Guest guest Posted April 26, 2010 Report Share Posted April 26, 2010 What's the URI Jean? Jama article today about The patient centered medical home movement - why nowGood stuffBasically I take this as 2 folks form Group Health in Washington touting their own stuff- rightfully so It is IMP stuff! They report that by reducing panels size, increasing the length of visits, and building care around a care based relationship with increases in phone and email follow up doing previsit chart reviews etc they were able to improve the patient experience of care , clinical work experience as well, and they had fewer er visits and urgent care visits(lower costs which made up for the longer visits) DUH! They are clear that for such a model to be broadly successful someone must " rethink reimbursmetn as well as adress resouce use " DUh These guys are honorary IMPS. NOw how do we get anyone else to listen especially those folks who might " redesign reimbursment " PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 beats me:) JAma April 28 2010 Vol 303 No16 p 1644- 1645 Larson and Reid What's the URI Jean? Jama article today about The patient centered medical home movement - why nowGood stuffBasically I take this as 2 folks form Group Health in Washington touting their own stuff- rightfully so It is IMP stuff! They report that by reducing panels size, increasing the length of visits, and building care around a care based relationship with increases in phone and email follow up doing previsit chart reviews etc they were able to improve the patient experience of care , clinical work experience as well, and they had fewer er visits and urgent care visits(lower costs which made up for the longer visits) DUH! They are clear that for such a model to be broadly successful someone must " rethink reimbursmetn as well as adress resouce use " DUh These guys are honorary IMPS. NOw how do we get anyone else to listen especially those folks who might " redesign reimbursment " PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR. -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 How large were panel sizes? You cannot do all this w panel of 2000 or even 1000. Sent from my iPhone Jama article today about The patient centered medical home movement - why nowGood stuffBasically I take this as 2 folks form Group Health in Washington touting their own stuff- rightfully so It is IMP stuff! They report that by reducing panels size, increasing the length of visits, and building care around a care based relationship with increases in phone and email follow up doing previsit chart reviews etc they were able to improve the patient experience of care , clinical work experience as well, and they had fewer er visits and urgent care visits(lower costs which made up for the longer visits) DUH! They are clear that for such a model to be broadly successful someone must "rethink reimbursmetn as well as adress resouce use" DUh These guys are honorary IMPS. NOw how do we get anyone else to listen especially those folks who might "redesign reimbursment" PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 I believe JAMA's policy is to wait until 1 week after the print edition has been published before posting content online. So we will have to wait unless someone wants to scan the article and post that. SetoSouth Pasadena, CA beats me:) JAma April 28 2010 Vol 303 No16 p 1644- 1645 Larson and Reid On Mon, Apr 26, 2010 at 5:53 PM, Graham Chiu <compkarorigmail> wrote: What's the URI Jean?On Tue, Apr 27, 2010 at 9:25 AM, <jnantonuccigmail> wrote: Jama article today about The patient centered medical home movement - why nowGood stuffBasically I take this as 2 folks form Group Health in Washington touting their own stuff- rightfully so It is IMP stuff! They report that by reducing panels size, increasing the length of visits, and building care around a care based relationship with increases in phone and email follow up doing previsit chart reviews etc they were able to improve the patient experience of care , clinical work experience as well, and they had fewer er visits and urgent care visits(lower costs which made up for the longer visits) DUH! They are clear that for such a model to be broadly successful someone must "rethink reimbursmetn as well as adress resouce use" DUh These guys are honorary IMPS. NOw how do we get anyone else to listen especially those folks who might "redesign reimbursment" PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR. -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Do you live next door to the JAMA publishers?April 28 edition isn't even online yet!http://jama.ama-assn.org/Current Issue: Vol. 303, No. 15, April 21, 2010 Dr DeAngelis, Editor in Chief of JAMA, summarizes and comments on this week's issue. You can also subscribe to the podcast or download the audio files. This Week in JAMA Free Full Text Original Contributions Caloric Sweetener Consumption and Dyslipidemia Among US Adults Free Full Text | JAMA Report Video Spoken Language Development in Children Following Cochlear Implantation Abstract | Full Text | eSupplement | Interactive Graphs Association of Maternal Stature With Offspring Mortality, Underweight, and Stunting in Low- to Middle-Income Countries Abstract | Full Text | eTables and eFigures | Interactive Information Graphic Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States Abstract | Full Text | eTable Locke, MD beats me:) JAma April 28 2010 Vol 303 No16 p 1644- 1645 Larson and Reid What's the URI Jean? Jama article today about The patient centered medical home movement - why nowGood stuffBasically I take this as 2 folks form Group Health in Washington touting their own stuff- rightfully so It is IMP stuff! They report that by reducing panels size, increasing the length