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https://www.readbyqxmd.com/read/29311170/integrating-community-health-workers-into-medical-homes
#1
Elizabeth A Rogers, Sarah Turcotte Manser, Joan Cleary, Anne M Joseph, Eileen M Harwood, Kathleen T Call
PURPOSE: Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMHs), few PCMHs in Minnesota have incorporated these health workers into their care teams. We undertook a qualitative study to (1) identify facilitators and barriers to utilizing a CHW model among PCMHs in Minnesota, and (2) define roles played by this workforce within the PCMH team...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29304742/key-attributes-of-patient-centered-medical-homes-associated-with-patient-activation-of-diabetes-patients
#2
Lori A Bilello, Allyson Hall, Jeffrey Harman, Christopher Scuderi, Nipa Shah, Jon C Mills, Shenae Samuels
BACKGROUND: Approximately 24 million Americans are living with diabetes. Patient activation among individuals with diabetes is critical to successful diabetes management. The Patient Centered Medical Home (PCMH) model holds promise for increasing patient activation in managing their health. However, what is not well understood is the extent to which individual components of the PCMH model, such as the quality of physician-patient interactions and organizational features of care, contribute to patient activation...
January 5, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29280778/perceptions-of-integration-of-the-clinical-pharmacist-into-the-pcmh-model-by-the-pcmh-team
#3
M Shawn McFarland, Kristen Lamb, Jonathan Hughes, Ashley Thomas, Justin Gatwood, Jacob Hathaway
INTRODUCTION: The patient-centered medical home (PCMH) model is a multidisciplinary, team-based approach to healthcare that focuses on actively involving the patient in clinical decision making. The Veterans Health Administration (VA), while desiring to be a national leader in the delivery of primary care services, used the principles of the PCMH model to design the patient-aligned care team (PACT). The purpose of this study, was to explore the perception of the PACT members after integration of a clinical pharmacist to the PACT...
December 22, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29261247/reduction-of-emergency-department-use-in-people-with-disabilities
#4
Lihao Chu, Neeraj Sood, Michael Tu, Katrina Miller, Lhasa Ray, Jennifer N Sayles
OBJECTIVES: To examine emergency department (ED) use by individuals with disabilities in safety-net clinics that have adopted the patient-centered medical home (PCMH) model. STUDY DESIGN: This is a retrospective matched cohort study. Prior to matching, we identified 2269 nonelderly Medicaid beneficiaries with disabilities from a Los Angeles Medicaid managed care plan in PCMH clinics and 21,897 in non-PCMH clinics. METHODS: To minimize self-selection bias from clinics and individuals, we created 3 comparison groups through a series of propensity score matching schemes that included matching clinics with similar health service utilization per patient and matching individuals with similar demographic characteristics and underlying health conditions...
December 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29243823/pathways-to-medical-home-recognition-a-qualitative-comparative-analysis-of-the-pcmh-transformation-process
#5
Peter Mendel, Emily K Chen, Harold D Green, Courtney Armstrong, Justin W Timbie, Amii M Kress, Mark W Friedberg, Katherine L Kahn
OBJECTIVE: To understand the process of practice transformation by identifying pathways for attaining patient-centered medical home (PCMH) recognition. DATA SOURCES/STUDY SETTING: The CMS Federally Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration was designed to help FQHCs achieve NCQA Level 3 PCMH recognition and improve patient outcomes. We used a stratified random sample of 20 (out of 503) participating sites for this analysis. STUDY DESIGN: We developed a conceptual model of structural, cultural, and implementation factors affecting PCMH transformation based on literature and initial qualitative interview themes...
December 15, 2017: Health Services Research
https://www.readbyqxmd.com/read/29237335/patient-centered-medical-home-measurement-in-school-based-health-centers
#6
Abbey Gregg, Li-Wu Chen, Jungyoon Kim, Hyo Jung Tak, Melissa Tibbits
School-based health centers (SBHCs) have been suggested as potential medical homes, yet minimal attention has been paid to measuring their patient-centered medical home (PCMH) implementation. The purposes of this article were to (1) develop an index to measure PCMH attributes in SBHCs, (2) use the SBHC PCMH Index to compare PCMH capacity between PCMH certified and non-PCMH SBHCs, and (3) examine differences in index scores between SBHCs based in schools with and without adolescents. A total of six PCMH dimensions in the SBHC PCMH Index were identified through factor analysis...
January 1, 2017: Journal of School Nursing: the Official Publication of the National Association of School Nurses
https://www.readbyqxmd.com/read/29204975/characteristics-and-disparities-among-primary-care-practices-in-the-united-states
#7
David Michael Levine, Jeffrey A Linder, Bruce E Landon
BACKGROUND: Despite new incentives for US primary care, concerns abound that patient-centered practice capabilities are lagging. OBJECTIVE: Describe the practice structure, patient-centered capabilities, and payment relationships of US primary care practices; identify disparities in practice capabilities. DESIGN: Analysis of the 2015 Medical Organizations Survey (MOS), part of the nationally representative Medical Expenditure Panel Survey (MEPS)...
