June 2011
Reinvigorating primary care—for providers and patients alike
Curbing costs while meeting patient needs is one ideal driving Group Health's expansion of the patient-centered medical home. Published in Health Affairs in May 2010, two-year findings from GHRI's pilot evaluation of the model's implementation at Factoria Medical Center showed continued improvements in patient experience, quality of care, and overall costs.
But these outcomes are only part of the story.
R. Reid, MD, PhD
"The pilot proved that we could improve not only cost, quality, and patient experience, but also the quality of the work environment," explains Associate Investigator Robert Reid, MD, PhD, a Group Health physician and the evaluation's lead researcher.
Among the most compelling findings are reduced burnout among primary care team members and improved recruitment and retention of primary care physicians. Dr. Reid, who assumed a new role in 2011 as Group Health's associate medical director of health services research and knowledge translation, calls it a "decompression of the workforce that allows them to do their best work."
"It's not that Factoria clinicians worked less under the new model," he says. "It's that they were feeling the work was doable and they were dealing with all their patients' care needs."
This transformation has roots in the "access initiative" Group Health launched in 2002, which streamlined care teams and offered patients same-day appointments, open access to specialists, and secure e-mail with providers. The changes boosted patient satisfaction but created unrealistic demands on clinicians, leading to challenges experienced nationwide in primary care: As our population ages and chronic illness increases, more physicians are feeling burnt out, reducing clinical time, or retiring early.
In 2006, Group Health responded with a "proof of concept" test of the patient-centered medical home at Factoria. The pilot's improved provider outcomes stem from features such as longer appointments, fewer patients per physician, increased non-physician clinical staff, and daily "team huddles."
The key question now is whether other clinics will experience the same positive outcomes. Thanks to a federal grant, Dr. Reid and his research team are eagerly continuing their evaluation.
Findings to date continue to make headlines and draw widespread acclaim for Group Health and for Dr. Reid's research—earning him invitations to speak to legislators, government officials, and health care leaders across the country.
But he says all the credit goes to the dedicated people at Group Health who deliver care day in and day out.
"It’s a partnership," he smiles. "The health care teams across Group Health do the hard work. We just study it."