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Resources : Access to Care & Information

Same Day Appointments

New website helps both physicians and patients understand and benefit from the new health care reform law

healthcareandyou.orgThe new website is designed primarily for consumers, but physicians can also use it to help their patients make informed health care decisions. The site provides easy-to-understand descriptions of nearly all aspects of the health care reform measure and offers in depth information on how the law handles medical treatments, disease prevention and coverage for pre-existing conditions. The site also features a state-by-state listing of health care coverage options available now and in the future. Read more at AAFP News Now »

» AAFP Resources: Same Day Appointments
The AAFP offers simple and useful Word and Excel tools to determine capacity and predict demand.

» Primary Care Access Measures at Institute for Healthcare Improvement
The IHI's Access outcome measures include Percentage of No-Show Appointments, Future Capacity, Third Next Available Appointment and Office Visit Cycle Time.

» Dartmouth College and Clinical Microsystems - Improving Access to Care Toolkits
Some of the very best materials on the topic of Advanced Access / Same Day Appointments are available from the smartly redesigned Clinical Microsystems site at Dartmouth.
• The Measuring Access Improvement Workbook
A valuable collection of international materials that samples best practices over a decade.
• Measuring Access Improvement - Patient Focused Access Measures
by Marjorie M. Godfrey, MS, RN and Victoria P. Patric, MHA

» STFM Competency-based Curriculum: Advanced Access Scheduling
Developed by George Valko, M.D., Department of Family and Community Medicine at Jefferson Medical College of Thomas Jefferson University, this resource will help you develop a working knowledge of Advanced or Open Access Scheduling and understand its role in office practice. Available at the FMDRL Web site.

Group Visits

» AAFP Resources: Group Visits (Shared Medical Appointments)
The AAFP offers a practical FAQ & Bullet-style exploration of Group Vists. A time-efficient way to get answers to common questions and acquire a basic understanding of the necessary preparations and actions.

» Group Visit Starter Kit
This excellent and very complete overview of group visits, created by the Group Health Cooperative and downloadable as a Word document from from the ICIC, offers everything from rationale to planning and implementation to coding and billing recommendations.

» The Finer Points of Group Visits
This PowerPoint presentation by Julie M. Schirmer, LCSW; Ed Shahady, MD; Brian Stello, MD and Lucy Candib, MD at FMDRL is an excellent primer for Group Medical Visits, including significant practical and useful information on differing models for visits, typical agendas and content as well as outcomes data and billing specifics.

» Roadmap for a Group Visit
Developed for a workshop at the 2006 STFM Predoctoral Education Conference, this MS Word document is a concise and instructive example of the "real world steps" necessary for a hypertension group visit, including a supplies list, objectives and a detailed sequence of activities. Download from FMDRL.

» Chronic Disease Management at Duke Family Medicine
This PowerPoint presentation available at FMDRL provides a detailed analysis of diabetes-focused group visits and self-care efforts in one practice, complete with time/energy and cost analyses. Available at Family Medicine Digital Resource Library.

» A Guide to Group Visits for Chronic Conditions Affected by Overweight and Obesity
The AAFP's Americans in Motion (AIM) initiative offers this step-by-step 16-page guide to conducting and getting paid for group visits for patients with chronic conditions directly related to overweight and obesity, including diabetes. Included are sample scripts for phone calls, sample invitation letters, confidentiality forms, checklists, and sample progress notes, as well as a "fitness inventory".

» Group Visit Consent Form
A prototype consent form and confidentiality agreement in Word document from the University of Virginia, available at Family Medicine Digital Resource Library.

» FPM Toolbox: Group Visit Resources
Encounter forms for nursing home group visits and diabetes-focused group visits, as well as a sample invitation letter for patients are offered at FPM's Web site.

» Competency-based Curriculum: Group Visits
Developed by a team of family medicine educators who are passionate about group medical visits, this resource will help you strategize, plan, and conduct group medical visits in primary care. Available at the FMDRL Web site.

e-Visits and Online Patient Services

Popular "Patient Portal" Options for e-Visits and e-Services
An overview of the features, benefits and differences among four popular Web portal Application Service Providers (ASPs) including Medfusion, iHealth's Medem, McKesson's Relay Health and ReachMyDoctor from RMD Networks.

Expert Advice: e-Visit Best Practices and Risk Management Tips
TransforMED consultant Dr. Joseph Scherger offers these tips and best practices for practices looking to use e-Visits to interact with patients.

Marketing E-Visits and e-Health Services
A list of fifteen useful, easy-to-implement ideas to help you inexpensively market your practice's online services.

Online Patient Education Resources for Practice Web Sites
TransforMED's "core list" of health care Web sites that your practice can add to your Web site

Culturally Sensitive Care

» HHS's Think Cultural Health
Sponsored by the Office of Minority Health (OMH), this site offers a Language Services Guide for patients with limited English proficiency, CLAS Standards (Culturally and Linguistically Appropriate Services) and the latest resources and tools to promote cultural competency in health care. Also available: A Physician's Practical Guide to Culturally Competent Care, which is a free online educational program CME-accredited for physicians, physician assistants, nurse practitioners, and pharmacists.

» The Provider's Guide to Quality and Culture - Quality and Culture Quiz
The quiz takes about ten minutes - there are 23 multiple choice and true/false questions. Once you complete the quiz, you can choose to learn more about any of the topics by exploring in-depth readings and following suggested activities.

» Taking Cultural Competency from Theory to Action
This report from The Commonwealth Fund provides principles and recommendations, best practices and case studies: "...while much work has focused on defining cultural competency, there has been considerably less on taking cultural competency from theory to action. This paper provides principles and recommendations for implementing cultural competency in the field."

» AAFP Resources: Cultural Proficiency
The AAFP has aggregated an excellent list of resources, including guidelines, self-assessments, links to relevant Web sites and multi-cultural educational materials.

» Medical Leadership Council on Cultural Proficiency (MLC)
The MLC Web site provides a variety of tools and resources for improving cultural proficiency, eliminating barriers to health care and reducing disparities. Of particular note are the database of Language Access Resources and Language Access Tools, which includes a Spanish-English dictionary of 14,000 health-related terms.

After-Hours Care Coverage

» Family Practice Management : Creating a Successful After-Hours Clinic
This 2004 case-study article by James Quackenbush, MD, Roger Shenkel, MD, and Victoria Schatzel, RN, CDE, describes their practice's after-hours clinic as "the most successful innovation in primary care delivery in our community in recent memory."

» The Journal of Family Practice : After-hours telephone triage affects patient safety
This March 2003 article by David E. Hildebrandt, PhD; John M. Westfall, MD, MPH; Peter C. Smith, MD succinctly presents the results and recommendations of a safety study, concluding that, "After-hours call systems in most primary care offices impose barriers that may delay care." The authors urge all clinicians that use an answering service to "examine their policies and procedures for possible sources of medical error."

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