College hosts conference about Patient-Centered Medical Home

College of Community Health Sciences faculty and staff, along with healthcare providers from Tuscaloosa and across the state, gathered for a two-day study and discussion on the Patient-Centered Medical Home.

The Patient-Centered Medical Home (PCMH) is a model of primary care delivery that is patient-centered, comprehensive, coordinated, accessible and focuses on quality and safety, according to the Agency for Healthcare Research and Quality.

The College hosted the conference “Building the Patient-Centered Medical Home: Inspiration and Tools to Help Transform Your Practice” on July 25 and 26 at Hotel Capstone on The University of Alabama campus. The conference was held to educate physicians and other health-care providers on how to incorporate this model into their medical practices.

“It’s about moving forward,” said Richard Streiffer, MD, Dean of the College, in his welcoming address. “That’s really what this conference is all about. It’s about moving forward as a College and a community with this concept of the Patient-Centered Medical Home.“

The conference featured experts in the concept of the Patient-Centered Medical Home (PCMH), implementers of pilot programs, leaders in family- and patient-centered health care and experts in the business side of the PCMH.

One of those speakers was Paul Grundy, MD, MPH, global director of Healthcare Transformation at IBM, where he develops strategies to shift health care delivery toward consumer-focused, primary-care based systems through the adoption of new philosophies, primary care pilot programs, new incentive systems and the information technology required to implement such changes. As a founding father of the PCMH, Grundy said that the medical home it isn’t a literal home for patients, but rather for data.

“Data is now made available, and it has to go somewhere and be acted on. And there has to be accountability that it is being acted on.”

Acting on that data means that every patient has a health-care plan that is managed by a team of providers, which overall, leads to promoting a healthy population, Grundy said. Another part of the PCMH is the idea of a medical neighborhood, Grundy said, or a model where primary care physicians work with specialists to provide comprehensive care for patients.

“This is not just about health care,” Grundy said. “This is about value for your state and for your community.”

The second plenary speaker at the conference was Beverley Johnson, president and CEO of the Institute for Patient- and Family-Centered Care in Bethseda, Md. Johnson served as a project director for a multi-year initiative to develop resource materials for senior leaders in hospital, ambulatory and long-term care settings on how to partner with patients and families to enhance the quality, safety and experience of care. In her talk, she focused on both patient-centered and family-centered health care and how the PCMH is a culture shift in health care.

“This is about culture change—it’s about the work you’re going to do together to profoundly change the culture of health-care organizations.”

Melly Goodell, MD, chair of Family Medicine at MedStar Franklin Square in Baltimore, MD, oversaw the 2011 achievement by MedStar’s Family Health Center of Level III NCQA Patient-Centered Medical Home status and the center’s acceptance as one of the 50 statewide practices into Maryland’s three-year PCMH Pilot Program, so she spoke about the process of changing into a PCMH as the morning plenary speech for the second day of the conference.

“[Change] is hard,” she said. “But you really do need to have an approach and some guiding principles around change.

Michael Canfield, MD, associate chief of staff of Ambulatory Care for the Central Alabama Veterans Health Care System in Montgomery, Ala., gave the lunchtime plenary speech later that day. Canfield worked as a family physician and was a partner with Palmetto Primary Care Physicians in Summerville, S.C. Palmetto is an organization of more than 90 physicians and 650 clinical and support staff who practice primary and specialty care at 32 offices in South Carolina.

Canfield talked about the business side of the PCMH model. He outlined the keys to success for Palmetto.

“The quality of the care of patients is the cornerstone of the group.” Canfield said. “And corporate decisions must have the consensus of the group and be for the good for the group.”

Other speakers included Mary Coleman, MD, PhD, professor of family medicine and director of community health clinics at Louisiana State University School of Medicine, who spoke about population and patient-care management; Melanie Tucker, PhD, assistant professor of Community and Rural Medicine and director of clinical investigations at the College, who spoke on leading patients to better health through health coaching; Sylvia Brown, executive director of Gulf Coast Patient Care Network, and Chelley Alexander, associate professor and chair of Family Medicine at the College, both of whom spoke about innovative care delivery.

At the end of the conference, Candice Biby, program coordinator for Family Medicine at the College, hosted a question-and-answer session about NCQA certification.

The College also hosted an evening event on Friday night at Hotel Capstone that was open to the public. “Better Care, Better Value: The Business Case for the Patient-Centered Medical Home,” started with remarks by Grundy and featured a discussion panel about the business side of the PCMH and included Grundy, Goodell, Kathleen Bowen, MD, medical director of BlueCross BlueShield of Alabama, and Robert Moon, MD, chief medical officer for Alabama Medicaid.

High school students participate in College’s summer rural programs

Forty-three high school students from rural Alabama who are interested in pursuing health care careers participated in two College programs this summer.

