patients with the tools and resources they need to move them from health care to health.
This infographic speaks to the challenges Emergency Departments face in caring and following up with the growing population of patients they see, and demonstrates how some EDs are seeing measurable improvements in care, patient satisfaction and efficiency.
Partnering with Patients, Families and Communities for Health: A Global Imper...EngagingPatients
Engagement is an essential tool to improving global health. This report introduces a new framework for engagement to help countries assess current programs and think strategically about future engagement opportunities. It spotlights barriers to engagement and offers concrete examples of effective engagement from around the globe.
Building Patient-Centeredness in the Real World: The Engaged Patient and the ...EngagingPatients
This paper examines the separate but intertwined ethical, economic and clinical concepts of patientcenteredness and how ACOs provide a structure for turning those concepts into a functioning reality.
Patients and their loved ones often hold critical knowledge that informs diagnosis. This toolkit from the Institute of Medicine offers patients, families and clinicians guidance on how they can collaborate to improve diagnosis.
Dr. Edward Wagner, Director (Emeritus) MacColl Center, Senior Investigator, Group Health Research Institute addresses the 2014 Weitzman Symposium on The Future of Primary Care
The Patient-Centered Medical Home Impact on Cost and Quality: An Annual Revie...CHC Connecticut
Dr. Nwando Olayiwola, Associate Director, Center for Excellence in Primary Care, Assistant Professor, University of California, San Francisco addresses the 2014 Weitzman Symposium on The Patient-Centered Medical Home Impact on Cost and Quality: An Annual Review of Evidence
Polls show overwhelming evidence that patients WANT to be involved in their medical records and health data, so they can partner with their clinicians for better health. Survey results from Society for Participatory Medicine 2014 and 2015 surveys.
Closing the Loop: Strategies to Extend Care in the EDEngagingPatients
This HIMSS15 presentation discusses the challenges faced in hospital emergency departments and offers insights for implementing a process to follow up with discharged ED patients to enhance outcomes and satisfaction,while optimizing utilization and reducing risk.
Creating a standard of care for patient and family engagementChristine Winters
Nationally-recognized governance expert Beth Daley Ullem addresses the state of patient engagement in heathcare and provides a vision for establishing a minimum standard of care for patient engagement programs.
mHealth Israel_Top Health Industry Issues of 2021_Will a Shocked System Emerg...Levi Shapiro
Presentation by PwC Health Research Institute for mHealth Israel, February 17, 2021: Top Health Industry Issues of 2021...Will a Shocked System Emerge Stronger?
Key Sections:
1) Rightsizing after virtual visit explosion
2) Changing clinical trials
3) Easing physician burden with digital
4) Healthcare forecast for 2021
5) Reshaping health portfolios
6) Resilient and responsive supply chains
7) Inter-Operability
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
2021-2022 NTTAP Webinar: Fundamentals of Comprehensive CareCHC Connecticut
Join us as we discuss the core concepts of team-based care and introduce elements of team-based care that builds upon these basics to support your teams in advancing their capability to provide satisfying and effective care to complex patient populations. .
We will be joined by Margaret Flinter, Senior Vice President/Clinical Director for Community Health Center, Inc., and both Thomas Bodenheimer, MD, Physician and Founding Director, and Rachel Willard Grace, Director, from the Center for Excellence in Primary Care.
Safety is Personal: Partnering with Patients and Families for the Safest CareEngagingPatients
The work of NPSF"s Lucian Leape Institute's Roundtable on Consumer Engagement, "Safety Is Personal: Partnering with Patients and Families for the Safest Care" is a call to action for health leaders, clinicians, and policy makers to take the necessary steps to ensure patient and family engagement at all levels of health care.The report identifies specific action items for health leaders, clinicians, and policy makers to pursue in making patient and family engagement a core value in the provision of health. care.
Can we solve the adult primary care shortage without more physicians? CHC Connecticut
Tom Bodenheimer,of the Center for Excellence in Primary Care at UCSF Dep’t of Family and Community Medicine talks about addressing the primary care shortage at the 2014 Weitzman Symposium
This presentation explains the concept of the patient-centered medical home (PCMH), its function and its intended effects. A brief overview of the history of PCMH is also provided, as well as a discussion of its operational characteristics, its principles and outcomes, and what is expected in the future for the PCMH model.
