Online Program

Evaluating patient-centered medical homes transformation in broward county, Florida

Tuesday, November 5, 2013

Nicole Cook, PhD, MPA, Master of Public Health Program, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL
T. Lucas Hollar, PhD, Master of Public Health Program, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL
Michael De Lucca, MHM, President and CEO, Broward Regional Health Planning Council, Hollywood, FL
Teina Phillips, MPA, Transforming Our Community's Health: TOUCH Program Director, Broward Regional Health Planning Council, Inc., Hollywood, FL
David Quinn, BS, MPH, Master of Public Health Program College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale-Davie, FL
Background: Nearly 20% of adults in Broward County (BC), Florida, the nation's 18th most populous county, have no health insurance. Un/underinsured persons have greater barriers to care, higher rates of chronic disease and poorer health outcomes than their insured counterparts. Primary-care health system reform includes patient-centered medical home (PCMH) transformation, which has shown promise for improving health outcomes and demonstrating cost-savings. BC's “Transforming Our Community's Health” initiative, funded through a CDC Community Transformation Grant, is developing PCMHs in 35 primary-care clinics serving un/underinsured populations.

Description: PCMH model was selected for focused evaluation based on its potential to transform care delivery among un/underinsured populations. We initially developed a comprehensive evaluation utilizing PCMH standards, clinical measures, and cost measures. As we learned more about the clinics and their disparate technology and preparedness for transformation, we discovered that our evaluation plan would produce findings of limited use. We reconstructed our evaluation to provide value for the community, and collaboratively developed a mixed-methods evaluation of PCMH readiness and implementation.

Lessons Learned: To better understand current-state PCMH and inform on future transformation activities, we revised our evaluation plan to incorporate organizational culture, patient experience, and identification of promising practices. In place of the intended quantitative evaluation, we developed a mixed-methods formative and process evaluation which incorporates semi-structured interviews, patient experience surveying and on-site observation. Conclusion: We will present a community-informed mixed-methods approach for evaluating PCMH transformation that provides useful information for safety-net clinics. We will present the tools and findings from our analysis underway.

Learning Areas:

Administration, management, leadership
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Public health or related research

Learning Objectives:
Formulate a community-informed mixed-methods evaluation of PCMH implementation and transformation activities. Identify best practices for evaluating opportunities and challenges facing providers implementing PCMH and transforming their practices. Assess potential organizational or systemic challenges to successfully implementing PCMH transformation in primary care clinics, particularly safety-net providers that serve disadvantaged and underserved communities.

Keyword(s): Community Health Centers, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Assistant Professor of Public Health at Nova Southeastern University where I teaches epidemiology and works with the healthcare community on several ongoing projects related to community health. Prior to this, I was employed at Health Choice Network, a national network of FQHCs for eight years, where I led national, state and local initiatives in chronic disease management, behavioral health, school health, cancer prevention, technology-supported quality improvement and PCMH preparedness.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.