The programs provide information about how to prepare for medical school and other health professions training and encourage students to return to their hometowns to practice. There is a critical need for health care professionals in rural Alabama.

Twenty-six 11th grade students participated in the Rural Health Scholars Program. The program is a five-week

program on The University of Alabama campus and students take college courses for credit, participate in seminars with practicing health care professionals and visit health care facilities.

The Rural Minority Health Scholars Program is for college-bound high school graduates from rural Alabama. The program is a five-week program on campus and students take classes and tutorials to enhance their knowledge and test-taking skills so that they can achieve competitive scores on the Medical College Admission Test (MCAT). They also visit local health care facilities and the Birmingham campus of the University of Alabama School of Medicine. The College also functions as the Tuscaloosa Regional Campus of the School of Medicine. Seventeen students participated in the program this summer.

The Rural Minority Health Scholars Program was begun to increase the number of minority students from rural Alabama who qualify for admission to medical school. Of the 130 Rural Minority Health Scholars who have participated in the program since its start in 2001, 11 have entered medical school. Meanwhile, two have entered the field of dentistry, two optometry, two pharmacy, nine nursing and one is training as a physician’s assistant.

Medical students inducted into Gold Humanism Honor Society

Medical students of the College of Community Health Sciences were inducted this month into the Gold Humanism Honor Society, a signature program of the Arnold P. Gold Foundation established to recognize medical students, residents and faculty who practice patient-centered medical care by modeling the qualities of integrity, excellence, compassion, altruism, respect and empathy.

Stevie Nichole Bennett, Anna Eunjoo Choe, Jacquelynn Kristina Parks, Shweta Naran Patel and James Anthony Raley, were the Class of 2015 inductees at the College, which serves as the Tuscaloosa Regional Campus for the University of Alabama School of Medicine, headquartered in Birmingham.

Amber Michelle Beg, John Thomas Killian, Jr., and Paul Frederick Sauer, Jr., were the inductees from the campus’ Class of 2016.

“Being inducted into the Gold Humanism Honor Society is really a special honor for these students,” says Heather Taylor, MD, assistant professor of Pediatrics and director of Medical Student Affairs. “They have been recognized by their peers for representing the ideals of compassionate, empathetic patient care. We could not be prouder of these students.”

The students’ nominations for the honor society originated from their student peers’ observations of their characteristics related to humanism. A selection committee then evaluates the nominees’ academic eligibility, along with program director evaluations and essays indicating the students’ willingness and qualifications of to serve if selected. About 10 to 15 percent of each class is selected to membership, says Brook Hubner, program director of Medical Education for the College.

There are more than 19,000 members nationally in training and practice.


Avery receives Health Policy Leadership Award

Daniel Avery, MD, professor and chair of the College of Community Health Sciences’s Department of Obstetrics and Gynecology, was the 2014 recipient of the Louis W. Sullivan, MD, Health Policy Leadership Award, presented by the American Board of Physicians Specialists (ABPS).

The award, named for Louis W. Sullivan, MD, the former Secretary of the U.S Department of Health and Human Services during the George H. W. Bush administration (1989-1993) and the founding dean of Morehouse School of Medicine in Atlanta, Ga., is presented to a physician who has served as a champion of major health policy changes and an advocate for health policy improvements. According to the ABPS, the award goes to someone who has made an outstanding contribution to improve the health status of an individual, a group of people, or a population.

The award was established in 2012 and was first presented to Omofolasade Kosoko-Lasaki, MD, associate vice president of Health Sciences and professor of surgery (opthamology), preventative medicine and public health at Creighton University School of Medicine in Omaha, Neb. She, in turn, nominated Avery for this year’s award.

Avery worked with Kosoko-Lasaki at the American Academy of Surgery, and she nominated Avery for his work as a family medicine physician who also provides obstetrical care in rural areas, including Winfield, Ala., where he has practiced since he completed his residency and currently provides obstetrical care for about 4,000 patients. Avery also provides obstetrical care to the Demopolis community after its Bryan Whitfield Memorial Hospital closed its labor and delivery unit earlier this year.

Kosoko-Lasaki also recognized Avery’s work with medical students who choose to practice family medicine in rural areas, Avery says. The College serves as the Tuscaloosa Regional Campus for the University of Alabama School of Medicine, which is headquartered in Birmingham. Avery says that Kosoko-Lasaki also cited his work with the Alabama Family Practice Rural Health Board.

“I am honored to have received this award,” Avery says. “The best part about it was that Dr. Sullivan came to the ABPS meeting and presented me with the award.”

Sullivan, who is now retired, remains, according to Avery, “a champion for the rural, underserved and minority populations.” He is a public member of the AAPS Board of Directors and chairman of the board of the National Health Museum in Atlanta.

