Wednesday, December 1, 2010

Redesigning Primary Care

The University of Utah’s Department of Family and Preventative Medicine (DFPM) and the University’s Health Care Community Clinics are collaborating with the David Eccles School of Business, the Department of Economics, and the College of Pharmacy to help redesign primary healthcare for today’s doctors and patients.

With the aid of three new federal grants totaling $4.5 million, they are implementing changes in two key areas. They are going to find ways to use information technology to help the university community clinic physicians better manage chronic diseases and secondly educate patients so people can do a better job controlling their overall health.

Rob Lloyd, Executive Director of the University’s community clinics, said, “Our community clinics are uniquely suited to participate in this innovative project. As an academic healthcare system, part of our mission is to improve the way healthcare is delivered.”

The funding awarded through HHS includes the “Beacon Community Cooperative Agreement”. The Beacon grant program was set up to build and strengthen health IT. The University’s grant was awarded as a subcontract of the $16 million Utah Beacon Cooperative Agreement being led by HealthInsight, a Salt Lake City-based non-profit.

The Beacon Community Grants will focus on using information technology to improve care for a group of patients with diabetes. The funds totaling $960,000 will enable the University community clinics to join a statewide computer information exchange and more care managers will be hired to ensure that patients with diabetes receive the care they need.

Two other grants “Transformed Primary Care—Care by Design” and “Primary Care Practice Redesign—Successful Strategies” both awarded through AHRQ for $3.5 million, will not only help the University’s community clinics expand their present diabetes care-management plan, but also help evaluate and expand “Care by Design”, a new approach to primary care that the clinics put in place in 2004.

This new “Care by Design” approach uses an integrated system in which acute, chronic and preventive care is overseen by a team of providers, including a primary care physician, nurses, physician assistants, pharmacists, medical assistants, and others as needed. Each team member fills a specific role and gives patients more personalized care while allowing physicians more time to discuss preventive care and other issues that can make long-term impacts on a patient’s health.

Patient education is integral to the “Care by Design” program, so community clinics are going to use grant funds to expand the patient education program started several years ago. For example, the health centers will continue to provide education at meetings so that patients with similar chronic illnesses will be able to meet with nurses, pharmacists, physicians, and others to learn how to better manage their conditions through diet, exercise, or in other ways.

The AHRQ grant funding will also help the community clinics evaluate how effective their changes are in providing primary care. The clinics are also going to undertake comparative effectiveness research to look at different healthcare treatments and find the therapies that have the best patient outcomes.