Our office wants to be your Medical Home. Home is where we should be comfortable and safe. Home is where we should participate in all levels. These themes can carry into your health care. A medical home coordinates care across all elements of the broader health care system, including specialty care, hospitals, home health care, and community services and supports.
This is long, so please read the TL:DR (Too Long, Didn’t Read) summary at the bottom if you don’t have time for the whole thing!
Our healthcare system is moving to a Population Health system in an attempt to make our healthcare better at a lower cost. Eighty percent of what affects health outcomes is associated with factors outside the traditional boundaries of healthcare delivery—health behaviors (diet, exercise, tobacco exposure, sexual activity), social and economic factors (employment, education, income, divorce, abuse), and physical environment (air quality, water quality). When healthcare delivery systems expand their interactions with people in these areas, it is expected that healthcare outcomes will improve.
What does population health mean to you? Hopefully it will mean we can keep everyone healthy for less money in the end. But it will also require your help. We know that some of these requirements are time consuming and may be annoying, but they are required by regulations. We are not making extra work for ourselves and for you for our own kicks!
- We will need to track patient satisfaction so we will be surveying patient families about their care. Please take a moment when you leave our office to do a survey. We have an ipad at the nurse’s station for this purpose.
- We need to insure that families get into specialists within an appropriate time. This does not mean that we have special powers to get your child in sooner than the specialist’s schedule allows, but it does mean that it’s important for you to contact the specialist to schedule the appointment within a week. After your child gets a referral to a specialist we will be watching for a consult summary. If we do not get one, we will contact you to be sure you were able to schedule an appointment. While this might seem obtrusive in repeated phone calls or portal messages, we are required to do this. Please schedule appointments as soon as you can or notify our office if you are unable to schedule or decide to not see the specialist.
- We need to do certain screenings at various ages or for specific diagnoses. Some of these are questionnaires that you can do before your visit. Before scheduled well visits you will receive a pre-visit email. Please read these carefully. There may be forms to fill out to help streamline your appointment. If you do not do these prior to your visit, you will need to do them before being seen. If your child is in need of a lab, please go to the lab in a timely fashion. If we do not receive results, we will contact you to be sure we didn’t miss the results.
- Insurance companies track your diagnoses and if appropriate treatments were given. For instance, if your child has moderate persistent asthma, he should be seen at least every 6 months for evaluation of asthma control and he should take a daily preventative medicine. If you’re not filling the prescription regularly, we will receive a letter from your insurance company notifying us of this and we may contact you to see why prescriptions are not being filled. Conversely, if your child has an upper respiratory infection and is treated with an antibiotic (even if it is not from our office) we will receive a scolding from your insurance company. We of course are not happy that we are being held accountable for the healthcare received at urgent care centers outside our office, but we are responsible for educating our patients. Please attempt to use our office when possible so we can help to insure your child gets treatment that meets current standard of care guidelines. See our Symptom Decision Chart to decide if your child needs to be seen after hours elsewhere or if they can wait to be seen. If you’re still not sure, call the on call person.
- Disease prevention is given priority with the population health model.
o We will focus on giving vaccines on time, talking about healthy habits (such as diet, exercise, helmet use, proper car seat use), and follow Bright Future Guidelines for routine visits and screenings.
o We will attempt to get every child in for their routine physical exams according to the Bright Futures Guidelines. Expect a phone call if your child is behind on “well visits”.
o We will enforce regular follow up for chronic conditions, such as ADHD, asthma, anxiety.
o We will screen for exposures to tuberculosis or lead. We will order labs for anemia at appropriate ages.
o We will be testing all “high risk” girls for gonorrhea and chlamydia with a urine sample at least once a year. Note: “High risk” does not always mean they are sexually active. It might be that they have abdominal pain or take oral contraceptives for menstrual cramps or heavy flow. Over testing is preferred to missing a case of asymptomatic disease and we all know that some teens are afraid to admit to behaviors.
- Treatment guidelines will be followed and tracked. If your child has a chronic condition (such as asthma, ADHD, obesity, and many more) we will track to be sure your child is seen within an appropriate time and has had appropriate evaluations and treatments. This means if your child has not had a visit to discuss this issue, we will be contacting you to schedule an appointment. If you haven’t done labs, xrays or other studies that are recommended, we will contact you. If you haven’t filled prescriptions regularly, we will contact you. If some of this annoys you, we understand. We don’t like being your babysitter either. Our doctors don’t want to spend their “free time” tracking down referrals or being scolded by insurance that another patient hasn’t filled their asthma controller medicine regularly. We still need to see patients during office hours, so this really does increase our workload. It’s not our choice though. It is where healthcare is going based on new laws and mandates. We must oblige. Please help us!
- We will avoid prescribing unnecessary tests and treatments. Do not demand treatments that are not necessary. This includes antibiotics for non-bacterial infections, labs that are not indicated, x-rays (or other imaging) for things that do not require an image, or referrals that do not require a specialist. If you think there is a need for one of these things, talk to your doctor about why you feel that way and listen to why they think it isn’t indicated. Communication is key to good care. There are certainly times that parents are right, and we will listen to your concerns and adjust our treatment plan accordingly if indicated. But too often parents want every study done despite no clinical indication or a prescription for something that doesn’t need a prescription. Doing things without a clinical indication only increases everyone’s costs for healthcare. Even if you’ve met your deductible for the year, the money will be applied to future insurance premiums. We all pay in the end!
- Use of outside urgent care and emergency room visits will be tracked by your insurance company. Attempts will be made to keep your children out of emergency rooms and urgent cares, which often cost more than your primary care office. We understand that there are times children really need to see someone after hours, but most visits to urgent cares and emergency rooms are not urgent or emergent, they are done for convenience. This increases healthcare costs and decreases the quality of care given because they do not have access to your child’s chart and your child’s doctor may or may not know about these visits, which fragments medical care. Emergency room and urgent care providers tend to order more tests and medicines because they do not have follow up and want to cover all the bases. Primary care practices have a better means for follow up, so can better monitor symptoms over time. We are expected to have availability outside of standard business hours to help accommodate families.
- We are open from 8 am until 6 pm Monday through Thursday, 8 am to 5 pm Fridays, and 8 am to noon on Saturdays with the exception of lunch from 12:30-1:30.
- We offer an urgent care for walk in visits six days a week for your convenience. See Urgent Care for specific hours and what is appropriately seen in our urgent care. Please consider this as an option whenever possible!
- Visit our Calendar to see specific office hours, holidays we're closed, and special events.
To help us with population health management, we have joined together with other local pediatricians and Children’s Mercy in the Children's Health Network (CHN). CHN's objective is to deliver high-value and integrated care that meets the Triple Aim for children in the target population. For more information see Children's Health Network.
- Read all pre-visit messages and fill out any surveys and forms included in the message.
- Schedule follow up appointments before you leave the office.
- Contact any specialist we have referred your child to within a week to begin the scheduling process and let us know if you cannot get an appropriate appointment.
- Pick up prescriptions and give medicines as directed. Call us if you cannot fill a prescription for any reason.
- Do any lab or x-ray as soon as possible or as directed by your physician.
- Schedule a well visit (AKA check up, sports physical) if your child is due.
- Help us provide the best care by taking our surveys to let us know what you like and don’t like about your visit.
- Use our office for visits as much as possible. If you aren’t sure if something can wait until office hours, check the Decision Chart or call!
- Do not demand treatments that are not necessary from us or an outside provider if the treatment is not indicated.