CCE Quarterly: Building Blocks of an Individual Care Plan

Recorded Friday, Oct. 24, 2014

This activity is designed for PCMH Certified Content Experts as well as staff members at primary care and specialty care practices that would like to identify strategies for developing effective health care assessments and individualized care plans for patients under the requirements of NCQA’s PCMH 2014 program.

Purpose and Objectives

Objectives: At the conclusion of this educational activity, participants will be able to: 

• Identify the required elements of a comprehensive health assessment
• Discuss techniques to assess readiness for change and goal setting
• Examine ways in which to engage patients in defining goals and self-care support techniques
• Analyze examples of care plans against NCQA’s requirements
• Discuss strategies for tapping into an EHR to develop care plans

Continuing Education 
NOTE: As a PCMH CCE Program update, this webinar provides maintenance of certification credit (2 points) for PCMH CCEs. 
This is a non CME/CNE activity. 

Faculty 
Linda K. Shelton, MA-HCA, PCMH CCE 
Linda Shelton, Partner at Discern, has more than 30 years of experience developing programs focused on innovations in health care. Her areas of expertise include physician performance measurement, the patient-centered medical home, pay-for-performance and transparency, and health IT adoption. At Discern, she leads client projects related to quality measurement and the medical home, and participates in the overall management of the firm. Her projects include the Georgia Academy of Family Physicians’ PCMH University, which has helped over 60 primary care practices to transform to PCMHs, the Maryland Multi-Payer PCMH Pilot, and case studies of high-functioning PCMHs. 

Prior to joining Discern, Linda operated her own consulting enterprise, LKS Consulting, advising clients on quality improvement initiatives and health care management strategies. She has a 20-year association with the National Committee for Quality Assurance (NCQA) as both an executive and a consultant. At NCQA she led the development of several NCQA physician measurement programs, including Physician Practice Connections (PPC—the forerunner of PCMH recognition) and NCQA’s contracts with the Integrated Healthcare Association’s pay-for-performance program in California. She also directed the work of several NCQA advisory panels with national health care leaders. Prior to 1993, Linda worked in consumer health education, managed care, IT, and public health. 

Linda has a master’s degree in health care administration from George Washington University and a bachelor’s degree from Tufts University. She has served as a speaker and task force participant for many national organizations, including eHI, the National Business Coalition on Health, the Care Continuum Alliance and the Health IT Summit. 

Elaine M. Skoch, RN, MN, EMBA, NEA-BC, PCMH, CCE 
Owner and Redesign Specialist, Health Systems Redesign Solutions 
Elaine has served in administrative and leadership positions, in a variety of public and private healthcare settings and has led major systems reorganization. As the Vice President and Chief Operating Officer of the Mental Health Consortium in Kansas, she worked with the 30 community mental health centers across the state to develop the infrastructure for the administrative services organization. In her role as Performance Improvement Manager and Practice Facilitator for TransforMED (the national PCMH demonstration project of the American Academy of Family Physicians) she worked with practices and participated in the development of the PCMH model on the national level. As Director of Systems Transformation with HealthTeamWorks, Elaine worked with practices and health systems all across the country in their efforts to transform to a more patient centered model of care, achieve medical home recognition, develop medical neighborhoods and build the foundational elements for delivering care within an accountable care structure. Her current efforts include working with the largest health system in Colorado to obtain recognition for their primary care practices as well as work on the development of the medical neighborhood with the system’s specialty practices. Elaine has worked closely with NCQA as PCMH standards have evolved and has been asked to present on several occasions by NCQA. Elaine was one of ten experts asked to review NCQA’s certification program for coaches assisting practices obtain NCQA recognition, and is a PCMH Certified Content Expert. 

Elaine is experienced in organizational development, strategic planning, marketing, change management, patient engagement and program evaluation. She holds a master’s degree in nursing from the University of Washington and an Executive MBA from Benedictine College. She is board certified by the American Nurses Association as a Nurse Executive at the advanced level and is a recognized as a PCMH Clinical Content Expert by NCQA.