December 4, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29194594/development-and-validation-of-a-short-form-safety-net-medical-home-scale
#8
Robert S Nocon, Kathryn E Gunter, Yue Gao, Sang Mee Lee, Marshall H Chin
OBJECTIVE: To develop a short-form Safety Net Medical Home Scale (SNMHS) for assessing patient-centered medical home (PCMH) capability in safety net clinics. DATA SOURCES/STUDY SETTING: National surveys of federally qualified health centers (FQHCs). Interviews with FQHC directors. STUDY DESIGN: We constructed three short-form SNMHS versions and examined correlations with full SNMHS and related primary care assessments. We tested usability with FQHC directors and reviewed scale development with an advisory group...
December 1, 2017: Health Services Research
https://www.readbyqxmd.com/read/29182358/diabetes-care-improvement-in-pharmacist-versus-nurse-supported-patient-centered-medical-homes
#9
Lillian Min, Christine T Cigolle, Steven J Bernstein, Kathleen Ward, Tisha L Moore, Jinkyung Ha, Caroline S Blaum
OBJECTIVES: In 2009 and 2010, 17 primary care sites within 1 healthcare system became patient-centered medical homes (PCMHs), but the sites trained different personnel (pharmacists vs nurses) to improve diabetes care using self-management support (SMS). We report the challenges and successes of our efforts to: 1) assemble a new multipayer (Medicare, Medicaid, commercial) claims dataset linked to a clinical registry and 2) use the new dataset to perform comparative effectiveness research on implementation of the 2 SMS models...
November 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29170019/evaluation-of-a-rapid-and-sensitive-rt-qpcr-assay-for-the-detection-of-ebola-virus
#10
M Biava, F Colavita, A Marzorati, D Russo, D Pirola, A Cocci, A Petrocelli, M Guanti Delli, G Cataldi, T A Kamara, A S Kamara, K Konneh, A Cannas, S Coen, S Quartu, S Meschi, M B Valli, A Mazzarelli, C Venditti, G Grassi, G Rozera, C Castilletti, A Mirazimi, M R Capobianchi, G Ippolito, R Miccio, A Di Caro
BACKGROUND: The 2013-2016 Ebola virus disease (EVD) outbreak showed a lack of diagnostic point-of-care methods. Currently, EBOV diagnosis relies on quantitative reverse-transcription-PCR (RT- qPCR), highly specific and sensitive, but requiring skilled personnel and well-equipped laboratories. In field settings, these factors and others, such as samples' time of collection and transportation, determine a prolonged turnaround-time to final results. In outbreak scenarios, a rapid and transportable method could eliminate issues of cohorting suspected and actual EVD patients for lack of diagnostic certainty...
November 20, 2017: Journal of Virological Methods
https://www.readbyqxmd.com/read/29161972/impacts-of-initial-transformation-to-a-patient-centered-medical-home-on-diabetes-outcomes-in-federally-qualified-health-centers-in-florida
#11
Heidi S Kinsell, Allyson G Hall, Jeffrey S Harman, Sweta Tewary, Andrew Brickman
OBJECTIVE: Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care. The study objective was to examine the effects of initial transformation to a level 3 National Committee for Quality Assurance (NCQA) certified PCMH in 2011, on clinical diabetes outcomes among 27 clinic sites from a network of FQHCs in Florida...
November 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29154464/patient-centered-medical-home-implementation-and-improved-chronic-disease-quality-a-longitudinal-observational-study
#12
Ann-Marie Rosland, Edwin Wong, Matthew Maciejewski, Donna Zulman, Rebecca Piegari, Stephan Fihn, Karin Nelson
OBJECTIVE: To examine associations between clinics' extent of patient-centered medical home (PCMH) implementation and improvements in chronic illness care quality. DATA SOURCE: Data from 808 Veterans Health Administration (VHA) primary care clinics nationwide implementing the Patient Aligned Care Teams (PACT) PCMH initiative, begun in 2010. DESIGN: Clinic-level longitudinal observational study of clinics that received training and resources to implement PACT...
November 20, 2017: Health Services Research
https://www.readbyqxmd.com/read/29153853/community-pharmacist-collaboration-with-a-patient-centered-medical-home-establishment-of-a-patient-centered-medical-neighborhood-and-payment-model
#13
Heidi R Luder, Pam Shannon, James Kirby, Stacey M Frede
OBJECTIVES: To determine the feasibility of a partnership between a community pharmacy and a patient-centered medical home (PCMH) by measuring the impact on office- and patient-level clinical outcomes. SETTING: Kroger Pharmacy and a PCMH practice in Cincinnati, OH. PRACTICE DESCRIPTION: The Kroger Co. is a large grocery store chain that operates 102 pharmacies in the Cincinnati-Dayton marketing area. The PCMH practice is an accredited PCMH office serving more than 9000 patients in the Cincinnati area...
