The “Adjust” from the Advisory Group: Part I

Eytan-Pchit-Advisory Group

PCHIT Advisory Group – Slides

This post is first in a series will summarize our status and input from our Advisory Group (Blogs are about a little information at a time). Both the Group and this audience are welcome to comment. Our goal is to make any adjustments necessary, now, and continually improve our process as we do this.

The summary comes in the form of an “A3” document and a short set of slides. The slides are published here.

A reminder that an A3 document really just outlines a story. It’s probably best for this medium for me to discuss the work of each Advisory Group member (with the exception of Patricia Flatley Brennan, who could not be with us this first time) and the impact on adjusting our work.

To also keep this manageable, I’ll do it over the course of the week, one each day.

Michael Barr, MD, MBA, FACP: Michael, as Vice President of Practice Advisory and Improvement for the American College of Physicians, is leading the Medical Home work of the College. This includes establishing the “systemness” of the Medical Home, as well as understanding the economics of the Medical Home. He is working with payers to establish the benefit to patients and ability of Medical Home to address self-management goals. As currently devised, this model is most effective in practices where there are longitudinal relationships, such as primary care, but also in specialty care in certain circumstances. Several demonstration projects are set to begin in 2008. The College’s Center for Practice Innovation has been working with small practices to transform them, in line with Medical Home principles. The ACP is heavily involved in technology issues, at the level of some delivery systems. Finally, we are alerted to the publication of a white paper in the Annals of Internal Medicine on payment methodologies.

Adjustment: The impact of Medical Home discussions locally and nationally is very clear, and observations in PCHIT should be connected to Medical Home principles. Ted Eytan is presenting at the CPI conference in Washington, DC, on November 17 and will be spending time with CPI staff and practices as part of this involvement. The ACP white paper will be reviewed by us as well for implications for PCHIT.

1 Comment

Michael's insights are critically important because we have to think creatively about new reimbursement models that suppport longitudinal care and continuity of care in order to provide appropriate incentives for clinicians to deliver patient-centered care. The PCMH model that ACP (and many other primary care-advocacy organizations and purchasers) has developed offers a creative alternative to the historical medical reimbursement approach that primarily rewards providers for what they "do to" people.

One issues that Michael and I have discussed in the past is how information prescribing and related patient-centered informational interventions can be more explicitly written into the PCMH model. As we develop PCHIT's recommendations going forward, I look forward to working with Michael and his colleagues in thinking about how to more explicitly structure that guidance to PCMH-oriented clinicians (see my comment in response to "Advisory Group Adjust: Charles Milligan, Jr…" for a quick summary of how the Ix Payer Workgroup hopes to help in that regard).


Ted Eytan, MD