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Maxine Hayes, MD, MPH Medical Home Conference May 30, 2007. Medical Homes in Washington: Reaching the “Tipping Point”. Welcome & Introduction. What is a Medical Home?.

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Maxine Hayes, MD, MPH

Medical Home ConferenceMay 30, 2007

Medical Homes in Washington: Reaching the “Tipping Point”



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What is a Medical Home?

  • A way of providing comprehensive, coordinated care that is built on a foundation of mutual respect and partnership between patients, their families, and health care providers. Also includes connection with community services such as family support.


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Accessible

Continuous

Comprehensive

Coordinated

Family-centered

Compassionate

Culturally effective

Defined by its Components


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One of the Six National Performance Measures for CSHCN

  • All CSHCN will receive regular ongoing comprehensive care within a Medical Home


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Providers

  • Develop partnership of mutual responsibility and trust with family and child

  • Deliver or direct primary care

  • Manage and facilitate all aspects of child’s care coordination


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Families

  • Diverse families empowered to play active role as a Medical Home team partner.


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Policy partners involved in moving MH concept forward include:

  • Medical Home Teams

  • Washington State AAP

  • Other providers (including oral and mental health)

  • Insurers

  • Families, schools, childcare providers

  • Interagency and community partners


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We’ve reached the “Tipping Point”! include:

  • “The Tipping Point, How Little Things Can Make a Big Difference” by Malcolm Gladwell (2000)

  • When an idea becomes commonplace, acceptable, part of the every day usage, and things start to change….


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What’s changing… include:

  • Medical Home concept and acceptance has grown!

  • Started with AAP in 1967.


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Medical Home Needs Assessment in 1993 led to 1995 “Training & Resource Project” with 12 county medical home teams.

“Promise to the State” (2001)

Medical Home Leadership Network grew out of this: now 21 teams

Medical Home Strategic Plan for CSHCN (2006)

History of MH for CSHCN in WA


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DOH Medical Home “Strike Team” “Training & Resource Project” with 12 county medical home teams.

  • “Medical Home Strike Team” 2006-Present

  • Focusing on bringing statewide efforts together to create a Medical Home strategic plan for all children and adults


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Medical Home Summit – November 2006 “Training & Resource Project” with 12 county medical home teams.

Beginning of a strategic planning process to spread the concept of Medical Home, using the new strategic plan for CSHCN as the foundation.


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The Tipping Point - What’s changing… “Training & Resource Project” with 12 county medical home teams.

  • There’s increasing agreement that MH means more than just having a primary care provider.


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What’s changing… “Training & Resource Project” with 12 county medical home teams.

  • Partnerships are expanding to include practitioners/specialties beyond Pediatrics.

  • Joint Principles of the Patient-Centered Medical Home, March 2007, exemplify broader acceptance.


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2006-2007 public policy initiatives “Training & Resource Project” with 12 county medical home teams.

  • State Initiatives that include Medical Home

    • SSB 5093 (Children’s Health Insurance- aka Cover all Kids)

    • Blue Ribbon Commission (insurance for all)

    • Kids Matter plan (early learning initiatives)

    • Autism Task Force recommendations

    • Oral Health State Access Action Plan for CSHCN


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What’s changing “Training & Resource Project” with 12 county medical home teams.

  • More communication between medical community, public health, early intervention

  • Family advisory groups

  • Dental homes integrating with medical homes

  • Head Start and Early Head Start require medical homes for children


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New Medical Home Tools “Training & Resource Project” with 12 county medical home teams.

  • Medical Home website: www.medicalhome.org

  • Medical Home key messages document

  • Medical Home monograph

  • Parent/Family Medical Home Checklist

  • Oral Health and CSHCN monograph and website

  • Bright Futures Oral Health document for CSHCN

  • New brochures for parents and providers 2007-2008

  • Family Leadership Training Curriculum – CSHCN Program


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Medical Home Quality Improvement “Training & Resource Project” with 12 county medical home teams.

  • Medical home is an effective approach to improving health outcomes:

    • Learning Collaboratives

    • Performance indicators in SSB 5093


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Together we can eliminate Health Disparities “Training & Resource Project” with 12 county medical home teams.

  • Significant health disparities

  • Medical Homes defined as culturally competent and family centered

  • Washington State’s increasingly diverse population requires providers to become well versed in cross cultural communication and care.


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Next Steps “Training & Resource Project” with 12 county medical home teams.

  • Develop strategies for financing care coordination

  • Seek additional funding, e.g. Epilepsy Grant

  • Support Learning Collaboratives


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What Teams will hear about today “Training & Resource Project” with 12 county medical home teams.

  • Strategies that are working for teams in our state

  • Opportunities to share and learn from each other.


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Reflections on the day “Training & Resource Project” with 12 county medical home teams.


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Determinants of Health “Training & Resource Project” with 12 county medical home teams.

Multiple levels of influence

HEALTH

L

I

F

E

S

P

A

N


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Health “Training & Resource Project” with 12 county medical home teams.

Behaviors and

Personal

Risk Factors

Institutionalized

Biases (racism, sexism, etc.)

Access to

Health Services

Trust in Health

System and

Research

Mental Health

and Social

Support

Stress due

To Social

Factors

Economic

Opportunity

and Equity

Education

Background

and

Opportunity

Environmental

Risk

Language and

Other Cultural

Factors

SOCIALDETERMINANTS OF HEALTH


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Discussion & Questions “Training & Resource Project” with 12 county medical home teams.


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