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https://www.readbyqxmd.com/read/28927493/review-of-patient-reported-experience-within-patient-centered-medical-homes-insights-for-australian-health-care-homes
#1
Mary O'Loughlin, Jane Mills, Robyn McDermott, Linton Harriss
Understanding patient experience is necessary to advance the patient-centred approach to health service delivery. Australia's primary healthcare model, the 'Health Care Home', is based on the 'Patient-Centered Medical Home' (PCMH) model developed in the United States. Both these models aim to improve patient experience; however, the majority of existing PCMH model evaluations have focussed on funding, management and quality assurance measures. This review investigated the scope of evidence reported by adult patients using a PCMH...
September 20, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28916250/successful-integration-of-pediatrics-into-state-health-care-reform-efforts
#2
Judith S Shaw, Susan E Varni, Elizabeth Cheng Tolmie, Mary Kate Mohlman, Valerie S Harder
Health care reform in Vermont promotes patient-centered medical homes (PCMH) and multi-disciplinary community health teams to support population health. This qualitative study describes the expansion of Vermont's health care reform efforts, initially focused on adult primary care, to pediatrics through interviews with project managers and facilitators, CHT members, pediatric practitioners and care coordinators, and community-based providers. Analyses used grounded theory, identifying themes confirmed by repeat occurrence across respondents...
September 12, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28891393/improving-ambulatory-care-resident-training-preparing-for-opportunities-to-treat-mental-illness-in-the-primary-care-setting
#3
Nada M Farhat, Jolene R Bostwick, Stuart D Rockafellow
PURPOSE: The development of an outpatient psychiatry clinical practice learning experience for PGY2 ambulatory care pharmacy residents in preparation for the treatment of psychiatric disorders in the primary care setting is described. SUMMARY: With the increased prevalence of psychiatric disorders, significant mortality, and limited access to care, integration of mental health treatment into the primary care setting is necessary to improve patient outcomes. Given the majority of mental health treatment occurs in the primary care setting, pharmacists in patient-centered medical homes (PCMHs) are in a unique position with direct access to patients to effectively manage these illnesses...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28887347/pharmacists-supporting-population-health-in-patient-centered-medical-homes
#4
Antoinette B Coe, Hae Mi Choe
PURPOSE: The integral role of pharmacists in supporting population health initiatives in the patient-centered medical home (PCMH) model of care is described. SUMMARY: Population health initiatives focus on the health outcomes of a group of patients; in the PCMH model, such groups of patients, known as panels, may be defined as patients assigned to a care team or provider. The basic characteristics of the PCMH model include physician-led, team-based practice; coordinated and integrated care within the PCMH and in the patient's community; provision of safe, evidence-based, high-quality care; incorporation of health information technology and continuous quality improvement strategies into panel identification, documentation, and care processes; improved access to care (e...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28885893/does-patient-centered-medical-home-recognition-relate-to-accountable-care-organization-participation
#5
Yi-Ling Lin, Yuan Du, Cristina Gomez, Judith Ortiz
As of April 2015, less than 10% of Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs) included Rural Health Clinics (RHCs). In order to understand why RHCs are not participating in this ACO model in greater numbers, this study examined the influence of several factors on ACO participation. Data for this study were collected via a survey distributed during the summers of 2012, 2013, and 2014 to all RHCs in 9 states. This study had a cross-sectional design using survey research. The unit of analysis was the RHC; the total sample size was 178...
September 8, 2017: Population Health Management
https://www.readbyqxmd.com/read/28865642/adapting-the-patient-centered-medical-home-to-address-psychosocial-adversity-results-of-a-qualitative-study
#6
Cecilia Vu, Emily Rothman, Caroline J Kistin, Kelly Barton, Barb Bulman, Ann Budzak-Garza, Denyse Olson-Dorff, Megan H Bair-Merritt
OBJECTIVE: The patient-centered medical home (PCMH) seeks to improve population health. However, PCMH models often focus on improving treatment of chronic diseases rather than on addressing psychosocial adversity. We sought to gather key stakeholder input about how PCMHs might feasibly and sustainably address psychosocial adversity within their patient populations. METHODS: We conducted 25 semistructured interviews with key stakeholders, such as physicians, nurses, medical assistants, and patients...
September 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28840913/effect-of-integrated-community-neurology-on-utilization-diagnostic-testing-and-access
#7
Muhamad Y Elrashidi, Lindsey M Philpot, Nathan P Young, Priya Ramar, Kristi M Swanson, Paul M McKie, Sarah J Crane, Jon O Ebbert
BACKGROUND: The primary care medical home (PCMH) aims to promote delivery of high-value health care. However, growing demand for specialists due to increasingly older adults with complicated and chronic disease necessitates development of novel care models that efficiently incorporate specialty expertise while maintaining coordination and continuity with the PCMH. We describe the effect of a model of integrated community neurology (ICN) on health care utilization, diagnostic testing, and access...
