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Ambulatory Practice of the Future
David Judge, MD – APF Medical DirectorNicola Majchrzak, MPH, MSW – APF Project Manager
Collaborators: MGPO, CIMIT, MGH Lab of Computer ScienceStoeckle Center for Primary Care Innovation, SimsLab
Boston, February 2010
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Agenda
Background and charge
Our Vision
Shifting Paradigms for Care
The APF Care Model
Discussion
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Background and Charge
Multidisciplinary team assembled in 2004, charged with designing a new care model to radically improve the care experience for patients and providers and anticipate the challenges of the future.
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“We will design the ambulatory care practice that delivers ideal care
in the ideal environment to optimize outcomes for all.“
The Ambulatory Practice of the Future
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Shifting Paradigms for Care
Focus on sickness Focus on health & wellness
Directive communication Culture of collaboration
One size fits all Mass customization
Individual experiences Team-based experiences
Event-based care Continuous care
Patient goes to treatment Treatment goes to patient
Obscurity Transparency
Static model Evolving care model
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Patient
The APF Care Model
• Health & Life Balance Plan-Compact-Orientation & guide- Customized care plan
• Advisory role in ongoing APF
development
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Patient
Care Team
The APF Care Model
• Members - MD, RN, NP, MA, Care coordinator, Greeter, Medical Secretary
• Acute / chronic care
• Proactive pop. mgmt.
• Shared responsibility of ongoing practice redesign
• ‘Productivity’ redefined (Compensation supports longer visits and non- traditional care activity)
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Patient
Care Team
Physical Practice
The APF Care Model
• Patient-centered design
• Critical components:
– Check-in Kiosk
– Living room/library
– Central team area
– APF Exam Room
– Large meeting space (group visits)
– Urgent care + Procedures
– Communication tech
– Prototyping Lab
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Patient
Care Team
Physical Practice
Virtual Practice
The APF Care Model
• APF Portal (LCS)
• Chart review, visit prep, ongoing care plan work
• Synchronous and asynchronous e-visits
• Remote physiologic monitoring (CCH, CIMIT)
• New services (online scheduling)
• Population management
• Peer–to–peer care
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Evaluation
Patient experience Provider and staff experience Clinical outcomes Utilization of services & cost
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Discussion