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Friday, August 13, 2010

Medical home ideas with low fiscal notes

Financial barriers to the medical home transformation process can be great. Why not select strategies that require no financial investment? The next great barrier is time. Why not select strategies that require very little money or time? They do exist.

The TransforMed national demonstration project was clear: The practice team needs to be solid prior to embarking on any other changes. So, why not start with the team? Ask yourself the following questions:

  • Is every person on the team working to the limits of their degree?
  • Is there more that a particular team member wants to do or could do?
  • Is our communication as effective as it could be?
  • Do we have protected time to work on our practice and communicate about it?
  • Are negative, undermining or passive-aggressive behaviors present in the practice?

If you answered yes to any of these questions, you can likely do some work on team building.

Team building can be as simple as looking at the weekly schedule and carving out (not necessarily adding) one hour for a weekly team meeting. Treat the staff to lunch or just a snack and make an agenda about things in the practice that don’t work quite right. Ask staff to help form the agenda. Then sit down and discuss these items. Allow staff to participate in coming up with solutions. Make a time-line for implementation of the solutions. The next week, return to the agenda, following up on last week’s items and adding new ones. The items you tackle need not be large. They can be small, such as changing the way information/paperwork flows from the front office to the back to speed up patient through-put.

Another item that you may want to start with is researching software and electronic health records (EHRs). Commit to spending 30 minutes per week, or to reading one article per week, for the next two months. If you have been planning to implement new software or an EHR, this short time commitment can get you started on the right road. Use networking tools such as AAFP e-mail discussion lists, Center for Health IT peer reviews or TransforMed's Delta Exchange to get questions answered and real-life references on software.

You could also take an assessment to understand your practice's readiness for change and medical home implementation. Check out the AAFP’s Patient Centered Medical Home checklist or TransforMed’s MHIQ. These tools will help identify the areas in which you are most ready for and most need change. They are free and take only a few minutes to complete.

Some practice members can also educate themselves about the components of the medical home and how to best implement them. There are many free resources to help, including TransforMed, MGMA the Institute for Healthcare Improvement and the AAFP. Even pharmaceutical companies are forming free medical home implementation tools. Team members can then educate the rest of the practice members.

Whatever you choose, realize that anything worth doing (I happen to think the medical home is definitely worth doing) requires some personal investment. But it does not necessarily have to be money.

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About the Author

Melissa Gerdes, MD, is a family physician practicing at Methodist Family Health Center – South Arlington in Arlington, Texas, and former president of the Texas Academy of Family Physicians.

Note: This blog is no longer updated; this is archived content.

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Real-Life Practice Transformation is a Family Practice Management (FPM) blog. However, the views expressed here are those of the individual authors. They do not necessarily reflect the opinion of FPM or the AAFP. The FPM blogs are not intended to provide medical, financial or legal advice. For more information see Terms of Use.