An announcement of and introduction to the 7th Medical Home Summit was published in this column on January 22, 2015.  Coincidently, that was exactly sixteen years from the date that SETMA first started using the electronic medical records (EMR) and from which SETMA defined the ten principles of designing a practice and an EMR, which turned out to be principles of medical home.  See:   http://jameslhollymd.com/Your-Life-Your-Health/pdfs/medical-home-summit.pdf

On March 21, 2015, SETMA’s eleven-member team left for Philadelphia for the 7th Annual Medical Home Summit.   The ten team members, who came from Beaumont, boarded a United Flight at 6:45 PM.  After sitting on the tarmac for 90 minutes, returning to the terminal, and generator repairs, never having left the plane after eight hours, we arrived in Philadelphia.  This is a photograph of the team leaving for home on March 25 th after a very successful meeting. . 

PRECONFERENCE FACULTY: SETMA's MEDICAL HOME JOURNEY 
THE CONTINUING PURSUIT OF EXCELLENCE

Back Row

• Jon Owens, BS - Mechanical Engineer, Clinical Systems Engineer, Member Accreditation Team, Beaumont, TX
• Jayne Bryant, RN, BSN   -- HCC Risk Specialists and EMR Trainer, Member Accreditation Team
• Theresa Bailey, LVN -- HCC Risk Specialists and EMR Trainer, Member Accreditation Team
• Jerry P. Abraham, MD, MPH, CMQ  Resident Physician, University of Southern California (USC) Family Medicine Residency Program at California Hospital; Trustee-Elect, American College of Medical Quality (ACMQ), Los Angeles, CA
• Richard W. Smith -- Member, Patient Centered Patient Home; Member, SETMA Community Council
• James L. Holly, MD -- Chief Executive Officer, SETMA; (Preconference Chair). Member Accreditation Team
• Margaret Ross, RN, MSN -- Director of Operations, Member, Accreditation Team
• Pat Crawford, CMOM, CMC, CMIS -- Director of Care Coordination, Member Accreditation Team

Front Row

• Samuel Kerl -- Member, Patient Centered Medical Home; Member, SETMA Community Council
• Brenda Kerl -- Member, Patient Centered Medical Home; Member, SETMA Community Council,
• Carolyn Holly, BA --  Team Supervisor

Without doubt the high light of the 4-hour pre-conference and of the main conference was the participation of Richard W. Smith, and of Samuel (Bill) & Brenda Kerl.  At the end of the Monday session, the audience was given an opportunity to express their appreciation of these three. The applause was loud and sustained as the affirmation of Richard, Bill and Brenda continued and continued.  Christine Bechtel, the leader of SETMA’s eighth session on Wednesday morning, in which Brenda participated, wrote the following:  “And thank you for connecting me to Brenda, who is awesome.  I had such fun with her.”  As Richard, Bill and Brenda shared their stories and experiences, it gave reality and validity to the conference unlike anything which can be given by formal or professional reports. 

Their Stories and others are told at www.jameslhollymd.com under Medical Home:

• Paternalism or Partnership - the Dynamic of the PC-MH
• Learning From One’s Mistakes
• Medical Home Poster Child
• Patient Centered Medical Home Poster Child: An Update after Five Years of Treatment in a Medical Home
• Homicidal Threat to Reciprocal Caring

The first session of the pre-conference was presented by SETMA’s Accreditation Team which includes, Margaret Ross, Jon Owens, Pat Crawford, Jayne Bryant, Theresa Bailey and Larry Holly.  The title was “PCMH Accreditation team -- How to Build and Maintain an Accreditation Team for PC-MH.”   The team did an excellent job of describing the team’s development and of the invaluable service they render to SETMA in first attaining and then maintaining accreditation by the National Committee for Quality Assurance (NCQA), the Accreditation Association of Ambulatory Healthcare (AAAHC), URAC (URAC) and the Joint Commission.  The audience response was outstanding. 

The second session was presented by Jayne Bryant, Theresa Bailey and Larry Holly.  It was entitled, “Unique Billing for PCMH -- Transition of Care/HCC Risk Management Audits for PC-MH.”  The key to this session was to capture the revenue which CMS makes available to a medical practice in order for SETMA to provide enhanced and advanced services to our patients.   Jayne and Theresa explained their work and gave an excellent presentation of the HCC coefficient and its value to the PC-MH.

The third session was presented by Richard Smith, Bill Kerl, Brenda Kerl and Pat Crawford.  It was entitled “PCMH Community Council -- the Staff, Value and Purpose of a Community Council for PC-MH.”  This unique opportunity lets patients participate in the design and re-design of SETMA.  They explained how patient insights enable SETMA to improve the services which are received at SETMA.  And, they described how as patients take ownership of SETMA’s success, they become more activated  and engaged in their own care. 

The fourth Session was presented by Jon Owens and Larry Holly.  It was entitled, “Data Informatics -- the Power of Informatics and the Philosophy of Quality Metrics in PCMH.”  As SETMA is in its seventh year of public reporting by provider name of over 300 quality metrics, SETMA believes that quality and safety are improved by this process.  It is SETMA’s belief that quality metrics should be met incidental to excellent care and not as the intent of care.  These metrics allow SETMA to know where we are, where we want to go and how to get there.

The fifth Session was presented by Richard Smith, Brenda Kerl and Bill Kerl.  It was entitled “PCMH Story Telling -- Value and Imperative.”  The power of story telling was related in this session.  The story of each member of the team was reviewed and the lessons which we learned were discussed.  The health benefit of a patient who has a sense of personal value and of personal virtue (power) to change their future and their lives, allowing them to develop trust in others, particularly their healthcare providers, was discussed. From “Value,” and “Virtue,” comes “trust,” from which comes “hope” that if a patient makes a change, it will make a difference in their life and health..

The sixth and seventh sessions were presented by Jerry Abraham and Larry Holly.  They were entitled:  “PCMH Medical Student and Residency Externship”; and, “Patient-Centered Conversations -- Patient Activity, Engagement and Shared Decision Making -- Transforming a Patient Encounter into a Real PCMH visit.”  The externship allows providers-in-training to learn about PC-MH and its principles with the ideals of PC-MH.  The dialogue between patient and provider contain in the patient-centered conversation changes the dynamic of the patient encounter. 

The ninth SETMA session entitled, “Accreditation and Recognition are good; but Culture is King,” was present by Larry Holly.  The session contrasted the details of patient-centered medical home accreditation with the transformative power of cultural change in the medical practice.  One statement in this presentation summarizes its core:  “As we celebrate science, we must not fail to embrace the minister, the ethicist, the humanist, the theologian, indeed the ones who remind us that being the bionic man or women will not make us more human, but it seriously risks causing us to being dehumanized. And in this embrace, we may just find the right balance between technology and trust and thereby find the solution to the cost of healthcare.”

Performance Evaluation

The conference director summarized the evaluations of SETMA’s conference presentations.  His note stated:  “Pre-conference was almost all Very Good or Excellent; Brenda was all excellent with some rave reviews; your solo talk was all excellent.  BRAVO!”