Patient-Centered Medical Home [PCMH]

Ferrante JM, Balasubramanian BA, Hudson SV, Crabtree BF.Principles of the Patient-Centered Medical Home and Preventive Services Delivery. Annals of Family Medicine.2010.8(2): 108-116.http://www.annfammed.org/content/8/2/108.abstract. Accessed April 26, 2013. PURPOSE Limited research exists examining the principles of the patient-centered medical home (PCMH) and improved outcomes. We examined whether PCMH principles (personal physician, physician-directed team, whole-person orientation, coordination of care, quality and safety, and enhanced access) are associated with receipt of preventive services. METHODS We undertook cross-sectional analyses using baseline patient and practice member surveys and chart audits from a quality improvement trial in 24 primary care offices. Association of PCMH principles with preventive services (receipt of cancer screening, lipid screening, influenza vaccination, and behavioral counseling) was examined using hierarchical linear modeling. RESULTS Higher global PCMH scores were associated with receipt of preventive services (β=2.3; P <.001). Positive associations were found with principles of personal physician (β=3.7; P <.001), in particular, continuity with the same physician (β=4.4; P = .002) and number of visits within 2 years (15% higher for patients with 13 or more visits; P <.001); and whole-person orientation (β=5.6; P <.001), particularly, having a well-visit within 5 years (β=12.3; P <.001) and being treated for chronic diseases (6% higher if more than 3 chronic diseases; P = .002). Having referral systems to link patients to community programs for preventive counseling (β = 8.0; P <.001) and use of clinical decision-support tools (β = 5.0; P = .04) were also associated with receipt of preventive services. CONCLUSIONS Relationship-centered aspects of PCMH are more highly correlated with preventive services delivery in community primary care practices than are information technology capabilities. Demonstration projects and tools that measure PCMH principles should have greater emphasis on these key primary care attributes.

August 13, 2019

Principles of the Patient-Centered Medical Home and Preventive Services Delivery

Ferrante JM, Balasubramanian BA, Hudson SV, Crabtree BF.Principles of the Patient-Centered Medical Home and Preventive Services Delivery. Annals of Family Medicine.2010.8(2): 108-116.http://www.annfammed.org/content/8/2/108.abstract. Accessed April 26, 2013. PURPOSE Limited research exists examining the principles of the patient-centered medical home (PCMH) and improved outcomes. We examined whether PCMH principles (personal physician, physician-directed […]
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Ferrante JM, Balasubramanian BA, Hudson SV, Crabtree BF.Principles of the Patient-Centered Medical Home and Preventive Services Delivery. Annals of Family Medicine.2010.8(2): 108-116.http://www.annfammed.org/content/8/2/108.abstract. Accessed April 26, 2013. PURPOSE Limited research exists examining the principles of the patient-centered medical home (PCMH) and improved outcomes. We examined whether PCMH principles (personal physician, physician-directed team, whole-person orientation, coordination of care, quality and safety, and enhanced access) are associated with receipt of preventive services. METHODS We undertook cross-sectional analyses using baseline patient and practice member surveys and chart audits from a quality improvement trial in 24 primary care offices. Association of PCMH principles with preventive services (receipt of cancer screening, lipid screening, influenza vaccination, and behavioral counseling) was examined using hierarchical linear modeling. RESULTS Higher global PCMH scores were associated with receipt of preventive services (β=2.3; P <.001). Positive associations were found with principles of personal physician (β=3.7; P <.001), in particular, continuity with the same physician (β=4.4; P = .002) and number of visits within 2 years (15% higher for patients with 13 or more visits; P <.001); and whole-person orientation (β=5.6; P <.001), particularly, having a well-visit within 5 years (β=12.3; P <.001) and being treated for chronic diseases (6% higher if more than 3 chronic diseases; P = .002). Having referral systems to link patients to community programs for preventive counseling (β = 8.0; P <.001) and use of clinical decision-support tools (β = 5.0; P = .04) were also associated with receipt of preventive services. CONCLUSIONS Relationship-centered aspects of PCMH are more highly correlated with preventive services delivery in community primary care practices than are information technology capabilities. Demonstration projects and tools that measure PCMH principles should have greater emphasis on these key primary care attributes.
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http://www.annfammed.org/content/8/2/108.abstract

