The Ohio Patient-Centered Medical Home Initiative

What’s the new Ohio Primary Care or “Patient-Centered Medical Home” Initiative?

Ohio is on the cutting edge of improving how primary care is delivered as well as expediting improvements in trainee education. In June 2010, the state identified primary care as the critical point of growth for providing high-value health care in the state, and for controlling escalating Medicaid costs. In particular, researchers saw a need for 1) Patient Centered Medical Homes all across the state and 2) updated medical training to prepare learners for these exciting new models of care delivery. (Click here to learn what a PCMH is and why it’s so important).
 
Soon thereafter,  Ohio House Bill 198 was created,  establishing the Patient-Centered Medical Home (PCMH) Education Pilot Project. This project granted $20,000 of funding to each of 44 primary care practices throughout Ohio to design, implement and transform into PCMHs. Each of the sites (later expanded to 50) is affiliated with one of four medical schools or one of five nursing schools in Ohio (see below for the list). The bill also creates a primary care scholarship for medical school and advance practice nurse (APN) students who commit to practice primary care in Ohio.
 
Finally, the bill seeks to advance curricular reform at the medical school, nursing school and primary care residency levels to incorporate the skills and competencies inherent in the PCMH model. (See below for a list of these skills).
 
For a full report on House Bill 198 please download the following report by the Ohio PCMH Pilot Project leadership team.

As a trainee, why should I care about this initiative?

Because it’s one of the most unique, visionary and concerted statewide efforts to commit to both improving how primary care is delivered and how providers are trained! For years we’ve known that the old model by which primary care has been organized has not worked for either patients or providers. New models, like the PCMH, have been created, and are doing fantastically where they exist. The problem is, very few students and trainees have been exposed to these new, exciting models, and even fewer learners are being prepared to practice in them through traditional models of medical education. This exposure is critical, not just as a means of helping folks understand the profound value of patient-centered, robust primary care delivery systems, but also as a means of beginning to familiarize learners with the specific competencies and skillsets inherent to these advanced models of primary care delivery. And, we’ve seen numerous examples of how students and trainees can help with the clinical innovation process itself!
 
The sooner learners become familiar with and involved in patient-centered, team-based, comprehensive and coordinated primary care delivery, the better.
 

What is the role of Primary Care Progress (PCP) in the Ohio PCMH Initiative?

PCP is partnering with the Department of Health to introduce these improved models of primary care delivery to trainees with the goal of having trainees take leadership roles in care and education redesign.  One component of this effort is accelerating student exposure to the excitement and value posed by these new models of care and to the inspiring clinicians and innovations in the PCMH pilot sites. The other is teaching trainees the leadership and community organizing skills to improve our healthcare system both in the clinic, where students can help with clinical innovation projects, and at health professional schools, where students can advocate for improved curricula.
 
PCP is helping to convene an Ohio Primary Care Student Leadership Team to bring the student voice to the Ohio PCMH Initiative. The PCP field team will be working with Team members to 1) teach them high value leadership, advocacy and clinical innovation skills to be brought back to the medical school and primary care clinical environment; and to 2) help plan statewide events to highlight the importance of primary care and the value of the PCMH.
 
In addition, PCP will be:
  • Sharing ideas and toolkits for trainee involvement in PCMH transformation with trainees and providers;
  • Facilitating growth of PCP chapters or similar trainee-led primary care spaces at Ohio medical and nursing schools;
  • Organizing further trainings and speaking engagements in Ohio on leadership, advocacy skills, and the value of new models of primary care delivery.
Throughout, we will also be creating and promoting Ohio-specific multimedia highlighting the excitement and value of PCMHs, as well as the firsthand experience of Ohio health care trainees and providers who are reinventing primary care.

What can trainees and faculty do to get involved now?

