designing a 21 st century approach to primary care
DESCRIPTION
Designing a 21 st Century Approach to Primary Care. John R. Griffith, Kyle L. Grazier, Scott B. Ransom University of Michigan Center for Health Management Research Industry Advisory Board October 7, 2005. Thank you for your generous funding. John, Kyle, Scott. - PowerPoint PPT PresentationTRANSCRIPT
Designing a 21st Century Approach to Primary Care
John R. Griffith, Kyle L. Grazier, Scott B. RansomUniversity of Michigan
Center for Health Management Research Industry Advisory Board
October 7, 2005
Thank you for your generous funding.
John, Kyle, Scott
“It is the grind that makes the happiness. To feel that your hours are filled to overflowing, that you can barely steal minutes enough for sleep, that the welfare of many is entrusted to you, that the world looks on and approves, that some good is always done to others,…that is happiness. For myself, I can conceive none other.”
WHY MIGHT DOCTORS BE UNHAPPY?
Primary Care-Selective and Integrative
Responsive to patient needs as patients perceive them
Provide benchmark care
Delight practitioners
Care that maximizes value
Financial incentives- designed by patients, providers, buyers
“Very scary, Jennifer—does anyone else have an H.M.O. horror story?”
The New Yorker July 19, 1999
For Caregivers
Personnel managementWork/life concernsStaffingLocum tenensStaff development
Transparent business operationsIncentive pay- quality, effectiveness,
satisfactionCapital- maintenance, expansionAccountability
21st Century Primary Care Model
NursePractitioner
SchoolNurse
Mall Nurse
PhysicianAssistant
Church Nurse
Phone/e-mailconnectivity
NurseMidwife
GroceryStoreNurse
In Home HealthConsults
Nur
se P
hone
Ser
vice
Invi
sib
le S
pec
ialis
tA
cces
s
InteractiveEducation
Patien
t
Po
pu
lation
Alerts
Mall-based
Healthcare
Primary Care Physician
On-line
reminders
Web access
For Patients
Coordinated choicesIntegrated information and treatment
supportGeographic access to careAlternative practitioners- “risk”
adjustedCost control-variable copaysScreening and prevention
Business Model
• Retailer of medical care• Organized vendors• PCP service lines• Financial gain
– Business efficiencies– Revised clinical care
• Improved prevention• Reduced unnecessary care• Managed chronic illness• Improved patient comfort & compliance with
reliability & quality
Hastings and St. Leonards Primary Care Trust
Organizational Forms
Entrepreneurial and patient focused IDS
Groups of PCPs with business/technological acumen and success
Insurance companiesHealth departments
Clinical Clinical Practice:Practice:
safe, safe, effective, effective, patient-patient-
centered, centered, timely, timely,
efficient, and efficient, and equitable careequitable care
Service Service Excellence:Excellence: Promotion of Promotion of
convenienceconvenience, , comprehensivenecomprehensivene
ss, service, ss, service, reliabilityreliability
Health Care Health Care Finance: Finance: Patient cost Patient cost
sharing, provider sharing, provider performance, performance,
incentives, and incentives, and protection against protection against
major lossmajor loss
Support Support Network:Network:
RecruitmentRecruitment, training, , training,
information, information, accounting, accounting, supplies, & supplies, &
facilitiesfacilities
Attributes of a 21st Century Primary Care Management Organization
So… Why Do It?
Central to the organization’s missionAddresses the most pressing issues of
the 21st CenturyA competitor is (always) in the wings
How To Do it?
LeadershipUnderstanding market needsUnderstanding provider needsUnderstanding consumer needsImplementationFinancial modelingPilot and Roll- Out
Research and Evaluation
Ask the questionsMeasure the processMonitor the outcomesQualitative and quantitative
methodsDesignData collectionAnalysis
“Study Finds …Bubkes”June 4, 2003 | Issue 39•21 BALTIMORE—A team of scientists at Johns Hopkins
University announced Monday that a five-year study has found absolutely nothing.
"I can't explain what happened," head researcher Dr. Jeremy Dhen said. "We meticulously followed correct scientific procedure. Our methods were sufficiently rigorous that they should have produced some sort of result. Instead, we found out nothing."
Dr. Dhen took the podium to make the team's closing statements.
"I just want to clarify that we had the best intentions going into this study,"
Dhen said. “We thought we would make a scientific discovery
that would benefit the health of millions. I guess we were wrong.
We tried to find a link, but instead we found bubkes.“.
Research and Evaluation
• Don’t miss the action• Feedback to stakeholders, designers• Does it work?
End of presentation
Linda Frances Happiness