MATEC will work with 15 clinics over the grant period to expand, improve, and increase efficiency and quality of HIV care through its HIV Practice Transformation Project (HPTP). MATEC’s approach to practice transformation (PT) is concerned with fundamental systems change for clinics and agencies, understanding that the highest quality and most effective care for people living with HIV involves all parts of their care setting.
PT as a model for change in primary care settings has been the focus of many recent studies and publications, specifically linked to the establishment of Patient-Centered Medical Homes (PCMH.) Improvement of the delivery of primary care has also been the focus of PT, independent of, though consistent with, PCMH designation. , The elements of PCMH and effective primary care have been identified in these publications and include traits of organization structure and service delivery that support the “triple aim” of health care reform: high quality care for the individual patient, population-based care to improve the general public’s health, and more efficient care to reduce unnecessary costs. These elements are consistent with the HIV Care Continuum, which focuses on identification of HIV infections, linkage and retention in care, and provision of highly-effective evidence-based treatment to attain undetectable viral load. It has been recognized that the broad scope of services provided under Ryan White Programs (e.g. interdisciplinary teams, patient engagement, and care coordination) are consistent with the elements of the PCMH model, addressing a patient’s needs in medical care, behavioral health, and social support.
There is growing evidence that practice transformation coaching (PTC) is an effective approach to assisting transformation to PCMH care delivery. It was shown to increase the number of PCMH components and adaptive reserve over a set time period beyond internal efforts only. PTC is an intensive hands-on effort that includes identification of a Coach to work with each clinic as they move forward on their chosen transformation goals. This approach will be incorporated into MATEC’s model for PT.