2025 ADFM Annual Conference

This project began in planning phase in 2020. A team of clinicians, nurses, practice managers, directors, health IT experts, and data analysts aim to strategically increase staff support in clinics to achieve improved measures of practice performance. We calculated a positive return on investment and received approval from the health system for 3 pilot locations. The project “went live” in February 2023 in one family medicine clinic, one internal medicine clinic, and one pediatric clinic. We identified the following initiatives: increasing RN-led Medicare Wellness Visits, reducing appointment no show rates, increasing Transitional Care Management services, performing on quality measures. We also measure and monitor patient experience, care team function and satisfaction, access measures, productivity, patient portal utilization, and contribution margin via a dashboard created specifically for this project. Recognizing contribution margin as a key performance indicator, we partnered with a team member from business intelligence to build a new dashboard for volume and performance metrics. As of 10/30/24, we demonstrate pre-pilot net revenue per month of $499,073 and post-pilot net revenue per month of $548,733. Contribution margin per visit improved from negative $7 pre-pilot to positive $10 post-pilot. Our pilot was deemed successful and is now termed a project with spread to two additional family medicine clinic locations in July 2024.

Our Department has been at the forefront of helping support and train faculty (both in our Department and throughout our medical campus) on anti-racism principles, how to integrate health equity and inclusive content into classroom/clinical teaching, and how to improve diversity and equity in committees and selection processes. We will be presenting our efforts to institute these faculty development trainings, including challenges and successes.

The Person-Centered Primary Care Measure (PCPCM) is a patient assessment of their longitudinal experience of care with a clinician and care team, evaluating core functions of primary care in the health system. However, the optimal process of implementation across health systems, including how and when to administer the survey, reporting, and process improvement activities tied to survey data, has not been established. We distributed the 11-question PCPCM experience survey to 329,450 patients empaneled across 78 primary care practices between April 2023 and January 2024. We evaluated survey completion parameters, psychometric properties, and mean responses in relationship to patient-level demographic variables. In this large, heterogeneous system of primary care practices, the PCPCM survey was successfully distributed using the Press Ganey (South Bend, IN) platform. We found a low response rate (6.4%), but demonstrated good internal consistency, with a skew toward higher scores. PCPCM scores varied by age, sex, race, primary care provider type, and the number of years the patient had been at their current primary care practice. Responses varied significantly by patient race, but differences were small and not uniform in direction. Black or African American patients were significantly less likely to believe that the care provided by the practice was informed by knowledge of their community, compared with all other racial groups. The PCPCM was implemented successfully in a large network of primary care practices, but more work is needed to improve the response rate. Future work should focus on the use of the PCPCM for practice and provider feedback and validation of individual PCPCM items. Our plan for this session is to present our implementation process, briefly review our initial findings, and future directions. Our hope is that more health systems and primary care practices will implement this important measure of primary care quality.

As our department rose out of the pandemic, leaders sought an initiative that would advance the development and wellbeing of all faculty whether they be clinicians, researchers, educators, or a mixture with an emphasis on non-research faculty. A two-day retreat revealed that the common wind in the sails of faculty members was curiosity. In response, our leadership team developed Inquiry over the past two years, a program that turns faculty and staff members' curiosity into deliberate and structured projects that can make a difference through sharing at the local, regional, national, and international levels. Our tag line: “Turning curiosity about what matters to us into inquiry that makes a difference to us.” Development of the Inquiry initiative has included creation of our Inquiry Portal, a centralized online location where requesters can share what they are curious about and ask for support in developing scholarship around their questions. To further this work, we have curated a team of part-time professionals including a research services specialist, a technical writer, a statistical data analyst, and two evaluation designers. Whereas the Inquiry Portal primarily accommodates requests narrow in scope (e.g., creation of a survey or manuscript assistance), the Pilot and Exploratory Program is staffed and funded to assist with multiple stages and needs of longer-term pilot or exploratory projects from start to finish which provides a small amount of funding and more research support for non-research faculty to advance their Inquiry projects.

The FM Department at the Zucker School of Medicine at Hofstra/Northwell created a GME POCUS program for the residents at the residency programs in the form of electives and a 12 week track (both ambulatory and inpatient). Simultaneously, the medical school had a UME curriculum for the students in POCUS starting from their first year. Upon the students entering the hospitals with their devices and entering residency programs, there was a need for credentialling of these individuals as well as the need for faculty to have the skills for oversight of new trainees. As such a standardized CME program was created along with delineation of privileges and credentialing guidelines.

Health systems’ business development processes have traditionally been designed around fee-for-service revenue opportunities. Health systems that are shifting towards value-based payment models must update how they assess business development opportunities including new clinical programs, growth, and optimization of resources. This presentation describes approaches that primary care leaders can leverage to advocate for business development processes that reflect the impact of value-based payment mechanisms on primary care services. The session sill include panel members discussing experiences leveraging value based care and population health to enhance clinical care, education, research, and health equity. The topic will be viewed from the lenses of academic departments, health systems, and payors.

Physicians undergo rigorous didactic and clinical education over many years in order to practice their specialties at a high level. However, physicians typically do not receive training in the art and science of adult learning theory and teaching, including instruction in leadership, mindsets, innovation, and adaptive challenges. Educational methods to most effectively impart this knowledge to future learners requires discipline-specific training and experience to develop this skill set to the fullest potential. The Academic Leadership Academy at the University of Tennessee HSC College of Medicine Knoxville has a curriculum that is designed to provide skill acquisition in several domains, including teaching and precepting, research and publications, academic career advancement and leadership. A cohort of 8-10 participants is chosen yearly through an application process that is open to all faculty of the UT College of Medicine Knoxville. Learning sessions include monthly two-hour Zoom meetings in the Faculty Development Seminar Series, and four in-person workshops of 5 hours each focusing on a deeper dive into leadership in Academic Medicine. Participants also work on a research project with opportunities to report on their progress throughout the year. Collaboration between departments is highly encouraged. All activities earn continuing medical education credit for a total of 75 CME credit hours for each participant through the year. Since the start of this program, all participants have been retained and are active in leadership in their respective departments. Many have progressed in academic rank, which is seen as a measure of the commitment to continued success of applicants after completion of the certificate program.