Preliminary Experiences with the Integration of a Patient-centered Medical Home into Ambulatory Healthcare Services Centers in Abu Dhabi

Background : Abu Dhabi Ambulatory Healthcare Services (AHS) provides primary health care to a network of 47 centers. A project was started in 2013 to improve health care delivery by transforming the AHS centers into patient-centered medical homes (PCMH). The aims of this study are the following: 1. To describe the process of applying the US NCQA standards to the local primary care system in Abu Dhabi. 2. To evaluate a pilot program to implement the NCQA standards and their impacts on multiple process outcomes. Methods : Design : This was a retrospective, before-and-after, quasi-experimental study in which 3 centers implemented PCMH standards while the rest maintained routine functioning. Intervention : The system redesign and care strategies were implemented following NCQA standards, with an emphasis on the introduction of primary care physicians, empanelment, population management, team building, and supportive policies, as well as utilizing and optimizing EMRs. Reports provided by the EMR system allowed live monitoring of progress and facilitated population management, coordination of care, referral and investigation tracking, safe prescribing strategies and continual key performance indicator (KPI) monitoring. CAHPS and PACIC were translated and validated. Results : The three pilot centers outperformed non-pilot centers in clinical outcomes. The 3 centers persistently exhibited better performance on their clinical KPIs. The CAHPS and PACIC results showed high overall satisfaction at the pilot centers compared to the comparison centers. Emergency room utilization was lower in the pilot centers (p Conclusion : This study shed light on a firm path to operationalizing PCMH to enhance the quality and access to care, complete with lessons learned to share with the community.