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Navigating Health Care: What is a Medical Home?
Rand: High-quality health care means getting the right care at the right
time. But research shows that it’s not always easy to find high-quality, safe
health care. And consumers who have several different health care conditions may
have an especially difficult time getting their care coordinated. That’s why
some experts say creating a health care team is the way to go to provide high
quality and safe care, and to give patients a better experience. Here to talk to
us about a model called the patient-centered medical home is AHRQ Director Dr.
Carolyn Clancy. Welcome, Dr. Clancy.
Dr. Clancy: Thank you.
Rand: Dr. Clancy, many consumers have heard that term, but aren’t quite
sure what it means. What is a medical home?
Dr. Clancy: That’s a really good question because the term has been used
in many ways. Also, sometimes people confuse a medical home with institutional
care or nursing home care. The most common definition of a patient-centered
medical home is a practice in which a group of health professionals provide a
type of new, expanded primary care - one that takes a team approach and puts the
patient at the center of that team. Medical home teams often include doctors,
nurses, pharmacists, physical therapists, social workers, and health educators
that work together and use technology to provide coordinated care to their
patients.
Rand: So, how is this different from what patients get now in many of
their primary care settings?
Dr. Clancy: The patient-centered medical home model is designed to give
consumers the primary care they need, while at the same time coordinating any
other care that they might need. This can greatly improve their experiences and
the results of their care. For example, say you need to be seen by a specialist
such as a cardiologist. In a medical home setting, your team will help you find
that specialist, set up your appointment, and then get you the information you
need to be prepared for the visit. Then, the medical home team will also make
sure you understand the recommendations of the cardiologist, and what your
options are for next steps. A medical home team provides continuity of care and
good communication to make sure that you get the best results from your care.
Rand: Is this medical home concept new?
Dr. Clancy: Well, the term "medical home" isn’t new. The American Academy
of Pediatrics introduced the term "medical home" in 1967. They were mostly
interested in providing better care to children with very complex medical
conditions with special needs. Recently, other primary care groups have begun to
use the term "medical home" to describe the collaborative, patient-centered
approach they had with patients and their patients’ families. So my point is
that the term has been around for a little while, but the concept has evolved
into how we use it today.
Rand: And where are we today? Is there one group that seems to be leading
the way?
Dr. Clancy: The primary care groups including the American College of
Physicians, the American Academy of Family Physicians, and the American Academy
of Pediatrics, and American Osteopathic Association have developed really great
models describing how medical homes should operate. And it’s also certainly
worth mentioning that the Centers for Medicare and Medicaid Services will launch
a patient-centered medical home demonstration project later this summer. This
three-year study will be one of the largest federal demonstrations about medical
homes to date and it will evaluate the impact that the medical home model has on
Medicare beneficiaries with chronic or prolonged illnesses. The outcomes of this
project will be particularly interesting for our aging population.
Rand: Speaking of evolving ideas, earlier you mentioned that technology
plays a role in patient-centered medical homes. How?
Dr. Clancy: Well, there are many types of technology that could be used
in the patient-centered medical home, just as health information technology is
being used more and more in many health care settings today to improve not only
the way clinicians work together but also the way patients can access their
health care team. For example, in the concept of a medical home, it would not be
unusual for a consumer to stay in touch with their health care team, follow up
on test results and ask questions through secure e-mail and telephone. Some
practices would even allow patients to see the appointment calendars of their
health care team and book their own appointments online.
Rand: That sounds like a great idea. The question that many consumers
probably have at this point is, "Where can I go to find a patient-centered
medical home?"
Dr. Clancy: Great question! So the bottom line is, the patient-centered
medical home model is spreading, but you may not be able to find them everywhere
yet. However, as a consumer, you get what you’re looking for in your health care
by taking an active role. I strongly encourage consumers to go to their
clinicians and say, "I want to be an active partner on my health care team. How
can we work together to make this happen?"
Rand: Dr. Clancy, thank you so much for joining us to share this great
information about patient-centered medical homes.
Dr. Clancy: My pleasure.
Rand: AHRQ has other resources for consumers, including the "Guide to
Health Care Quality - How to Know it When You See it," and it’s available for
free online at
ahrq.gov/consumer.
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