The relationship between the patient/family and the provider/care team is at the heart of the Patient-Centered Medical Home (PCMH) Model of Care.
Empanelment is the act of assigning individual patients to individual primary care providers (PCP) and care teams with sensitivity to patient and family preference. It formalizes and affirms these partnerships and sets the stage for all of the other components of effective PCMH practice.
For many practices, empanelment is a cultural transformation. Providers and care teams must shift their focus from caring for individual patients to managing the health of a defined population of patients. Empanelment also requires a shift from reactive to proactive care. The goal of focusing on a population of patients is to ensure that every established
Patient-centered interactions are considered one of the most important elements of the PCMH model. It involves the active expression of patient-centered care. Patient-centered organizations respect patients’ values and preferences, engage them and their families in healthy behaviors, and expand care capacity to equitably serve patients and families of diverse cultures and with diverse needs. To effectively respond to patients’ values, preferences, and needs, and to improve their experience of care, patient-centered medical homes need feedback from patients and families on the care they deliver.
Elements of Patient-Centered Interactions
Respect patient and family values and expressed needs.
Encourage patients to expand their role in decision-making, health-related behaviors, and self-management.
Communicate with their patients in a culturally appropriate manner, in a language and at a level
The Stage 2 Final Rule (CMS-0044-F) changed the way shared Certified EHR Technologies are handled for the Stage 2 measure option for summary of care records at transitions of care and referrals. Previously, if multiple EPs are using the same certified EHR technology in different physical locations/settings (e.g., different practice locations), there must be a single test performed for each physical location/setting.
The intent of the objective is to demonstrate that a provider has the full capability to use their certified EHR technology to successfully transmit a summary of care document to a different EHR vendor in a live setting.
Under changes made in the Stage 2 Final Rule providers that use the same EHR technology and share a network for which
The PCMH should be designed to enhance the patient experience. This shift requires a transformation, not an incremental change from one that focused on physician workflow. Transformation to a PCMH requires a continuous, unrelenting process of change. It represents a fundamental re-imagination and redesign of practice, replacing old patterns and processes with new one. Transformation includes new scheduling and access arrangements, new coordination arrangements with other parts of the health care system, new ways of bringing evidence to the point of care, quality improvement activities, development of team-based care, changes in practice management, new strategies for patient engagement, and multiple new uses of information systems and technology. These multiple components of a PCMH are highly interdependent. Each component, when implemented,
How many of you remember this information published in RAND Health in 2009 in an article entitled “Changing Views on Chiropractic”?
“What Role Should Chiropractic Have in Health Care?
Where chiropractic fits in today's health care system is still unclear. The lack of high-quality studies reported in the medical literature makes it difficult to arrive at comprehensive conclusions about the value of chiropractic care. For example, RAND researchers could say only that spinal manipulation benefits some people with acute low-back pain. They didn't find enough data from well-designed studies to say anything about chiropractic's value for chronic low-back pain or low-back pain that involves an irritated sciatic nerve; about the complication rate of chiropractic treatment; about the number of manipulations needed to