As part of our ongoing effort to help coordinate the care of patients, Community Medical Group has Clinical Integration programs that focus on developing process improvement programs, quality metrics and chronic disease management tools. Each Clinical Integration program is developed by a committee of providers with an interest and content knowledge in that field. The core goal of these programs is to provide evidence based disease management guidelines based upon national best practice guidelines, and then to monitor the success of these guidelines.
Clinical Integration Program Summary
Community Medical Group has been engaged in fostering continuity and communication across disciplines, building bridges between primary care providers, specialist and ancillary services. Our multi-disciplinary clinical integration programs include standardized care protocols based on up-to-date evidence based guidelines and best practice recommendations for assessment, testing, management, follow up and referrals.
CMG’s quality improvement initiatives have undergone enhancements from a focus on process and quality to the inclusion of protocols and measures that address outcome and efficiency around Preventative care, pediatric asthma, adult diabetes, adult heart disease, depression and diabetes, chronic kidney disease, ED visits, admissions, readmissions, generic prescribing and utilization of urgent cares.
Community Medical group has expanded the efforts to reflect the full continuation of care in our Behavioral Health population and Radiology program. We are also developing a physician referral process, additional clinical protocols and guidelines. One of our goals is for providers to communicate and exchange information securely regarding clinical integration utilizing our website and other information technology.
The deployment of our data warehouse, incorporating claim information form the payers, will further enable assessment of the efficacy of our patient centered programs as we incorporate metrics to evaluate the degree and quality in patient care. The ability to collaborate with payer sources has been instrumental; it has gained us the capability of creating gaps in care list for practices. The gaps in care report gives the provider the opportunity to follow up with patients who are missing follow-up appointments and preventative screenings.
The Quality Based programs-Community Medical group has about seven different clinical integration committees charged with designing different quality improvement programs within the organization.
The following is a list of the Clinical Integration Committees:
Clinical Integration Steering Committee –This committee oversees all of Community Medical Groups Clinical Integration Committees.
- Adult Medicine
- Behavioral Health
- Care Transitions
- Pediatric Asthma
- Urgent Care
- Women’s Health