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Although efforts to transform primary care are in their early stages, organizations are taking steps to change care delivery and measure and report their progress during the journey.
“When patients are chronically unwell, healthcare assessment and intervention must be tailored to each patient’s unique needs,” he writes. “Without considering a patient’s residential environment, working conditions, social and spiritual support systems (or the lack of them), and the behavioral context of illness, the medical interventions that support disease management will often be ineffective.”
For example, he says in some states, Kaiser Permanente deploys a dermatologist to do approximately 100 consults each day, while working in concert with primary care providers via an electronic interface. The end result? In-person specialist consults are available to the most complex, unstable patients, he writes.
It’s processes--rather than people--that serve as the most daunting barriers to improving primary care, according to Harvey, whose organization embraces the Balanced Score methodology to capture what he calls “Triple Aim Plus One” and financial performance measures. Incorporating the well-being of healthcare providers, Triple Aim Plus One--often referred to as the Quadruple Aim--at Martin Point Healthcare means that executives set measures and targets each year--and those become goals at the nonprofit’s primary care practices.
Key to his team’s success, writes Harvey, is transparent reporting of all measures--including individual providers' performance and patient experience metrics. Martin Point Healthcare matches up high-performing clinicians with their peers who need coaching to attain improvement on these measures.
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