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Together. Today. Tomorrow. 21 st Century Model of Primary Care for Chronic Diseases Jane Allen Calhoun, Director, Clinical Services Anna Lyn Whitt, Executive Assistant to CEO
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Today. Tomorrow. Together. 21 st Century Model of Primary Care for Chronic Diseases Jane Allen Calhoun, Director, Clinical Services Anna Lyn Whitt, Executive Assistant to CEO. Board of Directors. Delta State University - John Hilpert, Chairman MS Valley State University – Donna Oliver - PowerPoint PPT Presentation
Transcript of Together.
Together.Today. Tomorrow.
21st Century Model of Primary Care for Chronic Diseases
Jane Allen Calhoun, Director, Clinical ServicesAnna Lyn Whitt, Executive Assistant to CEO
Delta State University - John Hilpert, Chairman
MS Valley State University – Donna OliverUniv. of MS Medical Center - James
KeetonMississippi State University - Melissa
MixonDelta Council - Bill KennedyCommunity Members – Bruce BrumfieldRepresentative Willie BaileyCass Pennington
Board of DirectorsBoard of Directors
DHA Overview
AccessAccess Increase access and availability of care
EducationEducation Offer health education programs
ResearchResearch Conduct and apply health research
Access, Education & Research
Service Area
MississippiMississippi’s National Ranking
% obese adults1 48th
% diabetes2 1st
Number of adults who smoke cigarettes 42nd
Asthma-related disease among school age students 50th
Teen pregnancy Highest
Infant mortality49th
Delta
MS US
Infant mortality per 1,000 13.2 11.4 6.9
Adult Obesity 34.4 30.9 24.4
Adult Diabetes 11.5 10.8 7.5
Level 1 Literacy or Below Unknown 30.0 14.0
Physicians per 10,000 1.1 1.8 3.00
Vital Stats
Physician Patient Loadby County = 5 or less physicians residing in county
= no physicians in county
http://www.healthpolicy.msstate.edu/publications/healthmaps/primcarephys.pdf
MSDH State Health Plan 2007
Within recommended patient load (1,429 patients PCP)Up to double recommended patient load2x to 4x recommended patient loadMore than 4x recommended patient loadNo PCP in County
Map 1: Patients per Primary Care Physician, 2002
The Destructive Cycle of The Destructive Cycle of Health Disparities in the Delta
When Good Health Drives the When Good Health Drives the Economy of the RegionEconomy of the Region
What are we doing to address this?What are we doing to address this? Mathematica
External evaluation GAP analysis
Project PortfolioShift from small, narrow research projects to broader, infrastructure building projects that are likely to have near-term effect on improving healthcare knowledge, access or quality.
Source: Social-ecological model from CDC.
Partners
Additional Collaborators Delta Area Health Education Center
(AHEC) Mathematica Policy Research Inc. Oak Ridge National Laboratories Hamilton Eye Institute Vanderbilt University University of Chicago Northwestern University
Delta Health Initiative Highlights
Addressing Solutions Today
Investments in Technology Streamline Rural Programs Enhance Rural Infrastructure
Investments in Technology
Consistent use of best practices regardless of clinic location
DHA TouchWorks Cluster
UMC TouchWorks Cluster
Electronic Health RecordsEHRs Benefit Our
Communities ~329,000 Patients in Delta
Database 13 site locations - DRMC Patient education for
chronic disease self-management
Improved medication management
Improved tracking of long-term outcomes
Reduction of health disparities
Expanding Infrastructure Rural TeleStroke VISICU—Telemedicine for Intensive
Care—University of MS Medical Center
TelePsychiatry Program—University of MS Medical Center
Vision Screening
21st Century Primary Care Model
• Transforming primary care practices in rural health clinics and free clinics in target counties
• Measuring impact on access to care, treatment outcomes, & provider and patient satisfaction
21st Century Model of Primary Care
∙ Utilizing the TransforMED Patient-Centered Model to better serve the needs of both patients and practices
21st Century Model of Primary Care
∙ The model encourages∙ Clinician-patient communication: trust, respect, shared decision- making ∙ Patient engagement ∙ Provider/patient partnership ∙ Culturally sensitive care ∙ Continuous relationship ∙ Whole person care
21st Century Model of Primary Care
Goal 1: Improved health outcomes for people with diabetes and hypertensionGoal 2: Increased access to goalGoal 3: Increased community awarenessGoal 4: Evaluate the effectiveness of the process and the outcomes of a PCMH model in the Delta and its impact on overall health outcomes
21st Century Primary Care Model
Applying PCMH principles to the traditional chronic care model
Enhancing access to a clinical team Adopting new technologies Improving quality, equity, and efficiency
Successful Communities
Workforce Development
Literacy
Early Childhood Interventions
Appropriate Healthcare
Successful Communities
Together.Today. Tomorrow.
