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https://www.readbyqxmd.com/read/28506398/integration-of-pharmacists-into-patient-centered-medical-homes-in-federally-qualified-health-centers-in-texas
#1
Shui Ling Wong, Jamie C Barner, Kristina Sucic, Michelle Nguyen, Karen L Rascati
OBJECTIVES: To describe the integration and implementation of pharmacy services in patient-centered medical homes (PCMHs) as adopted by federally qualified health centers (FQHCs) and compare them with usual care (UC). SETTING: Four FQHCs (3 PCMHs, 1 UC) in Austin, TX, that provide care to the underserved populations. PRACTICE DESCRIPTION: Pharmacists have worked under a collaborative practice agreement with internal medicine physicians since 2005...
May 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28486061/patient-centered-medical-home-membership-is-associated-with-decreased-hospital-admissions-for-emergency-department-behavioral-health-patients
#2
Akuh Adaji, Gabrielle J Melin, Ronna L Campbell, Christine M Lohse, Jessica J Westphal, David J Katzelnick
The objective was to examine the impact of a multipayer patient-centered medical home (PCMH) on health care utilization for behavioral health patients seen at a tertiary care emergency department (ED). A retrospective health records review was performed for PCMH and non-PCMH patients who presented and received a psychiatric consultation during a 2-year period in the ED of the Mayo Clinic Hospital in Rochester, Minnesota. Univariable and multivariable associations with the outcomes of admission and return visits within 72 hours were evaluated using logistic regression models and summarized with odds ratios (ORs) and 95% confidence intervals (CIs)...
May 9, 2017: Population Health Management
https://www.readbyqxmd.com/read/28481843/vha-patient-centered-medical-home-associated-with-lower-rate-of-hospitalizations-and-specialty-care-among-veterans-with-posttraumatic-stress-disorder
#3
Ian Randall, David C Mohr, Charles Maynard
OBJECTIVE: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH) model, termed Patient Aligned Care Teams (PACT), in 2010. We assessed the association between PACT and the use of health services among U.S. veterans with posttraumatic stress disorder (PTSD). METHODS: VHA clinical and administrative data were obtained for the pre-PACT period of April 1, 2009 to March 31, 2010 and post-PACT period of June 1, 2011 to May 31, 2012...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28481602/a-national-evaluation-of-homeless-and-nonhomeless-veterans-experiences-with-primary-care
#4
Audrey L Jones, Leslie R M Hausmann, Gretchen L Haas, Maria K Mor, John P Cashy, James H Schaefer, Adam J Gordon
Persons who are homeless, particularly those with mental health and/or substance use disorders (MHSUDs), often do not access or receive continuous primary care services. In addition, negative experiences with primary care might contribute to homeless persons' avoidance and early termination of MHSUD treatment. The patient-centered medical home (PCMH) model aims to address care fragmentation and improve patient experiences. How homeless persons with MHSUDs experience care within PCMHs is unknown. This study compared the primary care experiences of homeless and nonhomeless veterans with MHSUDs receiving care in the Veterans Health Administration's medical home environment, called Patient Aligned Care Teams...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28468524/accountable-care-in-transitions-action-a-team-based-approach-to-reducing-hospital-utilization-in-a-patient-centered-medical-home
#5
Emily M Hawes, Jennifer N Smith, Nicole R Pinelli, Rayhaan Adams, Gretchen Tong, Sam Weir, Mark Gwynne
BACKGROUND: There is limited data describing the role of the patient-centered medical home (PCMH) in successful transitions programs and more information is needed to determine the transition points where pharmacist involvement is most impactful. METHODS: A family medicine center developed a multidisciplinary outpatient-based transitions program focused on reducing emergency department (ED) and hospital use in medically complex patients. Key team members were a medical provider, clinical pharmacist practitioner (CPP), and care manager...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28467266/patient-centered-medical-home-recognition-and-diabetes-control-among-health-centers-exploring-the-role-of-enabling-services
#6
Jessica M Dobbins, Nicholas Peiper, Emily Jones, Richard Clayton, Lars E Peterson, Robert L Phillips
The patient-centered medical home (PCMH) model has been considered a promising approach to improve chronic care delivery, particularly among patients with diabetes. There is theoretical support to suggest that certain nonmedical services, such as enabling services (eg, case management, social work, transportation), embedded within PCMH could be contributing to successful model implementation. It remains unclear whether PCMH recognition or enabling services are related to diabetes control. Federally Qualified Health Centers (FQHCs) are an important setting in which to study this relationship given the considerable effort required to implement the PCMH model and the ubiquity of enabling services in these safety net settings...
