Primary Care Medical Home Veterans Health Administration

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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_at_va.gov

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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
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VA Primary Care Integrated Model

• Mental Health Services
• Comprehensive Womens Health
• Returning Combat Veterans
• Traumatic Brain Injury
• PTSD
• Spinal Cord Injury Services
• Geriatric Services
• Clinical Pharmacy

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VA Patient Centered Medical Home
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Veteran-Centered Medical HomeImplementation
Strategies

• 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

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Veteran-Centered Medical HomeImplementation
Strategies

• 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

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Medical Home Readiness Evaluation (ACP Home
Builder) September 2009 Pilot Data
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Patient-Centered Medical Home Evaluation
Institute of Medicine Dimensions of Quality
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