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    Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

    Contact us at PHA email and be sure to visit us at PHA Website

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Leveraging Health IT to Strengthen Patient Engagement

Leveraging Health IT to Strengthen Patient Engagement

In the spirit of moving innovation forward, I found relevance in the following article about engendering trust using healthcare technology.  In the crossfire of my own struggles with technology, I can appreciate the very salient points outlined by the author.  Specifically, he asserts that healthcare IT can be the lever for improving the physician-patient relationship through the following means.

In the first instance, he points out that technology can help a physician provide SMARTER care.  With escalating numbers of insured patients attempting to be seen by a shrinking provider pool, new delivery methods must be sought to meet this demand.  While the article addresses wellness and preventative care, it is a natural extension to mention patient’s interest in mobile visits.  Incorporating SMS, video and email into the physician toolbox is tantamount; however, certain touch points require a face to face interaction…and the mobile visit solves this dilemma.  In fact, I would dare say that all mediums should be utilized to ensure that the patient’s particular learning mode is engaged and the provider’s message is reinforced.

Secondly, healthcare IT can optimize physician workflow and remove administrative shackles draining resources and diverting attention from the more complex tasks at hand – treating chronically ill patients.  As noted, “technology can take over for clinicians when it comes to some of the more benign data capture and aggregation roles.”  While this can cover items such as first time visit paperwork, it can also be employed for personal health records, population health management, as well as the patient”s & provider’s modification of the medical record.  And by lightening the physician’s load, they are free to pursue clinical partners and engage them in community health and prevention efforts.  At minimum, in celebration of National Public Health Week, there should be a focus on data exchange for immunization and prevention.

Thirdly, one of the core means of establishing trust occurs through the delivery of personalized messages in a format most conducive to each individual patient’s learning and retention style.  Using technology to engage patients and stay connected during their care demonstrates concern and establishes trust – an integral component to the healing process and a competitive edge for a practice seeking to maximize efficiency and minimize cost.

Last, but not least, the author stresses that technology must be implemented in a safe and secure manner in order to protect and preserve the relationships with one’s patients.  Specifically, “being aware of the security of the larger ecosystem of which an organization is part is a way to quell data loss and enhance the trust of patients.”  Perhaps one of the most difficult things to do today, but arguably should not be forgotten in the quest to do no harm.

 

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse PractitionerPhysician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates that stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

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Engaging Specialty Practices in the Patient Centered Medical Neighborhood

Engaging Specialty Practices in the Patient Centered Medical Neighborhood

Building on last week’s post about embracing change for healthcare transofrmation, it was intriguing to learn about the NCQA’s new patient centered medical home program for specialty practices.  Kicking off  March 25, the Patient Centered Specialty Practice (PCSP) recognition highlights specialty practices committed to access, communication and care coordination as “neighbors” that surround and inform the medical home and colleagues in primary care, according to NCQA.  And I regret to say that I missed the informational webinar, including an NCQA advisor and guest speaker from one of the local healthcare systems.

Had I attended the webinar, I would have been better prepared to query the CEO of a hospital within the same healthcare system at a recent American College of Healthcare Executives (ACHE) function.  Interestingly, we had a lengthy conversation regarding the system’s desire to exchange data within the area; however, the CEO noted that current system architecture made it challenging enough to simply share information amongst health system participants.  With one of the key tenets for the PCSP recognition being timely exchange of data, this is a bit of a conundrum.  While the Direct project offers a simple solution, the ultimate goal will be to facilitate and encourage physicians to search for records in efforts to keep all parties abreast of the care plan.  And while this is a tremendous step, we also noted that retail & urgent care clinics, solo primary care practices and free-standing care centers need to get in on the game too.

I also see a need for ancillary providers to be included as well.  Not only would individuals benefit from the opportunity to view x-rays but, more to the point, visualizations, similar to the one here.  While Physical Therapists do an excellent job engaging patients in discussion, they would have far greater impact with the ability to illustrate their points on an interactive tablet app.  And thinking out loud, wouldn’t it be great for individuals to be able to reference the same app at home – to review the information and implement “their’ steps in the care plan?

 

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse PractitionerPhysician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates that stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Innovating Medicaid with the Medical Home Model

Innovating Medicaid with the Medical Home Model

After reading Cheryl Clark’s interview with Dr. Bruce Siegel, President & CEO of the National Association of Public Hospitals and Health Systems, she points out that if the entities existing in one of the 30 states now threatening to refuse to expand their Medicaid eligibility rules to 138% of the federal poverty leveldon’t receive assistance, they’ll continue to provide uncompensated care for many of their sickest patients.  For organizations already stretching to deliver care to the most vulnerable populations, it was encouraging to learn that seven more states have joined the Medicaid ACO project, which targets low-income populations for care improvements and cost reduction via the medical home.

Will a move away from managed care to care coordination payments provide enough incentive for chronically ill Medicaid patients to obtain necessary primary care versus waiting for an urgent or emergent situation to send them to the emergency department?  Dr. Lisa Letourneau, executive director of Maine Quality Counts, a regional healthcare improvement collaborative and  physician champion for the Maine Patient-Centered Medical Home pilot, thinks so.  In order for the 108 practices that have applied for the Medicaid health home pilot, they must have NCQA medical home recognition or have applied for it, maintain an EHR and commit to 10 core expectations of medical home that go beyond National Committee for Quality Assurance (NCQA) conditions.