Clinical Workforce Development NCA Informational WebinarCHC Connecticut
Learn more about training and technical assistance offered through Community Health Center Inc.'s National Cooperative Agreement (NCA) on Clinical Workforce Development. Hear more about FREE Learning Collaboratives opportunities to enhance or implement a model of Team-Based Care at your Health Center, and how to implement a Post-Graduate Residency program for Nurse Practitioners and Post-Doc Clinical Psychologists.
Dr. Edward Wagner, Director (Emeritus) MacColl Center, Senior Investigator, Group Health Research Institute addresses the 2014 Weitzman Symposium on The Future of Primary Care
The Patient-Centered Medical Home Impact on Cost and Quality: An Annual Revie...CHC Connecticut
Dr. Nwando Olayiwola, Associate Director, Center for Excellence in Primary Care, Assistant Professor, University of California, San Francisco addresses the 2014 Weitzman Symposium on The Patient-Centered Medical Home Impact on Cost and Quality: An Annual Review of Evidence
Polls show overwhelming evidence that patients WANT to be involved in their medical records and health data, so they can partner with their clinicians for better health. Survey results from Society for Participatory Medicine 2014 and 2015 surveys.
Closing the Loop: Strategies to Extend Care in the EDEngagingPatients
This HIMSS15 presentation discusses the challenges faced in hospital emergency departments and offers insights for implementing a process to follow up with discharged ED patients to enhance outcomes and satisfaction,while optimizing utilization and reducing risk.
Creating a standard of care for patient and family engagementChristine Winters
Nationally-recognized governance expert Beth Daley Ullem addresses the state of patient engagement in heathcare and provides a vision for establishing a minimum standard of care for patient engagement programs.
mHealth Israel_Top Health Industry Issues of 2021_Will a Shocked System Emerg...Levi Shapiro
Presentation by PwC Health Research Institute for mHealth Israel, February 17, 2021: Top Health Industry Issues of 2021...Will a Shocked System Emerge Stronger?
Key Sections:
1) Rightsizing after virtual visit explosion
2) Changing clinical trials
3) Easing physician burden with digital
4) Healthcare forecast for 2021
5) Reshaping health portfolios
6) Resilient and responsive supply chains
7) Inter-Operability
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
2021-2022 NTTAP Webinar: Fundamentals of Comprehensive CareCHC Connecticut
Join us as we discuss the core concepts of team-based care and introduce elements of team-based care that builds upon these basics to support your teams in advancing their capability to provide satisfying and effective care to complex patient populations. .
We will be joined by Margaret Flinter, Senior Vice President/Clinical Director for Community Health Center, Inc., and both Thomas Bodenheimer, MD, Physician and Founding Director, and Rachel Willard Grace, Director, from the Center for Excellence in Primary Care.
Safety is Personal: Partnering with Patients and Families for the Safest CareEngagingPatients
The work of NPSF"s Lucian Leape Institute's Roundtable on Consumer Engagement, "Safety Is Personal: Partnering with Patients and Families for the Safest Care" is a call to action for health leaders, clinicians, and policy makers to take the necessary steps to ensure patient and family engagement at all levels of health care.The report identifies specific action items for health leaders, clinicians, and policy makers to pursue in making patient and family engagement a core value in the provision of health. care.
Can we solve the adult primary care shortage without more physicians? CHC Connecticut
Tom Bodenheimer,of the Center for Excellence in Primary Care at UCSF Dep’t of Family and Community Medicine talks about addressing the primary care shortage at the 2014 Weitzman Symposium
This presentation explains the concept of the patient-centered medical home (PCMH), its function and its intended effects. A brief overview of the history of PCMH is also provided, as well as a discussion of its operational characteristics, its principles and outcomes, and what is expected in the future for the PCMH model.
Clinical Workforce Development NCA Informational WebinarCHC Connecticut
Learn more about training and technical assistance offered through Community Health Center Inc.'s National Cooperative Agreement (NCA) on Clinical Workforce Development. Hear more about FREE Learning Collaboratives opportunities to enhance or implement a model of Team-Based Care at your Health Center, and how to implement a Post-Graduate Residency program for Nurse Practitioners and Post-Doc Clinical Psychologists.
Domestic Violence Against Women And Girls In Powerpoint (Created By Mann Bdr...Mann Pariyar
This is the first power point slides I made, the contents in this slides are taken from various books N I do hope that it will bring a positive effect in the society.
Any comments you have can be sent at rainfall12@hotmail.com or mann061@yahoo.com.
