PCMH - Getting Ready for Transformation
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Transcript of PCMH - Getting Ready for Transformation
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Patient Centered Medical Home:Getting Ready for Transformation
Vicki Young, PhDJanet Viars, RN, MPH
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Goals and Objectives
Understand the Application Process
Understand the Recognition ProcessRecognize How Achieving Stage 1 MeaningfulUse Facilitates PCMH RecognitionBecome familiar with the PCDC Assessment
Tool
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The Application Process
PCMH Application
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The Application Process
Practice Specific
An incorporated group of 3 or more clinicians inan office who use the same systems and staff Only clinicians that may be selected as a PersonalClinician are eligible for Recognition
All eligible clinicians practicing together at apractice site must be included in the PCMHapplication
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Application Requirements
Account Information
Demographic information about the practiceNCQA Legal DocumentsPCMH Recognition Program AgreementHIPAA Business Associate Agreement
Practice Site InformationName and address of each site in theorganizationSite contact information
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Application RequirementsMulti-Site Group Self-AssessmentQuestionnaire
Determines the practices eligibility for Multi-SiteSurvey process
Clinician InformationNumber and name of each eligible clinician andlink to the site where they provide care
ApplicationThe practice provides the license number for theSurvey Tool and information about each
site where the survey will be completed
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Application Requirements
Important Conditions
The practice identifies 3 important conditionsInclude chronic or recurring conditions such asasthma, diabetes, CHF, mental health issuesConsiderations in selection include:
x
Prevalence of diagnosisx Importance of care management and self-managementx Availability of evidence-based guidelines
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Practice Readiness Evaluation
Self-Evaluation may be conducted before
submission of survey tool.Estimates the scoreNot viewable by NCQA
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The Recognition Process
PCMH
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PCMH Recognition
Survey submitted on-line
Documentation attached in Document Library and linked to pertinent element60 days for turn-around on approval fromNCQA
Recognized for a 3-year period
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Meaningful Use: The Foundation of aMedical Home
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Stage 1 Meaningful Use and PCMH
Review of Meaningful Use
Reporting for 90 day period during first year andfull year for subsequent yearsMust Meet Objectives and Clinical Quality Measures
To meet objectives must report on 15 coreobjectives and 5 out of 10 from menu setMust report on 6 Clinical Quality Measures
x 3 Core Measuresx 3 Additional Measures
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PCMH-M/U RelationshipsPCMH M/U
All of the many thingsthat people need to doin order to assurehigh quality patient-
centric care in asustainable mannerand at a cost that isaffordable to society.
All of the many thingsthat computers needto do to store,organize, and manage
information in a way that supports peoplein the enterprise of healthcare.
Jeff Hummell, MD, Qualis Health
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PCMH and Meaningful Use MeasuresPCMH Meaningful Use
Enhance Access andContinuity
Identify and ManagePatient PopulationsPlan and Manage CareProvide Self-Care
Support andCommunity Resources
Track and CoordinateCare
Measure and ImprovePerformance
Improve quality,efficiency and reduce
health disparitiesEngage patient &families
Improve CareCoordination
Improve population &public health
Ensure privacy andsecurity
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PCMH/MU Clinical Quality Measures/UDS
:Triple Dip!!!PCMH M/U UDS
(2011 measures)
3 ImportantConditionsExamples:
Unhealthy Behaviors -Smoking or Obesity
Hypertension orCHF
Core SetHypertensionTobacco
assessment andintervention Adult weight
screening
Proposedand/or Revised Adult weight
screening and F/UTobacco
assessment andintervention
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PCMH/MU Clinical Quality Measures/UD STriple Dip!!!
PCMH M/U UDS(2011 measures)
3 Important
ConditionsExamples: AsthmaUnhealthy
behavior obesity (children)
Alt. Core Set
Children weightassessment andcounseling
Flu vaccine forages > 50
Childhoodimmunizationstatus
Proposed or
RevisedChildren weight
assessment andcounseling Asthma
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Next StepsJune 10, 2011 - Medical Directors Preconference atthe Clinical Network Retreat
June 11, 2011 Breakout Session at ClinicalNetwork Retreat Webinar Series Deep Dive into Standards
June 29 Standards 1 and 2August 2 Standards 3 and 4August 24 Standards 5 and 6September 28 - Pulling it all together
Fall 2011 Begin first collaborative toward PCMHRecognition
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PCDC Assessment Tool
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PCDC Assessment Tool
PCDC Assessment Tool for NCQA 2011Standards