Data-driven transformation to an oncology patient-centered medical home.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 285-285 ◽  
Author(s):  
John David Sprandio ◽  
Brian Flounders ◽  
Maureen R. Lowry ◽  
Susan Higman Tofani
Keyword(s):  
Medical Home ◽  
Hospital Admissions ◽  
Care Delivery ◽  
Point Of Care ◽  
Performance Status ◽  
Clinical Decision ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Oncology Patient ◽  
Nccn Guidelines

285 Background: Consultants in Medical Oncology and Hematology (CMOH) implemented an EMR in 2003. It fell short in the compilation and presentation of meaningful data upon which to base clinical decisions. CMOH created a new workflow and effectively integrated the EMR with a practice-developed clinical decision support software (CDSS) called Iris. Methods: A project team outlined the data sources required in making a clinical decision and reviewed staff workflow. Within six months, they developed a system for displaying data from internal and external sources into a single scrollable screen for use by the physician at the point of care. Results: Iris promotes a rapid-learning cycle that results in 1) improved adherence to NCCN guidelines; 2) enhanced access and continuity of symptom management; 3) enhanced communication, tracking, and coordination of care; 4) reduction in ER utilization/hospital admissions; 5) a performance status driven approach to end of life care; 6) a systematic measurement of physician performance. This approach enabled CMOH to meet the NCQA’s criteria for level III Patient-Centered Medical Home in 2010. Conclusions: Implementation of EMRs alone does not improve health care delivery. Rather, it is the merger of clinical operations workflow and technology infrastructure delivering consumable data to providers that drives quality improvements and enhancements to the value of cancer care. [Table: see text]

Patient-Centered Medical Home Membership Is Associated with Decreased Hospital Admissions for Emergency Department Behavioral Health Patients

2018 ◽  
Vol 21 (3) ◽  
pp. 172-179 ◽  
Author(s):  
Akuh Adaji ◽  
Gabrielle J. Melin ◽  
Ronna L. Campbell ◽  
Christine M. Lohse ◽  
Jessica J. Westphal ◽  
...  
Keyword(s):  
Emergency Department ◽  
Behavioral Health ◽  
Medical Home ◽  
Hospital Admissions ◽  
Patient Centered Medical Home ◽  
Patient Centered

Can a Patient-Centered Medical Home Lead to Better Patient Outcomes? The Quality Implications of Geisinger’s ProvenHealth Navigator

2011 ◽  
Vol 27 (3) ◽  
pp. 210-216 ◽  
Author(s):  
Daniel D. Maeng ◽  
Thomas R. Graf ◽  
Duane E. Davis ◽  
Janet Tomcavage ◽  
Frederick J. Bloom
Keyword(s):  
Patient Outcomes ◽  
Medical Home ◽  
Care Delivery ◽  
Quality Care ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Care Delivery Model ◽  
Short Period ◽  
Patients With Diabetes ◽  
Stage Renal Disease

One of the primary goals of the patient-centered medical home (PCMH) is to provide higher quality care that leads to better patient outcomes. Currently, there is only limited evidence regarding the ability of PCMHs to achieve this goal. This article demonstrates the effect of PCMHs in improving certain clinical outcomes, as shown by the ProvenHealth Navigator (PHN), an advanced PCMH model developed and implemented by Geisinger Health System. In this study, the authors examined the claims data from Geisinger Health Plan between 2005 and 2009 and estimated the effect of PHN on reducing amputation rates among patients with diabetes, end-stage renal disease, myocardial infarction, and stroke. The results show that, despite its relatively short period of existence, PHN has led to significant improvements in certain outcomes, further illustrating its potential as a care delivery model to be adopted on a wider scale.

scholarly journals Veteran Patient Perspectives and Experiences During Implementation of a Patient-Centered Medical Home Model

2017 ◽  
Vol 5 (2) ◽  
pp. 107-113 ◽  
Author(s):  
Anaïs Tuepker ◽  
Summer Newell ◽  
Christina Nicolaidis ◽  
Marie-Elena Reyes ◽  
Maria Carolina González-Prats ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Medical Home ◽  
Care Delivery ◽  
Hybrid Approach ◽  
The United States ◽  
Patient Centered Medical Home ◽  
Veterans Health ◽  
Health Administration ◽  
Patient Centered

Background: The Veterans Health Administration (VA) has implemented the largest shift to a patient-centered medical home (PCMH) model of care in the United States to date. Objective: We interviewed veterans about their experiences of primary care to understand whether they observed changes in care during this period as well as to learn which characteristics of care mattered most to their experiences. Method: Qualitative interviews were conducted with 32 veterans receiving primary care at 1 of 8 VA clinics in the northwest United States. Interviews were analyzed using an inductive–deductive hybrid approach by an interdisciplinary team that included a veteran patient. Result: Participants noticed recent positive changes, including improved communications and shorter waits in clinic, but rarely were aware of VA’s PCMH initiative; a strong relationship with the primary care provider and feeling cared for/respected by everyone involved in care delivery were key components of quality care. The needs of the veteran community as a whole also shaped discussion of care expectations. Conclusion: The PCMH model may provide benefits even when invisible to patients. Veteran awareness of population needs suggests a promising role for veteran involvement in further PCMH transformation efforts.

