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Health Care Home – Creating a platform for high performing primary care

Adj. A/Prof Walter KmetCEO WentWest, WSPHN

Mental Health Forum18th May 2016

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PHN Framework: Identifying opportunities for health system improvement in western Sydney

Western Sydney PHN –Health system Improvement opportunities

Whole-of-system (Macro level): Enhanced structural integration across the various health services serving the population of western Sydney and covering both private and public health sectors.

Care/population groups (Meso level): Enhanced service integration for targeted health initiatives including local and national priority focus areas and/or sub-populations that have been identified as a result of PHN population needs analyses.

Patient-centric integrated and coordinated care (Micro level): Improved delivery of patient-centric health services to individuals and their carers through a coordinated set of care interventions that ensure the right care is provided in the right place at the right time.

Advocacy

Commissioning

Integration

Western Sydney PHN – Health

system Improvement opportunities

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Our role beyond “health”

Impact on the health system is largely a function of the environment people live in

health environment

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1374 AHPs, 332 General Practices

Corporate -National

4%

Corporate -Private Group

1%

Over 10 GPs3%

Large Group (6-10 GPs)

10%

Small Group (2 -

5 GPs)39%

Solo (1 GP)43%

Uncatergorised

Speech Pathologist

Social Worker

Radiographer

Psychologist

Prosthetist/Orthotist

Podiatrist

Physiotherapist

Pharmacist

Pedorthist

Osteopath

Optometrist

Occupational Therapist

Multiple Qualifications

Massage Therapist

Exercise Physiologist

Dietician/Nutritionist

Diabetes Educator

Clinical Psychologist

Chiropractor

Audiologist

Acupuncturist

Aboriginal Health…

0 100 200 300 400

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Rethinking Primary Care

Source: UCSF Center for Excellence in Primary Care. http://www.ucsf.edu/news/2014/08/116856/team-based-approach-primary-care

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What defines good quality primary

care in Australia?

“the emphasis has been on referral rather

than integration”

“there is little active team management

across specialist medical practitioners,

nursing, pharmacy and allied health”

Gratten Institute: Chronic failure in primary care 2016

7Source: www.ahrq.gov

Defining the Medical Home

The medical home is an approach to primary care that is:

Committed to Quality

and SafetyMaximizes use of health IT, decision

support and other tools

AccessibleCare is delivered with short

waiting times, 24/7 access and

extended in-person hours

CoordinatedCare is organized across the

‘medical neighborhood’

ComprehensiveWhole-person care provided

by a team

Person-Centered Supports patients and families

in managing decisions and

care plans

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Strengthening building blocks of

an integrated care system

Support with Enablers

Payment Governance Information Leadership Support

“Quadruple Aim”

Organise Delivery

Protocols

Care

plans

Performance

review

Care

coordination

and delivery

Understand Needs

Low risk

Moderate risk

High risk

Very low

risk

Very high risk

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Integration of mental health &

primary care – PCHRIS 2015

• Taking in account the local context• Engaging in formal/informal partnerships• Articulating governance/identifying leadership• Reforming the way we pay• Establishing (common) infrastructure• Accounting for organisational culture• Encouraging respectful communication• Providing inter-professional education• Reducing stigmatisation & discrimination• Collecting data/information to assess quality of care

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How do we integrate care?

Connecting/coordinating

AND

Changing/transforming

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Thank you

@WKmet

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As the Western Sydney Primary Health Network,

WentWest is focused on addressing both regional and

national health challenges. Together with health

professionals, partners from both the health and hospital

sector, consumers and the broader community,

WentWest seeks to identify gaps and commission

solutions for better health outcomes.