Imagine if you had been waiting in your physician’s office for over an hour only to be told exactly what you were feeling, what you will take for it, and how you will feel in a matter of days. While this may not be completely unusual, imagine that you had no opportunity to voice your own concerns during this process. I recently became interested in the concept of the patient-centered medical home, or PCMH, and the principles that govern their operation. The patient-centered medical home is a model organization of primary care that provides patient-centered, comprehensive, accessible, coordinated care, and a systems-based approach to quality and safety. When all of these items are working together, it transforms primary care into “what patients want it to be.” Not only can medical homes lead to higher quality and lower costs, they can improve patients’ and providers’ experience of care.
The medical home encompasses five functions and attributes:
– Comprehensive Care: Providing sufficient care to patients involves a team of health care practitioners.
– Patient-Centered: The PCMH provides primary health care that is relationship-based wit an orientation toward the whole person.
– Coordinated Care: Patient treatment is coordinated among all health care outlets, including specialty care, hospitals, home health care, and community services.
– Accessible Services: Instrumental in the PCHM is the ability to deliver accessible services with shorter waiting times, enhanced in-person hours, and around the clock telephone or electronic access to a member of the care team.
– Quality and Safety: The PCMH demonstrates a commitment to quality and quality improvement.
I believe that the above characteristics of a PCMH shouldn’t be limited to those coordinated models of treatment and greater emphasis should be placed on keeping patients and their families engaged throughout all treatment systems. Patients should not only be involved in their own health care, but serious consideration should be given to their insights regarding practice improvement, policy design and implementation. An increased level of engagement can improve patient knowledge, self-efficacy, outcomes, and may even lead to reductions in utilization or costs of care. Unfortunately, there is no one-size-fits all solution; patient engagement will look very different for different practices, patient populations, and individual patient-provider interactions. I challenge all health care providers to examine closely the benefits as well as the limitations of the PCMH model and apply these important principles in their own practices or health care organizations.