Two Way Asychronoous Communication - EHR
The Primary Care Model of the Future
- Prevention and healing vs. testing and prescribing
- PCMH Team Care: providers and health coaches
- Encounters vs. office visits
- Pro-active Health Risk Assessments
- Technology: EHR, RelayHealth, mobile monitoring
- Address behavioral issues
- Community integration
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New Model - Blends Two Key Elements
Patient-Centered Medical Home Model
- Team-based
- Technology-enhanced and connected
- Dashboard-enabled
- Home-based hub for biometric monitoring
- Chronic Care Management
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Population Health Management Model
- Health Risk Assessment “Plus”
- Prescription for better health (shared decision model)
- Proactive outreach—keep healthy people healthy (apps, interactive tech)
- Health coaching (live, phone, virtual) to address risk factors and chronic care
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Evidence That it Works
Patient-Centered Medical Home at Walter Reed
- Reduced ER visits by 6.8%
- Decreased pharmacy costs by 12.9%
- Achieved $333 annual cost reductions for chronic care patients
- Improved HEDIS (quality) scores, as well as access and patient trust
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