August 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28817857/patient-centered-home-model-of-care-and-the-role-of-patient-care-teams-in-the-treatment-and-management-of-chronic-disease
#8
Maryam Rahim Sheikh, Muhammad Shahjahan Khan, Jean M Lageson
Patient-centered medical home (PCMH) is a concept of a team of providers caring for a panel of patients with the goals to improve the quality of care while simultaneously decreasing the cost of that care. The clinical evidence that the PCMH approach achieves either goal is mixed. More studies are in progress that will provide more data.
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28808852/patient-experience-with-the-patient-centered-medical-home-in-michigan-s-statewide-multi-payer-demonstration-a-cross-sectional-study
#9
Issidoros Sarinopoulos, Diane L Bechel-Marriott, Jean M Malouin, Shaohui Zhai, Jason C Forney, Clare L Tanner
BACKGROUND: The literature on patient-centered medical homes (PCMHs) and patient experience is somewhat mixed. Government and private payers are promoting multi-payer PCMH initiatives to align requirements and resources and to enhance practice transformation outcomes. To this end, the multipayer Michigan Primary Care Transformation (MiPCT) demonstration project was carried out. OBJECTIVE: To examine whether the PCMH is associated with a better patient experience, and whether a mature, multi-payer PCMH demonstration is associated with even further improvement in the patient experience...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28804084/comparison-of-patient-experience-between-a-practice-for-homeless-patients-and-other-practices-engaged-in-a-patient-centered-medical-home-initiative
#10
Bittie Behl-Chadha, Judith A Savageau, Monica Bharel, Michael Gagnon, Pei-Pei Lei, Carla Hillerns
Despite its increasing popularity, little is known about the patient-centered medical home (PCMH) model in primary care settings serving homeless populations. Our objective was to understand how patient experience differs between a PCMH demonstration practice designed for homeless people in Massachusetts and other practices participating in the same statewide initiative. The study population included 194 homeless patients and 1,868 patients from comparison practices. Patient experience was compared on key measures of patient-centeredness, while applying case-mix adjustment to control for sociodemographic and clinical factors...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28758564/do-medical-residents-perform-patient-centered-medical-home-tasks-a-mixed-methods-study
#11
Lauren Block, Nancy LaVine, Jennifer Verbsky, Ankita Sagar, Miriam A Smith, Susan Lane, Joseph Conigliaro, Saima A Chaudhry
BACKGROUND: Increasingly, residents are being trained in Patient-centered Medical Home (PCMH) settings. A set of PCMH entrustable professional activities (EPAs) for residents has been defined but not evaluated in practice. OBJECTIVE: To understand whether residents trained at PCMH sites reported higher likelihood of engaging in PCMH tasks than those training in non-PCMH sites. DESIGN: Survey and nominal group data from post-graduate trainees at three residency programs...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28746024/impact-of-longitudinal-electronic-health-record-training-for-residents-preparing-for-practice-in-patient-centered-medical-homes
#12
Jung G Kim, Hector P Rodriguez, Katherine At Estlin, Carl G Morris
INTRODUCTION: Competence in using an electronic health record (EHR) is considered a critical skill for physicians practicing in patient-centered medical homes (PCMHs), but few studies have examined the impact of EHR training for residents preparing to practice in PCMHs. This study explored the educational outcomes associated with comprehensive EHR training for family medicine residents. METHODS: The PCMH EHR training consisted of case-based routine clinic visits delivered to 3 resident cohorts (N = 18)...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746023/the-patient-centered-medical-home-as-a-community-based-strategy
#13
Berkeley A Franz, John W Murphy
Increasing attention has been devoted to the important role that primary care will play in improving population health. One innovation, the patient-centered medical home (PCMH), aims to unite a variety of professionals with patients in the prevention and treatment of illness. Although patient perspectives are critical to this model, this article questions whether the PCMH in practice is truly community-based. That is, do physicians, planners, and other health care professionals take seriously the value of integrating local knowledge into medical care? The argument presented is that community-based philosophy contains a foundational principle that the perspectives of health care practitioners and community members must be integrated...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28745137/exploring-the-value-proposition-of-primary-care-for-safety-net-patients-who-utilize-emergency-departments-to-address-unmet-needs
#14
Kimberly R Enard, Deborah M Ganelin
BACKGROUND: An underlying assumption of strategies intended to promote appropriate primary care over emergency department (ED) use for ongoing health care needs is that patients will understand the "value proposition" of primary care: that they will receive specific benefits from primary care providers over and above what they receive from EDs. However, there is evidence that this value proposition may be unclear to safety-net patients. The goals of this study are to describe factors motivating ED use for low-acuity conditions; describe similarities and differences in usual source of care (USOC) experiences, by ED versus non-ED setting; and assess awareness and perceptions of the patient-centered medical home (PCMH) concept among safety-net patients...