With best regards,
mANN
Prevalence and associated factors of domestic violence among pregnant women a...Diwash Timilsina
A cross-sectional study was carried out in the selected health institutions of Sunsari and Siraha district. In this study during October 21 to November 25, 2013, Purposive sampling technique was used to collect data. Structured questionnaire was administered to the pregnant women in the study area. The prevalence rate of domestic violence was found to be 18.32 percent. A total of 144 (67%) respondents out of 215 experienced domestic violence during their pregnancy.
What are the signs of domestic violence?
• Destructive criticism and verbal abuse: shouting/mocking/accusing/name calling/verbally threatening.
• Pressure tactics: sulking, threatening to withhold money, disconnect the telephone, take the car away, commit suicide, take the children away, report you to welfare agencies unless you comply with his demands regarding bringing up the children, lying to your friends and family about you, telling you that you have no choice in any decisions.
• Disrespect: persistently putting you down in front of other people, not listening or responding when you talk, interrupting your telephone calls, taking money from your purse without asking, refusing to help with childcare or housework.
• Breaking trust: lying to you, withholding information from you, being jealous, having other relationships, breaking promises and shared agreements.
• Isolation: monitoring or blocking your telephone calls, telling you where you can and cannot go, preventing you from seeing friends and relatives.
• Harassment: following you, checking up on you, opening your mail, repeatedly checking to see who has telephoned you, embarrassing you in public.
• Threats: making angry gestures, using physical size to intimidate, shouting you down, destroying your possessions, breaking things, punching walls, wielding a knife or a gun, threatening to kill or harm you and the children.
• Sexual violence: using force, threats or intimidation to make you perform sexual acts, having sex with you when you don't want to have sex, any degrading treatment based on your sexual orientation.
• Physical violence: punching, slapping, hitting, biting, pinching, kicking, pulling hair out, pushing, shoving, burning, strangling.
• Denial: saying the abuse doesn't happen, saying you caused the abusive behavior, being publicly gentle and patient, crying and begging for forgiveness, saying it will never happen again.
Importance of information system in raising public awareness about domestic v...Masum Hussain
Across the globe, information system tools have helped fuel social movements. Information system has been shown to strengthen social actors’ ability to challenge and change power relations in society, providing platforms for debate, reflection, influencing and mobilizing people. To better understand the potential of information system to engage especially young people in efforts to prevent domestic violence the Partners for Prevention regional project, Engaging Young Men Through Information system for the Prevention of Domestic violence’ which supported information system awareness campaigns designed to raise awareness and motivate young people to take action to prevent domestic violence has revealed practical lessons from three awareness campaigns on the effective use of information system tools for violence protection.
Edwina Rogers, executive director of Patient-Centered Primary Care Collaborative, began her presentation by highlighting the movement to advance medical homes.
With the U.S. being the number one in the world for the cost of healthcare and ranked number 37 in the quality category, something needs to change. Rogers discussed the broad stakeholder support and participation for the movement, as well as the incredible volunteer involvement. The four ‘centers’ include: the Center to Promote Public-Payer Implementation, the Center for Multi-Stakeholder Demonstration, the Center for eHealth Information Adoption and Exchange and the Center for Health Benefit Redesign and Implementation. Medical Homes will provide superb access to care, patient engagament in care, clinical information systems, care coordination, team care, patient feedback and publically available information.
Edwards explained that the Obama administration believes the medical homes concept is the best way to approach healthcare reform. The U.S. House of Representatives has showed great support for the movement and is helping develop and allocate funds for a five-year pilot program. She expressed her enthusiasm for the movement and her prediction that the medical home model is certainly the future of health care.
A complete version of Rogers’ presentation on the Patient-Centered Primary Care Collaborative is available online.
Advancing Team-Based Care: Complex Care Management in Primary CareCHC Connecticut
This webinar investigated the ways that team members can contribute to the care of patients with complex medical and/or social needs. The focus was on developing the expanded care team and ensuring ready communication between the core and expanded care teams. Models for effective care management were presented.
This webinar was presented May 5, 2016 3:00 p.m. Eastern Time
The Future of the American Healthcare Delivery System in an Era of ChangePYA, P.C.
