Illinois Medical Home Project

ILLINOIS MEDICAL HOME PROJECT ABSTRACT YEAR 4

Project Title: Illinois Medical Home Project (IMHP)
Project Number: 1 H02MC02609-04-01 (CFDA #93.110, Priority Three)
Principal Investigator: Charles N. Onufer, MD, FAAP Phone: 217-793-2340
Project Director: Kathy Sanabria, MBA, PMP Phone: 312-733-1026
Organization Name: Illinois Chapter, American Academy of Pediatrics (ICAAP)
Address: 1358 W. Randolph St., Suite 2 East, Chicago, IL 60607-1522
Phone: 312-733-1026 ext 208 Fax: 312-733-1791 E-mail: ksanabria@illinoisaap.net

Project Period: 4 years from July 1, 2004 to June 30, 2008

PROBLEM:

Primary care providers lack information, understanding, and training about the medical home model and benefits of providing community-based, family-centered care.

GOALS AND OBJECTIVES:

Goal 1 Plan, develop, and implement the IMHP (Objectives: A. Convene Project Advisory Committee (PAC) annually; B. Adhere to grant work plan and MCHB reporting requirements.) Goal 2 Provide IMHP practices and others with specialized education, resources, training, and technical assistance to build community-based medical homes (Objectives: A. Establish systems within 19 primary care practices to support quality improvement (QI) initiatives [nine practices years one and two for Phase I and 10 practices years three and four for Phase II]; B. Improve the ability of practices to be medical homes through training and assistance.) Goal 3 Promote/support community inclusion of Children and Youth with Special Health Care Needs (CYSHCN) by strengthening linkages between IMHP sites and community resources (Objectives: A. Improve quality/frequency of communication between practices and community partners; B. Improve quality/frequency of communication between practices statewide and state/community-level CYSHCN systems.) Goal 4 Enlist the involvement of providers at large, community groups, insurers, and other stakeholders in IMHP (Objectives: A. Implement a public relations plan to promote the medical home to providers and families; B. Implement a strategic plan to spread medical home messages and strategies across Illinois.) Goal 5 Improve capabilities at the practice/systems levels statewide for development of medical homes (Objectives: A. Ensure commitment and action of state government decision makers and leaders to improve systems; B. Evaluate progress and identify needs in adapting statewide systems; C. Enable practitioners and community service representatives to improve coordination of services.) Goal 6 Evaluate the efficiency and effectiveness of the IMHP (Objective A. Implement the Institutional Review Board-approved project evaluation protocol to measure change in medical home capabilities and compare with baseline.

METHODOLOGY:

The IMHP uses the “Plan-Do-Study-Act” cycle of practice improvement. The project establishes systems within and beyond 19 practices to support medical home initiatives utilizing the Center for Medical Home Improvement (CMHI) Tool Kit, training materials, and resources; QI team facilitators; technical assistance; learning sessions; practice and family surveys; and modest funding to support practices. Facilitators utilize knowledge of medical home concepts, family involvement, and proven QI techniques to support office-based changes to better serve CYSHCN and their families. The project implements a public relations strategy to promote medical home and hosts meetings and in-services to spread implementation.

COORDINATION:

The IMHP is administered by ICAAP in collaboration with the Illinois Title V agency, the Division of Specialized Care for Children (DSCC), University of Illinois at Chicago (UIC). Representatives from Family Voices of Illinois, Illinois Academy of Family Physicians, Illinois Council on Developmental Disabilities, and Illinois Department of Healthcare and Family Services serve on the PAC. Over twenty Illinois state agencies and private organizations contribute to the project.

EVALUATION:

Data are collected from phase I and II practices at baseline and 18-24 months later using CMHI Medical Home Index, Medical Home Family Index/revised Family/Caregiver Survey, Practice Assessment Checklist, and Team surveys to measure changes in delivery of care, access to services, and satisfaction with care. During phase II, a control study measures the effect facilitators have in building medical homes. 

EXPERIENCE TO DATE:

During Phase I the IMHP established a formal relationship with the Illinois Title V agency, DSCC, and UIC to implement the grant; appointed a PAC and Evaluation Subcommittee; subcontracted with the UIC, School of Public Health, to design/implement the evaluation protocol and attain IRB approval; enlisted nine practices to serve as demonstration sites; facilitated monthly QI team meetings; held three bi-annual learning sessions; pilot-tested a new evaluation tool; translated evaluation tools and family communications into Spanish; gathered and analyzed practice baseline and follow-up data; developed an IMHP Web site; administered the Illinois Provider Directory for CYSHCN; published eight articles on the IMHP; published and widely disseminated two Newsletters; and developed public education materials for families. For Phase II, the project methodology has been refined based on lessons learned and is being implemented with five practices assigned facilitation support and five practices receiving technical assistance to measure the effect facilitators have in implementing change. A medical home coloring contest targeting elementary school children is underway. The IMHP is collaborating with the American Board of Pediatrics to develop a medical home QI board recertification program.

KEYWORDS:

access to health care, children with special health care needs, early intervention, family centered health care, parent professional relations, medical home, interagency cooperation, pediatricians, quality assurance, and reimbursement

ANNOTATION:

Using measures of practice behaviors and an outcomes-based, continuous quality improvement process, the Illinois Medical Home Project (IMHP) provides training and technical assistance to 19 practices or public health clinics implementing the medical home model. The IMHP informs Illinois providers and families about the medical home, provides access to an effective strategy for improving practices, encourages family involvement, collaborates with state leaders and policymakers to implement medical homes, improves reimbursement for care coordination, and measures the impact of the project.

Phase II Sites

Phase I Sites

Reporting!

In May 2006 the IMHP submitted its Year 2 Progress Report to the Maternal and Child Health Bureau. To view this report and learn about the project's experiences to date, click here. In March 2007 the IMHP submitted its Phase I Progress Report to the Maternal and Child Health Bureau. To view this report and learn about the project's experiences to date, click here.

On this Web page you will find information about the following:
IMHP Goals
Project Staff
Project Advisory Committee
Project Evaluation

Click the links below to learn more about the:
Project Evaluation	Medical Home Tools for Providers	Medical Home Tools for Families

Targeted IMHP Goals

Project Advisory Committee
The IMHP convened a Project Advisory Committee of general pediatricians, developmental and behavioral pediatricians, family physicians, parents of CSHCN, and organizational representatives to provide oversight for the implementation of the project.

Karen Belcher	Parent
Helen Binns, MD, MPH, FAAP	Children's Memorial Hospital
Larry Desch, MD, FAAP	Hope Children's Hospital
Margie Harkness	Illinois Council on Developmental Disabilities
Jerie Beth Karkos, MD, FAAP	SIU School of Medicine
Faye Manaster	Family Voices of Illinois
Christeen Mauerman	Parent
Sean McCormick, MD	Pediatric Health Associates
Stephen E. Saunders, MD	Illinois Department of Healthcare and Family Services
Charles Onufer, MD, FAAP	Division of Specialized Care for Children
Edward Pont, MD, FAAP	Pediatrician
Jamil Rana, MD, FAAP	Pediatrician
Marian Sassetti, MD	Family Physician
Shelly Shallat, MD	Pediatrician
Kate Valentine	Illinois Academy of Family Physicians

The Illinois Medical Home Project is supported through grants from
the U.S. Department of Health and Human Services,
Health Resources and Services Administration,
Maternal and Child Health Bureau, 1H02MC02609-01-00.