Medical Homes – Defining What Patients Want

February 13th, 2011 by Nick Jacobs Leave a reply »

The definition of a medical home can be confusing to those who have not been dedicated students of this terminology. As the medical home concept has been added to the healthcare landscape of  the U.S., many uninformed healthcare professionals look at each other and shrug as if they seem to expect to see villages being built with work-out facilities and critical care equipment as part of the accoutrements. Instead, the concept of the medical home (also known as the Patient Centered Medical Home – PCMH) refers to patient-centered care, a phrase that we and Planetree have been using for over thirty years.

Imagine a physician’s office or clinic where the patient’s records are reviewed prior to each visit to ensure that the necessary immunizations, tests and wellness milestones are in place and accounted for on a consistent basis. If that stretched your imagination, consider a medical support staff that communicates by secure e-mail and phone to organize the patient’s care. Add to that an electronic medical record system that tracks the patients, their tests and prescriptions. That is just the beginning of what a medical home could be and do.

One of the companies with which SunStone Management Resources is working goes so far as to add nurse- patient advocates to the mix and then assigns them to help sort through the morass of decisions every person faces with significant co-morbidity risk factors. This system not only helps the patient, it holds down costs by giving people a stable, well-coordinated patient centered medical experience. As an advocate, I believe that it will be key to stopping the loss of billions of dollars in unnecessary treatment costs that conversely leaves millions of our citizens without appropriate medical care.

These outcomes can only be achieved by developing years-long, longitudinal relationship with the primary care provider and their team, and with patient advocate nurses who are assigned to work with those teams to help sort out the redundant tests and medications that often evolve from interacting with as many as nine different specialists each year. This number of hands usually results in at least 15 office or clinic visits and countless unnecessary tests. Imagine how great it would be to have someone who can lead the patients more efficiently through this journey.

In a recent edition of Modern Healthcare, Andis Robeznieks wrote an article entitled “In Search of Medical Homes.” Interestingly, it described the evolving requirements from the National Committee for Quality Assurance for medical home standards. Some of you may remember that this journey began officially in 2008. Of course, the Joint Commission and the Accreditation Association for Ambulatory Health Care were also in on the act as they began that same journey. The question posed by these organizations centers around the unique qualities of a patient-centered medical home.

Somava Stout, MD - Cambridge Medical Associates - Nick Jacobs, FACHE

Somava Stout, MD

Even though, as the article pointed out, the NCQA was experiencing success from their medical home practices business line, patients weren’t experiencing that same feeling of success, attention or comfort. According to Mr. Robeznieks this fact was eagerly confirmed by the patients as they filled out their patient satisfaction scores. The piece went on to outline the latest and greatest revisions to the NCQA standards which included, heaven forbid, a stronger voice from the patients. My favorite quote from the article was from Dr. Somava Stout, Vice President of Patient–Centered Medical Home Development for the Cambridge Health Alliance: “One of the things we do over and over again in healthcare is we don’t remember to include the patient as a partner in designing the (personal ) healthcare system.”

In summary, medical homes would provide patient-centered care that results in reduced visits to specialists and allows less expensive primary care doctors to care for the majority of people’s health care needs. This in turn would result in higher quality outcomes with greater patient satisfaction and more funds to take care of the under insured.

Sounds like a plan.

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