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Chapter FFM Implementation Guide |
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Chapter FFM Workshop |
Chapter FFM Implementation Guide
The following tools were developed based on feedback from chapter executives that have developed and presented on FFM within their chapters. These tools are provided as a guide to all chapters for use in developing their own FFM implementation plan. Following is a brief history of the FFM project with information on what is being done on a national level and what can be done a chapter level.
Please provide your comments, best practices, and feedback about implementing FFM at your chapter to the FFM Project Manager, Marilyn McMillen.
BACKGROUND OF THE FFM PROJECT
Seven organizations collaborated:
- American Academy of Family Physicians
- American Board of Family Medicine
- AAFP Foundation
- Association of Family Medicine Residency Directors
- North American Primary Care Research Group
- Society of Teachers of Family Medicine
- Association of Departments of Family Medicine
5 Family Medicine Challenges
- Creating public understanding of family medicine
- Organizing individuality of practices into a coherent, recognized brand
- Winning respect in academic circles
- Making family medicine an attractive career choice
- Leading in including science and technology in practice
10 Recommendations
- New Model of Family Medicine – Based on a relationship-centered personal medical home
- Electronic Health Records – Will be implemented to support the New Model of family medicine
- Family Medicine Education – Training will support the development of family physicians ready to deliver the basket of services as promised through the New Model of Family Medicine
- Lifelong Learning – Family medicine will develop a comprehensive, lifelong learning program
- Enhancing the Science of Family Medicine –Participation in the generation of new knowledge will be integral to the activities of all FPs and will be incorporated into FM training.
- Quality of Care – Academic FM and community-based FPs to address quality goals specified in the IOM Chasm Report.
- Role of Family Medicine in AHCs – Assess and enhance family medicine departments’ position within AHC setting.
- Promoting a sufficient family medicine workforce – Recruit and train a culturally diverse FP workforce
- Communications – A unified communications strategy to promote awareness and understanding of the New Model of family medicine and the concept of a personal medical home.
- Leadership and Advocacy – Promotion of family physicians and other primary care physicians as health policy and research leaders in communities, government, and with other influential groups.
Process for Implementing Recommendations
- “Family” discussion
- Prioritization of resources regarding recommendations
- National Efforts via lead organizations
- Local Efforts via AAFP chapters and members
Strategies for Implementing FFM
- Each of the 10 Strategic Initiatives prioritized and lead organizations assigned
- Tactics given an organizational priority
- “Helping organizations” identified; and
- “Organizational response” developed
- FFM Deputies to oversee implementation
Expectations of FFM
- Enhance the role of FPs through patient-centered care
- Bring technology into the FP office to increase efficiency and effectiveness
- Enhance reimbursement mechanisms for FPs
New Model of Practice
- Personal Medical Home for every American
- Patient-centered care that ensures patients are active participants in their health and health care
- Team approach to providing care
- A Consistent Basket of Services that patients can come to expect from the practice of family medicine
- Elimination of barriers to access
- Advanced information systems
- Re-designed offices
- Whole person orientation
- Care provided within a community context
- Emphasis on quality and safety
- Enhanced practice finance
6th Task Force on Financing
- The Task Force Six Report was published in 2004 Nov-Dec Annals of Family Medicine
- Task Force Six Goal: Develop a financial model that assesses the impact of the NMFM on practice finances.
TF6 Results
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Within current fee-for-service system, full implementation of the New Model of care could result in:
- 26% increase in compensation for prototypical FMP
- Or decrease work hours by 12% and maintain level of compensation
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Cost of the New Model
- To transition to the New Model of care: from $23,000 to over $90,000 per physician*
- Costs include: EHR, open access scheduling, group visits, online appointments, chronic disease management, practice guideline software, and changes in compensation with new model
* These are figures from Table 10 of TF6 report.
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Recouping Investment
- Report estimates recouping investment in implementing New Model of Care within 2 years
- National health care expenditures overall could fall according to the model by 5.6% if every American used a primary care physician as his/her usual source of care. If so, this would result in an annual savings of $67 BILLION and improved care
TF 6 Recommendations
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A national demonstration project to be launched including:
- 10-20 family medicine practices of varying sizes, locations, and patient populations, to fully implement all elements of New Model.
- An “in vivo” exercise focused on demonstrating “proof of concept.”
- A multi-method evaluation program imbedded in the project to determine empirically the business and medical performance characteristics of New Model.
