PPC-1 -- Access and Communication
Element A -- Access and Communication Processes
Data Point 1 -- Scheduling each patient with a personal clinician for continuity of care

While in an electronic world, continuity of care is principally the result of all providers in all locations contributing to a common data base which is always available for a patient’s evaluation and treatment, SETMA strives to schedule each patient with their personal clinician.  SETMA collects data to show that it meets its standards on continuity.

When and if the primary care provider is not available another member, usually a physician or nurse practitioner, who is on the same care-management team, will see the patient.  Typically, all members of the Care-Coordination team will be in the same physical location.

All points of appointment access including front desk, unit clerks, nurses, website, and appointments by telephone will review the patient-visit history prior to finalizing a new appointment; for efficiency this is done electronically. By doing this, the staff can easily determine who the Primary Care Physician is and what members of the Medical Home Care Coordination team can assist with the patient’s care.

Every attempt will be made to schedule the patient with the person physician, however if this delays the appointment process, another Primary Care Physician within SETMA will be utilized. This is easily accomplished due to the electronic medical record, allowing every provider access to patient data thus leading to timely appointments and consistent continuity of care.

The Medical Home Coordination Review template which is shown below, aggregates all of the data which supports our PCMH effort. Particularly, it identifies the members of the Care Coordination team which participates in the care of each patient registered in the PCMH.