'Perfect example' of why medical home demo proved so important

By Molly Merrill
05:10 PM

Web tools that were developed as a result of the National Demonstration Project on the patient-centered medical home, an initiative by the American Academy of Family Physicians (AAFP) and its subsidiary TransforMED, are featured in report published on Monday that include all of the findings of the two-year project.

The project, which was undertaken by TransforMED and funded by the AAFP, ran from June 2006 to May 2008. It was the first and largest "proof-of-concept" project to determine empirically whether the TransforMED Patient-Centered Medical Home (PCMH) model of care could be implemented successfully and sustained in today's healthcare environment.

The demonstration project also served as a learning lab to gain better insight into the kinds of hands-on technical support family physicians want and need to implement the PCMH model of care. 

"From the beginning, the national demonstration project was viewed as more of a learning lab than a research or demonstration project," said Terry McGeeney, MD  president and CEO of TransforMED. "The model was changed seven times during the project," he explained. "When something wasn't working, we changed it, with the end goal of developing a viable model of care with the tools and resources to support it."

Some of theses resources include Web tools such as:

  • The Medical Home Implementation Quotient: a free, online self-assessment that allows practices to find out where they stand on the journey to becoming a medical home.  It is designed to provide practices with meaningful feedback on the valuable key features of the PCMH and primary care. This tool was not in existence when the NDP began, but now serves as the starting point for all TransforMED practice re-design projects.

McGeeney says that practices can use the tool to track their progress in becoming certified as a medical home by the National Committee for Quality Assurance. He says once there is a final rule on meaningful use, they will also incorporate a "crosswalk" that will track how they are meeting the criteria.

  • Delta-Exchange: an online social networking site to address the proven need for additional support through peer-to-peer learning. For a small monthly fee, primary care physicians and their staff can receive targeted support from TransforMED's  facilitators and connect with their peers via discussion zones. Members also gain access to a robust repository of tools, resources, case studies and practical how-to articles on practice transformation topics such as implementing team-based care, reducing patient cycle times, change management and maximizing office space. The site also hosts regularly scheduled, live Webinars on a variety of PCMH and practice improvement topics ranging from optimized billing and collection to implementing open-access scheduling. Members also can download workflow and procedure forms that can be customized to individual practices.

This tool has been particularly helpful for small practices who might feel isolated, says McGeeney. "It's basically Facebook for the medical home. It's not quite as sophisticated but its close," he says.

Web tools continued on next page.

  • Patient Experience Assessment Tool: which assesses which practice attributes are most important in the eyes of the patient and not what the practice considered important to the patient. PEAT now enables practices to receive real time feedback from patients, prompting them to pay thoughtful attention to the patient experience throughout the PCMH transformation process.

Integrating PEAT with the practice management solution is still a work in progress, says McGeeney.  They are currently configuring it so that it automatically populates patient data. 

McGeeney says everyone of these tools was developed as a result of the demonstration and are "perfect examples of why the demonstration project was so important."

To date, TransforMED has seen evidence that implementing PCMH components is well worth the time and effort required. At the conclusion of the project, NDP participants from each practice formed a group to enable them to stay in touch and continue learning from one another. The group's members – who call themselves the Touchstone Group – acknowledge transformation is not easy, but still advocate for the new model and would not be willing to return to pre-NDP ways of practicing medicine.

 "Recommendations for the patient-centered medical home model will continue to come forth, but the TransforMED NDP achieved what it set out to do," said AAFP President, Lori Heim, MD.

The report is published as a series of manuscripts in a special supplement to the May/June 2010 Annals of Family Medicine. The title of the report is "Evolution of the American Academy of Family Physicians' Patient-Centered Medical Home National Demonstration Project."