‘Big enough to serve, small enough to care,’ is a motto Tonya Bartholomew, practice manager for the Platte Valley Medical Clinic, thinks fits the clinic well.
“We practice good, old, small-town medicine,” Bartholomew said. “We have so many services that are not typical. You would find a lot of the services we offer in Laramie or Cheyenne and it’s only because of the Corbett Medical Foundation.”
The Corbett Foundation enables the clinic to employ three medical providers: a physician, a physician’s assistant and a nurse practitioner and having three providers makes it possible for the clinic to provide emergency medical services 24 hours a day, seven days a week.
Now the Foundation is helping the clinic become accredited as a Patient-Centered Medical Home (PCMH).
The PCMH model of care delivery was created in 1967 by the American Academy of Pediatrics to gather all the paper records of a child in one practice. In 2003, the chronic care model of a medical home was developed.
In addition to changing the way clinics and hospitals interact, the PCMH model seeks to change incentives from individual, episodic care to population health management.
“It’s all about preventive-centered care,” Bartholomew said. “I like to call it concierge service. It is looking at the whole patient population, not just your sick ones – people don’t come to the doctor usually until they are sick.”
“Conna McGuire will be our patient care coordinator, our go-to person for this,” Bartholomew said.
McGuire will query through medical records the clinic’s entire patient population and make sure patients are managing medications correctly and have current lab results. McGuire will then call and schedule patients for tests or procedures they might need.
“That’s what I mean by a concierge service,” Bartholomew said. “You are facilitating patient compliance and that is one aspect.”
The other aspect is talking to other clinics and hospitals to get updates on patients as they are treated, finding out when they will be discharged and what they need upon arrival at home.
“Patients have so much on their mind when something has happened,” McGuire said. “It is nice if we can take some of the burden off of them.”
Instead of using patients themselves as the go-between, the PCMH model increases physician-to-physician communication and as more providers move toward the new model, communication among the medical community should become easier.
“The clinic already does a good job of so many of these things already – we already don’t let them walk out the door without scheduling appointments,” Bartholomew said. “(Dr. Bartholomew) contacts hospitals and follows up on that kind of stuff. The problem is trying to get the hospitals to communicate back.”
The PCMH model started on the East Coast, but is slowly taking hold in other parts of the country.
Dr. Brent Sherard heads up the Wyoming Integrated Care Network (WICN) and said he has been looking at the PCMH model for five or six years.
“It’s starting to gain some momentum in Wyoming,” he said.
Seven clinics in Cheyenne and one in Casper converted to the PCMH model a little over a year ago, and statewide 18 more, including the clinic in Saratoga, kicked off conversion in September.
The process is evolving to accommodate Wyoming’s unique environment as more clinics and hospitals in the state become involved.
“Wyoming is rural, so we have challenges other states don’t have,” Sherard said. “Saratoga is especially unique because it’s very rural and very isolated.”
Sherard said WICN received $250,000 from the state legislature. Those funds, plus part of an innovation grant award from the federal government in the amount of $14.2 million will go towards paying TransferMED, an organization that helps train clinic personnel in the medical home model.
WICN is trying to take the program statewide and in some ways, Wyoming is ahead of the game from a national perspective because of its small population.
“The challenge in the future is getting everybody connected, creating a health information exchange where we can connect everybody’s medical records while maintaining privacy so a doctor in Sundance can connect and speak with a doctor in Saratoga,” Sherard said.
“I’m impressed with Dr. Bartholomew,” Sherard said. “He is really on the cutting edge. Saratoga is lucky to have him.”