- Ming Tai-Seale, Ph.D., MPH, Senior Investigator, Health Policy Research, PAMFRI
Transforming Primary Care Practice
Although leading medical professional societies have identified Patient Centered Medical Homes (PCMH) as a key to revive primary care in the United States, the PCMH model remains largely an aspiration nationwide. Based on the Palo Alto Medical Foundation’s (PAMF) years of experience in implementation of components of the Patient Centered Medical Home and a winning research proposal, researchers at the PAMF Research Institute (PAMFRI) have been awarded a competitive grant from the U.S. Department of Health and Human Service’s Agency for Healthcare Research and Quality (AHRQ) to conduct a study of PAMF as a Patient Centered Medical Home.
Researchers will gather qualitative (studying interviews) and quantitative (studying measures) information about the actual primary care transformation processes and outcomes. “Insights learned from the study will inform future PCMHs elsewhere and policymakers in need of empirical evidence in developing PCMH payment and administrative policies,” said Principal Investigator Ming Tai-Seale, Ph.D., MPH, Senior Investigator, Health Policy Research at PAMFRI. “Lessons learned from the transformation process, including understanding critical drivers; costs involved; and impact on frontline staff, physicians, and patients, will be informative to other primary care settings undergoing or thinking of undergoing transformation to PCMHs.”
PAMF Experience with Patient Centered Medical Homes
- PAMF has been implementing components of PCMH since 1999, and each PAMF division was certified by NCQA’s Physician Practice Connection as a Patient Centered Medical Home in 2006.
- As a large multispecialty practice, PAMF’s experience is applicable to a wide range of health care delivery settings.
- The diversity of PAMF’s practice size (from a few physicians to a few hundred physicians), culture, location, heterogeneous patient population and payer mix provide the variability needed to assess the effects of interventions.
- All PAMF clinics use the same EpicCare Electronic Health Record (EHR) system, allowing uniform assessments across sites.
- The PAMF Research Institute has a team of experienced investigators with direct access to data, medical leadership and patients, yet remains as an independent research institute to publish all findings.
Aims of the Patient Centered Medical Home Study
- Describe methods used to transform practices, with attention to the organizational context and culture and conditions within which changes have occurred.
- Assess the changes in processes, intermediate clinical outcomes, and costs and efficiency of care. Empirical approaches range from key informant interviews, focus group, to a retrospective quantitative quasi-experimental study with data drawn from EpicCare EHR, IDX scheduling, and billings data.
- Determine the impact of the transformative processes on the actual experiences and satisfaction of doctors, patients and staff. Key informant interviews and focus groups data will be collected for the study and leveraged with routinely collected past and ongoing surveys undertaken by the organization.
Learn more about the PAMF Research Institute.
Learn more about the Agency for Healthcare Research and Quality (AHRQ).
Learn more about Patient Centered Medical Homes.
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