Medical Home: Activities
The overall goal for this work group is to develop effective partnerships to further Medical Home practices in the region.
Accomplishments The work group formed in the spring of 2008. A diverse group (including primary care physicians, Medical Home experts, regional newborn screening program professionals, specialists from metabolic disease practices, and individuals dealing with an inherited condition) was brought together to increase the understanding and utilization of Medical Home practices in the region. The group continues to expand its membership, furthering the reach and goals of the work group.
In collaboration with the Medical Home work group, Chris Stille, MD, MPH, has developed a care coordination tool for use with specialists, families and the primary care medical home. The development of this tool was funded through the NEGC Innovative Grant funds. The tool is a one-page form which is completed during physician (specialists and primary care) office visits. When completed, there is documentation of the concerns, treatments and follow-up, identifying who will take the lead in each area. This greatly enables the communication among the clinicians and empowers the families. Current Work Click here to read about the current Family Care Plan project and download the form! Field testing of the care coordination the tool will continue in 2 specialty clinics with 10 patients/families. This research will collect information related to the number of plans implemented and the number of office visits documented.
The work of the Medical Home work group will continue to integrate with that of the Transition work group through joint meetings. The care coordination tool has already been adapted for use in Transition by Dr. Waisbren.
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