of visits, and building care around a care based relationship with increases in phone and email follow up doing previsit chart reviews etc they were able to improve the patient experience of care , clinical work experience as well, and they had fewer er visits and urgent care visits(lower costs which made up for the longer visits) DUH! They are clear that for such a model to be broadly successful someone must " rethink reimbursmetn as well as adress resouce use " DUh These guys are honorary IMPS. NOw how do we get anyone else to listen especially those folks who might " redesign reimbursment " PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR. -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 Yeah we a re tight . I dunno i go to the mailbox on Mondays and there it is the panel sizes were taken down TO 1800 from i think 2300.Obviously these guys are not iMPS they have staff to do followup and other stuff This was not an article per se it was a 2 ok 1.5 page commentary but it hit the nail on the head( there wasn;t data on how much was saved in er use..etc They just said that justifed the cost of changes they made in the offices.. What I thought wa s interesting was that this was an a article on Patient center medical homes that talked about Patient Homes without NCQA, blue ribbons, metrics and certiifcates of achievement It was straight on basic- see th e patietn for longer, have followup , etc basic primary care 101 Continuity access efficiency comprehensive care over time DUH( Someone named wrote about this in 2002 in FPM. " the practice has memory of the patient. " )I will try to scan it and send in the AM Do you live next door to the JAMA publishers?April 28 edition isn't even online yet!http://jama.ama-assn.org/Current Issue: Vol. 303, No. 15, April 21, 2010 Dr DeAngelis, Editor in Chief of JAMA, summarizes and comments on this week's issue. You can also subscribe to the podcast or download the audio files. This Week in JAMA Free Full Text Original Contributions Caloric Sweetener Consumption and Dyslipidemia Among US Adults Free Full Text | JAMA Report Video Spoken Language Development in Children Following Cochlear Implantation Abstract | Full Text | eSupplement | Interactive Graphs Association of Maternal Stature With Offspring Mortality, Underweight, and Stunting in Low- to Middle-Income Countries Abstract | Full Text | eTables and eFigures | Interactive Information Graphic Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States Abstract | Full Text | eTable Locke, MD beats me:) JAma April 28 2010 Vol 303 No16 p 1644- 1645 Larson and Reid What's the URI Jean? Jama article today about The patient centered medical home movement - why nowGood stuffBasically I take this as 2 folks form Group Health in Washington touting their own stuff- rightfully so It is IMP stuff! They report that by reducing panels size, increasing the length of visits, and building care around a care based relationship with increases in phone and email follow up doing previsit chart reviews etc they were able to improve the patient experience of care , clinical work experience as well, and they had fewer er visits and urgent care visits(lower costs which made up for the longer visits) DUH! They are clear that for such a model to be broadly successful someone must " rethink reimbursmetn as well as adress resouce use " DUh These guys are honorary IMPS. NOw how do we get anyone else to listen especially those folks who might " redesign reimbursment " PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR. -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 The money is in the system. How much more money would be left to pay the doctors if they got rid of the endless admin stuff and stream lined it and got rid the cut taken for profit. We could get paid by the hour, instead of by what. Yeah we a re tight . I dunno i go to the mailbox on Mondays and there it is the panel sizes were taken down TO 1800 from i think 2300.Obviously these guys are not iMPS they have staff to do followup and other stuff This was not an article per se it was a 2 ok 1.5 page commentary but it hit the nail on the head( there wasn;t data on how much was saved in er use..etc They just said that justifed the cost of changes they made in the offices.. What I thought wa s interesting was that this was an a article on Patient center medical homes that talked about Patient Homes without NCQA, blue ribbons, metrics and certiifcates of achievement It was straight on basic- see th e patietn for longer, have followup , etc basic primary care 101 Continuity access efficiency comprehensive care over time DUH( Someone named wrote about this in 2002 in FPM. " the practice has memory of the patient. " )I will try to scan it and send in the AM Do you live next door to the JAMA publishers?April 28 edition isn't even online yet!http://jama.ama-assn.org/ Current Issue: Vol. 303, No. 15, April 21, 2010 Dr DeAngelis, Editor in Chief of JAMA, summarizes and comments on this week's issue. You can also subscribe to the podcast or download the audio files. This Week in JAMA Free Full Text Original Contributions Caloric Sweetener Consumption and Dyslipidemia Among US Adults Free Full Text | JAMA Report Video Spoken Language Development in Children Following Cochlear Implantation Abstract | Full Text | eSupplement | Interactive Graphs Association of Maternal Stature With Offspring Mortality, Underweight, and Stunting in Low- to Middle-Income Countries Abstract | Full Text | eTables and eFigures | Interactive Information Graphic Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States Abstract | Full Text | eTable Locke, MD beats me:) JAma April 28 2010 Vol 303 No16 p 1644- 1645 Larson and Reid What's the URI Jean? Jama article today about The patient