Article Figures & Data
Figures
- Figure 1.
Flow of events in the NDP.
NDP=National Demonstration Project.
- Figure 2.
The original “New Model” of practice as conceptualized by TransforMED.
AAFP = American Academy of Family Physicians; app’t = appointment; CHIT = Center for Health Information and Technology (AAFP); mgmt=management; NP=nurse practitioner; PA=physician assistant.
Reprinted with permission from TransforMED, Leawood, Kansas.
- Figure 3.
The revised model of practice tested in the NDP, as formalized in 2008.
HR=human resources; NDP=National Demonstration Project. Reprinted with permission from TransforMED, Leawood, Kansas.
Tables
Characteristic Facilitateda% Self-Directed % NDP = National Demonstration Project. a One facilitated practice withdrew shortly after the start of the NDP. Age of practice, y ≤5 35 33 6–10 24 5 11–20 6 29 >20 35 33 Size Solo (± midlevel clinicians) 35 22 Small (2–3 physicians) 24 12 Medium (4–6 physicians) 17 44 Large (≥7 physicians) 24 22 Setting Rural 29 33 Suburban 53 55 Urban 18 11 Scope of practice Home visits 29 50 Prenatal care 23 55 Hospital care 59 66 Labor and delivery 23 44 Ownership structure Physician owned 59 61 Health or hospital system owned 41 39 Health information technology Electronic medical record 76 61 Electronic prescribing 70 44 Practice Web site 35 50 Interactive patient portal 5 5 Access to care Same-day appointments 53 61 Group visits 6 11 e-Visits 17 5 Population management Disease registry 0 5 Team model 12 11 Practice and Group Dropout Date Size, Location, Ownership Practice Age, y Reason for Dropout IRB = institutional review board; NDP = National Demonstration Project. Note: One facilitated practice dropped out of the NDP when the health system IRB did not approve inclusion in the study. All data related to this practice were expunged. D-1: Self-directed October 2006 Large, metropolitan, system owned 17 Restructuring within system closed the original family medicine practice that applied to the NDP D-2: Self-directed March 2007 Medium, suburban, physician owned 25 Practice said they had too many competing demands to participate in NDP data collection D-3: Self-directed April 2007 Solo, rural, physician owned 2 Local hospital closed, forcing close of practice; physician joined practice in another town D-4: Facilitated March 2008 Solo, suburban, physician owned <1 Physician owner closed original practice and joined another Facilitated Practices Self-Directed Practices HIT=health information technology; HR=human resources; NDP=National Demonstration Project. Access to NDP Web site, e-mail listserv Access to NDP Web site, e-mail listserv 4 NDP on-site learning sessions 1 self-organized retreat Monthly conference calls, 1 Webinar Evaluation team presence at retreat Daily access to facilitator by telephone/e-mail 1 NDP on-site learning session Facilitator site visits (3–6 total) Evaluation team site visit (1 total) Evaluation team site visit (1 total) Limited access to consultants (national experts) Discounted HIT and facilitator assistance with implementation Assistance with practice management (eg, HR, meetings, policies and protocols) Assistance with financial management (eg, budgets, forecasting, collections) Assistance with change management (eg, conflict resolution, all-staff retreats, communication, teamwork) Assistance with personal development (eg, leadership coaching, communication) Assistance with practice metrics (eg, collection and analysis of own data for improvement) Evaluation team connection to facilitators Facilitated Practices Self-Directed Practices NDP=National Demonstration Project. Prestige of being part of important project; being in national spotlight Prestige of being part of important project; being in national spotlight Support of other practices and TransforMED Support of other practices, especially after midway retreat Accountability to facilitator; external support and assistance Desire to perform well despite self-directed status Evaluation team site visit
