JamesLHollyMD.com

	James L. Holly, M.D.

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Letters - Example of Patient-Centered Medical Home August 2010 Family Members Response to First Visit to SETMA: Family Members Response to First Visit to SETMA

I wanted you to see(note below) one patient's response to a first clinic visit Tuesday. This is another "poster child" for "coordinated," "integrated," "personalized," Patient-Centered Medical Home care. All screening and preventive health issues were addressed, even though it was a first visit. All applicable quality metrics were met including PCPI, HEDIS, NQF, NCQA, Diabetes Center of Excellence, PQRI, AQA and SETMA standards.

Coordinated visits were conducted on Tuesday with primary care, neurology, ophthalmology, cardiology testing and laboratory testing. Because the patient has diabetes, needed to be fasting, and lives two hours away, our staff had lunch ready for the patient so that immediately after having labs drawn, he and his wife could eat.

Many of the laboratory tests were available before the patient left the clinic and those were reviewed at the time of the visit. Wednesday, after all labs returned, the patient was mailed the following documents:

Encounter documentation of visit
Diabetes Plan of Care and Treatment Plan
Hypertension Plan of Care and Treatment Plan
Lipid Plan of Care and Treatment Plan
And, a Follow-up telephone call was made to the patient to make sure that:
1. All medications had been obtained
2. All labs were reported verbally to the patient
3. All follow-up instructions and referrals were understood and would be kept

This is Patient-Centered Medical Home. We will get better at it, but we now understand the mission. We will see in six weeks how the therapeutic changes which we have made impact his health. This is the kind of care which it will be our purpose to give to all of our patients.

James L. Holly MD

From:
Sent: Wednesday, August 18, 2010 8:55 PM
To: James L. Holly
Subject: Thanks so much

Dr. Larry,

What a visit with your and your many staff members yesterday. We have never received such "royalty" treatments as was shown to ___________ and me yesterday. As I told a couple of your people who called to check on Paul today, you need to consider moving your medical facility to Louisiana (which I know isn't going to happen). It would be wonderful to have such a medical team in our area to take care of us -- I did not know such clinics were around, but then again, I rarely go to see a doctor.

We ran through a terrible rain storm coming into Lake Charles yesterday afternoon, which made driving a new and unfamiliar vehicle a bit tense for me, but all went well. _____ was very tired when we arrived home. He was running a low grade temp this afternoon, so I gave him some Ibuprofen. He is resting now and I hope he will rest well tonight. Some nights he has nightmares so it makes for a long night for me - he rarely wakes up during those times.

Don't mean to bore you with our issues. Mere words of thanks aren't adequate to express know how grateful we felt for the kindness and courtesy shown to us yesterday. We'll see all of you in late September.

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