During a recent radio interview on The Bev Smith Show, two listeners called in with similar complaints:

• “I felt like a statistic when I called my doctor’s office to ask a question about a prescription he wanted me  to take.  I was put on hold twice, and then he told me that he didn’t have time to talk to me.”
• “My son was supposed to have a DPT shot, but he had a cold.  When I called the pediatrician’s office to ask if I should bring him in or wait till he got over his cold, the doctor asked me, “Where did you get your medical degree from?”

After apologizing, I thought aloud, “There has to be a better way to deliver medical care.”  After all, we had just finished talking about workforce burnout and what happens when we expect our doctors to be in too many places at the same time.

I mentioned the concept of the Patient-Centered Medical Home, a healthcare setting that facilitates partnerships between individual patients, their personal physicians, and the patient’s family. A scorecard designed by the National Committee for Quality Assurance (NCQA) quantitates the effectiveness of a Patient-Centered Medical Home according to:

• Access and Communication
• Patient Tracking and Registry Functions
• Care Management
• Patient Self-Management Support
• Electronic Prescribing
• Test and Referral Tracking
• Performance Reporting and Improvement
• Advanced Electronic Communications

According to Dr. Joseph Scherger, Clinical Professor of  Medicine at the University of California, San Diego, Medicare Demonstration projects will launch in eight states this year.  Primary care practices will earn $40-$52 per patient per month based on their NCQA scorecard, mentioned above.  Practitioners who perform well will earn a substantial increase over what they are paid now for treating patients who come in for episodic visits.  If successful, this model will encourage practitioners to reach out to patients with chronic diseases in a more proactive fashion and help coordinate patient care and improve clinical outcomes (Sawyer LM, Sabogal F, Scherger JE. 2009. Next Generation Improvement for Healthcare Systems. CAHQ Journal, Quarter 1: 16-21).

What do you think?

• Is our present model of providing care predominantly by appointment visits inadequate
• Can a model like a Patient-Centered Medical Home leverage health information technology to improve clinical outcomes
• Does this model represent something with which you and your family would be comfortable

As always, I welcome your input to improve healthcare collaboration.  I am adding a concern because I feel that the freeze on what is labeled “discretionary spending” is hindering the teaching, speaking, and consulting efforts that support the free distribution of this blog.  Although we may believe that collaboration is the only low-hanging fruit that the recession has not taken away from us, we need to move from slogans to action.

If you know of anyone who views collaboration as a vital short- and long-term differentiation strategy, please put me in contact with her or him by clicking here.

Kenneth H. Cohn
© 2009, all rights reserved