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Patient centered medical home

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https://www.readbyqxmd.com/read/28930708/may-medical-centers-give-nonresident-patients-priority-in-scheduling-outpatient-follow-up-appointments
#1
Armand H Matheny Antommaria
Many academic medical centers are seeking to attract patients from outside their historical catchment areas for economic and programmatic reasons, and patients are traveling for treatment that is unavailable, of poorer quality, or more expensive at home. Treatment of these patients raises a number of ethical issues including whether they may be given priority in scheduling outpatient follow-up appointments in order to reduce the period of time they are away from home. Granting them priority is potentially unjust because medical treatment is generally allocated based on medical need and resource utilization, and then on a first-come, first-served basis...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28927493/review-of-patient-reported-experience-within-patient-centered-medical-homes-insights-for-australian-health-care-homes
#2
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/28924623/the-effectiveness-of-pharmacist-provided-telephonic-medication-therapy-management-on-emergency-department-utilization-in-home-health-patients
#3
Stephanie A Gernant, Margie E Snyder, Heather Jaynes, Jason M Sutherland, Alan J Zillich
BACKGROUND: Preventable emergency department (ED) use may be targeted with interventions for improving the medication use process, as medication misadventures and non-adherence frequently cause preventable ED utilization. One intervention that could prevent ED visits is Medication Therapy Management (MTM). OBJECTIVE: To evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing emergency department utilization within a Medicare insured home health population...
October 1, 2016: Journal of Pharmacy Technology: JPT: Official Publication of the Association of Pharmacy Technicians
https://www.readbyqxmd.com/read/28923818/what-makes-for-successful-registry-implementation-a-qualitative-comparative-analysis
#4
Jodi Summers Holtrop, Tristen L Hall, Claude Rubinson, L Miriam Dickinson, Russell E Glasgow
PURPOSE: Registry implementation is an important component of successfully achieving patient-centered medical home designation and an important part of population-based health. The purpose of this study was to examine what factors are evident in the successful implementation of a registry in a selection of Colorado practices involved in quality-improvement activities. METHODS: In-depth, small-group interviews occurred at 13 practices. The data were recorded, transcribed, and qualitatively analyzed to identify key themes regarding elements of successful registry implementation...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28916250/successful-integration-of-pediatrics-into-state-health-care-reform-efforts
#5
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/28891445/patient-variables-associated-with-the-assignment-of-a-formal-dementia-diagnosis-to-positively-screened-primary-care-patients
#6
Tilly Eichler, Jochen René Thyrian, Johannes Hertel, Steffen Richter, Bernhard Michalowsky, Diana Wucherer, Adina Dreier, Ingo Kilimann, Stefan Teipel, Wolfgang Hoffmann
BACKGROUND: Main objective was to analyze the associations of patient variables (depression, quality of life, anti-dementia drug treatment, knowledge about dementia) with the assignment of a formal diagnosis of dementia to community-dwelling primary care patients who have screened positive for dementia. METHODS: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner based randomized controlled intervention trial...
September 7, 2017: Current Alzheimer Research
https://www.readbyqxmd.com/read/28891393/improving-ambulatory-care-resident-training-preparing-for-opportunities-to-treat-mental-illness-in-the-primary-care-setting
#7
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/28887348/population-health-management-in-a-small-health-system-impact-of-controlled-substance-stewardship-in-a-patient-centered-medical-home
#8
Felicity A E Homsted, Chelsea E Magee, Noah Nesin
PURPOSE: The success of a patient-centered medical home in providing population health management (PHM) services through controlled substance stewardship is described. SUMMARY: In 2013, Penobscot Community Health Care (PCHC), in Bangor, Maine, was fully engulfed in the prescription opioid crisis. At PCHC, patients' opioid doses were startlingly high. Within the organization, measures to ensure that prescriptions were being used as prescribed, and not diverted, were underutilized...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28887347/pharmacists-supporting-population-health-in-patient-centered-medical-homes
#9
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/28886703/factors-associated-with-foot-ulceration-and-amputation-in-adults-on-dialysis-a-cross-sectional-observational-study
#10
Michelle R Kaminski, Anita Raspovic, Lawrence P McMahon, Katrina A Lambert, Bircan Erbas, Peter F Mount, Peter G Kerr, Karl B Landorf
BACKGROUND: Adults on dialysis are at increased risk of foot ulceration, which commonly precedes more serious lower limb complications, including amputation. Limited data exist regarding the prevalence and factors associated with foot disease in this population. Hence, this study set out to investigate factors associated with foot ulceration and amputation in a dialysis cohort. METHODS: This study presents a cross-sectional analysis of baseline data from a multi-center prospective cohort study...
September 8, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28885893/does-patient-centered-medical-home-recognition-relate-to-accountable-care-organization-participation
#11
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/28885096/infant-hydrocephalus-in-sub-saharan-africa-the-reality-on-the-tanzanian-side-of-the-lake
#12
Maria M Santos, Derick K Rubagumya, Imani Dominic, Amos Brighton, Soledad Colombe, Philip O'Donnell, Micaella R Zubkov, Roger Härtl
OBJECTIVE Infant hydrocephalus is estimated to affect more than 100,000 new infants each year in sub-Saharan Africa (SSA). Bugando Medical Centre (BMC), a government-funded and patient cost-shared referral center, serves over 13 million people in the Lake and Western regions of Tanzania. The goals of this study were to characterize the infant population affected by hydrocephalus who presented to BMC and were treated with a ventriculoperitoneal shunt (VPS) to determine the rate of early complications associated with this surgical procedure and to assess its potential risk factors...
