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https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#1
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/28435481/a-patient-centered-emergency-department-management-strategy-for-sickle-cell-disease-super-utilizers
#2
Grant G Simpson, Hallie R Hahn, Alex A Powel, Robert R Leverence, Linda A Morris, Lara G Thompson, Marc S Zumberg, Deepa J Borde, Joseph A Tyndall, Jonathan J Shuster, Donald M Yealy, Brandon R Allen
INTRODUCTION: A subpopulation of sickle-cell disease patients, termed super-utilizers, presents frequently to emergency departments (EDs) for vaso-occlusive events and may consume disproportionate resources without broader health benefit. To address the healthcare needs of this vulnerable patient population, we piloted a multidisciplinary intervention seeking to create and use individualized patient care plans that alter utilization through coordinated care. Our goals were to assess feasibility primarily, and to assess resource use secondarily...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434390/how-preferences-for-continuity-and-access-differ-between-multimorbidity-and-healthy-patients-in-a-team-care-setting
#3
Katherine M Ehman, Mark Deyo-Svendsen, Zachary Merten, Anne Marie Kramlinger, Gregory M Garrison
INTRODUCTION: Team-based care has become an essential part of modern medical practice. Patient-centered medical homes often struggle to balance the dual competing goals of acute access and continuity of care. Multimorbidity patients may value continuity more than healthy patients, and thus may prefer to wait to see their primary care physician (PCP). METHODS: A total of 1700 randomly selected healthy adults and multimorbidity patients were asked to rate satisfaction with care and presented with 4 acute and 4 chronic scenarios to choose an access and continuity preference in an anonymous mailed survey...
April 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28409703/beyond-screening-a-stepped-care-pathway-for-managing-postpartum-depression-in-pediatric-settings
#4
Su-Chin Serene Olin, Mary McCord, Ruth E K Stein, Bonnie D Kerker, Dara Weiss, Kimberly E Hoagwood, Sarah M Horwitz
The negative consequences of untreated postpartum depression (PD) for both the woman and her infant are well established. The impact of maternal depression has led to recommendations on systematic perinatal depression screening. Unfortunately, large-scale initiatives on PD screening have found no benefit unless systems are in place to facilitate appropriate interventions for women who screen positive. Pediatric primary care has been a focus of efforts to support screening and management of PD because pediatric providers, unlike adult healthcare providers, have the most frequent contact with postpartum women through well-child visits...
April 14, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28397131/making-a-medical-home-for-ibd-patients
#5
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/28387979/prescription-contraception-use-and-adherence-by-women-with-substance-use-disorders
#6
Gillian Griffith, Tara Kumaraswami, Stavroula A Chrysanthopoulou, Kristin M Mattocks, Robin E Clark
BACKGROUND AND AIMS: Unintended pregnancy rates are high among women with substance use disorders (SUDs), which could be partly explained by lower use of and adherence to contraception. We aimed to test: (1) the association of SUD with prescription contraceptive use, contraceptive method selection, and adherence; (2) whether practices participating in the Patient-Centered Medical Home Initiative (PCMHI) had better contraceptive use and adherence for patients with SUD; (3) for differences in the association of SUD with adherence by type of contraceptive used...
April 7, 2017: Addiction
https://www.readbyqxmd.com/read/28387598/patient-experiences-with-care-differ-with-chronic-care-management-in-a-federally-qualified-community-health-center
#7
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/28385024/patient-experience-midway-through-a-large-primary-care-practice-transformation-initiative
#8
Kaylyn E Swankoski, Deborah N Peikes, Stacy B Dale, Nancy A Clusen, Nikkilyn Morrison, John J Holland, Timothy J Day, Randall S Brown
OBJECTIVES: To determine how the multipayer Comprehensive Primary Care (CPC) initiative that transforms primary care delivery affects the patient experience of Medicare fee-for-service beneficiaries. The study examines how experience changed between the first and second years of CPC, how ratings of CPC practices have changed relative to ratings of comparison practices, and areas in which practices still have opportunities to improve patient experience. STUDY DESIGN: Prospective study using 2 serial cross-sectional samples of more than 25,000 Medicare fee-for-service beneficiaries attributed to 496 CPC practices and nearly 9000 beneficiaries attributed to 792 comparison practices...
