There.  I said it.

I’m learning this new language of “patient-centered medical home” and I’m not sure I belong here.

OK...let me scratch that.  I KNOW that what I do...and most of us do qualifies.  We treat the WHOLE patient.  We make sure that they get their preventative services (or at least, we encourage them to go).  Oh, OK, I may not be the best cheerleader when it comes to encouraging colonoscopies, but I can honestly tell my patients, “Hey, I’ve had one...and it really isn’t THAT bad.” I recommend them, at least.  And their PAPs, mammograms, flu shots, pneumovax, etc.

However, as I mentioned a few weeks ago, my practice is partaking (ala “bite off more than most would chew”) of a PCMH initiative which sounds absolutely great.  Better patient care...more goals met...share things with other practices to achieve better patient outcomes overall.

Until we realize that...we’re still a small practice.  With two providers...and a TERRIFIC staff, who ALREADY multi-tasks in so many ways.

And how in the HECK are we going to accomplish this?

I had the opportunity a few weeks ago to have a telephone conference with a practice in northeast PA who employs the same EMR we use.  They are fully immersed in the PCMH “thing.” They have had our EMR provider formulate HUNDREDS of formulas for data mining...many of them are patient-centered, others are administrative.  Other formulas...well I’m not sure what they do.  Suffice it to say, they have created over 1200 formulas that they use...apparently, with some regularity.

They have done so much work on this initiative that they have hired a full-time EMR “super-user.” Yes...you read that correctly.  Someone whose only job is to input and extract data.  Oh...and they have a case manager whose ONLY job is to call and remind patients to get their labs...go for their eye exams...call up the ophthalmologists or optometrists and get their office visit notes, go for their podiatry exams, etc....ALL to “count” in the PCMH data.  She does chart reviews to see what is needed...and makes sure it gets done.

Because...bottom line:  if it isn’t in your chart as the PCMH, it DOESN’T count.

So...given that we are a small office and do NOT have the resources to hire a full-time IT person or case manager...that job falls to me and the staff.

I realized with our wonderful staff of THREE people and ONE office manager...this stuff “ain’t’ happenin’ ” as quickly as I’d like.  Quirks need to be ironed out.  Data input from our labs needs to be addressed.  We need to call-back people who haven’t been in for visits in over a year...nor had labs for longer than that.

Oh, and I need to design a tri-fold presentation of what we’re working on by Friday’s collaborative meeting...that I just found out about.  Yeah.  RIGHT.  Art project for ME this time, not my kids.  (smile)

My boss told me to forget it.  We’re just in the baby steps of this process.  For the initiative to expect this of us is ridiculous.  And while I agree on one level...if we’re the only practice to show up without a “tri-fold board,” I will feel stupid.  Dumb.  Backwards.  Because it’s not like we’ve twiddled our thumbs since the last meeting in October.

So...I will see if I can devise a “happy medium.” Something that shows we’re working on things...without losing my sanity in the process.

And as a side note, MY team, the Steelers, are in the Super Bowl...so I have my homework goals set...because I’m not missing THAT for any collaborative.  Go Black-N-Gold!  (smile)

Kim Spering is a family nurse practitioner who currently works at Brndjar Medical Associates, P.C., a family practice in Emmaus, PA.  Her past experience includes the fields of medical/surgical ICU, open heart/trauma ICU, labor and delivery, nursing education, nursing supervision, and as a nurse practitioner in both family practice and OB/GYN settings.  She currently serves as a NP preceptor for her graduate school alma mater, DeSales University, as well as for local baccalaureate programs.  She is passionate about patient education and helping patients understand that they are ultimately responsible for their own health.  She also firmly believes that the public needs to be educated on the value of NPs and PAs in meeting the health care needs of the next decade and beyond. In her free time, Kim enjoys family vacations with her optometrist husband, Mark, and her two sons, Matthew and Connor.

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