Patient-Centered Medical Home

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Imagine a diabetes patient going to her primary-care physician with health concerns related to her condition. Instead of getting an initial assessment and being referred out, an interdisciplinary team immediately starts working on her case, involving her throughout the process. As part of that team, a psychologist assesses her level of depression, knowing that it often goes hand in hand with diabetes. The psychologist might also devise behavioral strategies to control her blood glucose levels.

That dream scenario would be commonplace in a patient-centered medical home, also referred to as a "health home." First conceived in 1967 by pediatricians as a way to coordinate care for children with developmental disabilities, the concept is regaining steam as a way to make primary care more robust, comprehensive and cost-effective. Versions of the concept — which is a central part of the 2010 health-care reform law — are already being adopted at the Mayo Clinic, the Department of Veterans Affairs and in pilot projects nationwide.

There is increasing evidence in the literature that care provided in a patient and family-centered medical home leads to improved outcomes. The medical home concept refers to the provision of comprehensive primary care services that facilitates communication and shared decision-making between the patient, his/her primary care providers, other providers, and the patient's family.

The PCMH concept was included as a program in national health care reform legislation with components similar to joint principles developed by the American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American College of Physicians (ACP), and the American Osteopathic Association (AOA):

 

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