Transcript Downtown Health Plaza of Baptist Hospital Mission Statement

Downtown Health Plaza of Baptist Hospital Mission Statement
The Downtown Health Plaza is committed to providing
quality and compassionate care to all we serve.
In Forsyth County the percent of
people below the poverty level
has increased over the last five
years from 9.9% in 2002 to 13.9%
in 2007. Twenty-two percent of
people under the age of 18 live in
poverty, and 25.7% of children
under age 5 do as well.
Payor Demographics by Department
YTD FY 09
15,000
10,000
ADULT MED
OB/GYN
5,000
PEDS
0
Personal Pay
FY 09
Personal Pay
Medicaid
Medicare
Managed Care
Medicaid
ADULT
MED
9,030
6,602
7,797
2,369
Medicare
%
35.0%
25.6%
30.2%
9.2%
OB/GYN
10,381
7,638
315
1,096
Managed Care
%
53.4%
39.3%
1.6%
5.6%
PEDS
547
14,420
3
1,029
%
3.4%
90.1%
0.0%
6.4%
Downtown Health Plaza Patient Visits by Race
FY 99 - FY 09
60.0%
Percentage
50.0%
Black
40.0%
White
30.0%
Hispanic
20.0%
Other
10.0%
0.0%
FY 99 FY 00 FY 01 FY 02 FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09
WHEN YOU ARE WELL
Downtown Health Plaza will help you - - Manage chronic diseases
Diabetes
Asthma
Hypertension
Receive preventive and diagnostic services
Annual physical exam
Immunizations
Blood and urine tests
Pap Smears
Mammograms
Obtain prescriptions
Referral to specialists
Support and Information
Educational materials
Support groups
Answer questions
Downtown Health Plaza Services
On Site Pharmacy
On Site Laboratory
On Site Radiology
Financial Counselors
Spanish-Language Interpreters
Specialty Services
On Call Services 24/7
Ob/Gyn
Pediatrics
CareNet Pastoral Counselors
Toward Higher-Performance Health Systems: Adults’
Health Care Experiences In Seven Countries, 2007
Schoen et al. Health Affairs 2007.
• METHODS - Telephone survey of adults in 7 countries,
using the answers to 4 questions
– (1) the adult has a regular doctor or place of care
– (2) doctor(s)/staff always or often know important
information about the patient’s medical history
– (3) the place is easy to contact by phone during regular
office hours
– (4) the doctor/staff at the source of care always or often
help coordinate care received from other doctors or
sources of care.
Toward Higher-Performance Health Systems: Adults’
Health Care Experiences In Seven Countries, 2007
Schoen et al. Health Affairs 2007.
• RESULTS
– The USA stands out for cost-related access barriers &
less-efficient care.
– 75% of adults viewed having a source of care that knows
them and helps coordinate care as very important.
– Having a medical home was associated with less
difficulty accessing care after hours, improved flow of
information across providers, a positive opinion about
health care, fewer duplicate tests, and lower rates of
medical errors.
Racial and Ethnic Differences in Getting Needed Medical Care
Are Eliminated When Adults Have Medical Homes
Pe rce nt of adults 18Š64 re porting alw ays
ge tting care the y ne e d w he n the y nee d it
Medical home
Regular source of care, not a medical home
No regular source of care/ER
100
75
50
74
76
74
53
52
38
74
52
44
50
31
34
25
0
Total
White
African American
Note: Medical home includes having a regular provider or place of care, reporting no
difficulty contacting provider by phone or getting advice and medical care on weekends
or evenings, and always or often finding office visits well organized and running on time.
Source: Commonwealth Fund 2006 Health Care QualitySurvey.
Hispanic
TH E
C OMMON W EA LTH
FU N D
CHARACTERISTICS OF A MEDICAL HOME
Accessible
Family-Centered
Thorough
Continuous
Coordinated
Culturally Competent
What Patients with Chronic Illnesses Need
• A “continuous healing relationship” with a care
team and practice system organized to meet their
needs for:
• Effective treatment (clinical, behavioral, supportive)
• Information and support for their self-management
• Systematic follow-up and assessment tailored to
clinical severity
• More intensive management during high risk
periods
• Coordination of care across settings and
professionals
Standards and Guidelines for the
Patient-Centered Medical Home
•
•
•
•
•
•
•
•
•
1: Access and Communication
2: Patient Tracking and Registry Functions
3: Care Management
4: Patient Self-Management Support
5: Electronic Prescribing
6: Test Tracking
7: Referral Tracking
8: Performance Reporting and Improvement
9: Advanced Electronic Communication
PPC 1: Access and Communication - The practice has standards for
access to care and communication with patients, and monitors its
performance to meet the standards
YES
1. Scheduling each patient with a personal clinician for
continuity of care
X
2. Coordinating visits with multiple clinicians and/or
diagnostic tests during one trip
X?
3. Determining through triage how soon a patient needs
to be seen
X
4. Maintaining the capacity to schedule patients the
same day they call
X
8. Providing urgent phone response within a specific
time, with clinician support available 24 hours a day, 7
days a week
X
NO
N/A
YES
NO
9. Providing secure e-mail consultations with physician or
other clinician on clinical issues, answering within a
specified time
X
10. Providing an interactive practice Web site
X
11. Making language services available for patients with
limited English proficiency
X
12. Identifying health insurance resources for
patients/families without insurance.
X
N/A
Percent of Patients Who Would Use Internet to
Schedule an Appointment at DHP
44%
Yes
56%
No
Percent of Patients Who Would Use Cell Phone Text
Messaging to Schedule an Appointment
at DHP
28%
Yes
72%
No
The Adult Medicine Clinic staff also presented a poster at the United
Healthcare Consortium (UHC) conference on the use of the iPod touch to
enhance patient education, improve patient flow, and address educational
needs of complex patients. Audio/Video educational modules about such
topics as warfarin therapy, diabetes, inhaler techniques, and test preparations
have been developed and implemented by the staff. Patient response has
been positive, and many older adults have been intrigued by the use of
handheld devices.
Future Plans
 National certification as a Patient-Centered Medical Home
 Possible extended clinic hours for primary care.
 Offer improved patient access with modern technologies such as internet use
or texting: Trials planned for 2010.
 Community Garden Project: Partnering with Goler CDC and Goler Manor
Apartment residents to promote healthy eating and community activity.
Continued Challenges
 Growing number of working families without access to affordable health
insurance
 Assuring mental health follow up for the 15% Medicine patients with severe
psychiatric issues
 Patients' ability to access needed medications
 Increasing cost of healthcare
 Increase in Forsyth citizens living in poverty with no insurance
 Growth rate of Hispanic population and resulting language, cultural issues