2014 - PCMH2A

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Move to next PCMH element - 2B

The practice provides continuity of care for patients/families by:

2.A.1 Assisting patients/families to select a personal clinician and documenting the selection in practice records.

Description Example/Screenshot/Documentation Source Date Added
A description of how a PCP is tracked in PCC Tracking a PCP in PCC PCC 07/03/14

2.A.2 Monitoring the percentage of patient visits with selected clinician or team.

A report with at least five days of data, showing the total percentage of patient encounters that occurred with personal clinicians is required to meet this factor.

Description Example/Screenshot/Documentation Source Date Added
Using PCC's recaller functionality to monitor the percentage of visits with a selected clinician Reporting % of visits with selected clinician PCC 07/03/14

2.A.3 Having a process to orient new patients to the practice.

The practice should have an orientation process for patients new to the practice. Orientation provides information about the medical home model, medical home responsibilities and patient responsibilities and expectations.

2.A.4 Collaborating with the patient/family to develop/implement a written care plan for transitioning from pediatric care to adult care.

Description Example/Screenshot/Documentation Source Date Added
Using PCC EHR Care Plan functionality for organizing materials and information in preparation for transitioning a patient from pediatric care to adult care. Using PCC EHR Care Plans for transitions of care PCC 07/07/14