VOL. 129 | NO. 160 | Monday, August 18, 2014
By Don Wade
The best ideas accomplish more than one thing. And so it is with Church Health Center’s commitment to earning accreditation as a Patient-Centered Medical Home (PCMH).
Dr. David Jennings of the Church Health Center said the new accreditation gives the center more of a team-based care approach.
(Daily News/Andrew J. Breig)
“We certainly didn’t have to do it,” said Jenny Bartlett-Prescott, CHC’s director of clinical services. “But it’s a way of providing patient care we believe in. It was a road map, if you will, for a path forward.”
The certification was obtained through the National Committee of Quality Assurance, a nonprofit with the mission of improving health care. The process took about two years.
The model has the “triple aim,” Bartlett-Prescott explained, of improving patient outcomes, improving patient experience, and improving value.
“Some studies show you don’t get the bang for your buck, but others show when you do it right you do,” Bartlett-Prescott said of the PCMH model.
“From a selfish standpoint, the Patient-Centered Medical Home stresses team-based care instead of the doctor doing everything,” said Dr. David Jennings, who has been a full-time physician at CHC for 12 years.
But Bartlett-Prescott says this does not mean patients are being diverted from their doctors to professionals with less formal training.
“This is not about shifting the medical care to non-physicians at all,” she said. “It’s widening the team that takes care of the patient.”
It also is about recognizing that the doctor is not, in all cases, the best one for a particular job. Medical assistants, who typically have just a year or two of training, check patients in and get their vitals. But that also means they are the first point of contact for establishing relationship, which is at the core of the patient-centric model.
“Sometimes they relate to the patient easier than I can,” Jennings said.
A physician, Bartlett-Prescott said, may not have time for an in-depth conversation or to ask every conceivable question. The PCMH model strives to give the patient more say in his care, but to reach that point may take some time.
Jennings says they are trying to get away from passive approaches that amount to telling the patient, “Just take this medicine and everything will be fine.”
And the taking of medicine can be complicated, depending on other factors in a patient’s life. Also, there’s more than medication to be considered in a patient’s care.
“We can have conversations that have nothing to do with medicine,” Bartlett-Prescott said, using a patient with hypertension as an example. “How’s your stress management? Are you getting enough sleep? Do you want to quit smoking?”
Said Jennings: “They’re more in charge of their own health care, especially with conditions like diabetes. And our care is less fragmented and we have fewer no-shows now. Patients are assigned to me and my team (or another doctor and that doctor’s team). So if someone comes in with a sore throat in between diabetes follow-ups, we can tweak a few things.”
In fact, more than 90 percent of CHC patients now see the same physician and care team.
Another component of the PCMH model is technology.
“Patients will have access to communicate with their provider and to make appointments online,” said April Crowder, CHC’s software and database coordinator. “They can pay online, get their diagnostic records, and review their medical records.”
With so many medical providers having some sort of electronic records system, this will assure CHC patients are in that loop.
“It’s important for referrals,” Bartlett-Prescott said, “to have good, solid handoffs of information.”
Jennings says the new approach also has provided another, perhaps unexpected, benefit for CHC.
“Our turnover in medical assistants has been less,” Jennings said, “because they’re getting to do more things that are creative like goal-setting.”