1. Advancing PCMH Model with IPE/ICP Principles IN-AHEC Network IPE Conference John Kunzer MD, MMM

2. No conflicts to disclose

3. Objectives 1.Define a Patient- Centered Medical Home (PCMH) and identify opportunities to advance PCMHs with IPE principles 2.Discuss examples of IPE within the clinical environment and lessons learned 3

4. Today’s Health Care Problems We spend more but get less U.S. ranks lowest in primary care orientation Number of medical students going into primary care has dropped 52% since 1997 Patients, staff, and physicians are not satisfied Nonemergency ambulatory care visits to clinics of safety-net hospitals grew twice as fast as visits to non-safety-net hospitals from 2006 to 2009

5. “The current care systems cannot do the job. Trying harder will not work. Changing systems of care will.” Crossing the Quality Chasm: A New Health System for the 21 st Century Institute of Medicine, 2001

6. 6 A PCMH isn’t New...

7. Wishard: A History of Building Patient-Centered Medical Homes Medical and Dental Services Mental Health Pharmacy Social Worker Patient Navigator Dietician Financial Counselor Lifestyle Coach Medical Legal Partnership Care Coordinators Healthy Families Women, Infant, and Children 7

8. A PCMH is Different... OLD One provider – One patient An Office Visit A Passive Patient NEW Team Based Care A Coordinated Experience An Engaged Patient

9. PCMH: The Future of Primary Care National Committee for Quality Assurance (NCQA) PCMH recognition program Patient Centered Primary Care Collaborative has over 600 members Pilot Programs have shown: –decreased staff burnout –increased patient satisfaction and quality –fewer emergency room visits –no difference in overall cost

10. The Patient-Centered Medical Home (PCMH) Personal physician for each patient Team based care Whole person orientation Care is coordinated or integrated Quality and safety Enhanced access Payment recognizes added value to patients 10

11. NCQA PCMH Standards 1.Enhance Access and Continuity 2.Identify and Manage Patient Populations 3.Plan and Manage Care 4.Provide Self-Care Support and Community Resources 5.Track and Coordinate Care 6.Measure and Improve Performance

12. Our Health Center Journey Multidisciplinary Medical Home Implementation Team formed in 2009 Champion Physician from each CHC Gap analysis conducted from current performance and NCQA standards for PCMH Pilot projects developed and best practices implemented 105 Ezkenazi Medical Group providers recognized and 14 Wishard practices recognized

13. Our Health Center Journey Standardized processes Continuing education for all staff Patient portal Huddles Increased same day appointments Quality Champion Teams Starting embedded RN care managers, electronic and telephone visits

14. VSQ STUFF

15. Implications for IPE Defining a common language and understanding is needed Labeling actions helps make it understandable Institutional support necessary “Champions” at each site Facilitate awareness of interdependence Culture change takes time Co-location does not equal collaboration Professional development

16. PCMH and IPE: Potential to Create High Performing Teams 1+1 <2 1+1 =2 1+1 =3 1+1 >4 PCMH+IPE <2 PCMH+IPE =2 PCMH+IPE =3 PCMH+IPE >4

17. Questions?