PYA Principal Dr. Kent Bottles, who is also PYA Analytics' Chief Medical Officer, gave the keynote address, "The Future of the American Healthcare Delivery System in an Era of Change at the Healthcare Business Intelligence Summit," September 19, 2013, in Minneapolis. Dr. Bottles discussed four key trends affecting the American healthcare delivery system: the Affordable Care Act (“ACA”), the digital revolution, big data, and social media. He examined how these trends together affect the way hospitals, providers, payers, employers, and government agencies adapt to the changing healthcare environment.
It’s no secret the U.S. health care system needs to change. The Affordable Care Act (ACA) introduced
a focus on new health care payment models, which placed clear economic incentives on providers
while also striving for better outcomes. Today, we see an emphasis on preventing hospital
readmissions, reducing emergency room visits and avoiding unnecessary health care utilization
while enhancing quality and the patient experience.
As a result, health care stakeholders are rethinking the way care is delivered, how data is used and
how people collaborate and communicate in more preventive, proactive ways. This means moving
from episodic, fee-for-service, disease treatment models toward value-based care delivery to
improve outcomes, better utilize resources and expand access to care. Improved population health
has become the Holy Grail of U.S. health care, with many early experiments and some promising
successes. We take a look at Banner Health, a pioneer in transforming their health delivery systems with Robert Groves, MD, Vice President, Health Management, Banner Health.
PCMH implementation, highly associated with important outcomes for both patients and providers. The rate of emergency department visits was significantly
lower in sites with more PCMH effective implementation. Efficient PCMH implementation favorably associated with patient satisfaction, staff burnout, quality of care, and use of health care services.
A systematic review of the challenges to implementation of the patient-centre...Paul Grundy
review the available literature to identify the major challenges and barriers to implementation and adoption of the patient-centred medical home (PCMH) model, topical in current Australian primary care reforms. documents the key challenges and barriers to implementing the PCMH model in United States family practice. It provides valuable
evidence for Australian clinicians, policymakers, and
organisations approaching adoption of PCMH elements
within reform initiatives in Australia.
"'I am proud that MaineCare has been working in partnership with other payers to advance payment reform through greater investment in primary care to both improve outcomes for patients and reduce preventable high cost spending in emergency departments and avoidable inpatient admissions.
– Mary C. Mayhew, Commissioner, Maine Department of Health & Human Services
Effective integration of specialty practices into medical neighborhoods is likely to require several important environmental precursors. First, a sound infrastructure
design can connect PCMHs to the spectrum of surrounding
specialty practices. An aligned information architecture
will be vital to adequate patient access, care coordination, and communication. Second, a patient centered
neighborhood will rely on an organizational culture that
supports shared learning and transparency of performance and cost data among participating practices. Third, payment incentives will have to be aligned around shared accountability for outcome and cost. Responsibility
for outcomes and total cost of care will have to rest not only with primary care clinicians, but also with specialists who perform(often expensive) procedures and specialty services.The launch of the NCQA’s PCSP recognition program is a sign of a new phase of delivery system reform
Summary -- Patient Centered Medical Home the Necessary Foundation for Accountable Care and Population Management.
In the next 10 years, we will be living in 1) mobile world 2) in the middle of an aging and chronic disease epidemic and 3) data. But , we will also have the ability to analyze data in a cognitive way this will do for doctors’ minds what X-ray and medical imaging have done for their vision. How? By turning data into actionable information. Take, for instance, IBM’s intelligent supercomputer, Watson. Watson can analyze the meaning and con-text of human language and quickly process vast amounts of information. With this in-formation, it can suggest options targeted to a patient’s specific circumstances.
We need the basic foundation to support this transformation a system integrator where data at the level of a patients flows and is held accountable and that model is the Patient Centered Medical Home. (PCMH) starts to happen when clinicians/ healers step up to comprehensive relationship based care empowered by tools to manage the data and communicate effectively. This move to PCMH level care requires the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system and all of that is power by data made into meaningful information.
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
The Patient-Centered Medical Home (PCMH) lies at the center of the effort to get at population health, integrated and coordinated care. PCMH is where the Primary care healer leads an organization that delivers clinician-led primary care, with comprehensive, accessible, holistic, coordinated, evidence-based coordination and management. In the USA this is now the standard in the US Veterans Administration and the US Military and under the ACA.
OVERVIEW -- Care by Design - Putting Care back into healthcare the University of Utah experience in building PCMH level care over the decade of 2001 to . 2011
Care by design magill lloyd successful turnaroundPaul Grundy
The University of Utah purchased a 100-clinician, 9-practice multispecialty primary care network in 1998. The university projected the network to earn a profit the first year of its ownership in a market with growing capitation; however, capitation declined and the network incurred up to a $21 million operating loss per year. This case study describes the financial turnaround of the network.
