Primary Care: The Opportunities & You

S

Primary Care: The Opportunities

& YouPrimary Care Progress

Agenda

Define primary healthcare and identify the value it creates

Explore how primary care is being transformed

Introduce you to innovators who are reinventing the field

Help you envision a role for yourself in this field

What is PRIMARY CARE, anyway?

“Primary care is the provision of accessible, integrated health care services by clinicians who are accountable for:• addressing a large majority of personal health care

needs

• developing a substantial partnership with patients

• practicing in the context of family and community”- The Institute of Medicine, 1996

Primary Care Re-imagined

Meet MJ

Meet MJ

MJ Today

Ideal Acute Care

Access

Care based in longitudinal relationships

Appropriate treatment

Use of IT & EBM

Care coordination

Ideal Chronic Care

.

Ideal Chronic Care

Enhanced access

Evidence based treatment

Education and empowerment

Team-based cared

Care coordination

Ideal vs Reality

Patient centered

Team based

Coordinated

Proactive

Doctor centered

Siloed

Fragmented

Reactive

POOR ORGANIZATION

The Patient-Centered Medical Home

New models of care focusing on: Patient-centeredness Collaboration Comprehensive care Accessibility Coordination Extensive use of IT & EMR Accountability

The Patient’s Experience

Video follows…

The Health Professional’s Experience

Video follows…

Far From Perfect

Patients receiving only 55% of recommended care

Rates of proving clinical preventive services are low 55% of routine screening tests 24% immunizations 9% of health-habit counseling servicesMcGlynn EQ et al. NEJM 2003;348:2635-2645

Stange KC et al. Prev Med. 2000;31:167-176

Far From Perfect

“Every system is perfectly designed to produce the results it gets.”

- Donald Berwick

Change is Afoot

Supportive multi-stakeholder coalition

New health law Increased payment to primary care providers Innovation grants Expanded training programs

Why the change in support?

Current system is bankrupting us

Despite high spending, we receive poor value

We need a robust primary care foundation!

Value added by Primary Care

Increased quality & decreased overall spending

Improved patient satisfaction

Increased provision of appropriate preventive services

Decreased use of Emergency Department resources

Fewer hospital admissionsO’Malley AS, et al. Arch Intern Med 1997;157(13)

Saultz JW, et al. Ann Fam Med 2004;2(5): 445-51

Petersen LA, et al. Med Care 1998;36(8): 1249-55

Medicare claims data; and Area Resource File, 2003

S

We all have our own stories

The Field is Reinventing Itself…

This is a work in progress

We’re incorporating ideas from outside of medicine

We’re harnessing the true potential of the workforce

Clinical Innovation

Video follows…

Wonderful Opportunity for Trainees

To bring trainees’ fresh perspectives and unique skills to bear

To add tremendous value

To craft a fulfilling career

Network of Primary Care providers and trainees Promote primary care in local communities Engage next generation in reinventing how we deliver care and train

providers

Get Involved! Promote primary care via Primary Care Speakers Bureaus Help reshape local primary care delivery via Primary Care Innovation

Collaboratives (PCIC) that pair students with clinician-innovators Participate in primary care curriculum reform to identify new skills and

competencies for successful practice.

Visit our website PrimaryCareProgress.org or find us on Facebook/Twitter

Challenges We Face

An increasing demand for primary care services while our supply of providers is shrinking.

Questionable quality of services rendered

Dysfunctional reimbursement system

New health law adds millions of new patients who need primary care

Where Primary Care Is Robust, Quality Is Higher

Where Primary Care Is Robust, Spending Is Lower