  • Learn more about the PCMH initiative.  See below for more info on this exciting new model of primary care, and read here for more about what a PCMH is.
  • Learn more about the importance of advocacy. Click here to learn about the changes you can make in your academic medical center.
  • Learn more about clinical innovation. Check out our toolbox and read examples of clinical innovation projects where trainees can play a role in PCMH transformation.
  • Accelerate PCMH transformation at your school.  Contact Primary Care Progress’ Senior Field Organizer, Uyen Doan, at uyen.doan@primarycareprogress.org to set up a call. We can help you strategize potential informative local speakers on primary care clinical innovation, educational activities, and other ways to excite, inform and engage your colleagues in primary care clinical innovation.
  • Share your stories of PCMH transformation. If you are part of a transforming practice, email media@primarycareprogress.org so that we can share your successes on our website and through social media – you’ll be inspiring thousands.
  • Invite us to speak.  Primary Care Progress has a number of experienced and inspiring leaders, like Dr. Andrew Morris-Singer, who have helped transform and energize communities across the country in a number of different settings. Contact info@primarycareprogress.org to book an engagement.
  • Start a Primary Care Progress chapter.  If you’re excited to create a space that engages all members of your local primary care community to push this exciting educational initiative forward at your school, then consider helping to form a local PCP chapter. Contact Uyen Doan at uyen.doan@primarycareprogress.org or e-introduce her to those trainees and energized leaders who you believe should be leading these local efforts.
  • Set up a call to learn more.  Primary Care Progress staff is available to speak and share more information about the Ohio PCMH initiative and about how PCP is getting involved, including how we might be able to help your community. Schedule a call at info@primarycareprogress.org
  • Keep visiting this page for updates on trainings on PCMH skills and advocacy in your local community.
 
Click here to learn more about building your primary care community.
 

What are some of the new PCMH competencies important for learners?

Some of the identified competencies include:
 
  1. Students will understand the importance of a personal clinician (a clinician who knows each patient as an individual) to the health of individual patients and the population as a whole.
  2. Students will recognize the importance of patient centeredness in successful health care outcomes.
  3. Students will recognize the importance of the team approach to patient care in successful health care outcomes.
  4. Students will recognize the importance of integrated, coordinated care in successful health care outcomes.
  5. Students will apply the principles and practices of evidence‐based population management and public health in an equitable manner to advance the health of the community.
  6. Students will recognize the importance of access to care that is high in quality and equitably applied in a way that meets the needs of the patient with respect to time of service and manner of delivery.
  7. Students will recognize the importance of continuous quality improvement, using best current evidence to develop and refine best practices for patient care.
  8. Students will understand the importance of information systems to the functionality of the patient‐centered medical home.
  9. Students will demonstrate appropriate leadership skills.
  10. Students will advocate for the Patient Centered Medical Home (PCMH) as a means of improving the health of the community.
 

Which are the affiliated academic medical centers?

HB 198 includes curriculum, scholarships, and access to the pilot sites for four “affiliated” Ohio medical schools (and only these medical schools). Each pilot site should have a representative with ties to one of four medical schools:
 
  1. Northeast Ohio Medical University
  2. Ohio University Heritage College of Medicine
  3. University of Toledo College of Medicine
  4. Wright State University Boonshoft School of Medicine
 
There are also five “affiliated” nursing schools:
 
  1. University of Akron College of Nursing
  2. Kent State University College of Nursing
  3. Ohio University School of Nursing
  4. University of Toledo College of Nursing
  5. Wright State College of Nursing and Health
 

How do the pilot sites fit in with this project?

In order to participate in the medical home pilot, all primary care practices must have an affiliation with at least one of the specified four medical schools or five nursing schools named above. Additionally, of all the pilot sites combined, at least four of the practices must be led by an Advanced Practice Nurse (APN) and no more than 40 of the practices can be physician-led.
 
Funds for the project will be used to help sites fund leadership training, educating staff about PCMHs, and securing necessary health information technology like electronic health records.
 

Who runs this pilot program?

Dr. Ted Wymyslo, Director of the Ohio Department of Public Health (ODPH) guides the pilot project along with Dr. Patrick Ecklar, Chair of the Education Advisory Group (EAG). The ODPH has received significant financial, administrative, and strategic support from the Ohio Academy of Family Physicians.
 
For an organizational structure map, please click here.
 

What scholarships are available?

Stay tuned! As of right now, all of the details for scholarship funding have not yet been fully approved, but the Educational Advisory Group as well as the Ohio Board of Regents are working to develop significant scholarship for students willing to commit to practice in primary care in the state of Ohio after training.