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Communication Between Primary Care Pediatricians and Specialists —Clarifying Expectations and Knowing When to Refer. Jennifer Lail, M.D., FAAP Florida Pediatric Medical Home Demonstration Project (C4K) Learning Session 2 April 27-28, 2012. Disclosure.
Jennifer Lail, M.D., FAAP
Florida Pediatric Medical Home Demonstration Project (C4K)
Learning Session 2April 27-28, 2012
I have no relevant financial relationships with the manufacturers of any commercial products and/or provider of commercial services discussed in this CME activity. I do not intend to discuss an unapproved/investigative use of a commercial product/device in their presentation.
Data Resource Center for Child and Adolescent Health http://www.childhealthdata.org/browse/snapshots/cshcn-profiles?rpt=9&geo=9
- McPherson, Arango, Fox: Pediatrics 1998; 102.
- The Child and Adolescent Health Measurement Initiative, 2009-10, NS-CSHCN, www.childhealthdata.org
Schedule a Chronic Care Management visit with a PVC prior
* O’Malley and Reschovsky, Arch.Int.Med, 2011
* –O’Malley and Reschovsky, Arch.Int.Med, 2011
Breast Feeding Support/Supplies/Home Care
Carseats for CSHCN
Dentistry (see also Oral Surg.)
Developmental Peds /Peds Rehab
G-Tube and Trach Care
Handicapped Parking Permits
Home Health Care/Equipment
Inclusion (see Transitions)
Physical Therapy/Sports Injury
Recreation for CSHCN
Safety and Hotlines
Social Services/Abuse/Domestic Violence
State of NC programs for CSHCN
-Index from CHPA Internal Directory of Resources, 2010, Chapel Hill, NC
*What Is Value in Health Care? Michael E. Porter, Ph.D., N Engl J Med 2010; 363:2477-2481 December 23, 2010
Recruitment:Ways to Work Together“The Patient-Centered Medical Home Neighbor—The Interface of the PCMH with Specialty/Subspecialty Practices”
Preconsultation exchange: “curbside”
Formal consultation: PCP as primary manager, Specialist as consultant (ex., PET placement)
Co-management: PCP comanages with Specialist
For Shared Management of the disease (ex., Type 1 DM)
With Principal care for the disease (ex., Leukemia)
With Principal care of the patient for a consuming illness, limited time period (ex., Prematurity)
Transfer of care --American College of Physicians, 2010
J.L., 4 year old girl with MR of ? etiology, severe sz disorder, osteopenia, GTube, recent adm. for spont. hip fx and post-op pneumonia. . . (Neuro, Ortho, Endocrine, Surgery are consults)Calls for appt. for fever and cough. . .
“Chapel Hill Peds patients EXPECT that we will be in communication with each other and have a sense of comfort that we are—behind the scenes—somehow connected and working together in their best interest.”
--Dr. Sarah Armstrong, Director, Healthy Lifestyles Program, Duke University Health System
“I think that the Medical Home gives us comfort as specialists that the patient’s whole realm will be cared for in a meaningful manner—a trach or a syndrome doesn’t keep them from being part of a larger community”.
--Dr. Amelia Drake, Chief, Pediatric Otolaryngology, UNC Hospitals