Healthy Living Patient-Centered Medical Home: Gaining Traction
I desire to commend the National Committee for Quality Assurance (NCQA), the American Academy of Family Physicians (AAFP), together with other physician-based organizations involved inwards writing the Standards together with Guidelines for Physician Practice Connections®—Patient-Centered Medical Home (PPC-PCMH™), which is available at this link.
I offset wrote virtually the medical abode concept inwards 2006 equally beingness a telephone commutation factor for our healthcare crisis at this link and together with then i time to a greater extent than inwards 2008 at this link.
The articulation principles of the PCC-PCMH are:
Personal physician—Each patient has an ongoing human relationship amongst a personal MD trained to provide offset contact, continuous together with comprehensive care.
Physician directed medical practice—The personal MD leads a squad of individuals at the practise grade who collectively convey responsibleness for the ongoing help of patients.
Whole individual orientation—The personal MD is responsible for providing for all the patient's wellness help needs or taking responsibleness for appropriately arranging help amongst other qualified professionals. This includes help for all stages of life; shrewd care; chronic care; preventive services together with halt of life care.
Care is coordinated or integrated across all elements of the complex wellness help scheme (e.g., subspecialty care, hospitals, abode wellness agencies, nursing homes) together with the patient's community (e.g., family, populace together with private community-based services). Care is facilitated yesteryear registries, data technology, wellness data commutation together with other agency to assure that patients teach the indicated help when together with where they demand together with desire it, inwards a culturally together with linguistically appropriate manner.
Quality together with safety are hallmarks of the medical home.
- Practices advocate for their patients to back upwards the attainment of optimal, patient-centered outcomes that are defined yesteryear a help planning procedure driven yesteryear a compassionate, robust partnership betwixt physicians, patients together with the patient's family.
- Evidence-based medicine together with clinical decision-support tools guide determination making.
- Physicians inwards the practise convey accountability for continuous character improvement through voluntary appointment inwards functioning measure together with improvement.
- Patients actively participate inwards determination making together with feedback is sought to ensure patients' expectations are beingness met.
- Information technology (IT) is utilized appropriately to back upwards optimal patient care, functioning measurement, patient instruction together with enhanced communication.
- Practices teach through a voluntary recognition procedure yesteryear an appropriate non-governmental entity to demonstrate that they take away keep the capabilities to provide patient-centered services consistent amongst the medical abode model.
- Patients together with families participate inwards character improvement activities at the practise level.
Enhanced access to help is available through systems such equally opened upwards scheduling, expanded hours together with novel options for communication betwixt patients, their personal MD together with practise staff.
Payment appropriately recognizes the added value provided to patients who take away keep a patient-centered medical home. While aspiring to improve patient care, the 4 main help groups envision implementation of the PCMH equally linked to to a greater extent than rational (and higher) payment for main care, which is inwards real frail status inwards the the U.S.A. The 4 main help groups, aided yesteryear others, take away keep held discussions amongst employers, wellness plans together with the federal authorities to encourage the evolution of PCMH implementation/demonstration programs. In concert amongst the articulation principles, the PPC-PCMH standards emphasize the role of systematic, patient-centered, coordinated help management processes.These principles are both audio together with doable! After seeing many skilful ideas evaporate due to lack of volition together with competing interests, I'm encouraged that strategies such equally the patient-centered medical abode are lastly gaining existent traction.
There are critics, however. For example, a recent article, titled Effectiveness of medical homes questioned, discussed how the “…effectiveness of medical homes equally a tool for improving help was called into inquiry at a hearing of the Senate Health, Education, Labor together with Pensions Committee…[because of] ‘concerns virtually how to best pattern together with implement such a model’…Some believe requiring MD referral for specialty services nether a medical abode model mightiness innovate a costly together with needless pace to linking patients to the correct beginning of help [arguing that] main help is non ever the most cost-efficient together with effective provider for every status together with disease.”
I concur that critical evaluation of all healthcare delivery models (including the patient-centered medical home) is a skilful thing. But I produce non concur amongst the criticism that main help physicians (PCPs) may non live the best people to create produce help coordination, fifty-fifty though for certain PCPs volition probable produce a improve undertaking than others inwards coordinating care. As a group, however, PCPs, beingness generalists, appear to me to live the ones best suited for the job. Nevertheless, it’s of import that our healthcare scheme enable PCPs to provide this crucial service yesteryear supplying them amongst effective wellness information technology tools together with paying them plenty to pass the fourth dimension necessary to coordinate together with evaluate help beingness rendered to their patients. Over the long term, this volition probable relieve money, peculiarly when treating patients amongst chronic conditions, yesteryear eliminating duplication of tests together with having multidisciplinary teams collaborating effectively.
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