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Primary Care in the United States: Lessons Learned to Inform Global Efforts to Improve Primary Care 
April 2017

These symposium proceedings are a source of lessons drawn from U.S. primary care to inform efforts to strengthen health systems in low- and middle-income countries. The Bill & Melinda Gates Foundation, recognizing the value of the U.S. experience in healthcare delivery, commissioned Qualis Health to convene a symposium on the topic at the Foundation’s Seattle headquarters on November 9, 2016

Sixteen experts from across the U.S. shared examples of healthcare delivery that illustrate high-functioning primary care, and described system innovations for improved care, better population health, and effective healthcare spending. Presenters introduced several emerging U.S. models of primary care delivery system design and recent innovations serving diverse populations. A distinguished reactor panel reflected on aspects of these American examples of interest to those working on primary healthcare system improvements globally.

The proceedings contain summaries of the presentations and reactor panel, links to the corresponding slides, and videos filmed during the symposium.

Oral Health Integration Implementation Guide
October 2016

This comprehensive guide provides an action plan and tools primary care practices can use to integrate oral health into their delivery of whole-person care.

Oral health problems are common, negatively impact other conditions such as diabetes and pregnancy, and result in expensive interventions that could be avoided with early detection and intervention. By screening for oral health risk factors and active disease, initiating appropriate preventive interventions, and coordinating dental care for those with active disease, primary care practices can improve patient outcomes and experience.

With 22 tools and seven case examples, the “Oral Health Integration Implementation Guide” builds on the Oral Health Delivery Framework described in “Oral Health: An Essential Component of Primary Care.” The Framework and tools were developed in partnership with 19 field testing sites over the course of 20 months.

The Oral Health Integration in Primary Care Project was sponsored by the National Interprofessional Initiative on Oral Health and funded by the DentaQuest Foundation, the REACH Healthcare Foundation and the Washington Dental Service Foundation.

Producing Accurate Clinical Quality Reports for Population Health: A Delivery System-Oriented Approach to Report Validation
March 2016

This white paper addresses the need to develop accurate and valid data reports for both internal clinical quality improvement purposes and external public data reporting purposes. It describes the foundational aspects of data reporting, including methodologies for generating reports, and the purposes for which the data can be used. It contains a process for identifying inclusion and exclusion errors that contribute to data report inaccuracy, as well as tools to help you validate your own clinical quality reports.

Oral Health: An Essential Component of Primary Care
June 2015

Oral health is essential for healthy development and healthy aging, yet there is an unacceptably high burden of oral disease in the U.S. This white paper makes the case for incorporating preventive oral healthcare as a component of routine medical care and structuring referrals to dentistry. The Oral Health Delivery Framework provides a practical method for primary care teams of all types to engage patients and families in the prevention and early detection of oral disease.

“Oral Health: An Essential Component of Primary Care” was published by Qualis Health with support from the National Interprofessional Initiative on Oral Health, DentaQuest Foundation, Washington Dental Service Foundation and the REACH Healthcare Foundation.

Endorsed by: American Academy of Nursing, American Academy of Pediatrics, American Academy of Physician Assistants, American Association of Colleges of Nursing, American Association for Community Dental Programs, Association of Faculties of Pediatric Nurse Practitioners, American Association of Public Health Dentistry, American College of Nurse Midwives, American Public Health Association–Oral Health Section, Association of Clinicians for the Underserved, Association of Maternal & Child Health Programs, Association for State and Territorial Dental Directors, Institute for Patient- and Family-Centered Care, National Association of Pediatric Nurse Practitioners, National Network for Oral Health Access, National Organization of Nurse Practitioner Faculties, National Rural Health Association, Patient-Centered Primary Care Collaborative, Physician Assistant Education Association

Supported by: American Academy of Family Physicians, National Association of Community Health Centers

The Safety Net Medical Home Initiative: Transforming Care for Vulnerable Populations
November 2014

This special supplement to the journal Medical Care presents the progress and lessons learned from the Safety Net Medical Home Initiative. It contains nine papers describing the 2008–2013 multi-state initiative that tested a replicable, sustainable implementation model to transform primary care safety net practices into patient-centered medical homes with benchmark performance in quality, efficiency and patient experience.

Safety Net Medical Home Initiative: Behavioral Health Integration Implementation Guide
October 2014

A component of the Safety Net Medical Home Initiative's Implementation Guide Series, these materials provide guidance and tools primary care practices can use to develop their vision for integrated care, create customized implementation plans reflective of their goals and resources, and build strong integrated care teams.

Advancing Primary Care through the Patient-Centered Medical Home Model and Optimization of Health Information Technology
September 2014

This white paper provides guidance to organizations engaged in the work of becoming a patient-centered medical home by showing how health IT can bolster PCMH objectives, such as generating and providing useful data, that can be applied to practice transformation efforts and allow for better communication with all members of the care team, including the patient.

Change Concepts for Practice Transformation and 2014 NCQA PCMH™ Recognition Standards: A Crosswalk
September 2014

There is a high degree of overlap between the Safety Net Medical Home Initiative’s Change Concepts for Practice Transformation and NCQA’s 2014 PCMH Recognition Standards. This crosswalk helps practices understand the commonalities between the SNMHI Change Concepts and the 2014 NCQA Recognition Standards.

The Journey Towards the Patient-Centered Medical Home: The Kansas City Experience
March 2014

This white paper was prepared to disseminate the learnings from the REACH Healthcare Foundation Medical Home Initiative to the broader health community as primary care practice is redesigned to adopt the patient-centered medical home model of care. It examines the journey of nine safety net primary care clinics in Kansas City as they strive to integrate components of patient-centered care into their daily work.

Standardizing the Problem List in the Ambulatory Electronic Health Record to Improve Patient Care

December 2012

This technical guide describes how to leverage the problem list for better individual patient care and population management and explains how practices can develop processes to standardize problem list maintenance. It was published as part of Qualis Health's work as the Washington & Idaho Regional Extension Center for Health IT.

Oral Health Integration in the Patient-Centered Medical Home Environment: Case Studies from Community Health Centers
September 2012

This paper presents case studies from community health centers that are aligning medical and dental care in the context of a PCMH to address the oral health needs of underserved populations.

The Changes Involved in Patient-Centered Medical Home Transformation
April 2012

Published in Primary Care Clinics, this article describes the process used to identify eight concepts and 32 key changes critical for PCMH transformation.


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