November 30, 2017

Inside one Nebraska clinic's transition to a patient-centered medical home

Daily Briefing

    To improve patients' primary care, Midwest Regional Health Services in Nebraska adopted a patient-centered medical home model—and the results were so impressive the organization created a consulting branch to help other independent practices transition to the model.  

    Are patient-centered medical homes living up to the hype?

    Clinic details

    The clinic, which has two locations in Nebraska, is part of the Nebraska Health Network, which includes roughly 1,500 doctors within Nebraska Medicine, Methodist Health System, and Fremont Health.  

    According to the Omaha World-Herald, Midwest Regional became the first clinic in the state to receive the highest level of certification from the National Committee on Quality Assurance in 2010. The clinic takes a team-based approach to improve care coordination, patient engagement, access to care, and disease prevention.  

    The clinic offers patients typical primary care services—such as immunizations, mammograms, and skin cancer checks—plus unconventional perks, like manicures on the clinic's popular "ladies' day," the World-Herald reports. Midwest Regional also hosts special days for diabetic patients to undergo preventive care, including annual diabetic eye and foot checks, and to develop personalized treatment plans. Similarly, the clinic runs healthy living groups centered on diet and exercise. The clinic's first group of 13 patients lost 66 pounds over the course of 12 weeks.

    Shelley Henderson, Midwest Regional's business manager, said the clinic relies on the broad range of skills among the clinic's staff—making full use of their licenses and calling on them to share their ideas and talent. For instance, the clinic has trained all its staff on how to care for certain diseases, such as diabetes, based on Midwest Regional's standardized care plan. In particular, under the clinic's standardized care plans for diabetic patients, staff must ask such patients who are not achieving health-related goals to come back to the clinic every four to six weeks until they meet those goals.

    Patients are not the only ones held accountable for quality goals, the World-Herald reports. Midwest Regional also posts physicians' quality measure scores on the waiting room wall, which has led to conversation about best practices and better accountability.

    Donald Darst, the president of Midwest Regional Health Services, said, "If we're asking patients to be accountable to us for their lives, then we need to be accountable to them for their results."

    Clinic sees positive results

    Darst said the health of patients has improved since adopting the medical home model.

    For instance, under the model, Midwest Regional reported today:

    • 86% of patients receive colonoscopies on time, compared with 46% in 2010;
    • 62% of diabetic patients receive an annual eye exam to check for early retina damage, compared with 34% in 2010;
    • 60% of diabetic patients have their blood sugar under control, compared with 43% in 2010; and
    • 40% of patients receive mammograms on time, compared with 20% in 2010.

    And the clinic aims to share these improvements with others. Lee Handke, CEO of the Nebraska Health Network, said Midwest Regional has started a consulting arm, called Celtic Healthcare Solutions, to help other independent practices implement the model—which Darst said is "about taking care of the patients and helping them take care of themselves" (Anderson, Omaha World-Herald, 11/27).

    Next, get our Medical Neighborhood Primer

    It's always good to do a gut-check and make sure that what you're working on—and spending your money on—is working running the way you want. But if your PCMH is seeing the positive outcomes outlined above, what is the next step? Check out our Medical Neighborhood Primer to find out.

    Get the Primer

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