This blog post is the fourth in the Supply, Demand and Medicine series on health care reform.
If you received your childhood education in America, chances are you spent much of your youth under the watchful eye of a homeroom teacher.
You may have passed through many other classrooms with many other teachers, but your homeroom teacher was the ultimate supervisor of your education, the one you could turn to in a time of need and the one teacher most likely to know what was going on in your life.
It was a comforting feeling wasn’t it? Having someone there to help coordinate your education and knowing your complete picture.
While the days of having homeroom teachers looking after your grades are probably well behind you, a similar model to look after your health, called patient-centered medical homes, is rapidly gaining popularity.
In the Know
A patient-centered medical home (PCMH) is an expanded, physician-led practice that takes a team approach to medicine with the goal of continuously improving care and serving as a patient’s medical “homeroom.”
The team usually consists of physician assistants, nurse practitioners, care coordinators and, of course, the physician.
Although PCMHs are generally primary care physician practices, some specialty medical societies are beginning to endorse the model for their fields of practice as well.
Certification as a PCMH is conducted through the National Commission for Quality Assurance, based on a set of criteria shown to improve outcomes for patients.
The criteria cover nine categories with each category featuring several key elements, such as:
- Use of electronic charting.
- Having written standards for patient communication and access.
- Properly using data to determine diagnoses and conditions.
- Using evidence-based guidelines for certain conditions.
- Systematically tracking patient results
While patients with a PCMH may visit other physician specialists or caregivers outside the PCMH practice, the PCMH is responsible for helping coordinate all aspects of care and being in the know about each patient’s overall health status.
This model of care is especially beneficial for patients with a chronic medical condition, like diabetes or heart disease, who may need to visit different specialists for problems associated with their condition.
Some patients may visit four or five independent specialists, but not have a primary care physician or health care provider who can look at the totality of the treatments and medications they are receiving.
This can lead to:
- Patients being on too many medications.
- Repeating tests/other redundancies.
- Excessive hospital admissions.
Quality Outcomes for All
It’s true that PCMHs hold extra benefits for patients with chronic conditions or end-stage diseases.
However, like a homeroom teacher who looks after every student in a class and not just those struggling, PCMHs make sense for everyone regardless of health status.
That’s because they are outcomes oriented. The team approach to care includes using standardized, evidence-based treatments for common problems that have been shown to lead to the best outcomes. Additionally, team care can lead to better access.
For example, if a patient wakes up feeling bad, they can call their physician’s office and are likely to get seen quickly because scheduling isn’t based solely on the availability of the physician.
The patient may not see the physician upon arrival, but rather a member of the PCMH team, such as a nurse practitioner, who knows their name, knows their health history and who works closely with their physician.
If an initial exam doesn’t yield a quick, obvious diagnosis, the PCMH team member can call in the physician. Additionally, if the patient is also under the care of a specialist, the PCMH office can call the specialist for consultation if necessary, all while the patient is onsite.
Together, a plan of care will be created.
For certain patients, this approach also may mean not only receiving recommendations while visiting their physician’s office, but then having a member of the PCMH team follow-up to ensure recommendations are being followed.
Besides quality and quickness, PCMHs may also reduce duplication of tests and paperwork and lower costs, which is good for everyone and the American health care system.
Finding a Home
North Texas is fortunate to be home to hundreds of PCMHs, many of which are members of the Baylor Quality Alliance (BQA).
In fact, with more than 320 PCMHs, BQA is home to one of the largest networks of NCQA-certified PCMHs in the country.
To find out if your physician is a PCMH, simply ask their office. Or you can search the NCQA directory for “Physician Practice Connections – Patient Centered Medical Homes” in your area.