Lessons Learned from Implementing the Patient-Centered Medical Home

Green, Ellen P.; Wendland, John P.; Carver, Michelle; Rinker, Cortney Hughes; Mun, Seong Ki

doi:10.1155/2012/103685

Cited by 9 publications

(18 citation statements)

References 21 publications

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“…There were reported challenges 41 , 43 , 44 , 48 relating to a shift in paradigm for individuals and practices, which required them to move away from a physician‐centred approach towards a team approach shared among other practice staff 17 , 39 , 43 , 44 , 49 . Transformation efforts were slowed or ceased by ineffective change management processes; 39 , 50 lack of leadership, 51 , 52 readiness for change, communication and trust; 17 , 44 , 50 ‐ 53 and culture 39 , 43 , 52 , 53 .…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the challenges to implementation of the patient‐centred medical home: lessons for Australia

Janamian

Jackson

Glasson

et al. 2014

Medical Journal of Australia

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Objective: To review the available literature to identify the major challenges and barriers to implementation and adoption of the patient-centred medical home (PCMH) model, topical in current Australian primary care reforms.Study design: Systematic review of peer-reviewed literature.Data sources: PubMed and Embase databases were searched in December 2012 for studies published in English between January 2007 and December 2012.Study selection: Studies of any type were included if they defi ned PCMH using the Patient-Centered Primary Care Collaborative Joint Principles, and reported data on challenges and barriers to implementation and adoption of the PCMH model. Data extraction:One researcher with content knowledge in the area abstracted data relating to the review objective and study design from eligible articles. A second researcher reviewed the abstracted data alongside the original article to check for accuracy and completeness.Data synthesis: Thematic synthesis was used to in three stages: free line-by-line coding of data; organisation of "free codes" into related areas to construct "descriptive" themes and develop "analytical" themes. The main barriers identifi ed related to: challenges with the transformation process; diffi culties associated with change management; challenges in implementing and using an electronic health record that administers principles of PCMH; challenges with funding and appropriate payment models; insuffi cient resources and infrastructure within practices; and inadequate measures of performance.Conclusion: This systematic review documents the key challenges and barriers to implementing the PCMH model in United States family practice. It provides valuable evidence for Australian clinicians, policymakers, and organisations approaching adoption of PCMH elements within reform initiatives in this country.A systematic review of the challenges to implementation of the patient-centred medical home: lessons for AustraliaOnline fi rst 21/07/14 A ustralia's fi rst National Primary Health Care Strategy 1 and resulting National Primary Health Care Strategic Framework 2 initiated growing interest and development in our primary care sector, particularly general practice. Clinicians, governments and organisations are now actively searching for new approaches, models of care and business levers to support the primary care quality, effi ciency and access gains sought. In December 2012, then Minister for Health Tanya Plibersek announced a focus on the patient-centred medical home (PCMH) as a model of interest. 3 The Royal Australian College of General Practitioners (RACGP) has also been a consistent champion of the model, urging adoption of its elements as part of current reforms and calling for the federal government to fund and implement key elements in its 2013-14 Budget submission. 4 The PCMH concept of care was introduced by the American Academy of Pediatrics in 1967, and was adopted in 2002 by the family medicine specialty. Four major primary care physician associations in the United ...

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Section: Resultsmentioning

confidence: 99%

A systematic review of the challenges to implementation of the patient‐centred medical home: lessons for Australia

Janamian

Jackson

Glasson

et al. 2014

Medical Journal of Australia

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“…22,25,26 Green has further identified HIT as a key strategy for helping to alleviate the PC physician shortage. 27 However, HIT has also been associated with interrupted work and increased provider burden. 28 Given VA's long HIT track record, VA PC experience with the overwhelming volume of EMR-based reminders and alerts in the context of inadequate clinical informatics support should raise caution for those assuming that "plugging in" an EMR will be a "fix all" for healthcare delivery challenges.…”

Section: Discussionmentioning

confidence: 99%

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

et al. 2014

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“…The team approach to outcomes-based care must continue to be emphasized. It is apparent that buy-in across all practice levels is important for improved patient outcomes (Green et al, 2012), and the medical social worker can play a unique and important role in bringing information about patient needs and challenges to the team, and generally addressing patients' barriers to care. Similarly, the role of the clinical nurse practitioner offers opportunities for improved patient outcomes, as they can effectively address a majority of patient care issues using a patient-centered approach (Eley et al, 2008).…”

Section: Opportunities For Social Workers In the Pcmhmentioning

confidence: 99%

Opportunities for Social Workers in the Patient Centered Medical Home

Hawk

Ricci

Huber

et al. 2014

Social Work in Public Health

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The Patient Centered Medical Home (PCMH) has been hailed as one method of improving chronic care outcomes in the United States. A number of studies have underscored the importance of the social work role within the PCMH, yet little existing research explores the social worker as a driver of improved patient care. The Pennsylvania Chronic Care Initiative was created with a primary goal of increasing the number of practices that were recognized as PCMH by the National Committee for Quality Assurance. This article describes findings from in-depth qualitative interviews with representatives from seven primary care practices, in which the authors examined barriers and facilitators to implementation of the initiative. Barriers to implementation included small practice size, payer-driven care, not having a strong physician champion, variability within patient populations, and high implementation costs. Facilitators included having a social worker coordinate behavioral health services, clinical nurse case managers, preexisting models of outcomes-driven care, and being part of an integrated health delivery and financing system. Recommendations strengthening the role of medical social workers in primary care practices are discussed.

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Lessons Learned from Implementing the Patient-Centered Medical Home

Cited by 9 publications

References 21 publications

A systematic review of the challenges to implementation of the patient‐centred medical home: lessons for Australia

A systematic review of the challenges to implementation of the patient‐centred medical home: lessons for Australia

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

Opportunities for Social Workers in the Patient Centered Medical Home

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