The project's independent evaluation team employed a multimethod evaluation strategy that used a wide lens and multiple perspectives to understand both the details and overall success of the transformative change process in the sample of 36 practices randomly assigned to either a facilitated or self-directed group. Practices in the facilitated group received an intense combination of on-site facilitation, learning sessions, and access to national consultants and pre-vetted vendors of a range of health information technologies. Final analyses were based on complete data for 16 facilitated and 15 self-directed practices.
The researchers report that practices in both the facilitated and self-directed groups were able to adopt numerous components from the NDP-model PCMH over 26 months. Practices that received intensive coaching from a facilitator adopted more NDP-model components. Adopting these predominantly technical elements of the PCMH appeared to have a price, however, as average patient ratings of these practices' core primary care attributes slipped slightly, regardless of group assignment.
Specifically, they report that at baseline, facilitated practices averaged 17 NDP-model PCMH components in place (44percent of all components) and self-directed practices averaged 20.1 components (52 percent of all components). At 26-month follow-up facilitated practices added an average of 10.7 components vs. 7.7 in the self-directed group. Some model components were more challenging and less likely to be implemented (e-visits, group visits, wellness promotion, population management and team-based care).
The self-directed practices were also successful in adopting m
|Contact: Angela Sharma|
American Academy of Family Physicians