Care by design 2 bodenheimer teams 2 utah chapterPaul Grundy
Putting Care back into healthcare the University of Utah experience in building PCMH level care. this talks about the team base experice as written up in 2007 by Tom Bodenheimer.
New zealand cantabury timmins-ham-sept13Paul Grundy
This is a great example of a community in New Zealand of the interrogation of social services and healthcare. They are changing the demand curve and getting away from “we need more and more resources to see more patients”. The language we use, very deliberately, is “right care, right place, right time”. Once you start getting the whole
system to work as one system, it starts flushing out unnecessary expenditure. So you can do more and/or do it better.’ worth a read.
I did a visit to new zealand in 2003 and did a number of talks from 2003 to 2005 on the transformation taking place in new zealand. back in NZ in 2014 so looked at those early slide so impressed with the leadership and the robust primary care
, patients reported higher overall satisfaction at a primary care practice that adopted the patient-centered medical home model along with lean process changes and physician payment reform.
.......................................................................................................
South central foundation Alaska
If you are in a mechanical manufacturing environment then hitting a target is a matter much like the throwing of a rock – figuring out speed trajectory
If you are in a messy, human, complex, adaptive environment it is like throwing a
bird at a target – it is all about the ‘attractor’
Healthcare mostly throws birds at targets and only thinks about the throwing part than wonders why the Human fails to hit the target
Partial and Incremental PCMH Practice Transformation: Implications for Qualit...Paul Grundy
Experience of BCBS Michigan in Building medical homes
Based on the observed relationships for partial implementation,full implementation of the PCMH model is associated with a 3.5 percent higher quality composite score, a 5.1 percent higher preventive composite score, and $26.37 lower per member per month medical costs for adults. Full PCMH implementation is also associated with a 12.2 percent higher preventive composite score, but no reductions in costs for pediatric populations. Incremental improvements in PCMH model implementation yielded similar positive effects on quality of care for both adult and pediatric populations but were not associated with cost savings for either population.
Conclusions. Estimated effects of the PCMH model on quality and cost of care
appear to improve with the degree of PCMH implementation achieved and with incremental improvements in implementation.
A new 2014 Patient-‐Centered Primary Care Collaborative
analysis found that the patient-‐centered medical home (PCMH) is having a significant impact on reducing costs
of care,unnecessary emergency department (ED) and
hospital visits, as well as increasing the provision of preventive services and improving population health. Among the report’s findings, approximately 60% of the PCMH evaluations reported decreases in cost of care or use of unnecessary/avoidable services, while approximately 30% reported improvements in population health.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
National Conference on Health and Domestic Violence. Plenary talk
1. Moving Sickcare to Support Violence Prevention
Patient Centered Medical Home
National Conference on Health Care and Domestic Violence
Paul Grundy MD, MPH - IBM Director, Healthcare Transformation
@Paul_PCPCC
https://twitter.com/Paul_PCPCC
2. The effects of violence on a victim’s health are severe
In addition to the immediate injuries:
• chronic pain,
• gastrointestinal disorders,
• psychosomatic symptoms,
• eating problems
• ACES
• It cost lots of $$ and loss productivity
• 29% of all women in the United States
who attempted suicide were battered.
3.
4. Safeness !!!
Safe and secure vs deprived of safety
Environment of visibility - seen and be seen vs Isolation Depravation
MARY !!
Connie Mitchell!! --- SPAIN !!
5. – BUT -where the delivery system works
– a Patient in a trusting relation with a
healer who is a comprehensivist where
the patients data is Used to support
We can have the tools to address an
issue as difficult as Violence.
In much of SICKcare, no one is in charge.
And the result is the most Wasteful and Unsustainable
6.
7. The System Integrator
Creates a partnership across the
medical neighborhood
Drives PCMH primary care redesign
Offers a utility for population health
and financial management
Away from Episode of Care to Management of Population
WITH DATA
Community Health
Population
Health
System Integrator
Patient
Experience
Per
Capita
Cost
Public
Health
@Paul_PCPCC
https://twitter.com/Paul_PCPCC
8.
