Pediatric Associates of the NW Blogs

Vocabulary for new (ish) Healthcare

Bruce Birk, MD
January 14, 2013 08:34AM

As we start another year, I find this is a great time to put my mind to the changes we will face in it. 2013 will be a special year for Pediatric Associates in that we will be making some changes to the general philosophy of how we care for our families. There has been a movement in medicine in America to better serve patients with chronic disease. Historically, individual doctors identified a patient as having a disease and then followed them along by themselves or with the help of more specialized doctors. Nowadays that seems quaint and not very effective. A patient with a chronic disease would be better served by a community of doctors, nurses, medical assistants, care managers, and support groups all coordinated together is some fashion. The catch phrase for this which you will hear many times in our office in the next year is “Care Management”. As a way to serve our patients better, we are going to be seeking out our families with chronic diseases (such as asthma, diabetes, attention deficit disorder, obesity, and cerebral palsy) and enrolling them in our Care Management program (at no extra cost). In doing so we will seek to be in contact more often and offer you services which you might not be aware are available to you (help with referrals, coordination of office visits, transportation to office visits, having your own Care Coordinator, etc.).

Also, historically the care of a chronic disease was dictated by the medical community. Nowadays, the patient is much more involved, knowledgeable and in control of their own care. As part of Care Management, your provider will work with you to establish specific goals to accomplish for your loved ones. So, if your child has asthma then your provider’s goal might be to make sure he is taking his asthma medications properly but your goal as a parent might be for him/her to play soccer without getting short of breath.

Who coordinates the care of a given patient has been a point of debate for a long time. Insurance providers, medical practitioners, healthcare systems, and patients all have a vested interest. In 2013, there is a growing emphasis on the medical practitioner as the focus of coordination of the care of their patients. The catch phrase for this is “Medical Home”. We are certified by the National Committee for Quality Assurance as a Level 3 Medical Home. In short, this means that we have systems which are well developed to coordinate our patient’s care at a very high level.

Lastly, with the changes of the Affordable Care Act, medical practices such as Pediatric Associates are being asked to show exactly what we are doing to help our patients with chronic disease in a more scientific manner. As I hope you noticed, we have been using electronic medical records (EMR) for many years. Part of our EMR lets us track our patient’s need in a specific manner. So, if your child has asthma, every time you step into the office with an asthma related issue our EMR notes it and tabulates what we are doing to help you. At the end of the year we look at the data to see if we are serving our asthma patients well. If we reach the highest of benchmarks for quality care we feel our system is working. If not, we make new goals for the coming year and adjust our system to make sure this happens. We also show our data to your insurance providers and other regulatory groups so they and you can know we are doing a quality job.

I hope this helps you as you work through the complex medical landscape. Our goal has always been to be the people behind the curtains making the medical world look easy to the people in the audience. We hope we continue to succeed.