Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon

Gelmon, Sherril B.; Bouranis, Nicole; Sandberg, Billie; Petchel, Shauna

doi:10.3122/jabfm.2018.03.170265

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…28 Health care systems need to support consistent documentation and billing of care coordination to provide equitable access and to enable examination of these services and their impact. 29 Once care coordination services become a standard element in electronic health records, we can use records to understand better who receives it, who does not, and who should. 30 These findings also have implications regarding the role of professional sources of emotional support and informal sources of emotional support for caregivers of CSHCNs.…”

Section: Discussionmentioning

confidence: 99%

Family Support Services and Reported Parent Coping Among Caregivers of Children with Emotional, Behavioral, or Developmental Disorders

Graaf,

Hughes,

deJong

et al. 2023

J Dev Behav Pediatr

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Objective: Caregivers of children with special health care needs (CSHCN) experience substantial strain caring for their child's special needs because of high needs for health and other support services. Caregivers of CSHCN with emotional, behavioral, or developmental problems (EBDPs) report stress and poor mental health at higher rates than caregivers of other CSHCN. Although family support services are associated with caregiver mental health and well-being among families of CSHCN, the association of these factors with caregiver coping has been underexamined. Method: Using the Double ABCX Model of Family Adaptation to guide variable selection, this study uses 2016 to 2019 data from the National Survey of Children's Health. Univariate, bivariate, and multivariate logistic analyses examined the association between caregivers' receipt of adequate care coordination and emotional support services and their reported coping with the day-to-day strains of parenting. These relationships are compared between caregivers of CSHCN with and without EBDPs. Results: Receipt of adequate care coordination was associated with higher rates of caregiver-reported positive coping for all caregivers of CSHCN who have no source of emotional support. Receipt of emotional support services was associated with increased reports of positive coping for caregivers for all CSHCN as well. Caregivers reporting only informal sources of emotional support, however, also reported higher rates of positive coping when compared with caregivers with no source of emotional support. Conclusion: Mobilization of resources that can aid caregivers in coordinating care and provide emotional support may play a key role in positive caregiver coping for families of CSHCN.

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Section: Discussionmentioning

confidence: 99%

Family Support Services and Reported Parent Coping Among Caregivers of Children with Emotional, Behavioral, or Developmental Disorders

Graaf,

Hughes,

deJong

et al. 2023

J Dev Behav Pediatr

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“…The challenge of providing high‐quality care while documenting and measuring outcomes is not unique to this study. Previous research has illustrated this challenge, particularly when electronic health technologies are not easily incorporated with other documentation demands/systems . Additionally, it is often the case that PCMHs opt to purchase third party analysis tools to supplement their EHRs to facilitate communication and reporting of patient data …”

Section: Discussionmentioning

confidence: 99%

“…The joint principles of the PCMH explicitly state "Information technology is utilized appropriately to support optimal patient care, performance measurement, patient education, and enhanced communication." 5 31 Additionally, it is often the case that PCMHs opt to purchase third party analysis tools to supplement their EHRs to facilitate communication and reporting of patient data. 31 FCC faculty and resident physicians described ongoing challenges with payment reform.…”

Section: Payment Reformmentioning

confidence: 99%

“…5 31 Additionally, it is often the case that PCMHs opt to purchase third party analysis tools to supplement their EHRs to facilitate communication and reporting of patient data. 31 FCC faculty and resident physicians described ongoing challenges with payment reform. One resident explained how the FCC has half of their patients on the fee-for-service model and the other half of their patients on a pay-per-member model.…”

Section: Payment Reformmentioning

confidence: 99%

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Beyond checkboxes: A qualitative assessment of physicians' experiences providing care in a patient‐centred medical home

Sklar

Seijo

Goldman

et al. 2019

Evaluation Clinical Practice

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Rationale, aims, and objectives The patient‐centred medical home (PCMH) is an innovative approach to health care reform. Despite a well‐established process for recognizing PCMH practices, fidelity to, and/or adaptation of, the PCMH model can limit health care and population health improvements. This study explored the connection between fidelity/adaptation to the PCMH model with implementation successes and challenges through the experiences of family and internal medicine PCMH physicians. Methods Interviews were conducted at two academic PCMH clinics with faculty and resident physicians. Data were transcribed and coded on the basis of an a priori code list. Together, the authors reviewed text and furthered the analysis process to reach final interpretation of the data. Results Ten faculty and nine resident physicians from the Family Care Centre (FCC; n = 11) and the Internal Medicine Clinic (IMC; n = 8) were interviewed. Both FCC and IMC physicians spoke positively about their clinic's adherence to the PCMH model of enhanced access to care, coordinated/integrated care, and improvements in quality and safety through data collection and documentation. However, physicians highlighted inadequate staffing and clinic hours. FCC physicians also discussed the challenge of providing high‐quality care amidst differences in coverage between payers. Conclusion There remains significant variability in PCMH characteristics across the United States and Canada. This qualitative analysis uncovered factors contributing to fidelity/adaptation to the PCMH model in two academic PCMH clinics. For the PCMH to achieve the Triple Aim promise of improved patient health and experience at a reduced cost, policy must support fidelity to core elements of the PCMH.

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“…Few practices have the staffing to implement integrated care, waiting lists are long and satisfaction with services is highly variable. 32,33 As a result, evidence on the value of care coordination in real-world settings is mixed. Care coordination has proven successful for improving adult psychiatric patients’ access to care, clinical outcomes, and patients’ experiences.…”

Section: Introductionmentioning

confidence: 99%

Realigning theory with evidence to understand the role of care coordination in mental health services research

Hynes

Thomas

2023

International Journal of Care Coordination

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Current theoretical models intended to guide health services research and evaluation lack care coordination-its features and impacts. These aspects are critical for understanding the role of care coordination in healthcare use, quality, and outcomes. In this Focus article, we briefly review the well-known Andersen individual behavioral model (IBM) of healthcare use and the Donabedian health system and quality model (HSQM) together with recent practice-based evidence. We propose a new integrated theoretical model of healthcare and care coordination. The model can serve as a guide for future research to better understand the variation in care coordination services and delivery and its added value to improving mental health in different real-world settings.

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Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon

Cited by 7 publications

References 16 publications

Family Support Services and Reported Parent Coping Among Caregivers of Children with Emotional, Behavioral, or Developmental Disorders

Family Support Services and Reported Parent Coping Among Caregivers of Children with Emotional, Behavioral, or Developmental Disorders

Beyond checkboxes: A qualitative assessment of physicians' experiences providing care in a patient‐centred medical home

Realigning theory with evidence to understand the role of care coordination in mental health services research

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