Many patients who get care at Air Force hospitals and clinics may not think much about the health care delivery model used by their care team. However, the Air Force Medical Service thinks about it a lot, and has developed a care model called the Air Force Medical Home to improve the quality, access and experience of care for patients.
The AFMH model is built around a team-based approach. Within their core team, each patient has a provider, nurse and technician. Other specialty providers are embedded in family health clinics to provide additional expertise.
“There is a high demand for our services,” said Lt. Col. Kyle Hudson, the Air Force Medical Home Clinical Operations Branch Chief. “Having embedded specialists in our family practice clinics helps our patients get care sooner, and improves the quality of care by letting patients see providers whose specialty is more in line with their needs.”
One example of this concept is the Behavioral Health Optimization Program, which places mental health professionals right in the family health clinic. During the course of a normal primary care appointment, the doctor can call in a mental health provider for a quick consultation, with no new appointment.
“We’ll have psychologists or clinical social workers with offices right next to the primary care provider who can address the behavioral aspects of health conditions,” said Hudson. “Common complaints like insomnia often have a behavioral component. Medications have a role, but so do improved sleep habits that can be taught by a behavioral health provider.”
Another way BHOP can play a key role is with conditions like diabetes. Some patients have a hard time accepting that they have the condition, or that they must take steps to treat it. Embedded behavioral health providers can be a motivator for such patients. They may not treat the condition itself, but can address the behaviors or habits contributing to the condition, or that are preventing successful treatment.
“BHOP providers also help a lot with patients who have depression and anxiety,” said Hudson. “Most patients diagnosed with those conditions are seen in primary care. Having the primary care provider make a warm hand off directly to a behavioral health provider for brief counseling sessions really enhances the treatment options.”
Another provider specialty embedded in the AFMH model is clinical pharmacy. Clinical pharmacists see patients regularly, often to address medication reconciliation.
“Clinical pharmacists are medication experts and can really help patients who are on multiple medications,” said Hudson. “They educate on medication benefits, side effects and interactions. They also help the primary provider optimize the medication list, and sometimes can remove unnecessary medications.”
Clinical pharmacists are also crucial when patients transition from inpatient to outpatient care. Patients often see a clinical pharmacist during their first appointment after leaving the hospital.
“There always is the possibility of miscommunication between the hospital physicians and the primary care team, especially about medications,” said Hudson. “A clinical pharmacist will make sure they have the right medications, and that the patient understands why they are taking them.”
The AFMH model is having a real, positive impact on care for Air Force patients. By removing barriers to specialty providers, patients get better access, better care and better health. Widespread research finds that patients in medical home style clinics make fewer trips to the emergency room and have fewer overall hospitalizations. More than 1.1 million patients are seen in 239 AFMH clinics worldwide, helping the Air Force Medical Service meet its goals of a better patient experience for our Airmen, their families and retirees.