A Patient-Centered Approach with

P.R.I.D.E.

Shaftel Benson Community Outreach Officer

Sandra Heath Outreach Worker II

Sumika Mackroy Outreach Worker I

Chamberlain Parker Consumer Assister

Objectives

• Who is Quality of Life Health Services, Inc.?

• What is a Patient Center Medical Home (PCMH)?

• What are the Benefits of a PCMH?• How do you Message to Patients?• What are the Patient-Centered

Services at QOLHS?

Quality of Life Health Services, Inc. Wayne C. Rowe, CEO

• Founded in 1977 as a Federally Qualified Health Center (FQHC)

• In 1998, received the Joint Commission on Accreditation of Health Care Organizations (JCAHO)

• In 2013, accredited as a Patient Center Medical Home (PCMH)

• 21 Health Centers; 18 service areas• People Caring About People

Quality of Life Health Services, Inc. Mission Statement

Quality of Life Health Services, Inc. Board of Directors believes that health care is concerned with the prevention of illness and the preservation and restoration of health. Health care is "essential" and the right of every individual.  Health care requires collaboration with a variety of professionals whose common interest is to strengthen the integrity of the human-environment relationship and therefore attempt to achieve optimum level of functioning and state of well-being. 

Quality of Life Health Services, Inc. Our Vision

… to continuously strive to efficiently provide health care, service and

education, which consistently meet or exceed the expectations of

patients, physicians, employees and the community.

What is a Patient-Centered Medical Home (PCMH)?

A system of care in which a team of health professionals work together to improve the quality, effectiveness and efficiency of the care they deliver while responding to each patient’s unique needs.

• Patient-Centered• Comprehensive• Coordinated• Accessible• Committed to Quality and Safety

“Joint Principles” of the Patient-Centered Medical Home

• A personal physician who coordinates all care for patients and leads the team.

• Physician-directed medical practice – a coordinated team of professionals who work together to care for patients.

• Whole person orientation – this approach is key to providing comprehensive care.

• Coordinated care that incorporates all components of the complex health care system

• Quality and safety – medical practices voluntarily engage in quality improvement activities to ensure patient safety is always being met.

• Enhance access to care – such as through open-access scheduling and communication mechanisms.

• Payment – a system of reimbursement reflective of the true value of coordinated care and innovation.

Patient ExpectationsEngaged, Happier, Healthy & Satisfied

• 75% want the ability to interact with their physician online (appointments, prescriptions, test results)

• 77% want to ask questions without a visit• 75% want email access as part of their

overall care• 62% of patients say access to these

services would influence their choice of physicians

-Source: Medfusion, an AAFP affinity partner

The Patient Centered Medical Home The Family Medicine Model

Great Benefits

Family Medicine

Health Information Technology

Practice Organization

Quality Measures

Practice Experienc

e

Patient-Centered | Physician-Directed

Culture of Improvement

Performance

Measurement

• Develop reliable systems to collect information

Reliable Systems

Quality Measures

Family Medicine

Patients Get What They Need

• Starts with a culture of improvement

• Ensure quality improvement initiatives are not punitive; should not discourage physicians from caring for patients

• Quality measures should be based in strong clinical evidence

• You can’t improve what you don’t measure

Convenient

Access

Personalized Care Care

Coordination

Quality Measures

Practice Experienc

e

Family Medicine

• Patients want convenient access to information, communication, and care

• Patients want to access to care when they are ill

• Patients are engaged in their own care and want to share in decision-making

• Patients want

increased ability to access information

• Patients want coordinated care

• Patients want new approaches to care: group visits and on-line services

Patients are More Satisfied with Their Care

Financial

Management

Personnel

Management

Clinical

Systems• All staff are aware of the most effective ways to deliver care

• National policies support the investment of resources into primary care practices that are effective and efficient

• Lab testing

• Prescriptions

• Patient Registries

Practice Organization

Practice Experience

• Every team member understands the important role they play in delivering efficient care and is empowered to make suggestions for improvement

Quality Measures

Practice Experienc

e

Family Medicine

Practice Works Effectively

Business & Clinical Process Automation

Connectivity & Communication

Evidence-BasedMedicine Support

Clinical Data Analysis& Representation

Health Information Technology

• Enhances care coordination by improving information flow with other physicians, practices and providers

• Improves patient -physician communication

• Can quickly pull clinical data for quality analysis

• Can enhance business processes

• Point-of-care learning

(e.g., Up-to-Date)

• Clinical decision support(e.g., Epocrates)

Practice Organization

Quality Measures

Practice Experienc

e

Family Medicine

• Patient reminders

• Patient notification for new information

• Reminders for recommended care or health maintenance

Information Managed Effectively

Great Benefits

Great Benefits• Great for patients

– Patients enjoy better health.– Patients share in health care

decisions.

• Great for physicians– Physicians focus on delivering

excellent medical care.

• Great for practices– Team works effectively together.– Resources support the delivery of

excellent patient care.

• Great for payers and employers– Ensures quality and

efficiency.– Avoids unnecessary costs.

Family Medicine

Health Information Technology

Practice Organization

Quality Measures

Practice Experienc

e

Communicating with Patients

Health literacy is the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

• Communicate• Educate• Involve• Referrals

QOLHS Patient Services• Care Team Huddles• Open Scheduling• Ultimate Performance Practice (UPP) program• Patient Service Calls• Patient Prompt• Patient Portal• Electronic Health Records• Closed Caption TV’s• Corporate Newsletters• Telemedicine

Resources with Quality Health Care & Patient Centered Care Services

www.qolhs.comwww.alphca.com

www.jointcommission.orgwww.pcpcc.org

“ I would rather know the person who has the disease than know the disease the person has.”

- Hippocrates