The CCC's mission is to "create an integrated delivery system for identified vulnerable populations in Travis County that considers the whole person, engages the patients as part of the care team, focuses on prevention and wellness and utilizes outcome data to improve care delivery."  One foundational element of the integrated delivery system is the patient-centered medical home (PCMH).

The Patient-Centered Medical Care Collaborative, an organization created to advance an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home (PCMH), states that   --

"The medical home is best described as a model or philosophy of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. It has become a widely accepted model for how primary care should be organized and delivered throughout the health care system, and is a philosophy of health care delivery that encourages providers and care teams to meet patients where they are, from the most simple to the most complex conditions. It is a place where patients are treated with respect, dignity, and compassion, and enables strong and trusting relationships with providers and staff. Above all, the medical home is not a final destination instead, it is a model for achieving primary care excellence so that care is received in the right place, at the right time, and in the manner that best suits a patient's needs."

In 2008, the National Committee for Quality Assurance (NCQA) created the nation's most widely-used PCMH recognition program.  To earn PCMH recognition, primary care practices must meet rigorous milestones within core PCMH disciplines, called "standards." These standards are:  Patient-Centered Access, Team-based Care, Population Health Management, Care Management and Support, Care Coordination and Care Transitions, and Performance Measurement and Quality Improvement.

This model of care has gained national acceptance.  The approved Texas 1115 Waiver program allowed DSRIP performing providers to launch a project "to expand or enhance the delivery of care provided through the Patient-Centered Medical Home (PCMH) model."

Drreginaldoneal.com

The Patient Centered Medical Home Project is a centerpiece of the CCC's fifteen DSRIP projects and is being led by CCC Program Managers Veronica Buitron-Camacho and Dayna Fondell.  The primary project goal is to establish a patient-centered model of care across all safety net providers and to improve the patient experience of care.  

Prior to the approval of the Texas 1115 Medicaid Waiver, the PCMH concept had been embraced by all three of the CCC's contracted Federally Qualified Health Center (FQHC) providers - CommUnityCare, Lone Star Circle of Care, and People's Community Clinic.  Through DSRIP-related activities, the CCC and its partner organizations developed the following PCMH principles to guide care for our target population, regardless of service location.

The CCC and its partners will --

• Provide access to culturally and linguistically appropriate team-based care that meets the needs of patients and families;

• Systematically record patient information and use it for population management to support patient care.

• Systematically identify individual patients, then plan, manage and coordinate their care based on their condition, needs, and evidence-based guidelines;

• Act to improve our patients' ability to manage their health by providing a self-care plan, tools, educational resources, and ongoing support;

• Systematically track tests and coordinate care across specialty care, facility based care, and community organizations;

• Use performance data to identify opportunities for improvement and act to improve clinical quality, efficiency, and patient experience.

Through the DSRIP project, the CCC's contracted FQHCs have adopted these principles, helping the PCMH vision become a reality for our safety net population. In addition, to ensure that our collective efforts are enhancing the patient experience of care, the CCC has created a Patient Experience Workgroup to determine the best strategy for assessing patient experience so that the system can continue to improve service delivery.

University of Texas Dell Medical School

The future of medical education continues to evolve

• Dell Medical School announced a landmark partnership with Huston-Tillotson University to address mental health challenges in East Austin (read Statesman op-ed);
• Community collaboration around medical education in Austin is getting national attention (see MedTech Boston feature); and
• In collaboration with UT's College of Fine Arts, the medical school has launched the Design Institute for Health, a first-of-its-kind effort to apply design thinking and creative solutions to health challenges.

Seton Medical Center at the University of Texas

Construction continues. . .  Seton Medical Center at The University of Texas will anchor a new downtown health district - an exciting new hub for medical care, research and education. This new teaching hospital will be built across 15th Street from University Medical Center Brackenridge and will be flanked by Dell Medical School, new research facilities, and medical office buildings.

Seton's new teaching hospital will become Central Texas' gateway to the future of care.  With Dell Seton Medical Center at The University of Texas, Austin will have more specialists for a growing population; sustain high quality care for all, with a special concern for the vulnerable; discover new treatments, and enjoy economic growth.