When a patient sees multiple providers, particularly for a chronic or complex condition, that patient’s care needs to be coordinated to ensure the delivery of safe and effective treatment. The patient who has a medical home has just that kind of healthcare coordination, with the primary care physician monitoring the patient’s health status and collaborating with other providers throughout the various stages of that patient’s life.
The patient-centered medical home (PCMH) is focused on the continuing care of the patient, rather than simply treating one condition for a limited period of time. In a PCMH, the primary care physician is able to engage the patient, to ask pointed questions, and to observe changes or signs that may need further exploration by a specialty provider or diagnostic lab.
As described by the Patient-Centered Primary Care Collaborative (PCPCC), “The medical home is best described as a model or philosophy of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. The Agency for Healthcare Research and Quality (AHRQ) describes the PCMH “as a way to improve health care in America by transforming how primary care is organized and delivered.”
The PCPCC adds that the PCMH is “a philosophy of health care delivery that encourages providers and care teams to meet patients where they are, from the most simple to the most complex conditions. It is a place where patients are treated with respect, dignity, and compassion, and enable strong and trusting relationships with providers and staff…. a model for achieving primary care excellence so that care is received in the right place, at the right time, and in the manner that best suits a patient’s needs.”
A PCMH is focused on the patient, with the primary care physician developing a close relationship with that patient. The provider collaborates with other healthcare providers and may work with the patient’s family as well, to cultivate a true understanding of all the factors affecting the patient’s health. The AHRQ also recognizes the role of health IT, including electronic health records (EHRs), “in successfully operationalizing and implementing the medical home.”