The Healthcare Delivery Providers, part of the Healthcare Marketplace specialization. Module 4.1.1, Overview of Primary Care Clinics. Learning modules for this lecture will be to get an overview of Primary Care and review how I have laid this module out. Doctor of Medicine, advanced practice registered nurse, physician's assistant, primary Care Physician or Primary Care Provider. Welcome to Module Four. In this particular module, it's all about physicians. And as you can imagine, physicians are a very key part of the healthcare delivery continuum. They provide services along all of the delivery sites, write prescriptions, diagnose and treat medical conditions, and so they're a really key partner in the evolution that is happening in the health care delivery system. So I am a physician, so I'll speak a little bit from my personal experience as well. Hopefully there will be some learnings for you around how physician practices are organized and how they are rapidly changing and transforming. So the way I've laid this module out is in three sections. The first is primary care physicians, so these are physicians and providers that take care of patients throughout their journey in the healthcare delivery continuum. The second part is the specialty physicians, so these are the subspecialists or the super specialists that deliver care for a smaller, focused part of the medical condition. And then the third section will be to look at some newer care delivery models that are emerging in the U.S. So again, welcome to the world of physician practices and the world of physicians and providers across the delivery continuum. So let's get started. So for physician practices, although physicians work in all of the different areas of the care continuum, so there are physicians here, physicians here, physicians here, physicians here, physicians here, here, some physicians here, we'll really be looking at the primary and specialty clinics. But I'll also look at how these export and share physicians with the other parts of the care continuum. So primary care really needs to be looked at as the primary contact for all of the patients and community dwellers in any geographical location, so it's the initial contact for most illnesses and preventive checkups. The primary care physicians have a longitudinal view of the care journey. So anytime a patient goes to the hospital, they come back to the primary care physician, and the record, and the longitudinal journey, and the history, and the interventions that were made throughout the care continuum, all the information, all resides within the primary care physician's office, or the primary care physician's record. Also, one of the key roles of primary care is that they coordinate care between all of the various specialists and care providers that their particular patient is seeing. Very important concept I want you to take away if that primary care is considered the base of any accountable care organization or the base of population health. So this is a primary care practice, another one, another one, and another one, and the ACO will be built on that. And the patients will be attributed based upon primary care providers stickiness. So all these patients belong to this ACO, and they are attributed based upon the primary care providers, so it's a very essential basement, or building block, of any ACO. They are also the accountable party for the quality results in all four of the quadruple aims, and they're improving, they're responsible for improving health is what are known as Ambulatory Sensitive Conditions. So these are the conditions that the ambulatory or prime many care providers impact to reduce the cost of care and improve quality. We will see there is increasing fragmentation of primary care practices. So for example, about ten years ago, when i was in primary care, I would see the patients in the clinic, I would see the patient in the ED, emergency department. And I would admit, and then follow the patient in the hospital, and then in the nursing home, so I was the primary coordinator of care for that particular patient. And as we have discussed and we will discuss, there are emergence of new specialists, for example, hospitalists in the hospital, emergency department physicians in the ED, SNFists, in the skilled nursing facilities. So it's not the same physician seeing the patient across the care journey. Now there might be four or five or seven physicians, so coordination is becoming more and more important and fragmented. And so the question is, how will the longitudinal journey be visualized and then impacted to improve the triple aim for any patient in a population? Do a quiz. The way I have laid out this module is in three sections. We'll discuss the primary care clinics and providers first. So how are they organized, what services they provide, how are they paid, how is their performance measured, and what are the challenges and innovations? Same thing then, we will do for the specialty care clinics in those four domains. And finally, we will look at some newer settings of healthcare delivery, where physicians and other clinical providers are providing care and changing the whole landscape of healthcare delivery. Here's a quick review of where physicians practice. So let's say there's a physician clinic with six physician, and the physician might go and see a patient in the hospital, although now there are hospitalists and physicians here. A physician could go and see patients in an ambulatory surgery center or see a patient in a skilled nursing facility, although there is increasing specialization where these sites are getting their own physicians. So physicians could be shared and exported from one site or one clinic. Also, as we will see, the clinics are becoming what are called multi-specialty clinics, so some physicians could be primary care physicians, others could be specialty physicians all in one campus. So, in summary, primary care is the holder of the longitudinal patient story and the ultimate coordinator of care throughout the care journey and the care continuum. Primary care is considered the basis of any accountable care organization, and is absolutely critical for achieving population health along the triple aim and quadruple aim axes.