November 15, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29094370/post-ebola-situational-assessment-of-opportunities-for-capacity-building-at-the-national-obstetrics-and-gynecology-referral-hospital-in-sierra-leone
#14
Rachel Chan Seay, Alimamy P Koroma, Jenell Coleman, John Sampson, Lucy Koroma, Emmanuel A Ugwa, Jean Anderson
OBJECTIVE: To describe a site assessment of the Princess Christian Maternity Hospital (PCMH; Freetown, Sierra Leone), the national referral center for reproductive, maternal, newborn, child and adolescent health (RMNCAH) services and logical site for focused efforts to train and expand the RMNCAH workforce in Sierra Leone. METHODS: In April 2016, a mixed-methods assessment approach was used involving facility observation and staff interviews using the WHO's Service Availability and Readiness Assessment (SARA) tool...
November 2, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29058625/the-impact-of-patient-advisors-on-healthcare-outcomes-a-systematic-review
#15
Anjana E Sharma, Margae Knox, Victor L Mleczko, J Nwando Olayiwola
BACKGROUND: Patient advisory councils are a way for healthcare organizations to promote patient engagement. Despite mandates to implement patient advisory councils through programs like the Patient-Centered Medical Home (PCMH), there is a paucity of data measuring the impact of patients functioning in advisory roles. Our objective is to investigate whether patient engagement in patient advisory councils is linked to improvements in clinical quality, patient safety or patient satisfaction...
October 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29034825/a-tale-of-four-practices
#16
Michelle Miller-Day, Janelle Applequist, Keri Zabokrtsky, Alexandra Dalton, Katherine Kellom, Robert Gabbay, Peter F Cronholm
Purpose The Patient-Centered Medical Home (PCMH) has become a dominant model of primary care re-design. This transformation presents a challenge to many care delivery organizations. The purpose of this paper is to describe attributes shaping successful and unsuccessful practice transformation within four medical practice groups. Design/methodology/approach As part of a larger study of 25 practices transitioning into a PCMH, the current study focused on diabetes care and identified high- and low-improvement medical practices in terms of quantitative patient measures of glycosylated hemoglobin and qualitative assessments of practice performance...
September 18, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28992154/the-patient-centered-medical-home-a-reality-for-hiv-care-in-nigeria
#17
Aima A Ahonkhai, Ifeyinwa Onwuatuelo, Susan Regan, Abdulkabir Adegoke, Elena Losina, Bolanle Banigbe, Juliet Adeola, Timothy G Ferris, Prosper Okonkwo, Kenneth A Freedberg
Objective: HIV care delivery in resource-limited settings (RLS) may serve as a paradigm for chronic disease care, but comprehensive measurement frameworks are lacking. Our objective was to adapt the patient-centered medical home (PCMH) framework for use in RLS, and evaluate the performance of HIV treatment programs within this framework. Design and setting: Cross-sectional survey administered within the AIDS Prevention Initiative in Nigeria (APIN) network. Participants: Medical directors at APIN clinics...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28990992/comparing-patient-centered-medical-home-implementation-in-urban-and-rural-vha-clinics-results-from-the-patient-aligned-care-team-initiative
#18
Victoria Johnson, Edwin Wong, Michelle Lampman, Idamay Curtis, John Fortney, Peter Kaboli, Stephan Fihn, Karin Nelson
Rural Veterans Health Administration (VHA) primary care clinics are smaller, have fewer staff, and serve more rural patients compared with urban VHA primary care clinics. This may lead to different challenges to implementation of the Patient-Centered Medical Home (PCMH) model, the Patient Aligned Care Team, in the VHAs' large integrated health system. In this cross-sectional observational study of 905 VHA primary clinics in the United States and Puerto Rico, we found overall PCMH implementation was greater in rural compared to urban primary care clinics...
October 4, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28990831/the-patient-centered-medical-home-model-healthcare-services-utilization-and-cost-for-non-elderly-adults-with-mental-illness
#19
Jennifer J Bowdoin, Rosa Rodriguez-Monguio, Elaine Puleo, David Keller, Joan Roche
BACKGROUND: The patient-centered medical home (PCMH) model is designed to improve health outcomes while containing the cost of care. However, the evidence is inconclusive. AIMS: The aim of this study was to examine the associations between receipt of care consistent with the PCMH and healthcare services utilization and expenditures for non-elderly adults with mental illness in the USA. METHOD: A surveillance study was conducted using self-reported data for 6908 non-elderly adults with mental illness participating in the 2007-2012 Medical Expenditure Panel Survey...
October 9, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28985219/the-ins-and-outs-of-vanillyl-alcohol-oxidase-identification-of-ligand-migration-paths
#20
COMPARATIVE STUDY
Gudrun Gygli, Maria Fátima Lucas, Victor Guallar, Willem J H van Berkel
Vanillyl alcohol oxidase (VAO) is a homo-octameric flavoenzyme belonging to the VAO/PCMH family. Each VAO subunit consists of two domains, the FAD-binding and the cap domain. VAO catalyses, among other reactions, the two-step conversion of p-creosol (2-methoxy-4-methylphenol) to vanillin (4-hydroxy-3-methoxybenzaldehyde). To elucidate how different ligands enter and exit the secluded active site, Monte Carlo based simulations have been performed. One entry/exit path via the subunit interface and two additional exit paths have been identified for phenolic ligands, all leading to the si side of FAD...
October 2017: PLoS Computational Biology
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