Northwest Health | WINTER 2009 By Ginny Smith

WHAT'S NEW

A Stronger Relationship With Your Doctor

"Medical home" approach to care recognizes changing patient needs

When Group Health leaders asked clinicians at Factoria Medical Center to envision the perfect patient experience two years ago, it wasn't a tough assignment. Clinicians wanted to reduce the number of patients they cared for so they could give each patient more attention. They wanted to be even more readily available to patients via e-mail and phone. They wanted to be more proactive in following up with patients.

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The feedback led to Group Health's first patient-centered "medical home," a two-year pilot completed last month. "Personal physicians at Factoria are partnering with their patients to manage all aspects of the patients' medical care — from preventive care and healthy lifestyles to specialty care and hospitalization," says Michael Soman, MD, Group Health's chief medical executive.

Concept is a natural for Group Health. The medical home approach is growing in popularity nationwide as a potential way to deal with unwieldy patient loads and the declining number of primary care physicians. The model also recognizes changing demographics: More patients need help managing chronic conditions rather than needing occasional care for acute problems.

While many aspects of medical homes can be adopted anywhere, Group Health offers several advantages, says Dr. Soman. "We are a multispecialty physician group and we offer health plans, so we already provide a comprehensive, integrated approach to care. And we already have a sophisticated electronic clinical information system that makes it easy to share information with doctors throughout our system."

The making of a medical home.The first step in establishing the Factoria medical home was to trim physicians' workloads by adding the equivalent of one-and-a-half doctors to the staff. Personal physicians now average 12 to 14 patient visits per day, down nearly 50 percent. They are freed up to quickly respond to patients via e-mail or phone, and can thoroughly address care and prevention needs with longer patient appointments.

Good results promise expansion in near future. Preliminary results from the medical home pilot are positive, says Dr. Soman. "We're seeing that when patients get more care from their personal physician, they need less care elsewhere — especially in the emergency department and hospital. Patients, physicians, and the entire clinical team report more satisfaction."

"This year, another physician group in Seattle will establish a medical-home clinic," says Primary Care Administrator Michael Erikson, "and one health care provider in our region hopes to have a couple of pilot programs in place as well. In comparison, Group Health plans to implement more than 20 additional medical homes in Puget Sound in 2009 and early 2010, and then move on to our Eastern Washington medical centers. We're definitely ahead of the curve on this innovative approach to care."