September 8, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28879421/the-history-of-rhoton-s-lab
#13
REVIEW
Toshio Matsushima, J Richard Lister, Ken Matsushima, Evandro de Oliveira, Erdener Timurkaynak, David A Peace, Shigeaki Kobayashi
The work performed in Dr. Rhoton's Lab, represented by over 500 publications on microneurosurgical anatomy, greatly contributed to improving the level of neurosurgical treatment throughout the world. The authors reviewed the development and activities of the Lab over 40 years. Dr. Albert L. Rhoton Jr., the founder of, and leader in, this field, displayed great creativity and ingenuity during his life. He devoted himself to perfecting his study methodology, employing high-definition photos and slides to enhance the quality of his published papers...
September 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28874320/exercise-training-for-intermittent-claudication
#14
Mary M McDermott
OBJECTIVE: The objective of this study was to provide an overview of evidence regarding exercise therapies for patients with lower extremity peripheral artery disease (PAD). METHODS: This manuscript summarizes the content of a lecture delivered as part of the 2016 Crawford Critical Issues Symposium. RESULTS: Multiple randomized clinical trials demonstrate that supervised treadmill exercise significantly improves treadmill walking performance in people with PAD and intermittent claudication symptoms...
September 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28872933/improving-the-asthma-disparity-gap-with-legal-advocacy-a-qualitative-study-of-patient-identified-challenges-to-improve-social-and-environmental-factors-that-contribute-to-poorly-controlled-asthma
#15
Drew A Harris, Anne Mainardi, Osatohamwen Iyamu, Marjorie S Rosenthal, R Douglas Bruce, Margaret A Pisani, Carrie A Redlich
OBJECTIVE: To identify challenges disadvantaged adults with asthma face in mitigating social and environmental factors associated with poor symptom control. METHODS: Using a community-engaged approach, we partnered with a community health center in New Haven, CT to conduct in-person interviews and a written survey of asthmatic adults with poor symptom control. Using the constant comparative method, we analyzed participant interviews to establish emerging themes and identify common barriers to improved outcomes...
September 5, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28872535/the-opportunity-awaits-to-lead-orthopaedic-telehealth-innovation-aoa-critical-issues
#16
Montri D Wongworawat, Gary Capistrant, John M Stephenson
Telehealth is a way to provide health-care services to a patient from a provider who is at another location. The most common methods include a live interactive visit with the patient, interpretation of imaging, and monitoring of patient progress. Principally, telehealth is a way of providing a service rather than a type of service. It is about patient care, not data care.Examples of orthopaedic applications include conducting patient examinations, interpreting imaging studies, and providing postoperative care...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28866894/more-chemo-or-home-hospice-narrative-results-from-an-n-of-1-trial
#17
Keith M Swetz
Words matter. They have tremendous power to heal or hurt. And although the patients we care for in oncology and palliative medicine often die from, or despite, their neoplastic illness; caregivers and loved ones often hold onto the words that clinicians share with them during their times of struggle and grief. In this narrative, the author (as first person) reflects on some systemic challenges he faced in dealing with illness and loss when his father battled two distinct neoplastic processes. He explores the commonalities and differences that he experienced as a palliative care physician, and how that has guided his medical practice moving forward...
June 23, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28865869/homing-in-on-the-social-systems-level-influences-on-overly-aggressive-treatments-at-the-end-of-life
#18
Elizabeth Dzeng, Daniel Dohan, J Randall Curtis, Thomas J Smith, Alessandra Colaianni, Christine Ritchie
CONTEXT: The American medical system is programmed to a default setting of aggressive care for the terminally ill. Institutional norms of decision-making have been shown to promote high intensity care, regardless of consistency with patient preferences. There are myriad factors at a system, clinician, surrogate, and patient level that drive the culture of overly aggressive treatments in American hospitals. OBJECTIVE: To understand physician perspective of the ways systems-level factors influence patient, physician, and surrogate perceptions and consequent behavior...
August 30, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28865642/adapting-the-patient-centered-medical-home-to-address-psychosocial-adversity-results-of-a-qualitative-study
#19
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/28865474/barriers-and-facilitators-to-implementation-of-va-home-based-primary-care-on-american-indian-reservations-a-qualitative-multi-case-study
#20
B Josea Kramer, Sarah D Cote, Diane I Lee, Beth Creekmur, Debra Saliba
BACKGROUND: Veterans Health Affairs (VA) home-based primary care (HBPC) is an evidence-based interdisciplinary approach to non-institutional long-term care that was developed in urban settings to provide longitudinal care for vulnerable older patients. Under the authority of a Memorandum of Understanding between VA and Indian Health Service (IHS) to improve access to healthcare, 14 VA medical centers (VAMC) independently initiated plans to expand HBPC programs to rural American Indian reservations and 12 VAMC successfully implemented programs...
September 2, 2017: Implementation Science: IS
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