Fort Smith Family Medical Center Earns Highest Patient-Centered Status

By Ben Boulden

The National Committee for Quality Assurance (NCQA) awarded Level III, the highest level patient-centered medical home (PCMH) recognition, to the Fort Smith Family Medical Center after it earned a score of 99 of 100 in its Level III assessment.

UAMS West is a regional center of the University of Arkansas for Medical Sciences (UAMS).

“UAMS West has always led the way in implementing the PCMH model,” said Mark Mengel, M.D., UAMS vice chancellor for regional programs. “A lot of credit goes to the collaborative style of Don Heard, its director, and his team’s passion and skill in implementing the many tasks associated with the PCMH model, and the residents’ and faculty’s willingness to support this change.”

The patient-centered medical home creates partnerships between individual patients, their physicians and the patient’s family. Care is facilitated by registries, information technology and health information exchange, so patients get the indicated care when and where they need and want it.

In 2012, several of the regional family medical centers, including the Fort Smith center, earned Level II status. UAMS spent $6-$8 million to hire additional personnel and purchase information technology to better integrate patient care at the regional centers. New software was used to create a disease registry and standardize data entry for electronic medical records.

Although some additional investment was made in hardware and software at the Family Medical Center to get to Level III, much of the effort was directed at improving work flows, Heard said. Doing that took the regional center’s 78.75 score for Level II to the 99 points and Level III.

Virginia King, R.N., PCMH coordinator at the Fort Smith Family Medical Center, said the improved work flows mean patients will get medical test results back sooner. For patients, it also means same-day appointments, quickly answered telephone calls, an on-call resident they can reach after hours and on weekends, and overall improved care coordination.

With the patient-centered medical home model, more frequent communication takes place outside the exam room between each patient and each center’s physicians and staff. Between visits, more is done to monitor a patient’s condition and help the patient stay on a treatment plan.

“It’s good to know that our patients are getting better care from an objective point of view by looking at their lab results, patient outcomes and hospitalizations,” said John Vinson, Pharm.D., director of pharmacy education at UAMS West. “It’s also good hearing people say that they have brought their mother or their sister here because they had never been to a doctor’s office where they spent so much time addressing concerns with their diabetes, including examining their feet. Things like that are very rewarding professionally for me as well as being very good for patient care and patient satisfaction.”

In addition to improving patient outcomes, the model promises to cut costs by reducing the need for hospitalization or emergency room care. According to the Robert Wood Johnson Foundation, seven medical home demonstration projects at primary care practices reported a 6 percent to 40 percent reduction in hospitalizations, a 7 percent to 29 percent decline in emergency room visits and a savings of $71-$640 per patient.

The UAMS Family Medical Center on the university’s main campus in Little Rock recently achieved a 99.25 score from NCQA and renewal of its Level III PCMH recognition. In 2010, it became the first primary clinic in Arkansas to receive the recognition, and the Family Medical Center is also the first in the state to have it renewed.

Nationally, about a quarter of the primary care practices have adopted the patient-centered medical home model.

Mengel said the other UAMS regional centers are on track to achieve Level III —the highest level of accreditation — by 2014.

The NCQA is a private, nonprofit organization dedicated to improving health care. It has worked with leading national medical organizations like the American College of Physicians and the American Academy of Family Physicians to develop PCMH recognition standards.

UAMS is the state’s only comprehensive academic health center, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a statewide network of regional centers; and seven institutes: the Winthrop P. Rockefeller Cancer Institute, the Jackson T. Stephens Spine & Neurosciences Institute, the Myeloma Institute for Research and Therapy, the Harvey & Bernice Jones Eye Institute, the Psychiatric Research Institute, the Donald W. Reynolds Institute on Aging and the Translational Research Institute. Named best Little Rock metropolitan area hospital by U.S. News & World Report, it is the only adult Level 1 trauma center in the state. UAMS has more than 2,800 students and 790 medical residents. It is the state’s largest public employer with more than 10,000 employees, including about 1,000 physicians and other professionals who provide care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS regional centers throughout the state. Visit or