Although there are already more than 100 ACOs that serve Medicare populations, the Medicaid population is notably sicker, poorer and requires more resources – a complex and challenging equation to say the least.  In efforts to utilize the most efficient resources, advanced nurse led medical homes with patient engagement technology provide an alternative worth considering for those rural locations struggling to meet budgetary requirements. With the brightest minds recently convening at the World Congress 2nd Annual Leadership Summit on Medicaid, one can only hope that they were discussing medical homes similar to Piedmont Health, North Carolina’s first community health center focused on delivering comprehensive primary care services and health education to its members.

With millions of dollars at stake and community health on the line, innovating Medicaid with the medical home model should be a priority today, and not tomorrow.

Patient Protection and Affordable Care Act (PPACA) Impact on the Future Healthcare Workforce

Patient Protection and Affordable Care Act (PPACA) Impact on the Future Health Care Workforce

With the landmark ruling upholding the Patient Protection and Affordable Care Act, it is not surprising to see the wide variety of reaction.  As noted in this local piece, healthcare systems see it as a step in a direction that they were already taking and nurse leaders are happy with the ruling since it elevates the profile of RNs in the new models of care that are evolving.  The one comment that caught my eye was the physician who wonders how the influx of new patients will be incorporated into an already overburdened health system.

In response to the physician – who is likely already overwhelmed with meaningful use, ICD-10/11 requirements and general management of a small business – there are a number of provisions that impact primary care, being the first stop in the food chain.  Specifically, the provisions address:

  • Free preventative care
  • Funds to community health centers
  • Community care transitions programs
  • Value-based purchasing
  • New models of primary care delivery – ACO, PCMH

While it is important to note these initiatives, the better question is what type of workforce provisions exist to execute them in these five states that are projected to have the highest healthcare job growth rate?  Through several additional actions, the law recognizes the importance of primary care physicians, nurse practitioners, physician assistants and other healthcare personnel via the following:

  • Creation of new primary care residency slots
  • Expansion of the National Health Service Corp
  • Tax benefits for working in rural areas
  • PA training in primary care
  • NP training
  • Nurse Practitioner led clinics
  • Funding for healthcare IT and other health profession training

Having just enough time to provide a brief snapshot, it is well worth your time to listen to Joanne Spetz, labor economist and professor at the UCSF Center for the Health Professions, discuss the Patient Protection and Affordable Care Act (PPACA) impact on the future healthcare workforce in the video below.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates that stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Innovating with Patient-Centered Medical Homes and Accountable Care Organizations to Improve Healthcare

Innovating with Patient-Centered Medical Homes and Accountable Care Organizations to Improve Health Care

With the close of the third National Accountable Care Organization (ACO) Summit in Washington, DC last week, it got me thinking about the Patient Centered Medical Home (PCMH) and ACO models.  Specifically, what are the differences and which is more appropriate for the future delivery of healthcare?

As defined by the four primary care societies (AAFP, AAP, ACP, AOA), the Patient-Centered Medical Home is as an approach to providing comprehensive primary care as a health setting that facilitates a continuous relationship between patients, the patient’s family when appropriate, and the patient’s personal primary care physician.  The joint principles supporting this model include:

  • Personal physician – serves as the primary contact and coordinator of care for a patient.
  • Physician directed medical practice – is led by the personal physician who directs the practice team to ensure continuous, comprehensive patient care.
  • Whole person orientation – in which the personal physician arranges and oversees care throughout patients’ various stages of life.
  • Care is coordinated and/or integrated – by the personal physician in connection with specialists and across settings facilitated by information technology and other appropriate tools.
  • Quality and safety – serve as primary guideposts for all aspects of a patient’s medical care.
  • Enhanced access – using tools such as open scheduling, extended hours, and various modes of communication between patients and providers.
  • Payment – is value driven and reflective of case mix, enhanced technologies, quality improvements, and shared savings achieved by successful patient management.

In keeping with these principles, the medical home goal is to deliver coordinated care in a seamless and efficient manner, thereby improving quality and reducing cost.

MedPAC has defined accountable care organizations (ACOs) as a set of providers associated with a defined population of patients, accountable for the quality and cost of care delivered to that population.  While the population is larger and generally involves multiple practices, similar intent remains for the ACO to reduce cost through enhanced preventative care, disease management and improved quality through coordination of care.  In order to manage a population effectively, ACO governance models often include not only physician members, but also, hospital or physician hospital organization (PHO) and/or payer representatives.  Structured purposefully in opposition to fee-for -service (FFS), ACO members are rewarded for efficiency in the form of a shared bonus.  If, on the other hand, an ACO underestimates the cost of operation, the providers will earn less, thereby becoming ‘accountable’.

Healthcare is, and likely will continue to be, a local service.  Determining whether a PCMH or ACO is more appropriate will be fueled by the local physician community’s appetite for and ability to change. Establishing clear goals with corresponding metrics, creating a path for process improvement and developing appropriate financial incentives will be integral  to driving this process forward.  In the absence of interoperable data, both organizational models must also find creative solutions for their health technology constraints.

As we prepare to learn the fate of the Patient Protection and Affordable Care Act, we find ourselves with the potential to transform care delivery through healthcare information technology, innovative team approaches and other new models of care.  With more than 500 physician practices in the United States, the metamorphosis to medical homes or ACOs will be a monumental undertaking.  Will it fundamentally improve care?  Listen in to find out more….

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates that stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website