Patient Centered Medical Home Learning Network Focuses on Social Determinants of Health

The HealthChoices Patient-Centered Medical Home (PCMH) Learning Network held 15 virtual office hours in July on screening and follow-up processes for social determinants of health (SDOH) during primary care visits. The Pittsburgh Region Health Initiative (PRHI) coordinates the PCMH Learning Network across Pennsylvania and facilitates the quarterly, regional learning collaborative sessions for the southwest/northwest and northeast regions. The PCMH Learning Network also held regional learning sessions for western, Lehigh/Capital, and southeastern Pennsylvania. The learning session for northeastern PA will be held in early August.

For Western PA, Anna Ratzliff, MD, PhD, Co-Director of the AIMS Center at the University of Washington, presented workflows and billing processes for an integrated care model called collaborative care management. Additionally, Bruce Block, MD, consultant for PRHI, described how to apply empathic inquiry skills to the SDOH screening and follow-up prices during primary care visits. The Learning Network is funded by the Physical HealthChoices Managed Care Organizations.