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https://www.readbyqxmd.com/read/27909251/-in-principle-we-have-agreement-but-in-practice-it-is-a-bit-more-difficult-obtaining-organizational-buy-in-to-patient-centered-medical-home-transformation
#1
Janelle Applequist, Michelle Miller-Day, Peter F Cronholm, Robert A Gabbay, Deborah S Bowen
The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state...
November 30, 2016: Qualitative Health Research
https://www.readbyqxmd.com/read/27893520/impact-of-a-patient-centered-medical-home-pilot-on-utilization-quality-and-costs-and-variation-in-medical-homeness
#2
Signe Peterson Flieger
This study evaluated the impact of a patient-centered medical home (PCMH) pilot on utilization, costs, and quality and assessed variation in PCMH components. Data included the New Hampshire Comprehensive Healthcare Information System and Medical Home Index (MHI) scores for 9 pilot sites. A quasi-experimental, difference-in-difference model with propensity score-matched comparison group was employed. MHI scores were collected in late 2011. There were no statistically significant findings for utilization, cost, or quality in the expected direction...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27893519/effects-of-hospital-systems-on-medical-home-transformation-in-primary-care-residency-training-practices
#3
Kyle Knierim, Tristen Hall, Douglas Fernald, Thomas J Staff, Emilie Buscaj, Jessica Cornett Allen, Mary Onysko, W Perry Dickinson
Most primary care residency training practices have close financial and administrative relationships with teaching hospitals and health systems. Many residency practices have begun integrating the core principles of the patient-centered medical home (PCMH) into clinical workflows and educational experiences. Little is known about how the relationships with hospitals and health systems affect these transformation efforts. Data from the Colorado Residency PCMH Project were analyzed. Results show that teaching hospitals and health systems have significant opportunities to influence residency practices' transformation, particularly in the areas of supporting team-based care, value-based payment reforms, and health information technology...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27893518/patient-centered-medical-home-implementation-and-burnout-among-va-primary-care-employees
#4
Joseph A Simonetti, Philip W Sylling, Karin Nelson, Leslie Taylor, David C Mohr, Idamay Curtis, Gordon Schectman, Stephan D Fihn, Christian D Helfrich
Burnout is widespread throughout primary care and is associated with negative consequences for providers and patients. The relationship between the patient-centered medical home model and burnout remains unclear. Using survey data from 8135 and 7510 VA primary care employees in 2012 and 2013, respectively, we assessed whether clinic-level medical home implementation was independently associated with burnout prevalence and estimated whether burnout changed among this workforce from 2012 to 2013. Adjusting for differences in respondent and clinic characteristics, we found that burnout was common among primary care employees, increased by 3...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27887032/provider-perception-of-pharmacy-services-in-the-patient-centered-medical-home
#5
Nicole P Albanese, Alyssa M Pignato, Scott V Monte
BACKGROUND: Despite the positive data on clinical outcomes, cost savings, and provider experience, no study has surveyed providers to evaluate what pharmacy services they find to be worthwhile. OBJECTIVE: To determine what clinical, cost/access, and educational pharmacy services providers in a patient-centered medical home (PCMH) consider worthwhile and the perceived barriers to successful pharmacist incorporation. METHODS: A cross-sectional online survey was distributed to primary care physicians, nurse practitioners, and physician assistants in a PCMH physician group...
November 24, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27880049/understanding-clinicians-attitudes-toward-a-mobile-health-strategy-to-childhood-asthma-management-a-qualitative-study
#6
Jessica P Hollenbach, Anna Cushing, Emilie Melvin, Bryanna McGowan, Michelle M Cloutier, Melissa Manice
OBJECTIVES: Mobile technology for childhood asthma can provide real-time data to enhance care. What real-time adherence information clinicians want, how they may use it, and if the data meet their clinical needs has not been fully explored. Our goal was to determine whether pediatric primary care and pulmonary clinicians believe a sensor-based mobile intervention is useful in caring for patients with asthma. METHODS: We recruited participants from 3 urban, primary care and 1 pulmonary practice from July to September 2015 in Hartford, CT...
November 23, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27876686/encouraging-patient-portal-use-in-the-patient-centered-medical-home-three-stakeholder-perspectives
#7
Gemmae M Fix, Timothy P Hogan, Daniel J Amante, D Keith McInnes, Kim M Nazi, Steven R Simon
BACKGROUND: Health care organizations are increasingly offering patients access to their electronic medical record and the ability to communicate with their providers through Web-based patient portals, thus playing a prominent role within the patient-centered medical home (PCMH). However, despite enthusiasm, adoption remains low. OBJECTIVE: We examined factors in the PCMH context that may affect efforts to improve enrollment in a patient portal. METHODS: Using a sociotechnical approach, we conducted qualitative, semistructured interviews with patients and providers from 3 primary care clinics and with national leaders from across a large integrated health care system...
