The North Carolina AHEC Program
and Partnerships in Practice
Transformation
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Mission Statement of
North Carolina AHEC Program
• The mission of the North Carolina AHEC Program
is to meet the state’s health and health workforce
needs by providing educational programs in
partnership with academic institutions, health
care agencies, and other organizations committed
to improving the health of the people of North
Carolina.
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Area Health Education Centers Program
• AHEC History and Background
– 1970 Carnegie Report - “Higher Education and
The Nation’s Health”
– 1972 Federal funding for initial 11 programs
– Federal funds for start up
– State and local support to sustain AHEC Programs long-term
• AHEC Program Today
– AHEC Programs in 47 states
– Over 240 regional AHEC centers
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Area Health Education Centers Program
• AHEC in North Carolina
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One of original 11 states
1974 state funding
Strong support of General Assembly
Close links to Office of Rural Health and other rural
initiatives
– NC AHEC largest and most comprehensive in the country
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North Carolina AHEC
Core Programs
• Community-Based Student Training
– To provide students opportunities to learn from preceptors
in the community and to have experiences that focus on
community health, primary care and prevention
• Community-Based Residency Training
– To prepare primary care physicians, general surgeons,
psychiatrists and other needed specialties for practice in
communities in the state
• Support for Practicing Health Professionals
– To keep providers up-to-date, enhance the practice
environment, and improve quality and patient safety
through continuing education programs and direct support
for community practices
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NC AHEC Statewide Map
Mountain
Greensboro
South East
Northwest
Southern Regional
Area L
Charlotte
Wake
Eastern
Source: NC AHEC Program
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AHEC Quality Initiative: Support for
Practicing Health Professionals
• Improved quality is part of our mission
• QI work complements our CE/CME programming
• QI gives us clear measures to demonstrate outcomes
based on clinical data
• AHEC already in thousands of practices statewide
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Placing students
Offering continuing education
Providing library resources
Many MDs are grads of AHEC residencies
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Improving Performance in Practice: A
National Quality Initiative
• NC one of two initial pilot states
• AHEC employs QIC (Quality Improvement Consultant)
• CCNC Network and AHEC selected M.D. practices to
participate
• Numerous QIC visits to practices according to level of need
a) Learn measurement
b) PDSA’s
c) Quarterly Regional Collaboratives – expert and peer sharing
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Services Evolution
• QI focus / Registry / Population management
DM and asthma (18 practices)
• PCMH and informatics added with emphasis
on care algorithms and self-management
teaching
• Full REC buffet
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AHEC Onsite Practice-Based Services
• Health Information Technology - EHR’s
• Patient-Centered Medical Home Recognition
• QI / Workflow Redesign using rapid practice
based measurement
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Services Provided by
Practice-based Consultants
Paper
Charts
Electronic
Health
Records
Meaningful
use of HIT
Improved
Clinical
Outcomes
Learn how to:
Learn how to:
Learn how to:
Learn how to:
•Assess the
needs of your
practice in an
EHR system.
•Select a
certified EHR
that meets
your needs
•Redesign
your paper
practice to
ready for an
EHR.
•Implement
an EHR for
optimal use in
your practice
•Use your
EHR to meet
the federal
requirements
for the
HITECH Act
Meaningful
Use Incentive
Payments
from
Medicare or
Medicaid
Produce
population –
based
reporting to
test the
efficacy of
your care
Use proven
methods and
techniques to
improve the
outcomes of
your patients
Patient
Centered
Medical
Home
Learn how to:
• Meet the
requirements
of the NCQA
Recognition
program for
PCMH
•Approach the
PCMH
application
process with
improvement
techniques
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• Priority primary care practices (10 or less docs
or rural or urban safety net) receive services at
no charge
• Developing a program for other specialties
that will be fee based
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Practical Implications
• 113,000 diabetic patients
• Strong diabetic control improved from a
baseline of 24% to 47% of diabetic patients
• Translates to 1900 lives saved over 10 years
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Current Enrollment
• 1020 practices
• 3742 primary care providers
• 3.8 million patients
• 900,000 with HTN; 400,000 Diabetics
320,000 asthmatics; 700,000 smokers
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Conclusions
• Key to success of AHEC – CCNC partnership
- Trusted entities known to collaborate well with others
- Statewide presence BUT Local personnel and offices
(infrastructure)
- Solutions are bottom up; NOT top down edicts
- Boots on the ground
• THE MESSAGE:
- Care Management, PCMH, EHR’s, and QI are all tools to help
practices help patients have the absolute best chance to live
a better and longer lives – practices can enlist help in
building these systems
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