Primary Care Medical Home Veterans Health Administration

1. Primary Care Medical Home Veterans Health Administration Joanne M. Shear MS, FNP-BC National Clinical Program Manager, Primary Care VA Central Office, Washington, DC joanne.shear@va.gov

2. Primary Care in the Veterans Health Administration Largest integrated health care system in the country Comprehensive electronic medical record 820 sites of Primary Care 152 Medical Centers 668 Community Based Outpatient Clinics (CBOC) 4.5 million primary care patients-each assigned to an individual primary care provider 12 million encounters/year Revisit rate (visits/yr): 2.5 21% had encounter in Mental Health 6.3% had admission 5,000 provider FTEE 72% physician, 20% Nurse Practitioner, 8% Physician Assistants. PCMM/VSSC data as of 5/15/09

3. VA Primary Care: Integrated Model • Mental Health Services • Comprehensive Women’s Health • Returning Combat Veterans • Traumatic Brain Injury • PTSD • Spinal Cord Injury Services • Geriatric Services • Clinical Pharmacy

4. VA Patient Centered Medical Home: 4

6. American College Physicians Home Builder assessment nationwide-completion October 2009. Start-up resources Funding to support new staffing model Team retraining and system redesign Collaboratives Medical Home including Chronic Disease Telephone Care Medical Home Learning “Colleges” Primary Care Team Dynamics Care Management and Coordination Consultation Teams Veteran-Centered Medical HomeImplementation Strategies 6 6

7. Demonstration “Laboratories” Intensive research, innovation and effectiveness evaluation Communication and Education VA Staff Primary Care Specialty Administrative Leadership Veterans Stakeholders Veteran Service Organizations Congress Public Veteran-Centered Medical Home:Implementation Strategies 7

8. Medical Home Readiness Evaluation (ACP Home Builder) September 2009 Pilot Data

9. Patient-Centered Medical Home Evaluation Institute of Medicine Dimensions of Quality

10. 10

11. 11

12. 12

13. 13

14. 14