Practice Models within Patient Centered Medical Home. Objectives. Describe Patient Centered Medical Home concepts Describe system redesign goals for providers and team members Explain how clinical pharmacy contributes in providing direct patient care
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Practice Models within Patient Centered Medical Home
Replaces episodic care based on illness and patient complaints with coordinated care and a long term healing relationship
Focused on the principle that all redesign is guided towards
Value is defined by the Veteran & Customer
The VETERAN first
The secondary customers next
Never on the system itself
Value changes as Veteran and Health care expectations evolve
Veteran Centered (each patient has their own)
Evidence Based (right care, right place)
Value is comprised of
Efficient/Costs (not solely financial)
System Redesign: Patient Center Care
McGinnis JM, Foege WH. Actual Causes of Death in the United States. JAMA 1993;270:2207-12.
Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual Causes of Death in the United States, 2000. JAMA 2004;291:1230-1245.
September 2009 American Journal of Managed Care
Improved Quality & Efficiency of Care
* Managing patient’s drug therapy to goal
for chronic disease states and other specialty care
Scope of Practice allows CPS to:
Courtesy of Dr. Rubin, D.O.
Chief of Primary Care Service
West Palm Beach VA Medical Center
Jesse Brown Chicago VA Medical Center
Chronic Disease Management Role of CPS
Standard Pharmacy Clinic Structure
Jesse Brown VAMC Home Model
Four Primary Care Teams
Data from 3/09 – 3/10;
source – VSSC cube and VISTA
Other Clinical Pharmacy Specialist Responsibilities
Specialty Clinical Pharmacy Clinics
Pharmacy Clinic Outcomes – Diabetes Management
Percentages given as a mean
Pharmacy Clinic Outcomes – Women’s Health
Multidisciplinary clinic model
Mean number of visits: 2.4 over 6 months
Values given as a mean
VA is a nationally recognized leader in Clinical Pharmacy Services.
The team based approach of the Patient Centered Medical Home provides the opportunity for this role and that of the other team members to become the standard of care.