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Designing a 21 st Century Approach to Primary Care

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.

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Designing a 21 st Century Approach to Primary Care

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  1. Designing a 21st 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

  2. Thank you for your generous funding. John, Kyle, Scott

  3. “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.”

  4. WHY MIGHT DOCTORS BE UNHAPPY?

  5. 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

  6. “Very scary, Jennifer—does anyone else have an H.M.O. horror story?” The New Yorker July 19, 1999

  7. For Caregivers Personnel management Work/life concerns Staffing Locum tenens Staff development Transparent business operations Incentive pay- quality, effectiveness, satisfaction Capital- maintenance, expansion Accountability

  8. st 21 Century Primary Care Model Interactive Web access Education On - line Nurse Phone/e - mail reminders Practitioner connectivity Invisible Specialist School Access Grocery Nurse Store Patient Nurse Alerts Population Primary Care Physician Mall Nurse Church Nurse Mall Service Nurse Phone - Healthcare Nurse Physician Midwife Assistant based In Home Health Consults

  9. For Patients Coordinated choices Integrated information and treatment support Geographic access to care Alternative practitioners- “risk” adjusted Cost control-variable copays Screening and prevention

  10. 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

  11. Hastings and St. Leonards Primary Care Trust

  12. Organizational Forms Entrepreneurial and patient focused IDS Groups of PCPs with business/technological acumen and success Insurance companies Health departments

  13. Attributes of a 21st Century Primary Care Management Organization Service Excellence: Promotion of convenience, comprehensiveness, service, reliability Support Network: Recruitment, training, information, accounting, supplies, & facilities Clinical Practice: safe, effective, patient-centered, timely, efficient, and equitable care Health Care Finance: Patient cost sharing, provider performance, incentives, and protection against major loss

  14. So… Why Do It? Central to the organization’s mission Addresses the most pressing issues of the 21st Century A competitor is (always) in the wings

  15. How To Do it? Leadership Understanding market needs Understanding provider needs Understanding consumer needs Implementation Financial modeling Pilot and Roll- Out

  16. Research and Evaluation Ask the questions Measure the process Monitor the outcomes Qualitative and quantitative methods Design Data collection Analysis

  17. “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.“ .

  18. Research and Evaluation • Don’t miss the action • Feedback to stakeholders, designers • Does it work?

  19. End of presentation Linda Frances Happiness

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