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One or more business entities should be created to facilitate the implementation of New Model. This business entity should:
- Provide products and services necessary for a turn-key implementation
- Provide consultation on select components of the model
- Be launched in tandem with the demonstration project
Barriers to Implementing the New Model
- Cannot purchase integrated technology solutions “off-the-shelf”
- Requires large upfront capital investment [see NMPRC below]
- Lack of know-how for implementing New Model features
- Lack of capital to finance the transition
New Model Practice Resource Center
The mission of the New Model Practice Resource Center (NPMRC), approved by the AAFP in November 2004 with a budget of $8 million, is to lead, facilitate and support the implementation of the New Model of Family Medicine in the US by providing affordable, turnkey solutions, including needed tools and know-how, to target family physician practices
FFM CHAPTER FOCUS
Four Key Strategies:
- Encourage members to read the FFM report in its entirety (32 pages) and according to their interests the 6 task force reports (links to both reports found on the FFM Web site.
- Encourage the New Model of family medicine
- Encourage all physicians to utilize electronic health records
- Increase family medicine education about FFM
- Increase communications with patients, physicians, health care providers and the general public
Preparing for FFM in Your Chapter
Strategic Planning
- Consider a Chapter Board of Directors strategic planning session on implementing FFM.
- Teach the New Model as a transformation, not a tweaking.
- The New Model requires changes both within family medicine and the larger health care system to achieve its full potential.
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Conduct long-term strategic planning meetings
- How can we excite our members about the FFM?
- How can we engage the general public?
- How can we position our chapter as a leader in implementing FFM?
Communication Plan
- Increase awareness about the FFM Project among your chapter’s members
- Involve others such as other medical specialty societies, your state Medicaid program, your local health plans and insurance carriers, etc.
- Increase awareness about the FFM Project among the general public
- Develop and distribute a news release to statewide media announcing the FFM Project results and recommendations
- Send a letter to the editor to your local or state newspapers
- Consider presenting FFM at editorial board meetings of local/chapter newspapers
- Post an announcement, news release and all media coverage on the FFM Project on your chapter’s Web site. Track your web site hits
- Sent updates about the FFM Project to chapter members via regular chapter communication pieces, such as newsletters
- Establish a committee of media trained family physicians who can serve as spokespersons on FFM issues across your state
- Take advantage of media relations opportunities in which the FFM Project can be integrated into family medicine related national health observance days
- Conduct additional research to determine the most effective way to reach members about the FFM messages and information
- Identify speaking opportunities for chapter leadership to increase awareness about the FFM in your area
- Investigate the opportunity of chapter leadership to submit guest articles about the FFM to trade publications and other organizational newsletters
- Continue scheduling editorial boards at statewide daily newspapers to increase awareness about the FFM project and to promote any new developments that arise
- Continue submitting letters to the editor and opinion editorials to statewide papers on behalf of your chapter’s physicians and student members
New Chapter Programs & Projects
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Consider new and innovative programs and projects that promote family physician training and use of New Model concepts and progressive techniques, such as:
- Group visits
- EHR systems
- Disease registries
- Empowered office staff to improve patient care
- Consider grants that your chapter may be eligible for to help fund FFM programs.
- Hold media events as appropriate to launch new programs that address FFM
- Create statewide learning collaborative focused on elements of the New Model.
- Create recurring forums for students, residents and family physicians to share their progress in implementing New Model practice.
Integration and Long-Term Outlook
- Consider developing a curriculum to teach your members about FFM (One example would be a course on the integration of EHR and IT systems)
- Ongoing communication workshops can be offered to members in conjunction with CME meetings and chapter events
- Consider an educational summit to bring together family medicine stakeholders to strategize for FFM in your chapter (i.e. medical schools, chairs of family medicine, etc.)
- Be a part of establishing the FFM approach as the standard practice for current family medicine medical students and resident physicians in your chapter
- Integrate FFM Strategic Initiatives into your chapter’s committee work plans 2004-2006
- Monitor and, where appropriate, incorporate “organizational responses” into committee work plans
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Assign FFM tactics to appropriate chapter committee(s)
- Example: Your chapter’s Medical Practice Affairs committee could incorporate tactics from the “New Model of Family Medicine” such as redesigning the work and workplaces of FPs
Tasks for Your Chapter’s Committees
- Examine similarities of chapter Strategic Plan and FFM Report Recommendations and Tactics
- Review organizational responses to tactics and determine whether to actively pursue or monitor (or both)
- Report to chapter Board of Directors on how Committees will help implement FFM
Encourage your Membership to get involved
Ways for chapter members to help:
- Join a chapter committee
- Read the report and discuss it with colleagues, friends, neighbors
- Become a volunteer speaker for the chapter
- Identify/promote best practices
- Join practice-based research network
- Invite others to help
FFM National and State Resources
- The FFM Final Report, Task Force Reports, Methodology, discussion forum
- Staff Executive – Norman Kahn MD, AAFP
- Assistant Staff Executive – Sarah Thomas, AAFP
- Deputy Staff Executive – Larry Green MD, AAFP
- Project Manager – Marilyn McMillen, MBA, AAFP