May 3, 2017: Population Health Management
https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#7
Jung G Kim, Carl G Morris, Paul Ford
PROBLEM: Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. APPROACH: In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#8
Melissa Nelson Scribner, Kasey Kehoe
The challenges to healthcare delivery posed by Hawai'i's unique geography, physician shortages, and dispersed population are of particular importance in light of implementing the Affordable Care Act (ACA). This study draws on central goals laid out in the ACA - to decrease costs, increase access, and improve patient outcomes. The use of the Patient-Centered Medical Homes (PCMHs) is a care model that has the potential to meet all three goals. How to identify the most effective way to develop PCMHs in the specific context of Hawai'i is the focus of this study...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28397131/making-a-medical-home-for-ibd-patients
#9
REVIEW
Lawrence R Kosinski, Joel Brill, Miguel Regueiro
PURPOSE OF REVIEW: The transformation from fee for service to fee for value requires structural changes to the way gastroenterologists manage patients with inflammatory bowel disease (IBD). A team-based approach using technology to engage patients is necessary for success. The Patient-Centered Medical Home (PCMH) represents a unique model that brings together these essential features. This paper describes how the PCMH model has been successfully applied to the management of patients with IBD...
May 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28387598/patient-experiences-with-care-differ-with-chronic-care-management-in-a-federally-qualified-community-health-center
#10
Claude M Setodji, Denise D Quigley, Marc N Elliott, Q Burkhart, Michael E Hochman, Alex Y Chen, Ron D Hays
This study compares patient experience among practices that vary in adoption of the chronic care management (CCM) dimension of the patient-centered medical home (PCMH) model that focuses on care coordination and management of chronic diseases. Study participants were 2903 adult patients (ages 18 years or older) at 14 primary care centers in California. Seven of the sites were classified as high (more CCM) and the other 7 low on a CCM index. Hypotheses were tested using ordinary least squares regression models...
April 7, 2017: Population Health Management
https://www.readbyqxmd.com/read/28367682/feasibility-and-acceptability-of-a-colocated-homeless-tailored-primary-care-clinic-and-emergency-department
#11
Sonya Gabrielian, Jennifer C Chen, Beena P Minhaj, Rishi Manchanda, Lisa Altman, Ella Koosis, Lillian Gelberg
OBJECTIVES: Homeless adults have low primary care engagement and high emergency department (ED) utilization. Homeless-tailored, patient-centered medical homes (PCMH) decrease this population's acute care use. We studied the feasibility (focused on patient recruitment) and acceptability (conceptualized as clinicians' attitudes/beliefs) of a pilot initiative to colocate a homeless-tailored PCMH with an ED. After ED triage, low-acuity patients appropriate for outpatient care were screened for homelessness; homeless patients chose between a colocated PCMH or ED visit...
March 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28364355/population-health-management-for-diabetes-health-care-system-level-approaches-for-improving-quality-and-addressing-disparities
#12
REVIEW
Julie A Schmittdiel, Anjali Gopalan, Mark W Lin, Somalee Banerjee, Christopher V Chau, Alyce S Adams
PURPOSE OF REVIEW: Population care approaches for diabetes have the potential to improve the quality of care and decrease diabetes-related mortality and morbidity. Population care strategies are particularly relevant as accountable care organizations (ACOs), patient-centered medical homes (PCMH), and integrated delivery systems are increasingly focused on managing chronic disease care at the health system level. This review outlines the key elements of population care approaches for diabetes in the current health care environment...
May 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28350639/measuring-the-cost-of-the-patient-centered-medical-home-a-cost-accounting-approach
#13
Robert D Lieberthal, Colleen Payton, Mona Sarfaty, George Valko
To explore the cost for individual practices to become more patient-centered, we inventoried and calculated the cost of costly activities involved in implementing the Patient-Centered Medical Home (PCMH) as defined by the National Committee for Quality Assurance. There were 3 key findings. The cost of each PCMH-related clinical activity can be classified in 1 of 3 major categories. Cost offsets can be used to defray part of the cost recognition. The cost of PCMH transformation varied by practice with no clear level or pattern of costs...