November 22, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27875602/practice-facilitation-for-pcmh-implementation-in-residency-practices
#8
Emilie Buscaj, Tristen Hall, Linda Montgomery, Douglas H Fernald, Jaclyn King, Nicole Deaner, W Perry Dickinson
BACKGROUND AND OBJECTIVES: Primary care residency programs continue to adapt and change to become high-performing training sites for advanced primary care. Practice facilitation is a key method to assist practices in implementing organizational changes. This evaluation described the unique nature and essential roles and qualities of practice facilitation for residency program patient-centered medical home (PCMH) transformation. METHODS: Evaluation of the Colorado Residency PCMH Project from 2009 through 2014 included template and immersion-crystallization approaches to qualitative analysis of field notes, key informant interviews, and meeting documentation to identify themes related to external facilitation for practice transformation in 11 Colorado primary care residency practices...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27875601/association-between-patient-centered-medical-home-features-and-satisfaction-with-family-medicine-residency-training-in-the-us
#9
Patricia A Carney, Elaine Waller, Eve Dexter, Miguel Marino, Stephanie E Rosener, Larry A Green, Geoffrey Jones, J Drew M Keister, Julie A Dostal, Samuel M Jones, M Patrice Eiff
BACKGROUND AND OBJECTIVES: Primary care residencies are undergoing dramatic changes because of changing health care systems and evolving demands for updated training models. We examined the relationships between residents' exposures to patient-centered medical home (PCMH) features in their assigned continuity clinics and their satisfaction with training. METHODS: Longitudinal surveys were collected annually from residents evaluating satisfaction with training using a 5-point Likert-type scale (1=very unsatisfied to 5=very satisfied) from 2007 through 2011, and the presence or absence of PCMH features were collected from 24 continuity clinics during the same time period...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27872354/integrating-maternal-mental-health-care-in-the-pediatric-medical-home-treatment-engagement-and-child-outcomes
#10
Mary C Kimmel, Rheanna E Platt, Danielle N Steinberg, Fallon Cluxton-Keller, Lauren M Osborne, Tracy Carter, Jennifer L Payne, Barry S Solomon
Maternal depression is associated with an array of poor child health outcomes, and low-income women face many barriers to accessing treatment. In this pilot study, we assessed treatment engagement in a maternal mental health clinic staffed by a case manager and psychiatrist in an urban pediatric practice. We also examined factors associated with engagement as well as child health outcomes and health care use. Nearly half of the women enrolled attended at least 4 sessions with a psychiatrist in 6 months. Text messaging with the case manager was associated with a greater compliance with psychiatrist sessions...
November 20, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27870544/referrals-and-the-pcmh-how-well-do-we-know-our-neighborhood
#11
Andrew Schreiner, Patrick Mauldin, Jingwen Zhang, Justin Marsden, William Moran
OBJECTIVES: Characterize patterns of referral from a patient-centered medical home (PCMH) and observe the association of provider experience, patient chronic disease burden, and risk of utilization on referral placement. STUDY DESIGN: Descriptive analysis of referral patterns in an academic, internal medicine PCMH. METHODS: We examined referrals (eg, specialist visit, testing, ancillary services) placed between July and December of 2014 in an academic PCMH caring for a total of 12,000 patients...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27869585/the-critical-components-of-an-electronic-care-plan-tool-for-primary-care-an-exploratory-qualitative-study
#12
Lisa Rotenstein, Suhavi Tucker, Rose Kakoza, Lori Tishler, Adrian Zai, Charlotte Wu
BACKGROUND: A critical need exists for effective electronic tools that facilitate multidisciplinary care for complex patients in patient-centered medical homes.Objective To identify the essential components of a primary care (PC) based electronic care plan (ECP) tool that facilitates coordination of care for complex patients. METHOD: Three focus groups and nine semi-structured interviews were conducted at an academic PC practice in order to identify the ideal components of an ECP...
July 4, 2016: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/27864208/payer-view-of-personalized-medicine
#13
Edmund J Pezalla
PURPOSE: The process and methods used by payers when evaluating coverage of personalized medicine testing are described. SUMMARY: Personalized medicine encompasses a number of diagnostic tools that measure drug metabolism, genetic risk for disease development, and tumor type or markers that can guide oncology treatments. However, whole genome testing, tumor marker testing, and testing for drug metabolism are additional costs to the healthcare system. In order to justify these costs, payers and health technology assessment bodies must evaluate the individual tests or groups of tests on their own merits...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27852789/patient-centered-medical-home-capacity-and-ambulatory-care-utilization
#14
Larry R Hearld, Kristine R Hearld, Claudia Guerrazzi
The patient-centered medical home (PCMH) has increasingly received attention as a model of care to potentially remedy the cost and quality problems that confront the US health care system, including and especially ambulatory care-related issues. This study examined the association between physician practices' PCMH capacity and 3 indicators of ambulatory care utilization: (1) emergency department utilization, (2) ambulatory care sensitive hospitalization rate, and (3) 30-day all-cause readmission rate. Results show that overall PCMH capacity is associated with lower rates, and technical aspects of the PCMH in particular were associated with lower utilization rates while interpersonal capabilities were not...
