1. CHCACT Collaborative PCMH Element 1 A
Jaquel Patterson, N.D., Director of Operations
Norwalk Community Health Center
September 15, 2011

2. PCMH 1: Enhance Access and Continuity
PCMH 1A: Access During Office Hours (MUST PASS, 50%+, 2 of 4 factors met)
The practice must have written process and defined standards, and demonstrates that it monitors performance.
Policy and Reports

3. PCMH 1A: Enhance Access and Continuity
PCMH 1A :General Guidelines
The patient can access the clinician and care team for routine and urgent care needs by office visit, by telephone, and through secure electronic messaging.
Patient care needs and preferences when determining urgency of patient requests for same-day access are reviewed.
Polices must be in effect for at least 3 months and demonstrate performance has been monitored.

4. PCMH 1: Enhance Access and Continuity Factor 1
PCMH 1A, Factor 1: Providing Same Day Appointments
Critical Factor—must be met to get any score on element
Also known as: “Open Access,” “Advanced Access,” or “Same Day- Scheduling.”
This must be based on practice triage. It does NOT include overbooked appointments.
Example: Third next available appointment (how are you accommodating to patient needs.)

5. PCMH 1: Enhance Access and Continuity: Factor 1
Resource: ProHealth

6. PCMH 1: Enhance Access and Continuity: Factor 1
Resource: ProHealth

7. PCMH 1: Enhance Access and Continuity Factor 1
Doctor 1
Doctor 2
Doctor 3
Open Access/Same Day slots are available daily; e.g % patient slots

8. PCMH 1: Enhance Access and Continuity Factor 2
PCMH 1A, Factor 2: Providing Timely Clinical Advice by Telephone During Office Hours
Clinicians return calls in a timely manner.
The practice must define the timeframe for a response and monitor timeliness of response to the practice’s standard.

9. PCMH 1: Enhance Access and Continuity Factor 2
Policy example
Resource: ProHealth

10. PCMH 1: Enhance Access and Continuity Factor 2
Report that shows response times.
For example, ShorTel report that shows when calls are picked up by physician, nursing station, etc. and see how the time corresponds to policy.
Report can be system generated or collected based on minimally 5 days of calls.
Time frame must be defined and measureable.

11. PCMH 1: Enhance Access and Continuity: Factor 2
Screenshot: Phone reports on clinician support during working hours
Resource: VXTracker

12. PCMH 1: Enhance Access and Continuity Factor 3
PCMH 1A, Factor 3: Providing timely clinical advice by secure electronic messages during office hours.
Factors 2 and 3 are comparable.
Response time to secure electronic messages must be defined in a policy and measured accordingly to this standards.
E.g. patient portal for secure messages. Not needed to meet this must pass. 2 of 4 factors met achieve a score of 50% which is the “Must Pass” cut-off score.

13. PCMH 1: Enhance Access and Continuity Factor 4
PCMH 1A, Factor 4: Documenting Clinical Advice in Medical Record
Must be documented whether its by phone or secure electronic messaging.
Practice must have a documented process and provides three examples of clinical advice documented for phone or electronic messaging. A report can also be used to show how often advice is documented in record (recent 1 month period).

14. PCMH 1: Enhance Access and Continuity: Factor 4
PPC 1A, Factor 4: Documented clinical advice from phone call. Same day access booked.

15. PCMH 1: Enhance Access and Continuity: Factor 4
Example Report

16. Summary Make sure policies are completed at least 3 months in advance.
Monitor adherence to these policies as defined by organization.
Make sure everything is measurable and reportable. Check with system capabilities for reports or responsible team member that tracks regularly.
MUST PASS = 50%