March 27, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28346620/varied-rates-of-implementation-of-patient-centered-medical-home-features-and-residents-perceptions-of-their-importance-based-on-practice-experience
#14
M Patrice Eiff, Larry A Green, Geoff Jones, Alex Verdieck Devlaeminck, Elaine Waller, Eve Dexter, Miguel Marino, Patricia A Carney
BACKGROUND AND OBJECTIVES: Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project. METHODS: We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28342621/how-nurse-led-practices-perceive-implementation-of-the-patient-centered-medical-home
#15
Rosemary Frasso, A Golinkoff, Heather Klusaritz, Katherine Kellom, Helen Kollar-McArthur, Michelle Miller-Day, Robert Gabbay, Peter F Cronholm
PURPOSE: The Affordable Care Act (ACA) promotes the Patient-Centered Medical Home (PCMH) model as a way to improve healthcare quality, the patient experience, and has identified nurse-led primary care as a mechanism meeting the increasing demand for quality primary care. The purpose of this study was to investigate the implementation of a PCMH model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. METHODS: Data were collected through in-depth interviews with providers and staff in nurse-led practices...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28319990/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#16
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28295249/development-and-validation-of-the-modified-patient-centered-medical-home-assessment-for-the-comprehensive-primary-care-initiative
#17
Dmitriy Poznyak, Deborah N Peikes, Breanna A Wakar, Randall S Brown, Robert J Reid
OBJECTIVE: To describe the modified Patient-Centered Medical Home Assessment (M-PCMH-A) survey module developed to track primary care practices' care delivery approaches over time, assess whether its underlying factor structure is reliable, and produce factor scores that provide a more reliable summary measure of the practice's care delivery than would a simple average of question responses. DATA SOURCES/STUDY SETTING: Survey data collected from diverse practices participating in the Comprehensive Primary Care (CPC) initiative in 2012 (n = 497) and 2014 (n = 493) and matched comparison practices in 2014 (n = 423)...
March 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28290952/transitioning-to-patient-centered-medical-homes-associations-with-appointment-availability
#18
Todd C Leroux, Murray J Côté, Hye-Chung Kum, Alan Dabney, Rebecca Wells
INTRODUCTION: Recent implementation of the Patient-Centered Medical Home (PCMH) in military primary care has gained significant traction and attention from leadership and policy makers. The study objective was to measure the rate of change in appointment availability before and after primary care clinics were certified as a medical home. Access to care is one core tenet of the medical home and appointment availability is an important indicator of access. MATERIALS AND METHODS: This was a retrospective, longitudinal observational study involving 21 U...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28264952/synthesis-of-research-on-patient-centered-medical-homes-brings-systematic-differences-into-relief
#19
Anna D Sinaiko, Mary Beth Landrum, David J Meyers, Shehnaz Alidina, Daniel D Maeng, Mark W Friedberg, Lisa M Kern, Alison M Edwards, Signe Peterson Flieger, Patricia R Houck, Pamela Peele, Robert J Reid, Katharine McGraves-Lloyd, Karl Finison, Meredith B Rosenthal
The patient-centered medical home (PCMH) model emphasizes comprehensive, coordinated, patient-centered care, with the goals of reducing spending and improving quality. To evaluate the impact of PCMH initiatives on utilization, cost, and quality, we conducted a meta-analysis of methodologically standardized findings from evaluations of eleven major PCMH initiatives. There was significant heterogeneity across individual evaluations in many outcomes. Across evaluations, PCMH initiatives were not associated with changes in the majority of outcomes studied, including primary care, emergency department, and inpatient visits and four quality measures...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264792/enhancing-mhealth-technology-in-the-patient-centered-medical-home-environment-to-activate-patients-with-type-2-diabetes-a-multisite-feasibility-study-protocol
#20
Ronald Gimbel, Lu Shi, Joel E Williams, Cheryl J Dye, Liwei Chen, Paul Crawford, Eric A Shry, Sarah F Griffin, Karyn O Jones, Windsor W Sherrill, Khoa Truong, Jeanette R Little, Karen W Edwards, Marie Hing, Jennie B Moss
BACKGROUND: The potential of mHealth technologies in the care of patients with diabetes and other chronic conditions has captured the attention of clinicians and researchers. Efforts to date have incorporated a variety of tools and techniques, including Web-based portals, short message service (SMS) text messaging, remote collection of biometric data, electronic coaching, electronic-based health education, secure email communication between visits, and electronic collection of lifestyle and quality-of-life surveys...
March 6, 2017: JMIR Research Protocols
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