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An Overview of the Patient Centered Medical Home

Practice Transformation Institute is rooted in the desire to help primary care physicians and their medical practice teams adopt the tenets of the patient centered medical home. The patient centered medical home (PCMH) is a health care initiative designed to improve patient health through an efficient, patient-centered health care delivery system.  The PCMH is a concept - not a place - that is founded on the patient/physician relationship, putting the focus back on the patient and treating the whole person.   
 
The PCMH seeks to retool the primary care physician’s office to ultimately renovate our health care system for better health outcomes, increased viability and long term cost savings and cost effectiveness. The patient centered medical home transforms not only the delivery of health care but administrative aspects as well, notably reimbursement and technology as it relates to patient follow-up and population based registries (formerly known as disease management registries).
The patient centered medical home is built upon principles that have been approved by the American Medical Association, the American Osteopathic Association, the American Academy of Family Physicians, the American Academy of Pediatrics, and the American College of Physicians.
Following are Principles of the Patient Centered Medical Home as outlined by the Patient Centered Primary Care Collaborative (www.pcpcc.net)
Personal physician - each patient has an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care.
Physician directed medical practice – the personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care of patients.
Whole person orientation – the personal physician is responsible for providing for all the patient’s health care needs or taking responsibility for appropriately arranging care with other qualified professionals. This includes care for all stages of life; acute care; chronic care; preventive services; and end of life care.
Care is coordinated from the primary care physician’s office across all elements of the complex health care system (e.g., subspecialty care, hospitals, home health agencies, nursing homes) and the patient’s community (e.g., family, public and private community-based services). Care is facilitated by patient data registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.
Evidence-based medicine and clinical decision-support tools guide physician and patient decision making
 
Physicians are accountable  for continuous quality improvement and use performance measurements for same
 
Patients actively participate  in decision-making and provide feedback to the physician to ensure their expectations are being met
 
Information technology, such as population based registries and e-prescribing are  used to support optimal patient care, measure performance and track outcomes
 
Practices go through a voluntary recognition process by an appropriate non-governmental entity to demonstrate that they have the capabilities to provide patient centered services consistent with the medical home model.
 
Enhanced access to care is available to patients through expanded hours and new options for communication between patients, their personal physician, and practice staff, such as follow-up web visits, email, and voluntary group visits between patients who share a common diagnosis and seek support for better self management of the disease, with a member of the primary care physician’s office serving as facilitator.
New Payment  approach recognizes the added value provided to patients from physicians who follow patient-centered medical home philosophies.
Transform your medical practice into a patient centered medical home. Practice Transformation Institute empowers physician leaders and their staff with valuable management skills and CME-accredited learning and evaluation.  
Practice Transformation Institute: The premier provider of CME and IACET-accredited learning events for physicians and their medical practice teams.