1. 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

2. 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

3. 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

4. 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

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

7. 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

8. 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

9. 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

10. 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

11. 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)

12. 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

13. 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

14. 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