VILSECK, Germany -- The health clinic here began transitioning to a new patient-focused model of health care April 30, which will deliver a more proactive, collaborative care experience and improve overall health and access for community members.
The Vilseck Health Clinic is implementing a Patient Centered Medical Home model, which is a patient care model used by many hospitals in the civilian sector.
"We are trying to change our way of thinking, which has kind of been the same for about the last 20 years," said Dr. Gary Kulka, a family physician and the primary care medical director for the clinic here. "Army medicine has really moved forward with this model in the last 18 months, so there are a growing number of clinics stateside that are now Patient Centered Medical Homes."
PCMH has been adopted by primary care and family practices for more than a decade, Kulka said. The model focuses on patient care by the entire medical professional team. A team of medics, nurses, physician assistants and other healthcare providers all work together collaboratively to provide coordinated, proactive medical care for a single patient and their family.
The focus will be on the best way to meet the patient's needs for restoring and maintaining their health, Kulka said. PCMH makes use of an entire team of professionals as well as technology to help patients communicate their concerns, which then allows for the team to develop and implement a plan of care together.
"PCMH adds significant, unique, medical capabilities to the clinic's services," said Lt. Col. Chris Rheney, the Vilseck Health Clinic commander, who points out some of the benefits for the change. "Increased staffing includes a clinical pharmacist for medication reconciliation and disease management appointments, a nutritionist for integration of dietary and caloric issues, a nurse case manager for assistance with complex cases and inpatient stays or network referrals, as well as more robust nursing support to improve the quality of time spent with the medical staff."
Patients experience improved access to the appropriate level of care because the entire team focuses on listening to the patient and communicating in a way and time that best suits the patient.
Technology is a huge part of a PCMH and enables the community to access their health record over the internet through Tricare Online, Rheney said. Patients can see their lab results immediately, request prescription refills, and make appointments convenient to their schedule. Traditional appointments where the patient sees the doctor face to face are only a small part of the PCMH model. Patients can request telephone consults, see an assessment nurse, or even use secure messaging to coordinate their care, discuss a medical issue or seek advice.
Changing the traditional model and embracing technology is important for the clinic staff as well as the patient, Kulka said.
"Each member of the team will have a tablet device," Kulka said. "We are teaching people how to use these computers and also the software that comes with it."
During the month of May, the training on the software and workflow assessment are two of the reasons the clinic is dedicating so much time to getting the transition right.
The incorporation of the technology and change to the way patients are cared for at the clinic will allow for better quality of care and maximum patient empowerment to affect their own health.
The change will not happen overnight, Kulka insists, and while fewer appointments are available during the months of training and transition, it is going to pay off in a huge way for the community in the long run, Rheney said.
One of the biggest changes people can anticipate from the transition to PCMH will be the change in culture for both the staff and patients as the clinic moves toward an open access appointment approach, which will take care of today's problems today, Rheney said. The focus for the clinic will be to see everyone who needs to be seen the same day they book their appointment.
The change is expected to save a lot of time and allow providers to focus more quality time on examining patients and discussing treatments, Kulka said. Instead of giving patients a segment of time during the day's appointment and then rescheduling appointments to address other issues at a later date, patients will see the process change toward taking care of as many medical problems as possible during a single visit.
"This will fill in a lot of those gaps that patients have been feeling and it will provide better continuity of care," Kulka said.
The medical team will address most of the patient's overall health issues, but the teamwork is not complete without the patient's communication, involvement and commitment in order to ensure a successful outcome, he said.
"Our goal is to be fully staffed and to have the Patient Centered Medical Home fully implemented by the end of the summer," Kulka said. "We believe we will be able to have so much more to offer the community and hope to be able to open up enrollment to more of our retirees and others."
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