March 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28379833/provision-of-palliative-care-services-by-family-physicians-is-common
#9
Claire K Ankuda, Anuradha Jetty, Andrew Bazemore, Stephen Petterson
OBJECTIVE: Provision of palliative care services by primary care physicians is increasingly important with an aging population, but it is unknown whether US primary care physicians see themselves as palliative practitioners. METHODS: This study used cross-sectional analysis of data from the 2013 American Board of Family Medicine Maintenance of Certification Demographic Survey. RESULTS: Of 10,894 family physicians, 33.1% (n = 3609) report providing palliative care...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28376438/those-left-behind-from-voluntary-medical-home-reforms-in-ontario-canada
#10
Tara Kiran, Alexander Kopp, Richard H Glazier
PURPOSE: Health systems are transitioning patients to medical homes to improve health outcomes and reduce cost. We sought to understand the characteristics and quality of care for patients who did and did not participate in the voluntary transition to medical homes. METHODS: We used administrative data for diabetes monitoring and cancer screening to compare services received by patients attached to a medical home (n = 10,785,687) with services received by those seeing a fee-for-service physician (n = 1,321,800) in Ontario, Canada, on March 31, 2011...
November 2016: Annals of Family Medicine
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/28339689/genomic-decision-support-needs-in-pediatric-primary-care
#16
Jeffrey W Pennington, Dean J Karavite, Edward M Krause, Jeffrey Miller, Barbara A Bernhardt, Robert W Grundmeier
Clinical genome and exome sequencing can diagnose pediatric patients with complex conditions that often require follow-up care with multiple specialties. The American Academy of Pediatrics emphasizes the role of the medical home and the primary care pediatrician in coordinating care for patients who need multidisciplinary support. In addition, the electronic health record (EHR) with embedded clinical decision support is recognized as an important component in providing care in this setting. We interviewed 6 clinicians to assess their experience caring for patients with complex and rare genetic findings and hear their opinions about how the EHR currently supports this role...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28335011/understanding-public-perception-of-the-need-for-major-change-in-latin-american-healthcare-systems
#17
Ricardo Pérez-Cuevas, Frederico C Guanais, Svetlana V Doubova, Leonardo Pinzón, Luis Tejerina, Diana Pinto Masis, Marcia Rocha, Donna O Harris, James Macinko
The opinions and experiences of the public regarding health services are valuable insights into identifying opportunities to improve healthcare systems. We analyzed the 2012-2013 Public Opinion Health Policy Survey carried out in Brazil (n = 1486), Colombia (n = 1485), El Salvador (n = 1460), Jamaica (n = 1480), México (n = 1492) and Panama (n = 1475). In these countries between 82 and 96% of participants perceived that their health systems needed fundamental changes. The most frequent barrier to access to healthcare was lack of the primary medical home, difficulties in obtaining medical care during the weekends and financial barriers...
March 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28323747/supporting-a-youth-with-cerebellar-ataxia-into-adolescence
#18
Veronica Meneses, Zurisadai Gonzalez-Castillo, Veronica B Edgar, Marilyn Augustyn
Zoe, a 13-year-old white girl, presents as a new patient to your pediatric clinic with complaints of frequent emesis, anxiety, and learning problems, and previous diagnosis of cerebellar ataxia. Parents accompany Zoe and state, "it is really hard for her to go out, she gets sick and falls easily." She was born full term by vaginal delivery without complications. Given globally delayed milestones, she received early intervention services. Feeding problems began at infancy, including gastroesophageal reflux and aspiration pneumonia...
April 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28319991/practitioner-application-a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#19
Pamela J Stoyanoff
No abstract text is available yet for this article.
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319990/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#20
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
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