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Health care — a team approach

Doctors throughout southern New Hampshire are embracing a new way of caring for people through Patient Centered Medical Homes, a team-based approach supporters say increases the quality of health care and decreases the cost.

Harvard Pilgrim Health Care recently wrapped up a 15-month pilot program with Foundation Medical Partners, the physicians group of Southern New Hampshire Health Systems, and Bedford Ambulatory Surgical Center.

The model of care is built on a foundation of care that is coordinated through a primary physician who taps into a network of nurse practitioners, clinicians, therapists and other health care providers to design individual health care strategies for each patient.

Key elements of the programs include expanded hours and access to doctors and health care providers and broad use of electronic medical records that allow a team to tailor treatments and reduce unnecessary or duplicate procedures and costly tests.

“It’s a proactive approach from the front desk to the physician,” said William Brewster, medical director for Harvard Pilgrim Health Care and an internist with a practice in Somersworth. Brewster said the new approach involves a different mindset that makes health care genuinely patient-centered.

During the 15-month pilot program, expanded office hours and access to providers cut high-cost visits to the emergency room by 10 to 12 percent. Immunization rates also increased dramatically. And according to Mark Santos, chief operating officer for the Foundation Medical Partners, the success isn’t just in the numbers.

“With a walk-in service open seven days a week, patients can come in on Thanksgiving Day in the afternoon and see someone who has their electronic medical record in front of them,” Santos said. Not only does that health care provider have the relevant information needed to treat the patient, but it also creates a much safer encounter, Santos said.

By creating a team approach or continuum of care, patients can access more support services that are coordinated by, but not directly provided, by doctors.

“There are a lot of talented people besides doctors working in health care,” Santos said. When patients are able to see those health care specialists through the program, doctors have more time to devote to more complicated cases that require more care.

And according to Mary Wallen, a spokeswoman for Harvard Pilgrim, the team approach increases the quality of care for patients.

“It’s a way to make sure nothing about a patient’s care falls through the cracks,” she said.

The model of care is a key part of the ongoing reform of the American health system, and six Foundation Medical Partners practices been recognized as official PCMHs through the National Committee for Quality Assurance.

Other foundation practices in Southern New Hampshire have applied for the PCMH credential and reviews are underway.

“PCMH will make primary care practices more attractive for doctors,” Brewster said. “But one of the most important changes is that patients will feel like they are part of a team.”

Santos said, “We think this work is a way to keep insurance premiums down and improve the quality of health care.’’

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