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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
#1
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/28758564/do-medical-residents-perform-patient-centered-medical-home-tasks-a-mixed-methods-study
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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/PCMH 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 enzyme's active site in their phenolate anion form. The crystal structure of VAO reveals that two tyrosine residues, Tyr-108 and Tyr-503, are positioned so as 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...
July 17, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28695425/community-health-workers-bring-cost-savings-to-patient-centered-medical-homes
#11
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
https://www.readbyqxmd.com/read/28677990/elements-of-the-veterans-health-administration-patient-centered-medical-home-are-associated-with-greater-adherence-to-oral-hypoglycemic-agents-in-patients-with-diabetes
#12
Nicholas Meo, Edwin Wong, Haili Sun, Idamay Curtis, Adam Batten, Stephan D Fihn, Karin Nelson
In 2010, Veterans Health Administration (VHA) primary care clinics adopted a patient-centered medical home (PCMH) model. This study sought to examine the association between the organizational features related to adoption of PCMH and the level of adherence to oral hypoglycemic agents (OHAs) among patients with diabetes. This retrospective cohort study involved 757 VA clinics that provide primary care to 440,971 patients with diabetes who were taking OHAs in fiscal year 2012. One-year refill-based medication possession ratios (MPRs) were calculated at the patient level...
July 5, 2017: Population Health Management
https://www.readbyqxmd.com/read/28670708/do-patient-centered-medical-homes-improve-health-behaviors-outcomes-and-experiences-of-low-income-patients-a-systematic-review-and-meta-analysis
#13
Carissa van den Berk-Clark, Emily Doucette, Fred Rottnek, William Manard, Mayra Aragon Prada, Rachel Hughes, Tyler Lawrence, F David Schneider
OBJECTIVES: To examine: (1) what elements of patient-centered medical homes (PCMHs) are typically provided to low-income populations, (2) whether PCMHs improve health behaviors, experiences, and outcomes for low-income groups. DATA SOURCES/STUDY SETTING: Existing literature on PCMH utilization among health care organizations serving low-income populations. STUDY DESIGN: Systematic review and meta-analysis. DATA COLLECTION/EXTRACTION METHODS: We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving low-income populations...
July 3, 2017: Health Services Research
https://www.readbyqxmd.com/read/28669855/the-vao-pcmh-flavoprotein-family
#14
REVIEW
Tom A Ewing, Marco W Fraaije, Andrea Mattevi, Willem J H van Berkel
The VAO/PCMH flavoprotein family consists of structurally homologous flavin-dependent enzymes that catalyze a wide range of chemical reactions. Family members share an architecture consisting of a conserved FAD-binding domain and a more variable substrate-binding domain, which enables varying interactions with a range of substrates while maintaining the same cofactor-binding fold. Here, we provide an overview of the current state of our knowledge on the members of the VAO/PCMH family. Based on a phylogenetic analysis, we divide the family into 11 subgroups...
June 29, 2017: Archives of Biochemistry and Biophysics
https://www.readbyqxmd.com/read/28665905/implementation-of-practice-transformation-patient-experience-according-to-practice-leaders
#15
Denise D Quigley, Alina I Palimaru, Alex Y Chen, Ron D Hays
OBJECTIVE: Examine practice leaders' perceptions and experiences of how patient-centered medical home (PCMH) transformation improves patient experience. SUBJECTS: Thirty-six interviews with lead physicians (n = 13), site clinic administrators (n = 13), and nurse supervisors (n = 10). METHODS: Semi-structured interviews at 14 primary care practices within a large urban Federally Qualified Health Center (FQHC) delivery system to identify critical patient experience domains and mechanisms of change...
July 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28620725/understanding-adaptations-to-patient-centered-medical-home-activities-the-pcmh-adaptations-model
#16
Tristen L Hall, Jodi Summers Holtrop, L Miriam Dickinson, Russell E Glasgow
Primary care practices have increasingly adopted the patient-centered medical home (PCMH) model and often adapted quality improvement efforts to fit local context. This paper implemented a modified framework for understanding adaptations in the context of primary care PCMH transformation efforts. We combined an adaptations model by Stirman et al. that categorized adaptations to evidence-based interventions in research studies with dimensions from the RE-AIM framework, as well as items specific to PCMH. The resulting constructs were translated into a "plain English" adaptations interview...
June 15, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28604260/developing-high-functioning-teams-factors-associated-with-operating-as-a-real-team-and-implications-for-patient-centered-medical-home-development
#17
Somava Stout, Leah Zallman, Lisa Arsenault, Assaad Sayah, Karen Hacker
Team-based care is a foundation of health care redesign models like the patient-centered medical home (PCMH). Yet few practices rigorously examine how the implementation of PCMH relates to teamwork. We identified factors associated with the perception of a practice operating as a real team. An online workforce survey was conducted with all staff of 12 primary care sites of Cambridge Health Alliance at different stages of PCMH transformation. Bivariate and multivariate analyses of factors associated with teamwork perceptions were conducted...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28585163/engaging-multilevel-stakeholders-in-an-implementation-trial-of-evidence-based-quality-improvement-in-va-women-s-health-primary-care
#18
Alison B Hamilton, Julian Brunner, Cindy Cain, Emmeline Chuang, Tana M Luger, Ismelda Canelo, Lisa Rubenstein, Elizabeth M Yano
The Veterans Health Administration (VHA) has undertaken primary care transformation based on patient-centered medical home (PCMH) tenets. VHA PCMH models are designed for the predominantly male Veteran population, and require tailoring to meet women Veterans' needs. We used evidence-based quality improvement (EBQI), a stakeholder-driven implementation strategy, in a cluster randomized controlled trial across 12 sites (eight EBQI, four control) that are members of a Practice-Based Research Network. EBQI involves engaging multilevel, inter-professional leaders and staff as stakeholders in reviewing evidence and setting QI priorities...
June 5, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28570299/hla-a-31-01-and-hla-b-15-02-association-with-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-to-carbamazepine-in-a-multiethnic-malaysian-population
#19
Amy Hui-Ping Khor, Kheng-Seang Lim, Chong-Tin Tan, Zhenli Kwan, Wooi-Chiang Tan, David Bin-Chia Wu, Ching-Ching Ng
The majority of the carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis CBZ-SJS/TEN are associated with HLA-B*15:02 in Asian populations where this allele is common. In contrast, the association with HLA-A*31:01 is only reported in Japanese and Europeans. This study aimed to further investigate the association with HLA-A*31:01 besides HLA-B*15:02 in a multiethnic Malaysian population. Twenty-eight CBZ-SJS/TEN cases and 227 CBZ-tolerant controls were recruited. Association was tested by comparing carrier frequencies of the alleles between cases and controls...
July 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28560769/patient-experience-of-chronic-illness-care-and-medical-home-transformation-in-safety-net-clinics
#20
Elizabeth L Tung, Yue Gao, Monica E Peek, Robert S Nocon, Kathryn E Gunter, Sang Mee Lee, Marshall H Chin
OBJECTIVE: To examine the relationship between medical home transformation and patient experience of chronic illness care. STUDY SETTING: Thirteen safety net clinics located in five states enrolled in the Safety Net Medical Home Initiative. STUDY DESIGN: Repeated cross-sectional surveys of randomly selected adult patients were completed at baseline (n = 303) and postintervention (n = 271). DATA COLLECTION METHODS: Questions from the Patient Assessment of Chronic Illness Care (PACIC) (100-point scale) were used to capture patient experience of chronic illness care...
May 30, 2017: Health Services Research
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