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Medical Homes gear up for patients

Community clinics enable 3,000 family members of active-duty military to return to Madigan’s care

Northwest Guardian

Published: 02:56PM May 1st, 2014
140502_madiganwelcomehomeart

Jay Ebbeson

Doctor Shawn Macleod and nurse Ann-Marie Martinez chat with patient Sally Baumbach at the Madigan-South Sound Community Medical Home in Olympia, Wash. "My family and I have been seen here since the clinic opened and we love it," said Sally Baum Bach. "Dr. Maccleod knows my family by our first names and my son can't wait to go see him, plus the nurses are awesome too."

Madigan Army Medical Center is welcoming ‘home’ about 3,000 family members of active-duty military personnel to its care.

The move is part of a larger operation by Western Regional Medical Command, said Major Michael Henry, chief of managed care at Madigan. The new rules apply to people who live within a 30-minute drive of Madigan’s Primary Care Clinic on Joint Base Lewis-McChord, assigning them to one of two Community Medical Homes. Those affected will receive information packets in the mail explaining the process, Henry said.

Two recent developments spurred this operation, named “Welcome Home to Army Medicine”: Madigan’s adoption of the Patient-Centered Medical Home model for delivering care to its patients, and the completion of its new Community Medical Home in Olympia, increasing Madigan’s patient capacity.

“We have the staff, we have these new facilities, and the natural progression is we need the patients to take care of,” Henry said.

The Medical Home model is something Madigan’s been working on for the past couple years, Henry said.

It creates for each patient a team of specialized nurses as well as a nurse-and-doctor team to bring care to the patient with more efficiency and effectiveness, Henry said. Labs, radiology, behavior health and pharmacy are all available on-site to patients.

“Those are all members of that team,” Henry said. “It’s more than just your provider and a nurse.”

Henry said many of those health care professionals are civilians, meaning military family members will be able to be seen by the same provider over time. The Department of Defense also digitizes all medical records, so that those will follow the patient wherever they go, adding more continuity.

“Knowledge is power, and it’s really a patient safety thing as well,” Henry said. “If your record moves with you and that information is available, your care is going to be that much better.”

Another central tenet of the model is secure messaging through vendor RelayHealth.

Henry said basic questions and prescription refills can be securely sent to the patient’s assigned nurse, who then can respond in short order. Patients then wouldn’t have to physically travel to the Medical Home for things like questions about a possible cold or to check on a prescription, Henry said.

If a family member has a concern during the Medical Home’s on-duty hours, same-day appointments can be made through the appointment phone desk, Henry said.

After-hours, patients have a couple of options. Henry said some things can be addressed by the on-call provider, but for those that can’t, that provider can authorize an urgent care visit as well.

When it came to capacity, Madigan previously simply did not have the room to effectively see and treat all of its potential patients. Under TRICARE, family members could, if unable to get in at Madigan, see doctors at civilian hospitals.

Henry said that with the new Medical Homes in Olympia and Puyallup, limited provider capacity no longer is a concern.

Financially, it’s a better deal too, Henry said. Patients won’t have the co-pays they shell out at civilian hospitals, especially for pharmacy benefits.

Some people might have concerns about being transferred from the civilian sector back to Madigan, Henry said, but current patient surveys dispute negative perceptions about Army medicine.

“Our positive points speak for themselves, in terms of the patient satisfaction side of it especially,” Henry said. “Of the thousands of other patients that are currently enrolled in these clinics, they’re very happy with the care they’re getting.”