Office Of Public Affairs

The Next Phase in the Evolution of Health Care

Jun 4, 2007 6:00 PM

Community Clinics Lead Way With 'Care By Design'

University Health Care's Community Clinics are receiving national attention for developing "Care By Design," one of the first models in the country to integrate acute, chronic, and preventive care into a comprehensive system for treating patients.

After implementing Care By Design in April 2005, patient satisfaction scores at the clinics jumped from 64 percent to 84 percent. Reflecting that success, community clinic representatives have been asked to present the model at several national conferences this year, including the Institute for Clinical Systems Improvement (ICSI) Colloquium in Minnesota, one of the country's leading quality improvement organizations.

Care By Design consists of three components--the Care Team Model, Appropriate Access, and Planned Care--which allow community clinic providers to plan each patient's care from before they enter the clinic through postappointment follow-ups.

"The needs and responsibilities of both patients and providers are changing," says Michael K. Magill, M.D., executive medical director of the community clinics and professor and chair of family and preventive medicine. "We believe Care By Design is the next phase in the evolution of health care to meet those changing needs."

Magill compares his experience as a physician with that of his grandfather's. "Years ago when someone went to see my grandfather, it was because they had been kicked in the head by a horse. He bandaged them up and they could return to the farm," he says. "Today, we still see acute cases. But we also treat patients with chronic conditions and try at the same time to keep people healthy and educate them about preventive care."

Rob Lloyd, executive director of the community clinics, saw the need for new delivery systems and recognized an opportunity to differentiate the clinics from other Utah health-care providers. "We asked patients what they wanted, and worked backwards," Lloyd says. "That's how this new model of care was born."

The Care Team model is a patient-centered collaboration between medical assistants (MAs) and physicians to minimize wait times and engage patients more in their own care. MAs assume a central role in "delivering" the visit, from greeting the patient and taking the medical history to drawing blood and documenting the physician's exam. This frees up doctors to spend more time talking with and listening to their patients.

Appropriate Access balances the needs of patients who want same-day appointments with those who have chronic illnesses and must be regularly seen and scheduled in advance. Planned Care uses evidence-based tools in electronic medical records to make each patient's visit more effective.

For the past two years, the health centers have been hosting "Learning Days" for physicians and administrators interested in the University Health Care model. More than 100 individuals from 19 organizations, including Kaiser Permanente, ThedaCare, and the Mayo Clinic have attended a Learning Day.

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