Health Care Talk (HCTalk.com)

[amolison]

Turning a doctor’s office into a “medical home”

University of Texas Health Science Center professor leads national research on new breed of primary care practice; findings published today in special edition of Annals of Family Medicine

SAN ANTONIO (June 7, 2010) — A professor from The University of Texas Health Science Center at San Antonio is exploring how to transform a doctor’s office into a “patient-centered medical home” that offers team-based care, better use of technology and a more personal experience for the patient that may ultimately improve health.

A special supplement of Annals of Family Medicine released Monday, June 7, contains eight articles authored or coauthored by Dr. Jaén explaining the process, outcomes and lessons of the project.

There is no single description of a patient-centered medical home – also called “advanced primary care” – although there are some generally accepted principles. These are broad and wide-ranging, calling for a team approach, elimination of barriers to access, electronic health records, redesigned offices, care within a community context and better financial practices.

“It’s proactive care,” Dr. Jaén said. “It’s a place where you get what you need when you need it and how you need it in terms of medical care.”

Depending on the practice, a patient might see some of the following signs of a patient-centered medical home:

• Access to medical staff: A patient can get an appointment the same day, reach someone in the practice in the middle of the night or e-mail the doctor with questions or concerns. Medical practices have extended evening and weekend hours. Patients have a relationship with doctors and medical staff who know them by name.
• Better use of technology: This might mean having lab results quickly integrated into a patient’s electronic medical record, or it could be the ability to instantly generate “disease registries,” or lists of patients with common conditions and needs, that can be used to remind patients about medications, tests or preventative procedures. It might be as simple as giving a patient online access to laboratory and imaging studies or the ability to e-mail a doctor or schedule an appointment online.
• Team approach to care: Each patient has a personal doctor who coordinates care. But patients interact with a number of medical staffers, depending on who is best suited to a given situation. A practice might have any combination of doctors, nurses and nurse practitioners, physician assistants, pharmacists, psychologists or other medical personnel who work together to provide integrated care. Dr. Jaén calls it “a partnership for the benefit of the patients.”
• Community-oriented care: A patient-centered medical home responds to the needs of its community. Patients with the same condition might be able to see their doctor together, addressing common concerns as a group. For example, smokers might be seen together for group coaching on how to quit smoking. Those patients can be seen individually as needed. Group visits also allow patients to share experiences and support each other. This also can be valuable in prenatal visits, weight loss, diabetes management and other cases. In some instances, practices have outreach to local sports teams for sports physicals and other community needs.

Dr. Jaén and his faculty have brought some of these changes to the family medicine clinic at the Medical Arts & Research Center (MARC), which houses UT Medicine San Antonio, the faculty practice group of the UT Health Science Center’s School of Medicine. The MARC was not among the practices studied in the national demonstration project.


http://www.uthscsa.edu/hscnews/singleformat2.asp?newID=3458