Online Program

Helping federally qualified health centers to meet patient centered medical home standards

Monday, November 4, 2013 : 11:30 a.m. - 11:45 a.m.

Sarah Krasny, BA, BS, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, TX
Bijal Balasubramanian, MBBS, PhD, Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center Houston School of Public Health, Dallas, TX
Shuting Liang, MPH, Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston, Houston, TX
Maria E. Fernandez, PhD, Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX
Background NCQA's Patient-Centered Medical Home (PCMH) standards require primary care practices to use electronic health records (EHR) to improve quality of care. My Own Health Report (MOHR) is a web-based tool that collects patient-reported measures and allows primary care physicians to routinely screen patients for behavioral (e.g., physical activity, nutrition, substance abuse) and mental health conditions. Federally Qualified Health Centers (FQHCs) that are already PCMHs or are seeking PCMH recognition are well positioned to benefit from integrating MOHR into their EHR system to manage and track patient health over time. Methods The NCI, AHRQ, and the NIH Office of Behavioral and Social Sciences Research are working with 8 academic partners to implement the MOHR project in 18 primary care clinics. Eight of the clinics are FQHCs while the other 10 are Practice-Based Research Networks. The MOHR project is a paired, clinic-level randomized pragmatic trial (9 intervention and 9 control clinics) where the control clinics will make up a delayed intervention group. The trial will begin March 2013. The 9 early intervention clinics will integrate MOHR into their normal workflow over a period of 4 months. Patient experience surveys will be administered to at least 150 patients per clinic to assess the impact of MOHR on the quality of patient-provider communication and behavior change counseling between the intervention and control sites. Factors associated with adoption and use of MOHR will be evaluated using a mixed-methods approach that includes collecting process evaluation, contextual, and cost data. Results The extent to which MOHR allows FQHCs to meet PCMH standards such as demonstrating continuous quality improvement and conducting comprehensive health assessments will be reported. We will also share individual and organizational factors that influenced the capacity of FQHCs to integrate MOHR into their EHR system in a meaningful way. We will report on how clinicians used MOHR as a foundation for behavior change and goal setting discussions. In addition, we will discuss how FQHCs used the patient-reported data generated through MOHR to plan, manage and coordinate patient care, especially for patients with chronic illnesses. Conclusion Routine collection of patient-reported measures is important to achieving high quality, patient-centered care. My Own Health Report is a tool that clinicians can use to counsel patients about behavioral and mental health issues in a meaningful way. This is especially important for FQHCs that are trying to provide comprehensive preventive services to patients through the PCMH model.

Learning Areas:

Administer health education strategies, interventions and programs
Chronic disease management and prevention
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Discuss how My Own Health Report helps FQHCs to meet their goal of becoming Patient Centered Medical Homes Describe how My Own Health Report influences patient care in primary care settings such as FQHCs Explain how My Own Health Report helps FQHCs meet opportunities and challenges in the Affordable Care Act Discuss how My Own Health Report is tailored to fit the organizational needs of FQHCs

Keyword(s): Primary Care, Health Behavior

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: My Own Health Report is currently under investigational use. Based on the results of the study it will be disseminated to other primary care practices and public health researchers.

Qualified on the content I am responsible for because: I have been responsible for implementing the My Own Health Report (MOHR) tool in a Federally Qualified Health Center in Houston, Texas as part of the national MOHR pragmatic trial. I work with providers, staff and administrators to ensure that the tool is successfully integrated into the clinic's workflow. My scientific interests include primary care health services research and chronic disease prevention.
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.