The National Committee for Quality Assurance (NCQA) recently recognized seven primary care practices at Rush as medical homes: physician practices that focus on ongoing health improvement rather than episodic care.
The NCQA's prestigious Physician Practice Connections-Patient Centered Medical Home (PPC-PCMH) level 3 designation — the highest possible level of recognition — put these practices in an elite group: They are among the first practices at an academic medical center in Illinois to receive this distinction.
"This is probably the biggest thing that's happened in primary care in the 20 years I've been here," says David Buyer, MD, medical director of physician services for primary care, who played a significant role in the yearlong collaborative process of applying for the designation.
These practices include the following:
Associates in Internal Medicine
Lifetime Medical Associates
Rush Pediatric Primary Care
Rush University Family Physicians
Rush University Physicians at Lincoln Park
Rush University Senior Care
West Loop University Medicine
Over the course of this process, all seven practices re-engineered their delivery of care, using technology and resource sharing to enhance their team-based approach to patient care and create a true medical home for patients. This high quality and efficiency resulted from adjustments that engendered the following enhancements to care:
- Physicians use newly developed templates to document patient goals, progress and education at each visit.
- Practices use a Web-based patient registry developed by Rush Health, which organizes patient data and presents information in a format that helps clinicians understand patient patterns, identify high-risk patients in need of care and appropriately allocate resources.
- Dedicated nurses support care coordination, contacting patients who need preventive care or encouragement to schedule office visits.
- Rush University College of Nursing's advanced practice nursing students participate in outreach to patients, care coordination and patient exams.
- The Rush Health and Aging program provides social work services for elderly patients.
Together, these enhancements have already begun to help improve patients' health. At Lifetime Medical Associates, for example, staff used the Web-based patient registry to identify a patient with diabetes whose hyperglycemia required immediate attention. Because the patient had not scheduled an appointment, they reached out to him and suggested that he visit the practice.
There, a team that included a physician, a nurse and a certified diabetic educator met with him several times over the course of a few weeks to help him change his diet and adjust his medications appropriately. After two months, his blood sugar had dropped by about 50 percent.
He wasn't alone. Norman Ryan, MD, senior medical director for performance improvement at Rush Health, says that cholesterol levels in heart disease patients and blood sugar levels in diabetic patients have improved significantly across the seven participating practices over the past seven months. Emergency room visits among these practices' patients have also decreased.
"We've built a new and improved foundation for the future delivery of health care," Ryan says.
*West Loop University Medicine is a private practice with a location at Rush.