Twelve months ago, under the direction of Dr. Desai, and with the support of Iowa Collaborative grant funding, the Primghar Mercy Medical Clinic initiated a model of delivering care called the Patient Centered Medical Home. The Patient Centered Medical Home is a framework for delivering care that is focused on an individual patient’s needs and preferences. As a team, the patient, their personal health care provider and clinic staff navigate the health care system working to prevent disease, treat acute and chronic conditions, and build health.
Originally conceived by the American Academy of Pediatrics in 1967 as a central location for medical records, the Patient Centered Medical Home has evolved to be much more. For the individual patient it serves as the primary access point for medical care in a partnership with their personal physician and his/her staff. The American Academy of Family Physicians, the American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association has developed the following Joint Principles to describe the characteristics of the Patient Centered Medical Home:
“The Patient Centered Medical Home is an opportunity to build on the excellence we’ve established in prior years,” explains Deb Prins, the Clinic Manager. “Quality improvement projects including Improving Diabetes Outcomes, Colon Cancer prevention, and Tobacco Cessation have positively impacted our patients. Board Certified physicians lead the practice utilizing evidence-based medicine to coordinate patient care. ”
Patient registry and e-prescribing are two high tech components being implemented in 2012. “The Patient Centered Medical Home is both high tech and high touch” is how Dr. Desai describes the model. “The whole person orientation creates a sense of partnership that enhances the experience for the patient, physician and staff”.
Left-Carol Brinkert, RN, BSN, Certified Health Coach
Right-Arlene Walker, Patient
Health Coaching is another component of the model. Health coaching assists the patient in identifying ways they can improve their health. It taps into the patient’s expertise and helps them identify goals and strategies for achieving those goals. Arlene Walker, a patient at the Primghar Mercy Medical Clinic, wrote about her experience with health coaching at the clinic. She writes “Last March a fasting blood test showed that both my cholesterol and diabetes numbers had elevated since the previous test six months prior. Depression began to set in as I wondered how to handle my physical condition. How could I keep my cholesterol and diabetes from getting worse? Then I was asked, ‘Would you like diabetes coaching?’ ‘Yes!’ I replied without hesitation. We made an appointment to meet and during the hour-long session, Carol Brinkert, RN, my health coach, gave me the freedom to express my concerns about eating right and getting some exercise. I knew I needed to fulfill a previously set goal of walking 30 minutes a day, but I easily made excuses and put off walking to do housework and other projects. Carol and I talked about it. She didn’t tell me that I had to walk for exercise. She said just enough to make me want to do it. That motivated me to become more disciplined because I knew Carol was not saying it out of a sense of duty but because she showed that she really cared about my health.
I can’t remember what else was said during that meeting but I began walking every day on the treadmill for 30 minutes and outdoors when the weather was nice. I knew Carol believed in me and that mattered. Now that I’ve established the habit with Carol’s coaching, walking has become a pleasure that I look forward to as often as I can get out and do it. Carol praises me for walking and my body feels better after walking. When Carol sees the reports I make on my glucose tests, she noted that walking gives me a better reading on my glucose tests.
Several weeks ago, when I expressed concern about getting the right foods in my diet and the right amount, Carol set up a meeting with Colleen King, the dietitian and me. I brought my questions and also some recipes I’d been trying. Colleen was helpful in making suggestions and a schedule for the amount of carbs for each meal and snack. We discussed foods that fit into the meal plan and that gave me confidence.
I can’t say enough about the effort Carol has put forth in this team partnership between us. She patiently answers questions, even questions I’ve asked before. I come away from a meeting with her knowing that one day at a time I can win the fight with my diabetes and high cholesterol. I appreciate this service that Mercy is providing. It makes me want to try harder to remain as healthy as possible.”
If you are interested in receiving care or learning more about the Medical Home model, please call 712-957-2310 to schedule an appointment.