July 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28738685/assessing-the-effect-of-the-vha-pcmh-model-on-utilization-patterns-among-veterans-with-ptsd
#15
Ian Randall, Charles Maynard, Gary Chan, Beth Devine, Chris Johnson
OBJECTIVES: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH)-based Patient Aligned Care Teams (PACT) model in 2010. We examined its effects on the utilization of health services among US veterans with posttraumatic stress disorder (PTSD). STUDY DESIGN: We analyzed VHA clinical and administrative data to conduct an interrupted time series study. Encounter-level data were obtained for the period of April 1, 2005, through March 31, 2014...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28720628/the-patient-centered-medical-home-pcmh-framing-typology-for-understanding-the-structure-function-and-outcomes-of-pcmhs
#16
Autumn M Kieber-Emmons, William L Miller
INTRODUCTION: Patient-centered medical homes (PCHMs) aspire to transform today's challenged primary care services. However, it is unclear which PCMH characteristics produce specific outcomes of interest for care delivery. This study tested a novel typology of PCMH practice transformation, the PCMH framing typology, and evaluated measurable outcomes by each type. METHODS: Using the Patient-Centered Primary Care Collaborative 2012 to 2013 Annual Review, this secondary analysis of the published PCMH literature extracted data from publications of 59 PCMHs...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720627/costs-of-transforming-established-primary-care-practices-to-patient-centered-medical-homes-pcmhs
#17
Neil S Fleming, Briget da Graca, Gerald O Ogola, Steven D Culler, Jessica Austin, Patrice McConnell, Russell McCorkle, Phil Aponte, Michael Massey, Cliff Fullerton
BACKGROUND: The patient-centered medical home (PCMH) shows promise for improving care and reducing costs. We sought to reduce the uncertainty regarding the time and cost of PCMH transformation by quantifying the direct costs of transforming 57 practices in a medical group to National Committee for Quality Assurance (NCQA)-recognized Level III PCMHs. METHODS: We conducted structured interviews with corporate leaders, and with physicians, practice administrators, and office managers from a representative sample of practices regarding time spent on PCMH transformation and NCQA application, and related purchases...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720620/in-this-issue-opiates-tobacco-social-determinants-of-health-social-accountability-for-non-profit-hospitals-more-on-pcmh-and-clinical-topics
#18
EDITORIAL
Marjorie A Bowman, Anne Victoria Neale, Dean A Seehusen
This issue contains several articles about the factors contributing to the complex and deadly interplay between social determinants of health, pain, mental illness, and addictive substances such as opioids and tobacco. One article clearly is a call to action: more than half of opioid prescriptions in the United States are given to patients with mental health problems. Two articles report work on the next steps for social determinants of health in health care settings. Social accountability based on community health needs assessments required of community hospitals should lead to the creation of more family medicine residency positions...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28717004/two-tyrosine-residues-tyr-108-and-tyr-503-are-responsible-for-the-deprotonation-of-phenolic-substrates-in-vanillyl-alcohol-oxidase
#19
Tom A Ewing, Quoc-Thai Nguyen, Robert C Allan, Gudrun Gygli, Elvira Romero, Claudia Binda, Marco W Fraaije, Andrea Mattevi, Willem J H van Berkel
A number of oxidoreductases from the VAO/para-cresol methylhydroxylase flavoprotein family catalyze the oxidation of para-substituted phenols. One of the best-studied is vanillyl-alcohol oxidase (VAO) from the fungus Penicillium simplicissimum For oxidation of phenols by VAO to occur, they must first be bound in the active site of the enzyme in their phenolate anion form. The crystal structure of VAO reveals that two tyrosine residues, Tyr-108 and Tyr-503, are positioned to facilitate this deprotonation. To investigate their role in catalysis, we created three VAO variants, Y108F, Y503F, and Y108F/Y503F, and studied their biochemical properties...
September 1, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28695425/community-health-workers-bring-cost-savings-to-patient-centered-medical-homes
#20
Maurice L Moffett, Arthur Kaufman, Andrew Bazemore
The Patient-Centered Medical Home (PCMH) model demonstrated that processes of care can be improved while unnecessary care, such as preventable emergency department utilization, can be reduced through better care coordination. A complementary model, the Integrated Primary Care and Community Support (I-PaCS) model, which integrates community health workers (CHWs) into primary care settings, functions beyond improved coordination of primary medical care to include management of the social determinants of health...
July 10, 2017: Journal of Community Health
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