Data-driven quality improvement in an oncology patient-centered medical home.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 54-54
Author(s):  
John David Sprandio ◽  
Maureen Lowry ◽  
Brian Flounders ◽  
Susan Higman Tofani
Keyword(s):  
Quality Improvement ◽  
Medical Home ◽  
Learning System ◽  
Data Driven ◽  
Physician Education ◽  
Patient Centered Medical Home ◽  
Telephone Triage ◽  
Time Data ◽  
Patient Centered ◽  
Oncology Patient

54 Background: In a 2012 abstract, Data driven transformation for an Oncology Patient-Centered Medical Home, Consultants in Medical Oncology (CMOH) demonstrated that standardized processes and enhanced IT capabilities (IRIS software app) provided a rapid learning system for the practice. Iris aggregated data became the basis for Quality Improvement Projects (QIPs) allowing CMOH to continue to improve in quality and cost measures. Deviation from performance trend is readily identifiable, providing operational direction. Methods: A review of 2012 data identified an increase in the rate of hospitalizations, initiating a QIP. We identified inconsistent processes in Telephone Triage Symptom Management at one of the three practice locations. It was determined that symptom calls in the early to mid afternoon were being directed to the ER, and a higher percentage of these evaluations resulted in admissions. Steps to restructure roles and internal processes and reinforced training followed, resulting in improvement. Results: After analysis of site specific performance, we centralized Telephone Triage services to reduce variability in execution. We addressed staffing issues, streamlined nursing and physician education around Triage related processes, revised algorithms, and improved education materials to enhance patient engagement. This resulted in resetting our trend in ER utilization and admissions, increasing the number of calls into the telephone triage service, increasing the percentage of symptoms managed at home and decreasing the number of office visits within 24 hours. Conclusions: Aggregated real-time data provides the tools to rapidly identify opportunities for improvement and conduct QIPs to enhance the quality and value of delivered services. Supportive software apps like Iris are foundational for practice transformation to future value-based cancer care models. [Table: see text]

scholarly journals Data-Driven Transformation to an Oncology Patient–Centered Medical Home

2013 ◽  
Vol 9 (3) ◽  
pp. 130-132 ◽  
Author(s):  
John D. Sprandio ◽  
Brian P. Flounders ◽  
Maureen Lowry ◽  
Susan Tofani
Keyword(s):  
Patient Care ◽  
Medical Home ◽  
Quality Measures ◽  
Care Team ◽  
Data Driven ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Oncology Patient ◽  
Quality Patient Care

As the use of EMR systems increases, new standardized quality measures that incorporate patient- and payer-centric outcomes need to be developed, and data must be collected in a manner that will not distract the physician-led care team from the delivery of quality patient care.

scholarly journals Did Arkansas’ Medicaid Patient-Centered Medical Home Program Have Spillover Effects on Commercially Insured Enrollees?

2020 ◽  
Vol 57 ◽  
pp. 004695801990075
Author(s):  
Jesse M. Hinde ◽  
Nathan West ◽  
Samuel J. Arbes ◽  
Marianne Kluckman ◽  
Suzanne L. West
Keyword(s):  
Medical Home ◽  
Hospital Admissions ◽  
Spillover Effects ◽  
Professional Services ◽  
Emergency Department Visits ◽  
Patient Centered Medical Home ◽  
Medicaid Patient ◽  
Coordinated Care ◽  
Patient Centered ◽  
Lower Health

Patient-centered medical homes are increasingly being implemented by state Medicaid programs to incentivize high-quality, coordinated care and ultimately lower health care spending. This study examined whether the Arkansas Medicaid Patient-Centered Medical Home Program’s practice-wide transformation activities had spillover effects on commercial beneficiaries. We used difference-in-differences to compare utilization and expenditures of commercially insured enrollees as their practices received Medicaid patient-centered medical home certification on a rolling basis between 2014 and 2016. We found a 5.7% increase in outpatient visits and 13% higher expenditures among early adopting practices. Even without associated reductions in costly emergency department visits or inpatient hospital admissions, decisionmakers should not lose sight of the potential value of increased engagement in and coordination of professional services for a population with high unmet health needs. Our results also emphasize that states can leverage Medicaid to spur system-wide transformation, and the investments generate spillover effects beyond those covered directly by Medicaid.

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