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Resources: Care Management

Wellness Promotion

» IHI Improvement report : Integrated Counseling and Wellness Services in Primary Care
A spot-on example of effective efforts to integrate wellness services by the team at Grand Valley Health Plan in Michigan.

» MyHealthyLiving.net
The MyHealthyLiving.net Web site aims to help primary care doctors assist their patients live healthier lives by providing patient education "information and guidance about diet, physical activity, smoking, and alcohol use" from "some of the best information available from major national organizations and government agencies."

» Motivate Healthy Habits
Move beyond "self-fulfilling prophecy of clinical nihilism." Guidebooks, training and assessments by Family Physician Dr. Rick Botelho help resistant patients and healthcare providers partner to successfully change unhealthy habits.

Disease Prevention

» Patient Self Management Tools Overview
A definition and broad overview of the types of self-management tools, distinguished "primarily by patient role and secondarily by variations in the complexity of technology."

» FPM Toolbox: Preventive care
Nine "flow sheet" tools "to help physicians track whether patients of any age have received the necessary preventive care services."

» ACPM - American College of Preventive Medicine
The American College of Preventive Medicine is the national professional society for physicians committed to disease prevention and health promotion.

» Disease Management Resource Guide
Disease Management. A collection of articles from MANAGED CARE magazine. ... places primary care physicians back at the center of care delivery [June 2005] ...

» FPM Toolbox: Disease Management Encounter Forms
AAFP's Family Practice Management makes available encounter forms, chart reminders and other tools for Asthma and Diabetes.

Chronic Disease Management

» Improving Chronic Care's Chronic Care Model
The Chronic Care Model emphasizes use of evidence-based guidelines, care coordination, follow-up and outcomes analysis, and patient self-management education and support.

Patient Engagement and Education

» Online Patient Education Resources for Practice Web Sites
TransforMED's "core list" of health care Web sites includes popular patient education Web sites, sites especially for parents and kids, Web sites that focus on HIV/AIDS, online patient support communities, sites that offer useful interactive animations, vaccine information, patient-centered lab test information, alternative health information and resources to help your patients learn about how to evaluate the accuracy and reliability of the proliferation of online rescources.

PATIENT EDUCATION TOOLS FOR PRIMARY CARE PRACTICES

INTRODUCTION TO THE PATIENT-CENTERED MEDICAL HOME
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©2009 Emmi Solutions

Emmi Solutions and TransforMED partnered to create a web-based patient education tool designed to play an integral role in the transformation of primary care practices to Patient-Centered Medical Homes. The result is an engaging and education multimedia experience that helps patients understand the Patient-Centered Medical Home and their important role in the collaborative health and wellness relationship with their primary care practice.

Put this exciting patient education tool on your website for FREE by clicking the "Download it" button, above.


Disease and Population Management Software/Registries

» IT Tools for Chronic Disease Management: How Do They Measure Up?
This 2006 "invitational product review" compares chronic disease management systems (CDMS) products to electronic medical record (EMR) products, evaluating the strengths and weaknesses of 10 commonly-used products in terms of their effectiveness in chronic disease management.

» Using Computerized Registries in Chronic Disease Care
Concluding that a registry is more affordable and speedier to deploy than an electronic medical record (EMR) system and is a practical tool for improving patient management, this CHCF report is intended to help physicians, clinics, and medical groups conduct their own assessments of these tools by offering practical information, including:
• Definitions, functions, and types of registries
• How to choose between a registry and an EMR
• Cost and workflow redesign considerations
• Examples of registries in use at the point of care and for population reporting

» Improving Chronic Illness Care - Registry Evaluation Form
ICIC's a Registry Evaluation Form (Microsoft Word document) will help to guide and structure your practice's evaluation of the available software, prior to making a purchase or implementation decision.

Evidence-based Decision Support

(Also see Quality & Safety Resources for more evidence-based Best Practices and Outcomes Analysis resources.)

» Introduction to Evidence-Based Medicine
From Duke University Medical Center Library and University of North Carolina at Chapel Hill Health Sciences Library.

» Evidence-Based Practice: An Interprofessional Tutorial
This two-lesson tutorial is "designed for students in healthcare fields, medical professionals, faculty, and anyone else interested in evidence-based practice."

» EBM Web Page Generator
A tool that walks you through a processor that culminates in the generation of a custom EBM Web page that you can add to your Web site.

Do you need experienced, effective help to become a Patient-Centered Medical Home?

TransforMED works closely with your practice to target, plan and implement the improvements your practice and care team need to achieve Medical Home designation.

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