Family Health Initiative offers team approach to health care Published Aug. 25, 2010 By Lt. Col. Julia Goode 81st Medical Group KEESLER AIR FORCE BASE, Miss. -- The Air Force's Family Health Initiative will be fully implemented in Keesler's family health clinic during September. The FHI, launched in August 2008 at Ellsworth Air Force Base, S.D., and Edwards AFB, Calif., is modeled on the patient-centered medical home, a 1960s concept making a comeback as the nation struggles to make health care more efficient. A patient-centered model consists of a primary-care doctor, nurse and technicians working as a team to provide treatment for most conditions and making referrals to specialists as necessary. Thirteen more Air Force medical treatment facilities implemented the FHI during 2008-2009. In 2010, 20 more Air Force MTFs, including Keesler, will put the FHI's tenets into practice. The model has the support of the American Medical Association, the American Academy of Family Physicians and other national health-care groups. "The patient-centered medical home is really about providing that personalized, continuous care that is comprehensive," said Dr. Lori Heim, a retired Air Force colonel who is AAFP president-elect. We're "trying to refocus (care) on what does the patient need and providing care through a team approach." Under the Air Force program, a family health team consists of a family practice physician, an extender (a physician assistant or nurse practioner), a registered nurse and five medical technicians. The FHI will solidify the Air Force Surgeon General's vision of how primary care at Air Force MTFs should be: a medical home that is pleasing to both patients and medical staff. The primary goals are improved doctor-patient relationships, better access to treatment and higher quality care. The FHI currently is limited to the family health clinic, though pediatrics could be included later. The FHI focuses on the personal relationship between patient and provider, creating a greater continuity of care. Building rapport with a medical team doctor, nurse and technician will put the focus more on preventive, proactive care instead of reactive care, leading ultimately to healthier airmen and their families. Keesler's family health clinic, which serves approximately 14,000 patients, will be restructured into six family-health teams. Each team will have a set population of approximately 2,500 patients. Although the transition to the teams will be virtually transparent to patients, the obvious changes will be centered on dedicated appointments with their assigned team doctor or team extender. Patients will no longer be booked with potentially 14 different clinic providers. Continuity of care will be achieved by having patients see only their medical team. As continuity builds between the team and patient, so should trust, resulting in a more satisfying health-care experience. As with all military organizations, deployments and personnel transfers are a reality and will result in periodic changes to a patient's medical team. When the team provider is absent for an extended period, the patient can anticipate an interruption in the continuity of care. For longer term absences, patients temporarily will be seen by another team. Additionally, about 1,000 of the clinic's 14,000 patients were "reassigned" to a new team to achieve the 2,500-patient balance per team. The clinic staff appreciates the understanding of patients notified they have a new family health physician or extender. The clinic will work hard towards a seamless transition as it continues to meet each patient's health-care needs.