August 7, 2019

The future of health information technology in the patient-centered medical home

Most electronic health records today need further development of features that patient-centered medical homes require to improve their efficiency, quality, and safety. We propose a road map of the domains that need to be addressed to achieve these results. We believe that the development of electronic health records will be […]
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Most electronic health records today need further development of features that patient-centered medical homes require to improve their efficiency, quality, and safety. We propose a road map of the domains that need to be addressed to achieve these results. We believe that the development of electronic health records will be critical in seven major areas: telehealth, measurement of quality and efficiency, care transitions, personal health records, and, most important, registries, team care, and clinical decision support for chronic diseases. To encourage this development, policy makers should include medical homes in emerging electronic health record regulations. Additionally, more research is needed to learn how these records can enhance team care.
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http://www.cimit.org/images/events/ciw/IT-in-Patient-Centered-Medical-Home.pdf

August 7, 2019

Guided Care Patient-Centered Medical Home

Guided Care® provides many aspects of a “patient-centered medical home” for the growing number of older adults with complex health needs. Scientific studies have shown that Guided Care improves the quality of care and suggests that it reduces overall health care costs. In Guided Care, a registered nurse, who is […]
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Guided Care® provides many aspects of a “patient-centered medical home” for the growing number of older adults with complex health needs. Scientific studies have shown that Guided Care improves the quality of care and suggests that it reduces overall health care costs. In Guided Care, a registered nurse, who is based in a primary care office, works closely with 3-4 physicians and health information technology to provide state-of-the-art care for 50-60 chronically ill Medicare beneficiaries. Following a comprehensive assessment and planning process, the Guided Care nurse educates and empowers patients and families, monitors their conditions monthly, and coordinates the efforts of health care professionals, hospitals and community agencies to be sure that no important health-related need slips through the cracks
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http://www.guidedcare.org/pdf/Guided%20Care%20summary%20and%20results.pdf

August 7, 2019

What is the Patient-Centered Medical Home?

A Patient-Centered Medical Home is a team-based model of care led by a personal physician who provides continuous and coordinated care throughout a patient’s lifetime to maximize health outcomes. The PCMH practice is responsible for providing for all of a patient’s health care needs or appropriately arranging care with other […]
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A Patient-Centered Medical Home is a team-based model of care led by a personal physician who provides continuous and coordinated care throughout a patient's lifetime to maximize health outcomes. The PCMH practice is responsible for providing for all of a patient’s health care needs or appropriately arranging care with other qualified professionals. This includes the provision of preventive services, treatment of acute and chronic illness, and assistance with end-of-life issues. It is a model of practice in which a team of health professionals, coordinated by a personal physician, works collaboratively to provide high levels of care, access and communication, care coordination and integration, and care quality and safety.
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http://www.acponline.org/running_practice/pcmh/understanding/what.htm

August 7, 2019

The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of Health Care

A policy paper providing proposals for resolving some of the major problems with the health care system in America was released today by The American College of Physicians (ACP) at its annual report on “The State of the Nation’s Health Care.” “The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of […]
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A policy paper providing proposals for resolving some of the major problems with the health care system in America was released today by The American College of Physicians (ACP) at its annual report on "The State of the Nation's Health Care." "The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of Health Care," proposes a fundamental change in the way that principal - or primary care - is delivered and financed. "ACP proposals would provide patients with access to care that is coordinated by their own personal physician," explained C. Anderson Hedberg, ACP president. "The physicians will be working in a practice environment organized around patients' needs." The paper recommends voluntary certification and recognition of primary care and specialty medical practices that use health information technology, quality measurement and reporting, patient-friendly scheduling systems and other "best practices" to deliver better value and improve care coordination for patients, especially those with multiple chronic illnesses.
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http://www.acponline.org/pressroom/admed_home.htm

August 7, 2019

Specialists/subspecialists and the patient-centered medical home

This article provides an overview of the Patient-Centered Medical Home (PCMH) care model. It provides a history and definition of the concept, a discussion of its growing acceptance by the health-care community, and a review of current public and public-private demonstration projects testing the concept. The role of specialty/subspecialty practices […]
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This article provides an overview of the Patient-Centered Medical Home (PCMH) care model. It provides a history and definition of the concept, a discussion of its growing acceptance by the health-care community, and a review of current public and public-private demonstration projects testing the concept. The role of specialty/subspecialty practices within the PCMH model is described, with a focus on the potential for these practices to serve as a PCMH for a subgroup of patients or, alternatively, as a PCMH "neighbor" that interfaces effectively with PCMH practices. The authors conclude that the model for effective connections between the PCMH and specialty/subspecialty practices requires further development, including the cross-specialty establishment of guidelines and processes regarding referrals, information flow, transitions in care, and accountability. The efforts of the American College of Physicians' Council of Subspecialty Societies PCMH Workgroup to further develop this model are described. The authors encourage involvement from all interested stakeholders to ensure that the issues and challenges identified are addressed through collaboration and consensus based on available evidence.
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http://journal.publications.chestnet.org/article.aspx?articleid=1086197

