This presentation explains the concept of the patient-centered medical home (PCMH), its function and its intended effects. A brief overview of the history of PCMH is also provided, as well as a discussion of its operational characteristics, its principles and outcomes, and what is expected in the future for the PCMH model.

1. The Patient Centered
Medical Home
Marwah Zagzoug
Wafa Hetany
Sara Abubotain
April 19, 2011

2. W.H.
Introduction
• What is it?
• What does it do?
Patient-Centered Medical Home (PCMH) is an approach to
providing comprehensive primary care for children, youth
and adults.
The PCMH is a health care setting that facilitates
partnerships between individual patients, and their personal
physicians.
(Fisher, 2008)

3. www.scmao.com
Introduction
Improve
patient care
and reduce
costs
Provide more
effective,
equitable, and
efficient
health
services.
Encourage
primary care
providers to
assume
responsibility
of all aspects
of patient
care.
Intended Effects:
(Fisher, 2008)
W.H.

4. www.scmao.com
History of the PCMH Concept
 Introduced by American Academy of Pediatrics
(AAP) in 1967
 Initially referred to a central location for medical records.
 The PCMH model received formal recognition in
2007 by
 American Academy of Family Physicians (AAFP),
 American Academy of Pediatrics (AAP),
 American College of Physicians (ACP),
 American Osteopathic Association (AOA).
 Since then, they have been endorsed by more than
12 physician organizations.
(Homer, Cooley, & Strickland, 2009)
W.H.

5. www.scmao.com
Operational Characteristics
Continuous
Comprehensive
Family-centered
Coordinated
Accessible
Compassionate
Culturally effective care
(Homer, Cooley, & Strickland, 2009)
W.H.

6. www.scmao.com
Joint Principles of PCMH (2007)
(Rosenthal, 2008)
W.H.

7. Patient Personal Physician
 Trusted personal physician
 Physician who provides, manages and
facilitates care
 Care is coordinated or integrated across
healthcare system
 More accessible practice with increased hours
and easier scheduling
 Enhanced payment that recognizes the added
value of delivering care through the PCMH
model
 Assistance to practices seeking
transformation
 Support to practices adopting HIT for QI
The PCMH Model
W.H.

8. Family Medicine Foundation
Great
Outcomes
Heath
Information
Technology
Practice
Organization
Patient
Experience
Quality
Measures
The PCMH Model
 Practice Organization
 Build a productive & supporting
environment
 Put Finances In Order.
 Health Information Technology
 Connect & communicate.
 Depends on clinical decision
support tools.
 Quality Measures
 Install a system to collect data.
 Use the system to improve care.
 Patient Experience
 Provide same-day appointments.
 Free-up appointment slots
 Educate and train staff.
(Backer, 2009)
W.H.

9. Current Challenges
S.A.

10. CEO OF New York-Presbyterian Hospital
In 2014: 32 million more Americans will have
health insurance and will need access to care.
Baby boomers are reaching retirement age,
and facing the increased medical needs of old
age
Physicians shortage
6,000 to 8,000 new physicians needed
annually on top of the 16,000 that are currently
produced each year
S.A.

11. PCMH Future
The PCMH has the potential to become an
important component of health reform
Truly transforming the U.S. health care system
around personalized medical homes embedded in
highly functional medical neighborhoods will
require
 better staffing models;
 more robust electronic information tools;
 aligned incentives for quality and efficiency within
payment and regulatory policies; and
 a culture of greater engagement of patients, their
families, and communities.
S.A.

12. How to tell if you have a PCMH?
 Can you get an urgent appointment within 24 hours?
 Can you reach someone in the practice by phone at night or on
weekends?
 Can you get test results quickly via e-mail or telephone, or on-
line?
 If you have a chronic condition, is there a system for tracking how
you’re doing?
 Does the practice include non-MD staff members such as
nutritionists or nurse practitioners to help you manage your
medications or chronic conditions?
 Does your primary-care doctor keep track of your treatment by
specialists?
S.A.

13. Times are Changing
Communication
Access
Convenience
Coordination
Responsiveness
Patients today are savvy consumers of healthcare and have
higher expectations
M.Z.

14. Patient Expectations
75% want the ability to interact with their
physician online (appointments, prescriptions,
test results).
77% want to ask questions without a visit.
75% want email access as part of their overall
care.
62% of patients say access to these services
would influence their choice of physicians
M.Z.

15. Path to Recognition
Follow the roadmap
M.Z.

16. www.scmao.com
PCMH Distribution
As of December 2010 there are 7,676 clinicians in 1,506
recognized PCMH practices in the US.
(National Committee for Quality Assurance [NCQA] , 2011)
M.Z.

17. Great Outcomes
Patients
• Enjoy better health
• Share in health care
decisions
Payers &
Employers
• Ensures quality & efficiency
• Avoids unnecessary costs.
Practices
• Team works
effectively together.
• Resources support
the delivery of excellent
patient care.
Physicians
• Physicians focus
more on delivering
excellent medical care
PCMH
Outcomes
M.Z.

18. References
 Backer, L.. (2009). Building the case for the Patient-Centered
Medical Home. Family Practice Management, 16(1), 14-8.
 Fisher, E. (2008). “Building a Medical Neighborhood for the
Medical Home.” New England Journal of Medicine 359 (12):
1202-1205.
 Fischer, J. (2011). CEO OF NewYork-Presbyterian Hospital
Discusses Impact of Health Care Reform on American Medical
Centers and Medical Innovation. Retrieved from:
http://nyp.org/news/hospital/reform-medical-center.html
 Homer, C., Cooley, W., & Strickland, B.. (2009). Medical Home
2009: What It Is, Where We Were, and Where We Are Today.
Pediatric Annals, 38(9), 483-90.
 Landon, B. Gill, J. Antonelli R and Rich, E. (2010). Prospects for
rebuilding primary care using the patient-centered medical home.
PubMed
 National Committee for Quality Assurance [NCQA] (2011).
Retrieved April 15, 2011 from:
http://www.ncqa.org/LinkClick.aspx?fileticket=QKn%2BiVilJ9Q
%3D&tabid=631&mid=2435&forcedownload=true

19. References
 Patient-Centered Primary Care Collaborative. (2009). Proof in Practice: a
compilation of patient centered medical home pilot and demonstration
projects. Retrieved April 15, 2011 from:
http://pcpcc.net/files/Grumbach_et-al_Evidence-of-Quality_
%20101609_0.pdf
 Rosenthal, T. (2008). “The Medical Home: Growing Evidence to Support
a New Approach to Primary Care.” Journal of the American Board of
Family Medicine 21 (5): 427-440.
 Rittenhouse, D. and Shortell, S. (2009). The Patient-Centered Medical
Home: Will It Stand the Test of Health Reform? PubMed.
 Rosenthal, M. Beckman, H. Forrest, D., Huang ,E, Landon, B and Lewis,
S. (2010). Will the patient-centered medical home improve efficiency and
reduce costs of care? A measurement and research agenda. PubMed
 Sinsky, C. (2011). The patient-centered medical home neighbor: A
primary care physician's view. PubMed
 Strickland, B., Jones, J., Ghandour, R., Kogan, M., and Newacheck, P.
(2011). The Medical Home: Health Care Access and Impact for Children
and Youth in the United States. Pediatrics, 127(4): 604 - 611.

20. That concludes our presentation
Speakers:
Wafa Hetany
Sara Abubotain
Marwah Zagzoug