The Patient-Centered Medical Home (PCMH)
The patient centered medical home is a model of care. It is not about a physical location. The PCMH could be in a physician practice, or in a patient's own home. The PCMH is about the organization and delivery of primary care services.
Family Centered Medical Home
The family centered medical home is American Academy of Pediatrics (AAP) model for delivering primary care to all children and youth, including children and youth with special health care needs. Remember in pediatrics that the 'patient' is the family as care of children is always within the family context.
- The pediatric care team works in partnership with a child and a child's family to assure that all of the medical and non-medical needs of the patient are met.
- The Care Team helps the family/patient access, coordinate, and understand specialty care, educational services, out-of-home care, family support, and other public and private community services that are important for the overall health of the child and family.
Watch the video below from the American Academy of Pediatrics' National Center on Medical Home Implementation.
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What is the medical home approach to care? - Calvin C.J. Sia, MD, FAAP
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Defining elements of the PCMH from the AHRQ Patient Centered Medical Home Research Center:
1. Comprehensive Care
- Provide physical and mental health care needs, including prevention and wellness, acute care, and chronic care.
- Team approach: physicians, advanced practice nurses, physician assistants, nurses, pharmacists, nutritionists, social workers, educators, and care coordinators.
- In small practices this may be a virtual team, linking services within the community.
2. Patient-Centered
- Model of shared decision making with patients and families.
- Holistic approach tailored to the needs, values, culture and preferences of each individual.
3. Coordinated Care
- Coordinate services across the spectrum from acute hospitalization, to specialty visits to home care.
- Serve as bridge when patient transitions back to the community after hospitalization.
4. Accessible Services
- Patient must have access to the care team outside of traditional office hours.
- Access to appointments for acute issues in timely manner.
- Availability of care in-person, by telephone or even email depending on preferences of patient.
5. Quality and Safety
- Ongoing quality improvement activities and use of evidence based practices.
- Collect data on performance measures and participate in public reporting.
In theory the PCMH is a solution to many of our challenges in health care: fragmented care, duplication of services, excessive use of specialty care, and lack of preventive services.
