Engaging Patients in the Advanced Practice Nurse Led Medical Home

Is it any coincidence that the American Medical Association annual meeting came to a close earlier this week…only to be followed by a close start to the American Academy of Nurse Practitioners annual event?  I hope not.  Despite being conducted more than six years ago, this study’s findings continue to

Is it any coincidence that the American Medical Association annual meeting came to a close earlier this week…only to be followed by a close start to the American Academy of Nurse Practitioners annual event?  I hope not.  Despite being conducted more than six years ago, this study’s findings continue to ring true:  Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care and the need to use scarce human healthcare resources has resulted in increased emphasis on primary healthcare.  Key to the findings were the fact that scope of practice, emphasizing the importance of role clarity and trust and ideological differences regarding disease prevention/health promotion all remain integral to the evolution of collaborative relationships between physicians and nurse practitioners.

While these collaborative relationships have been important in the past, they are being pushed to the forefront as we hurtle to the finish line, eagerly anticipating which parts, if any, of the Patient Protection and Affordable Care Act (PPACA) will make it across the finish line.  As Michelle Papachrisanthou, RN, MSN, CPNP, DNP-S, outlines in her article, The DNP and the Healthcare Home, “an estimated 30% increase in U.S. medical school enrollment would be needed for the physician population to meet the population growth, aging and other healthcare factors that the United States faces. This equates to a shortage of 124,000 physicians by the year 2025. Moreover, the population is projected to grow by more than 50 million between 2006 and 2025 to 350 million. When universal healthcare is added to the above equation shortages, we are now an additional 31,000 providers short.”  Recognizing the need for primary care, the Centers for Medicare & Medicaid Services (CMS), recently announced a new initiative that will provide funds to eligible hospitals to increase the availability of clinical training settings that will bolster the skills and supply of APRNs.

With a requirement for participating organizations to deliver fifty percent of clinical training in non-hospital settings in the community, CMS appears to agree with Dr. Papachrisanthou’s assertion that, “the DNP emphasis on primary care and its streamlined clinical focus promotes itself as a solution to lead the way for healthcare homes and the future of healthcare.”  In addition, she points out that scope of practice and prescriptive authority still preclude some states from participating and must be amended for true transformative change.  Forging a step in the right direction, the National Committee on Quality Advancement (NCQA) began recognizing nurse led medical homes in 2011.  As witnessed in the video below, Nurse Practitioner led medical homes fill a mission-critical void by successfully engaging chronically ill patients that suffer from a myriad of psycho-social issues.  Marry this concept with technology that allows the providers to extend their engagement beyond the walls of the clinic…and we begin to see opportunity for marked improvement.  With record numbers of uninsured patients – most evident in the Southwest – poised to descend on the emergency department, isn’t it time for your organization to consider advance practice nurse led medical homes?

11th Street Family Health Services from Champion Nursing on Vimeo.