Development of a Safety Net Medical Home Scale for Clinics

Abstract

The SNMHS demonstrated reliability and convergent validity for measuring PCMH adoption in safety-net clinics. Some clinics have significant PCMH adoption. However, room for improvement exists in most domains, especially for clinics with fewer providers.

Asking the Patient About Patient-Centered Medical Homes: A Qualitative Analysis

“…At all eligible sites, practice managers or designees completed the Safety Net Medical Home Scale (SHCHS), a validated survey to quantify a practice's degree of PCMH adoption. 9,10 The survey was designed to capture elements pertinent to serving diverse socioeconomic populations in a variety of primary care settings, and not exclusively safety-net clinics. 9,10 We scored and ranked practices on the degree of PCMH adoption using a scoring algorithm accompanying the survey that produces a total medical home score (scale of 0 to 100) based on the average of six domains: access and communication, patient tracking and registry, care management, test and referral tracking, quality improvement, and external coordination.…”

Characteristics Associated with Patient-Centered Medical Home Capability in Health Centers: A Cross-Sectional Analysis

“…28 Among these, 749 (74%) completed the 2009 Commonwealth Fund National Survey of Federally Qualified Health Centers, 29 which generated scores on a scale from 0 to 100 as a measure of PCMH capability. 27 We then merged these data with data extracted from the 2007-2011 American Community Survey, 30 2007 HRSA-American Medical Association physician data, 31 Compared with the 706 HCs included in the analysis, the 308 excluded HCs tended to have fewer patients, more medical visits per physician full-time equivalent (FTE), and a greater number of younger, minority, and homeless patients, and were located in Primary Care Service Areas (PCSAs) with a larger proportion of minority population (Supplemental Table 1). …”

“…It was assessed by executive directors via the 2009 Commonwealth survey and was scored by the Safety Net Medical Home Scale (SNMHS), a validated scale developed in safety net clinics. 27,29 SNMHS included aspects that were of particular importance to safety net clinics, such as providing timely specialty care for uninsured patients and providing language services for patients with limited or no English proficiency. 32 The scale generated scores on a scale of 0 (worst) to 100 (best) for six PCMH subscales: access and communication, patient tracking and registry, care management, test and referral tracking, quality improvement, and external coordination (Supplemental Table 2).…”

“…We assessed PCMH capability using a validated medical home scale developed for safety net clinics 27 and measured HC, patient, neighborhood, and regional characteristics by combining different data sources. This study helps HCs and policymakers identify strategies that are most effective for promoting PCMH adoption.…”

Capability for Change at Community Health Centers Serving Asian Pacific Islanders: An Exploratory Study of a Cancer Screening Evidence-based Intervention

“…Existing literature on the dissemination of EBIs among CHCs is limited with early research focused on the introduction of electronic medical record systems (DePue et al, 2002;Amodeo et al, 2006;Miller and West, 2007;Shields et al, 2007;Trafton et al, 2007), diabetic screening (Chin et al, 2001;Walker et al, 2001;Birken et al, 2013), tobacco cessation (De Pue et al, 2002), and mental health psychoeducation (McFarlene et al, 2001). More recently, studies of CHCs have sought to understand broader, more fundamental changes to patient care, such as the long-term impact of quality improvement interventions (Chin, 2010) and newer models of care delivery like the Patient-Centered Medical Home (PCMH) (Birnberg et al, 2011).…”