centered medical home movement - why nowGood stuffBasically I take this as 2 folks form Group Health in Washington touting their own stuff- rightfully so It is IMP stuff! They report that by reducing panels size, increasing the length of visits, and building care around a care based relationship with increases in phone and email follow up doing previsit chart reviews etc they were able to improve the patient experience of care , clinical work experience as well, and they had fewer er visits and urgent care visits(lower costs which made up for the longer visits) DUH! They are clear that for such a model to be broadly successful someone must " rethink reimbursmetn as well as adress resouce use " DUh These guys are honorary IMPS. NOw how do we get anyone else to listen especially those folks who might " redesign reimbursment " Jean -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- Graham Chiuhttp://www.compkarori.co.nz:8090/ Synapse - the use from anywhere EMR. -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined. This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2010 Report Share Posted April 27, 2010 The endless admin stuff is necessary. Without it, physicians and patients would be spending even more of other people's money and there'd be even less money available for necessary care. Until we admit that we need to ration third party care, the admin stuff, high deductibles and copays are the only brakes on that part of the system. As for profit, I'd much rather deal with profit seeking Anthem than nonprofit Medicare or Medicaid. My profit making mechanic, carpenter and supermarket aren't particularly overpriced either. Back to the article, I'm looking forward to see IMP ideas kicked around in JAMA but I don't have a copy yet at the office. How does Farmington get mail so quickly? The money is in the system. How much more money would be left to pay the doctors if they got rid of the endless admin stuff and stream lined it and got rid the cut taken for profit. We could get paid by the hour, instead of by what. On Mon, Apr 26, 2010 at 5:20 PM, Jean Antonucci <jnantonuccigmail> wrote: Yeah we a re tight . I dunno i go to the mailbox on Mondays and there it is the panel sizes were taken down TO 1800 from i think 2300. Obviously these guys are not iMPS they have staff to do followup and other stuff This was not an article per se it was a 2 ok 1.5 page commentary but it hit the nail on the head( there wasn;t data on how much was saved in er use..etc They just said that justifed the cost of changes they made in the offices.. What I thought wa s interesting was that this was an a article on Patient center medical homes that talked about Patient Homes without NCQA, blue ribbons, metrics and certiifcates of achievement It was straight on basic- see th e patietn for longer, have followup , etc basic primary care 101 Continuity access efficiency comprehensive care over time DUH ( Someone named wrote about this in 2002 in FPM. "the practice has memory of the patient.") I will try to scan it and send in the AM On Mon, Apr 26, 2010 at 7:29 PM, Locke <lockecoloradogmail> wrote: Do you live next door to the JAMA publishers? April 28 edition isn't even online yet! http://jama.ama-assn.org/ Current Issue: Vol. 303, No. 15, April 21, 2010 Dr DeAngelis, Editor in Chief of JAMA, summarizes and comments on this week's issue. You can also subscribe to the podcast or download the audio files. This Week in JAMA Free Full Text Original Contributions Caloric Sweetener Consumption and Dyslipidemia Among US Adults Free Full Text | JAMA Report Video Spoken Language Development in Children Following Cochlear Implantation Abstract | Full Text | eSupplement | Interactive Graphs Association of Maternal Stature With Offspring Mortality, Underweight, and Stunting in Low- to Middle-Income Countries Abstract | Full Text | eTables and eFigures | Interactive Information Graphic Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States Abstract | Full Text | eTable Locke, MD On Mon, Apr 26, 2010 at 4:04 PM, Jean Antonucci <jnantonuccigmail> wrote: beats me:) JAma April 28 2010 Vol 303 No16 p 1644- 1645 Larson and Reid On Mon, Apr 26, 2010 at 5:53 PM, Graham Chiu <compkarorigmail> wrote: What's the URI Jean? On Tue, Apr 27, 2010 at 9:25 AM, <jnantonuccigmail> wrote: Jama article today about The patient centered medical home movement - why now Good stuff Basically I take this as 2 folks form Group Health in Washington touting their own stuff- rightfully so It is IMP stuff! They report that by reducing panels size, increasing the length of visits, and building care around a care based relationship with increases in phone and email follow up doing previsit chart reviews etc they were able to improve the patient experience of care , clinical work experience as well, and they had fewer er visits and urgent care visits(lower costs which made up for the longer visits) DUH! They are clear that for such a model to be broadly successful someone must "rethink reimbursmetn as well as adress resouce use" DUh These guys are honorary IMPS. NOw how do we get anyone else to listen especially those folks who might "redesign reimbursment" Jean -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- Graham Chiu http://www.compkarori.co.nz:8090/ Synapse - the use from anywhere EMR. -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!) Email is best used for appointment making and brief questions Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org -- M.D. www.elainemd.com Office: Go in the directions of your dreams and live the life you've imagined. This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error. Quote Link to comment Share on other sites More sharing options...
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