The benefits of the National Demonstration Project on the patient-centered medical home, an initiative by the American Academy of Family Physicians (AAFP) and its subsidiary TransforMED, are still being realized two years after the project ended.
The project, which was undertaken by TransforMED and funded by the AAFP, ran from June 2006 to May 2008. It was the first and largest "proof-of-concept" project to determine empirically whether the TransforMED Patient-Centered Medical Home (PCMH) model of care could be implemented successfully and sustained in today's healthcare environment.
The demonstration project also served as a learning lab to gain better insight into the kinds of hands-on technical support family physicians want and need to implement the PCMH model of care.
"Recommendations for the patient-centered medical home model will continue to come forth, but the TransforMED NDP achieved what it set out to do," said AAFP President, Lori Heim, MD.
"From the beginning, the national demonstration project was viewed as more of a learning lab than a research or demonstration project," added Terry McGeeney, MD, president and CEO of TransforMED. "The model was changed seven times during the project," he explained. "When something wasn't working, we changed it, with the end goal of developing a viable model of care with the tools and resources to support it."
Trinity Clinic – Whitehouse in Texas, a participant in the demonstration, is on track for where its medical director thought it would be two years after the pilot. “I am sure most participants in the project took a break. We did,” said Melissa Gerdes, MD. “Healthcare reform put everyone on pins and needles.” At that time the economy was also “tanking” and it was hard for practices to put out money for this, she said.
But now the clinic is back on track and in the process of applying to the National Committee for Quality Assurance (NCQA) for Level 1 recognition for PCHM in the primary care division, which has a deadline of May 2011.
Gerdes says one of the reasons for applying for medical home recognition is that it will afford the clinic the opportunity to participate in other pilots. At the time Healthcare IT News spoke to Gerdes the clinic was meeting with officials from the Texas Medical Home Initiative (TMHI), a two-year pilot, which aims to develop, implement and evaluate the PCMH primary care delivery model in Texas. The pilot, which is expected to start soon, will have physician organizations, payers and primary care practices in Texas collaborating. One of the requirements for participation is that providers are at Level 1 of the PCMH.
Ninety-five primary care providers of Trinity Clinic will be applying for Level 3 recognition, as well, says Gerdes.
This is no small feat given that the application alone can take 60-70 man-hours, she said.
The clinic is taking advantage of some of the Web resources for providers that were developed as a result of the demonstration project. For example Gerdes is a member of Delta-Exchange, an online social networking site that addresses the need for additional support through peer-to-peer learning. "It's basically Facebook for the medical home. It's not quite as sophisticated but it’s close," says McGeeney.
Gerdes says she used the Medical Home Implementation Quotient (MHIQ), a free, online self-assessment to find out where her clinic stood in the journey to becoming a medical home. Going forward she says it will be used for all primary care providers at Trinity Clinic.
Once there is a final rule on meaningful use, the MHIQ will also incorporate a "crosswalk" that will track how practices are meeting the criteria, said McGeeney.
These tools were developed as a result of the demonstration and are "perfect examples of why the demonstration project was so important," he said.