9. 36.3% Drop in hospital days
32.2% Drop in ER use
12.8% Increase Chronic Medication use
-15.6% Total cost
10.5% Drop Inpatient specialty care costs
18.9% Ancillary costs down
15.0% Outpatient specialty down
Outcomes of Implementing Patient Centered Medical
Home Interventions: A Review of the Evidence from
Prospective Evaluation Studies in the US - PCPCC Oct 2012
Smarter Healthcare
10. •9.9 percent lower rate of adult ER visits
•27.5 percent lower rate of adult ambulatory care sensitive
inpatient stays
•11.8 percent lower rate of adult primary care sensitive ER
visits
•8.7 percent lower rate of adult high-tech radiology usage
•14.9 percent lower rate of pediatric ER visits
•21.3 percent lower rate of pediatric primary-care sensitive ER
visits
24 July 2014 Michigan Blues’ patient-centered medical home program
shows statewide transformation of care YEAR 6
4,022 primary care doctors at 1,422 practices around the state
in its sixth year of operation. These practices care for more
than 1.2 million BCBSM members.
11. 17 found
improvements in
cost
24 improvements in
quality
10 found
improvements in
access
8 found
improvements in
satisfaction
24 found
improvements in
utilization
15. Preventive
Medicine
Medication
Refills Acute Care
Nursing
Test Results
Master Builder
DOCTOR
Source: Southcentral Foundation, Anchorage AK
Behavioral
Health
Case
Manager
Medical
Assistants
Chronic Disease
Monitoring
Practice transformation away from episode of care
16. Source: Southcentral Foundation, Anchorage AK
PCMH Parallel Team Flow Design: the glue is real data, not a doctor’s brain
Medication
Refills
Chronic
Disease
Monitoring
Test
Results
Acute
Care
Preventive
Medicine
Point of
Care Testing
Acute
Mental
Health
Complaint
Chronic
Disease
Compliance
Barriers
Healthcare
Support
Team Behavioral
Health
Medical
Assistants
Case
Manager Clinician
17. Healthcare Will Transform --- Family Medicine for America’s Health
Data Driven
Every person has a plan
Team based
Managing a population
down to the person
.
18. Today’s Care PCMH Care
My patients are those who make appointments to see
me
Our patients are the population community
Care is determined by today’s problem and time
available today
Care is determined by a proactive plan to
meet patient needs with or without visits
Care varies by scheduled time and memory or skill of
the doctor
Care is standardized according to evidence-based
guidelines
Patients are responsible for coordinating their own
care
A prepared team of professionals coordinates all
patients’ care
I know I deliver high quality care because I’m well
trained
We measure our quality and make rapid changes to
improve it
It’s up to the patient to tell us what happened to them
We track tests & consultations, and follow-up after
ED & hospital
Clinic operations center on meeting the doctor’s
needs
A multidisciplinary team works at the top of our
licenses to serve patients
Slide from Daniel Duffy MD School of Community Medicine Tulsa Oklahoma
19. Superb Access to
Care
Patient Engagement in
Care
Clinical Information
Systems, Registry
Care Coordination
Team Care
Communication
Patient Feedback
Mobile easy to use and
Available Information
Defining the Care Centered on Patient
20. Payment reform requires more than one method, you
have dials, adjust them!!!
“fee for health”
“fee for value”
“fee for outcome”
“fee for process”
“fee for belonging
“fee for service”
“fee for satisfaction”
21.
22. Nearly 1/3 traditional Medicare tied to alternative reimbursement models—such as Patient
Centered Medical home (PCMH)/ accountable care organizations (ACOs) or bundled
payments—by the end of 2016 50% by end 2018
And end of 2018 90% of traditional Medicare payments to quality or value through programs
such as the Partnership for Patients Hospital, Value Based Purchasing and the Hospital
Readmissions
https://www.youtube.com/watch?v=UY088YyQ6uA
23. Benefit Redesign - Patient Engagement
Different Strategies for Different Healthcare Spend Segments
% Total
Healthcare
Spend
% of Members
Those who
are well or
think they
are well
Those with
chronic
illness
Those with
severe, acute
illness or
injuries
24. Public Health
Prevention
Specialists
PCMH 2.0 in Action
Community Care Team
Nurse Coordinator
Social Workers
Dieticians
Community Health Workers
Care Coordinators
Public Health Prevention
HEALTH WELLNESS
Hospitals
PCMH
PCMH
Health IT
Framework
Global Information
Framework
Evaluation
Framework
Operations
A Coordinated
Health System
25. Call & Check Providing support
and care for all in the community