Better Patient Care Through Primary Care Transformation

08 May 2013

Change has come quickly in Oregon over the past few years. In 2009, the Oregon state legislature created the Oregon Health Policy Board and Oregon Health Authority (OHA) to address the issues of cost, quality, and access to health care. In 2010, the Oregon Health Policy Board developed Oregon’s Action Plan for Health to lay out strategies and a timeline for actions that will lead to lower costs and improved quality in Oregon’s health care system. As part of the strategy, the Patient- Centered Primary Care Home Program (PCPCH) within the OHA sets the standards, recognizes, and promotes the development of patient-centered primary care homes to improve care across the board and bring down health care costs. To help primary care practices improve care and meet PCPCH standards, the OHA collaborated with the Oregon Health Care Quality Corporation (Quality Corp), leader of the Aligning Forces for Quality initiative in Oregon, to launch the Patient-Centered Primary Care Institute as a public-private partnership. The overall goal is to ensure that 75 percent of Oregonians have access to a recognized primary care home by 2015.

The PCPCH, also known as patient-centered medical home, is a model of primary care that has received attention in Oregon and across the country for its potential to advance the “Triple Aim” goals of health reform: improving the patient experience of care, improving the health of populations, and reducing per capita costs of health care. Primary care homes achieve these goals through a focus on wellness and prevention, coordination of care, active management and support of individuals with special health care needs, and a patient and family-centered approach to all aspects of care. Patients should be able to get the care they need, when they need it, and that care should be the best possible. Clinics must demonstrate their ability to provide comprehensive services onsite and meet the standards of care in order to be recognized as a primary care home by the state of Oregon.

The overall goal is to ensure that 75 percent of Oregonians have access to a recognized primary care home by 2015.

Quality Corp is capitalizing on its role neutral convener to help primary care practices in Oregon begin their transformation and meet primary care home standards. “We’re leveraging all of our resources to share materials—matching needs to people,” said Susan Kirchoff, Quality Corps’ project director. “With the infrastructure in place, the Institute is taking off to support practices as a catalyst and convener.”

The Patient-Centered Primary Care Institute will support practices with technical assistance and create ample opportunities for practices to learn from each other. The Institute offers web-based tools and webinars to primary care practices across Oregon. A select group of practices are also included in learning collaboratives, receiving hands-on training and a series of in-person meetings facilitated by local technical assistance experts.

“The Institute is a way for practices to share best practices, successes, and failures,” said Evan Saulino, MD, clinical advisor with the Patient-Centered Primary Care Home Program. He added, “The Institute helps overcome the ‘tyranny of the urgent’ in primary care practices; it lets us take a step back from the day-to-day rush.” By taking the time to self-assess, practices can realize physicians’ and staffs’ desire to give patients the best care possible.

“The Institute helps overcome the ‘tyranny of the urgent’ in primary care practices; it lets us take a step back from the day-to-day rush.”

Four different learning collaboratives were created to address the diverse needs of practices. The group in the Portland and Salem area is made up of larger practices. One group includes only pediatric practices. The third group is composed of practices in the more rural area of eastern Oregon. The final group consists of practices that are already recognized as primary care homes and wish to continue improving care. The collaborative nature of the Institute lets the practices share lessons learned and best practices with the other groups.

Not only will practices have the opportunity to share best practices, but technical assistance (TA) providers also are working together to share expertise and advice. This unique approach allows TA providers to better serve the diversity of practices, whether rural or urban, recognized as a primary care home, or just on the cusp of transformation. “TA providers are the foundation, sharing information and creating a repository of expert knowledge,” said Mindy Stadlander, a TA provider from CareOregon.

The ultimate gains of the Institute will be better patient care through true practice transformation. The 2015 goal means these improvements in health care must come about swiftly. “All of this work must be done rather quickly—a challenge we think we can overcome with putting all our heads together,” said Kirchoff. Quality Corp will continue to play its role as a catalyst, convener, and organizer to support the spread of primary carehomes in Oregon.

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