Daisuke Yamashita MD, Roger Garvin MD Leadership selective curriculum Use of TransforMed MHIQ module to understand and promote the PCMH Daisuke Yamashita MD, Roger Garvin MD

PCMH is becoming central to FM Background PCMH is becoming central to FM Inconsistent training during medical school No well developed residency curriculum Increased focus on clinic based training Limited time in the clinic during internship

Leadership Selective Month A 4 week long rotation with interns Attend OHSU board of directors meeting Attend OHSU residency section meeting Complete TransforMED MHIQ modules Conduct individual leadership project 2 half days of continuity clinic 4 half days of reproductive health clinic 1 hour wrap up session for reflection

Medical Home Implementation Quotient Web-based self assessment tool Total of 129 questions Assess implementation of 9 PCMH components Gives four performance levels Needs significant improvement Needs improvement Good Advanced

Understanding of PCMH Two residents did not change One resident changed two points Feel comfortable implementing

Quotes from interns abut PCMH What I knew Team Based Care Coordination of care One stop shopping for Pt. Chronic Disease Mgt New approach Information Technology What I learn Finance and Practice Management Billing, Reimbursement Safety compliance Patient Satisfaction Survey Open Access Importance of EMR

How was your experience? Great opportunity to orient to my clinic. Got to know clinic manager and office staff Felt PCMH was more flexible concept rather than one model Shared patient’s experience being in large medical system Policies or manuals were hard to find PCMH concept may differ among providers

Aspects that they want to work on Patient education (web portal) Patient Centeredness (advisory board, customizing care based on patient needs) Chronic Disease Management Understand billing and finance of the clinic Patient Engagement and self Care Formalizing practice policy or procedures

Clinic A Clinic B Clinic C 252 Level 3 302 Level 4 250 Level 3 Trend in MHIQ score Clinic A Clinic B Clinic C 252 Level 3 302 Level 4 250 Level 3 Oct/09 Nov/09 Jul/09 294 Level 4 267 Level 3 Dec/09 Jan/10 Mar/10 257 Level 3 Apr/10

Protocol for resident-run obstetric clinic Used for additional CME Individual Projects Protocol for resident-run obstetric clinic Used for additional CME Carrier building Workbook (2 interns) Worked with international health NGO Worked with Special Olympic NGO Develop practicum projects for MPH Reproductive Health Clinic (2 interns)

MHIQ module is easy to navigate Summary MHIQ module is easy to navigate Forces interns to ask questions about their clinics Gives back ground information on PCMH Residents feel unfamiliar with two areas Quality and Safety Practice Management: especially reimbursement Empowers residents to be part of PCMH implementation process

Feed back to each clinic on their progress as a PCMH Future Direction Feed back to each clinic on their progress as a PCMH Most interns hope to have hands on experience in implementing PCMH components through out the training. Longitudinal Curricula through 3 years

Please fill out a evaluation! Session #: PV5 Questions? Please fill out a evaluation! Session #: PV5 Title: Use of TranforMED Medical Home Implementation Quotient Module to Understand and Promote PCMH Presenters: Daisuke Yamashita Roger Garvin