August 7, 2019

Joint Principles of the Patient Centered Medical Home

The Patient Centered Medical Home (PCMH) is an approach to providing comprehensive primary care for children, youth and adults. The PCMH is a health care setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient’s family. The AAP, AAFP, ACP, and AOA, representing approximately […]
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The Patient Centered Medical Home (PCMH) is an approach to providing comprehensive primary care for children, youth and adults. The PCMH is a health care setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient’s family. The AAP, AAFP, ACP, and AOA, representing approximately 333,000 physicians, have developed the following joint principles to describe the characteristics of the PC-MH.
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http://www.pcpcc.net/content/joint-principles-patient-centered-medical-home

August 7, 2019

Joint Principles of the Patient-Centered Medical Home (March 2007)

The Patient-Centered Medical Home (PC-MH) is an approach to providing comprehensive primary care for children, youth and adults. The PC-MH is a health care setting that facilitates partnerships between individual patients, and their personal physicians, a
The Patient-Centered Medical Home (PC-MH) is an approach to providing comprehensive primary care for children, youth and adults. The PC-MH is a health care setting that facilitates partnerships between individual patients, and their personal physicians, a
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http://www.medicalhomeinfo.org/downloads/pdfs/jointstatement.pdf

August 7, 2019

Implications of Reassigning Patients for the Medical Home: A Case Study

PURPOSE Improving patient-doctor continuity is one goal of the medical home, but achieving this goal may require physicians to reduce panel size. This article examines the impact on patient experience and utilization of Group Health Cooperative’s process of reassigning patients to new physicians as part of their medical home demonstration […]
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PURPOSE Improving patient-doctor continuity is one goal of the medical home, but achieving this goal may require physicians to reduce panel size. This article examines the impact on patient experience and utilization of Group Health Cooperative’s process of reassigning patients to new physicians as part of their medical home demonstration project. METHODS This work represents a subanalysis of the Group Health medical home pilot evaluation. Study participants include 8,005 adults who received primary care in 2006 and 2007 at an urban practice owned and operated by a not-for-profit integrated delivery system. Approximately one-quarter of patients were selected to be reassigned to a new physician. Primary care, emergency department, secure messaging, and telephone utilization were captured through automated sources. Patients’ experience was measured before and after implementation of the medical home for a subset of 1,098 patients. RESULTS Patients who were retained by their existing physicians were older, sicker, and had longer preexisting patient-doctor relationships. After reassignment, reassigned patients were less likely to use primary care services but equally likely to use the emergency department. They were no less satisfied with their care experience. CONCLUSIONS Informational and managerial continuity may mitigate deleterious effects of reassignment, but more must be done to actively bind reassigned patients to the medical home to improve relational continuity with younger, healthier patients. Key Words: Patient-centered medical home, primary health care, continuity of patient care, physician-patient relations, patient-centered care
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http://www.annfammed.org/cgi/content/abstract/8/6/493

August 7, 2019

Patient Outcomes at 26 Months in the Patient-Centered Medical Home National Demonstration Project

Jaen CR, et al.Patient Outcomes at 26 Months in the Patient-Centered Medical Home National Demonstration Project. Annals of Family Medicine.2010;8(S-1):S57-S67. http://www.annfammed.org/content/8/Suppl_1/S57.abstract .Accessed 7/10/14 PURPOSE The purpose of this study was to evaluate patient outcomes in the National Demonstration Project (NDP) of practices’ transition to patient-centered medical homes (PCMHs).
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Jaen CR, et al.Patient Outcomes at 26 Months in the Patient-Centered Medical Home National Demonstration Project. Annals of Family Medicine.2010;8(S-1):S57-S67. http://www.annfammed.org/content/8/Suppl_1/S57.abstract .Accessed 7/10/14 PURPOSE The purpose of this study was to evaluate patient outcomes in the National Demonstration Project (NDP) of practices’ transition to patient-centered medical homes (PCMHs).
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http://www.annfammed.org/cgi/content/abstract/8/Suppl_1/S57