PCMH Transition Success Requires Outside Resources

Successfully transitioning to the medical home model of care, and gaining NCQA recognition for doing so, is no easy task. In fact, it’s so challenging that most practices will need some outside help to succeed in the endeavor.

"If you take anything away from this, don’t do this alone if you don’t have to," Kirsten Platte, executive director of Community Health Access Network (CHAN), a nonprofit member organization of 25 federally qualified health centers, told attendees during her session, "It Takes a Village to Become a Medical Home," at the HIMSS13 Conference in New Orleans.

Platte, and her co-presenter Marcy Doyle, chief operating officer at Lamprey Health Care, Inc., a Federally Qualified Health Center (FQHC) with multiple sites in New Hampshire and a level three NCQA-recognized medical home, said that while the transition to the medical home has benefits, it is also expensive and time consuming. An FQHC is a community-based health center designated by the federal government that adheres to certain regulations related to providing health services to individuals regardless of their ability to pay. 

Actions critical for a successful transition, for instance, include big technology investments such as an EHR, if a practice does not already have one, or if a practice does not have an adequate one, said Doyle. The medical home is "technology heavy, meaning you really do need an EHR to manage this process and you need to be able to harness that EHR with bidirectional interfaces."

But even though the pair were presenting in front of a largely health IT crowd, they did say it takes more than hardware and software to get things started and running smoothly.

Other time and resource investments required of practices to successfully transition include training staff members to adhere to medical home recognition criteria, and stepping up efforts to increase patient engagement, said Doyle. "Every part of PCMH really involves a team, and a patient as a central member of that team."

While Doyle and Platte said partnering with other entities can help practices through the transition, it wasn’t necessarily other practices they were referring to.

Doyle said the New Hampshire Health Information Exchange, the Regional Extension Center of New Hampshire, the New Hampshire Area Health Education Center, even a nearby hospital, which provided Lamprey online access to a risk assessment of the practice’s patients that had been hospitalized and discharged, were key to the practice’s successful transition.

CHAN, of which Lamprey Health Care is a member, also held meetings between staff members across its various member sites. That way, it could compile best transition processes together in a central location for all the practices to access, said Platte.

Another great area of help for practices undergoing the transition to medical home, Platte said, is a practice that has already successfully done so. "Really take advantage of that expertise," she said, noting that practices should reach out to those successful practices for advice. "... Utilize your contacts, your peers, your friends, your enemies, anyone that’s going down that path that can help you so you don’t reinvent the wheel."