Re: TransforMED

October 23, 2008

so sofia. I have done alot of work with the NCQA project :)I admire you for taking the transformed quiz as I have not spent the time to do so myslef.The concepts of a medical home should be good access ,continutiy, safe timely care ,that is evidence based right?

Of course you can do that in your one person office- perhaps better than in a big office where patients can get lost among various " team members " remember that these measuring instruments a re imperfect.

I would look to these instruments ONLY to give you a guidance, a hint, a clue ,about whether you can tune up your processes to do a better j ob NOT as a scorekeeper with a strict pass fail gradeI know that some are worried oh If I do not meet X criteria i will not be a medical home and I will not be paid any better

All this is still pretty ill -formed In Maine-I live in MAIne- no major player has signed on to anything more than ' well let s look at a pilot project we will begin that in 2009 and then we will see what w e will do with regular across the board docs an d policies after that(I mean like the world could end)

You could do a few things1 Have your patients use HowsYourHaelth.org Are you in am IMP cohort ? Do you have an IMP #? If not can i help you ge t one and use HYH ,which is a really good way and much less painful for you to get good data , on how you are doing on key measures

OR you could get the tool form the NCQA for free and just run through that-- but that tool is cumbersome some questions are repetitive of themselves on a microminutia level and often the questions seem to reflect more the ability of your emr to be a good data collector and have more bells and whistles, as well as the tool seems to care if you have written policies for x y and z more than it than it really measures how you really take care of patients.

Does that help you at all?Jean

OK-so I took the AAFP " quiz " on the " Medical Home " TransforMED website.

Apparently, I am " just meeting " standards. Based on the questions they

asked, I don't think this concept is possible in a micropractice. Some

of the questions were just plain dumb. One section was malfunctioning

and I know I scored low on that part!

How is it possible to meet NCQA standards if you only have one

physician? I also don't believe I need to buy more technology in order

to justify their beaurocracy. Has anyone implemented TransforMed or has

anyone taken the medical home quiz? How do you track your " data " for

chronic disase?

I'm so confused!

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

October 24, 2008

Sofia:

The TransforMed tool is supposed to help you figure out if you are meeting the

standards of the NCQA Medical home (under that definition). is

correct. There is as of yet little actual $ coming to practices that meet

the NCQA standards (except in select pilot projects that mostly are to start in

2009). In a micropractice, the burden of creating the documentation to “prove”

that you have a medical home is sort of ridiculous. BUT, there has to be

some type of measurement, or how can you call yourself “a medical home”.

The HYH data should go a long way towards providing that data for purposes of

tracking. Some EMR products also have the ability to do reports for same

purpose, but most are not ready with the capacity.

Well, while we wait for the policy people

to figure out what they will do with payment reform, etc, my best advice is to

stay accessible to patients and provide the best medical care you can in the

most efficient manner you can.

I am nearly 3 years into my practice and

though there is some “steady state”, I weekly decide I need to

change something to improve care delivery. There is a huge learning

curve, but it has slowed down in the last 9-12 months to a dull roar.

This feels amazing and I continue to love “my job”.

Ramona

PS: My practice was one of the “TransforMed”

practices and after the 2 year study, I can say that it was of great benefit to

be part of the project. However, there is admittedly less value from this

organization for a small (IMP) practice than for larger more traditional models

of practice. Do not spend more money than you can afford. Stick to

this listserve and you will learn how to do things that make sense for a

micropractice!

From: [mailto: ] On Behalf Of Sofia Fernandez, MD

Sent: Thursday, October 23, 2008

4:33 PM

To:

Subject:

TransforMED

OK-so I took the AAFP " quiz " on the

" Medical Home " TransforMED website.

Apparently, I am " just meeting " standards. Based on the questions

they