Profession

Practices making strides to transform family medicine

Participating practices are 10 months into a two-year project to change family medicine to a new, patient-centered model of care.

By Damon Adams — Posted Feb. 5, 2007

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Welcome to the virtual office of Bob Eidus, MD. It doesn't take a car to get here. Just the click of a few computer keys.

Patients visit the doctor via e-mail for $30. Typically, the encounter is a follow-up electronic session for something Dr. Eidus treated at his solo practice in Cranford, N.J.

"We're marketing them as online house calls," Dr. Eidus said. "In the long run, they will expand our capacity to treat patients. It gives tremendous convenience to patients."

The virtual effort is one way Cranford Family Practice is reshaping itself as part of a national demonstration project of TransforMED, an $8 million practice redesign initiative of the American Academy of Family Physicians. In April 2006, the AAFP announced that three dozen practices, including the Cranford practice, had been selected for the project.

Ten months later, the practices are integrating aspects of the initiative into reality. TransforMED is planning a second demonstration project for this summer.

"It's all going quite well. We feel as though we've been very successful," said Terry McGeeney, MD, president and CEO of TransforMED.

"Different practices are working on different things," he said.

TransforMED was the result of the Future of Family Medicine report, which national family medicine organizations released in 2004. The report called for transforming the specialty to a new model whose core elements include patient-centered care, electronic medical records, team approach to care, open access for patients, and a focus on quality and safety.

A financial analysis of the project said the estimated transition costs for the model would range from $23,442 to $90,650 per doctor, depending on the initial productivity loss related to implementing an electronic medical records system.

TransforMED's two-year demonstration project began in July 2006, and practices are now being evaluated and are sharing information on an ongoing basis. A final report is set to be released in 2009.

Moving toward patient-centered care

The effort received a big boost late last year when the Commonwealth Fund awarded a $263,658 grant to family medicine researchers at the University of Texas Health Science Center at San Antonio, which is working with the AAFP on TransforMED. Researchers will use the grant to evaluate the initiative's impact from the patient's perspective.

This summer, TransforMED plans to start a second demonstration project to test "new and innovative ways to train residents," Dr. McGeeney said. Family residency programs nationwide will take part in the project.

Meanwhile, practices in the existing demonstration project are pleased with their progress.

Dr. Eidus said the biggest change to his practice was starting virtual office visits last month. His practice had an electronic medical records system before joining the project, but the virtual visits are helping transform his office to the new model of care.

He said the virtual approach is convenient for patients who are unable to get away from work or home, and it allows for more open-access scheduling at his office.

"For follow-up [visits], it's a good way to do it," he said.

Trinity Clinic Whitehouse, a family medicine group practice of three physicians in Whitehouse, Texas, started using virtual visits last month. Medical Director Melissa Gerdes, MD, said the practice had promoted the service to patients, and she expects them to embrace it.

"It's going to be a very slow process. Patients are not jumping on the bandwagon as quickly as I thought they would," she said.

Another demonstration project participant, Myrtue Medical Center Clinics in Harlan, Iowa, is launching its electronic medical record system. The large group practice also has started open-access scheduling and is getting close to beginning chronic disease management, said Medical Director Don Klitgaard, MD.

"It's definitely going to make things more patient-centered," he said. "It's high-tech but still high-touch."

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