According to the Alabama Department of Public Health, the lack of OB/GYN services in rural counties makes it challenging for rural residents to receive adequate prenatal care. In Alabama, 25.9 percent of the live births in 2012 occurred with less than adequate prenatal care, according to the ADPH and the Adequacy of Prenatal Care Utilization (Kotelchuck) Index. The lack of adequate prenatal care can lead to problems and complications, according to the U.S. Department of Health and Human Services. Babies of mothers who do not receive prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care, the department says.

Residency Director named Interim Chair of Family Medicine

Richard Friend, MD, director of The University of Alabama Family Medicine Residency • Tuscaloosa and vice chair of the College’s Department of Family Medicine has been named interim chair of the department.

Friend will continue to serve as director of the residency, one of the oldest and largest in the country and part of the College. He replaces Chelley Alexander, MD, an associate professor who has served as chair of the department since 2006. Alexander recently accepted the position of chair of the Department of Family Medicine at East Carolina University’s Brody School of Medicine in Greenville, N.C., and begins work there next month.

“I am looking forward to stretching my skills and talents to lead a bigger department, and continuing their legacy as a great place to train primary care physicians,” Alexander says. She added: “I have spent 20 wonderful years at CCHS, first as a medical student and then as a resident, affiliate faculty member, assistant residency director, residency director, assistant dean and chair. To my department, it has been an honor to serve as your chair over the last nine years. To all my colleagues, I think the College is well poised to continue its exceptional training of students and residents for the state of Alabama.”

Richard Streiffer, MD, dean of the College, thanked Alexander for her years of service. “Thank you for your dedication and hard work these many past years and we wish you all the best.”

HIV/AIDS spread in South subject of article, College faculty’s research

HIV/AIDS, long thought an urban disease, has migrated south to rural communities. Nearly 50 percent of all new cases of HIV infection in the United States are in the South, and African-American men and women living in the South are hardest hit.

In Alabama, in the impoverished Black Belt region, counties like Lowndes, Hale, Greene, Macon, Dallas and Montgomery routinely rank among the highest in new incidence rates for HIV in the state. Only a quarter of the population of Alabama is black, but nearly 75 percent of HIV patients there are, according to the Emory University Rollins School of Public Health.

In addition to a reluctance to talk about HIV and AIDS is the stigma of being gay, especially in the African-American community, says Pamela Payne-Foster, MD, an associate professor of Community and Rural Medicine for the College and deputy director of its Institute for Rural Health Research. Foster says that stigma puts people at risk for HIV.

Foster studies the spread of HIV in the South, and some of her work was recently cited in an article by New York City-based Al Jazeera America, an American news organization launched in 2013 with 12 bureaus in major cities around the country and three broadcast centers.

In the article, Foster said that when she interviews people living with HIV in rural Alabama, they regularly list church as the place they feel most stigmatized. “One of their greatest fears is that when they tell the pastor that they are HIV-positive, that information will spread throughout the congregation. They feel it should be confidential so they say, ‘If you want to keep a secret don’t tell anybody in the church.’”

At the same time, Foster said, HIV-positive men and women report a deep desire for a connection to their church communities. In many of these isolated towns, including those in the Alabama Black Belt, churches also function as a social club, after-school program and food bank. “The church should be a place that is open for people living with HIV/AIDS,” she says.

A few years ago, Foster borrowed an anti-stigma curriculum that had been used in churches in Ghana and decided to test it in Alabama. It took her a year and a half to recruit 12 churches to participate in the study. She hopes the study will not only educate congregations about HIV/AIDS, but also reduce stigma around it.

HIV/AIDS has migrated to Deep South, where stigma endures, Al-Jazeera America reports

When Pamela Payne Foster, Associate Professor in the College of Community Health Sciences’s Department of Community and Rural Medicine and Deputy Director of the College’s Institute for Rural Health Research, came to Alabama in 2004, she started an HIV/AIDS tour through the Black Belt to raise awareness and increase testing.

“We did town hall meetings and we wanted people to come out and get tested,” she said. “No one showed up.”

Foster studies the spread of HIV in the South. She said that when she interviews people living with HIV in rural Alabama, they regularly list church as the place they feel most stigmatized.

UA Matters: Staying Safe in the Water

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UA discussion focuses on business side of Patient-Centered Medical Home

The University of Alabama College of Community Health Sciences will host a special event, “Better Care, Better Value: The Business Case for the Patient-Centered Medical Home,” July 25 at Hotel Capstone on UA’s campus.

The event is free of charge and open to the public.

UA College of Community Health Sciences to host Patient-Centered Medical Home conference

The University of Alabama’s College of Community Health Sciences will host a conference this month that focuses on the Patient-Centered Medical Home and ways physicians and other health-care providers can incorporate this model of care into their medical practices.