Patient Centered Medical Home

You may have heard the terms “Patient Centered Medical Home” or “Primary Care Medical Home” (PCMH for short) and wondered what exactly that means.

By Michael Murnik, MD

You may have heard the terms “Patient Centered Medical Home” or “Primary Care Medical Home” (PCMH for short) and wondered what exactly that means. Maybe you’ve even heard about Blue Hill Memorial Hospital’s three family medicine practices all being “level 3 Patient Centered Medical Homes”. Let me explain what that means and why I’m so proud of that recognition.

The idea of a medical home – a familiar place where you’d go for most of your healthcare needs – has been around for a long time. Some of us are old enough to remember doctors’ offices that fit that description, with nurses and staff who knew you and your needs – and took care of them.

Starting in the late 1960s, medical groups realized that everyone would be better off if they had a family doctor or primary care practice like that to go to for health care. Numerous studies have shown that outcomes are better and costs are lower when people have access to primary care services that feel like home – their patient centered medical home.

In more recent decades, as lower costs and improved health have become a more pressing need for our country, various models have been tried in attempts to deliver primary care services widely. Several consistent themes emerged from those trials. An ideal primary care site would provide care that is safe and of good quality, comprehensive, coordinated, centered around the patient’s needs, and with easy access or entry to see the providers you need. The current PCMH model is meant to deliver on these five themes and is a big part of almost all plans to reform our healthcare system.

Patient centered care means patients and families are involved partners in decisions about their care. Comprehensive care means taking care of most of a person’s physical and mental health needs by using a team – physicians, nurses, counselors, dieticians, pharmacists, health coaches, social workers – all located in one place for “one stop shopping”.

Coordinated care means keeping track of care received elsewhere, in hospitals or at specialists’ offices for instance, and maintaining a central record so that different plans of care don’t interfere with each other. This is mostly done through computers and electronic medical records. Computer systems can also track when screenings and labs are due and how well diseases are being managed.

Access means being able to get what you need – when and where you need it. Hours are being expanded, schedules redesigned, and new ways to communicate with your team have been created, such as secure electronic portals.

Quality and safety are tracked and built into the clinics by adopting standardized plans of care based on the best scientific and medical evidence. Doing all this consistently requires new ways of thinking about clinics, building new teams, using new technologies, and figuring out how to pay for it.

All three of Blue Hill Memorial Hospital’s Family Medicine practices in Blue Hill, Castine, and Stonington, have the highest (level 3) national certification. Monitoring of quality measures and patient health outcomes are required of all Patient Centered Medical Homes and this is an important part of the new ways that the U.S. is working on how to pay for quality healthcare.

The Institute for Healthcare Improvement has a “triple aim” for improving care in the U.S., improving not just the health of the population, but the experience of the care, and decreasing the cost as well. A colleague recently rephrased this as “keeping people healthy and happy efficiently”. However healthcare changes to try to achieve those goals, PCMHs will probably be part of the solution. Hopefully it will feel something like the good old days, only better.

What you can do! Have questions? Ask your health care provider to explain how the new changes are improving your health care.

Your Health Matters is a monthly health column by Healthy Peninsula and the Blue Hill Memorial Hospital. Michael Murnik, MD is a family practice physician and Medical Director of Blue Hill Memorial Hospital Family Medicine.