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, their personal physicians and, when appropriate, their family.
Principles
- 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 who collectively take on the responsibility for the ongoing care of the patient’s health.
- Whole-person orientation — the personal physician is responsible for providing for the entire patient’s health care needs or 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 and/or integrated across all elements of the 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 information technology and health information exchange to assure that patients get the indicated health care when and where they need it in a culturally and linguistically appropriate manner.
- Quality and safety are hallmarks of the medical home.
- Evidence-based medicine and clinical decision-support tools guide decision-making.
- Physicians in the practice accept accountability for continuous quality improvement through active engagement with patients and active participation in decision-making and by seeking feedback to ensure that patient’s expectations are being met.
- Information technology is used appropriately to support patient care, performance measurement, patient education and better communication.
- Practices go through a voluntary recognition process to demonstrate that they are able to provide patient-centered services consistent with the medical home model.
- Patients and families participate in quality improvement activities at the practice level.
- Enhanced access to care is available through such systems as open scheduling, expanded hours and new options for communication between patients, their personal physician and practice staff.