Southwest Medical Associates

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1 Southwest Medical Associates

2 Introduction Nine medical centers + five SMA Convenient Care clinics 60% primary care (IM/FP, Peds, Ob/Gyn) Eight medical sub-specialties Adult and pediatric hospitalist groups Urgent care/23-hour stay facility Two anesthesia groups/ county trauma contract Ambulatory surgery center/ 10 operating rooms Digital radiology Over 240 providers Onsite labs/radiology in each medical center Senior lifestyle centers 2

3 SMA Options of Care 3

4 Patient Centered Medical Home SMA has received a level 3 designation as a Patient-Centered Medical Home. The highest level in the State. PCMH: An innovative program for improving primary care using specific criteria sets. Provides practices information about organizing care around patients, working in teams and coordinating and tracking care over time. Facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient s family Uses registries, information technology and other means to assure that patients get the indicated care in a culturally and linguistically appropriate manner 4

5 Technology and Healthcare 5

6 Technology Integration Electronic Medical Record Tasking Referral integration E-Rx Home Health Physicians Digital Imaging Radiology Cardiology Integrated into EMR External Connections Quest Lab Pharmacies Referrals specialists Urgent Care Nurse Practitioners Web-based Self-Service Appointment scheduling E-visits Problems Portable medical record Rx renewal Results Vitals Advanced directive Care Teams Physician Assistants Custom Clinic Tools Kiosk check-in Skype- like customer service Kiosk Patient education Patient medical profile (wrapper) for triage Patient Notifications Automated phone calls and Appointment reminders Rx notifications Orders/results notifications 6

7 Acuity Model ODM CF CHN On Demand Condition Focused Complex/High Needs Under 65 No hospitalizations No chronic diseases Under 65 One or more chronic diseases with less than two acute admits ACUITY-BASED CARE OPTIONS 65 or older Medicare recipient Two or more chronic diseases with three or more acute admits 15 or more encounters Health risk screening education Wellness services Conven. Care Urgent care E-visits Commercial PCP Disease management programs Patientcentered medical home Extensivist medical home Palliative care Hospice 7

8 Wrapper Patient Acuity Stratification Web Call Center Front Desk

9 SMA Patient Portal Urgent Care Wait Times Secure Patient Login Real-time Scheduling Medication Renewal Requests Patient Health Information 9

10 Customer Service E-Visits 10

11 Result Letters Letter to Home Copy to Portal Copy Viewable in Call Center

12 Visit Summary Printed at Visit if Requested Available on Portal in 48 hrs Viewable at Call Center Viewable at Front Desk

13 Point of Service Tools 13

14 Post Acute and In Home Care SMA Family companies include Hospice, Home Health and DME/Pharmacy Company Wound care program Telemonitoring services Inspiris Care Plus Program began in fall of

15 Metrics Bed days Admits per thousand- 209 Days per thousand HEDIS results Projected STAR ratings for STAR for LDL screening in DM and Cardiovascular patients 5 STAR for BMI measurement, Nephropathy screening in DM, and DMARD use in RA 4 STAR in Breast and colorectal cancer screening, DM HbA1C control 15

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