Patient-centered medical homes are gaining popularity

For students preparing to be medical assistants, nurses and doctors, one career option is to explore the growing trend in patient-centered medical homes. An increasing number of federally qualified health centers in the U.S. are providing patient-centered medical home (PCMH) options. In homes like these, physicians and medical assistants work closely with a specific patient to treat and manage their illness. Successful models of PCMHs require their staff to be highly skilled and educated.¹ Some hospitals believe this kind of care will better serve their patients with a more personal approach, and they plan to offer their staff of medical professionals training and preparation to assist the residents.

The need to deliver more efficient and personalized primary care has led many physicians and health care professionals to support the increase in patient-centered medical homes. In PCMHs, a more team-based approach is encouraged with sharing and record keeping. Doctors are more accessible in person, via phone, email or Internet, versus through automated answering services or clinic schedules.² However, the support of doctors and other medical professionals is not enough to put this new treatment option into practice everywhere. Patients are have an integral part to play in making PCMHs a success.

Patients need to be engaged in this kind of reform

The American Academy of Family Physicians is a national medical society that is devoted to primary care. It collaborated with TransforMED, a nonprofit consulting firm created by the AAFP society to help physicians turn their practices into medical homes.² Their studies into the efficacy of patient-centered medical homes found that many doctors’ offices could easily implement the elements of PCMH care into their practice. In 2006, 36 primary care offices in the U.S. began to utilize PCMH practices by installing electronic medical record systems, reorganizing ineffective scheduling routines and focusing not on a specific illness but rather the patients’ overall well-being and lifestyle. Teams of doctors, medical assistants, nurses and medical managers were treating patients, instead of the patient meeting with just one provider. Doctors who were involved in these initial stages of patient-centered medical home care reported more contentment and enthusiasm in their workplace. Doctors found that by streamlining office procedures and working as a cohesive team, their workload was easier to handle.²

However, patients who experienced the first trials of PCMHs reported feeling disoriented because they were not used to seeing more than one doctor. Many patients initially said they preferred the one-on-one approach that is traditional in most practices. Doctors involved in these first trials neglected to consult patients on how they would feel in a more team-based atmosphere. Patients did report that they were getting into their doctors’ offices more quickly, and that their progress was being followed more closely than before. However, the fact that the providers in the office were still learning most of the new technology that was installed as electronic records replaced paper ones made patients feel overlooked. These patients were aware of the changes in their doctors’ practices but did not feel like they were a part of those adjustments to their treatment.²

Doctors begin to consult their patients to customize care

Patient surveys have played an important role in developing patient-centered medical homes. Medical practices were encouraged to involve patients in the improvements by consulting their patients on whether a PCMH approach was appealing to them. Doctors were also advised by researchers studying PCMHs to create patient advisory councils, comprised of groups of patients who could meet regularly to talk about how their needs could be better served.²

Assessment surveys were created by the researchers involved in this reform to study the views of patients on access to providers, patient-provider communication and overall care. Practices evolving into patient-centered medical homes can use these surveys regularly to monitor their progress and gauge their success. Effects of changes, how to adjust and refine them, and how to make patients’ experiences better are all accessible for doctors with the use of these surveys.²

One doctor who was involved in the demonstration project of PCMHs created a national coalition of patient advocacy groups and providers called the Patient-Centered Primary Care Collaborative, which is focused on creating more medical homes across the United States.² The organization understands the need to increase efficiency in doctors’ offices without overlooking the needs of the patients there.

¹ “Medical Assistants & Patient-Centered Medical Homes,” PR Newswire.com, Jan. 22, 2014,
http://www.prnewswire.com/news-releases/webinar-medical-assistants–patient-centered-medical-homes-241457221.html

²  Chen, Pauline W. M.D., “Putting Patients at the Center of the Medical Home,” NY Times.com, July 15, 2010,
http://www.nytimes.com/2010/07/15/health/15chen.html?pagewanted=all&_r=0