November 15, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27849352/medical-home-transformation-and-breast-cancer-screening
#15
Amy W Baughman, Phyllis Brawarsky, Tracy Onega, Tor D Tosteson, Qianfei Wang, Anna N A Tosteson, Jennifer S Haas
OBJECTIVES: The patient-centered medical home (PCMH) continues to gain momentum as a primary care delivery system. We evaluated whether medical home transformation of primary care practices is associated with the use of breast cancer screening, a broadly endorsed preventive service. STUDY DESIGN: Retrospective cohort study evaluating 12 Brigham and Women's Hospital (BWH)-affiliated primary care clinics in greater Boston, Massachusetts. METHODS: Practice transformation was measured quarterly using a continuous PCMH transformation score (range = 0-100) modeled after National Committee for Quality Assurance recognition requirements...
November 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27844476/coprescribing-naloxone-for-patients-on-chronic-opioid-therapy-les-sons-learned-from-a-patient-safety-initiative-in-primary-care-training-sites
#16
William Delaney, Jessica Huff, Sandra Mini, Aiswarya Thomas, Ralph Tremaglio
OBJECTIVE: To describe the development and implementation of a resident-led effort to increase coprescription of naloxone in a primary care setting. DESIGN: An exploratory, prospective pilot project to increase coprescription rates of naloxone. SETTING: Four primary care offices in western Connecticut serving as medical home training sites for primary care residents. PATIENTS, PARTICIPANTS: All patients on chronic opioid therapy...
September 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27836506/evaluating-community-health-centers-adoption-of-a-new-global-capitation-payment-echange-study-protocol
#17
H Angier, J P O'Malley, M Marino, K J McConnell, E Cottrell, R L Jacob, S Likumahuwa-Ackman, J Heintzman, N Huguet, S R Bailey, J E DeVoe
Primary care patient-centered medical homes (PCMHs) are an effective healthcare delivery model. Evidence regarding the most effective payment models for increased coordination efforts is sparse. This protocol paper describes the evaluation of an Alternative Payment Methodology (APM) implemented in a subset of Oregon community health centers (CHCs), using a prospective matched observational design. The APM is a primary care payment reform intervention that changed Oregon's Medicaid payment for several CHCs from fee-for-service reimbursement to a per-member-per-month capitated payment...
November 9, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27834306/citation-context-and-impact-of-sleeping-beauties-in-paediatric-research
#18
REVIEW
Jernej Završnik, Peter Kokol, Stefano Del Torso, Helena Blažun Vošner
OBJECTIVES: 'Sleeping beauties', i.e. publications that are not cited for a long while, present interesting findings in science. This study analysed the citation trends of sleeping beauties in paediatric research. METHODS: The study used bibliometric software to analyse the papers citing sleeping beauties in paediatric research, to understand the context in which paediatric sleeping beauties were finally cited and the impact of these sleeping beauties on paediatric research...
November 10, 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27833396/strengthening-the-coordination-of-pediatric-mental-health-and-medical-care-piloting-a-collaborative-model-for-freestanding-practices
#19
Carolyn A Greene, Julian D Ford, Barbara Ward-Zimmerman, Lisa Honigfeld, Anne E Pidano
BACKGROUND: Collaborative pediatric mental health and primary care is increasingly recognized as optimal for meeting the needs of children with mental health problems. This paper describes the challenges faced by freestanding specialty mental health clinics and pediatric health practices to provide such coordinated mind-and-body treatment. It describes critical elements of a proactive approach to achieving collaborative pediatric care under real-world circumstances using the patient-centered medical home neighborhood (PCMH-N) model...
October 2016: Child & Youth Care Forum
https://www.readbyqxmd.com/read/27829766/a-descriptive-study-on-awareness-about-oral-health-among-pediatric-practitioners-in-kanchipuram-district
#20
S Rajalingam, V Leela Rani
BACKGROUND: Pediatricians and other health-care providers could play an invaluable role in ensuring the maintenance of optimal preventive as well as curative dental health in children. This study was aimed at assessing the pediatrician's perspective on basic oral health care in children in Kanchipuram district. MATERIALS AND METHODS: A questionnaire survey was carried out among Pediatricians which covered various aspects of knowledge, attitude, and role of pediatricians in preventive dental care...
October 2016: Journal of Pharmacy & Bioallied Sciences
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