Patient-Centered Care

Blood PressureHave you heard the term Patient-Centered Care or Medical Home recently? It’s the latest buzz in health care circles, but the important question is what does it really mean?

First, let me make this point. Patients are not generally knowledgeable consumers of healthcare. One case in point: most patients assume that the care they’re receiving is high-quality care. I first learned this as part of my work with the Future of Family Medicine (FFM) project where we researched what patients thought of primary care and family medicine.

We learned in the FFM research that patients look for these qualities in a physician:

  • A physician in their insurance plan
  • A convenient location
  • Availability for an appointment
  • Basic communication skills
  • Age/Experience

Do you see the word quality in this list? No? That’s because patients have traditionally assumed that quality is inherent in doctor’s practices across the country.

What has been assumed by patients and what is reality do not quite meet. Patients shouldn’t feel too bad about this, because doctors have assumed the same thing as well.

Getting Real

In reality, most primary care practices are run on a day-to-day basis, meeting the challenges of today the best they can. As a result, most of the care delivered across the nation today is more reactive than proactive. And practices have provided that care in a more physician-centric model where the hours of operation are based on what works for the doctor(s), the care is directed at the patient rather than working with the patient, etc.

Practices are not really to blame for this. It is the model under which they have worked and within the system that was created. According to the Annals of Family Medicine, this old model of primary care medicine has these characteristics:

  • Practices are physician-centric
  • Care provided is reactive
  • Practices use paper medical records
  • Quality and safety are assumed
  • Haphazard disease management provided
  • Care is experienced-based
  • Primary care practices struggle financially
  • Unnecessary barriers to access

The Patient-Centered Medical Home provides an opportunity for care to be provided in the following ways:

  • Systems support continuous healing relationships
  • The patient is center stage
  • Open access to the practice
  • Care is both responsive and prospective
  • Care is integrated
  • Care is evidence-based
  • Processes are in place for ongoing measurement and improvement of care provided
  • Purposeful, organized chronic disease management
  • Practices use electronic health record systems
  • Practices have positive financial margins

What is PCMH?

According to the Patient-Centered Primary Care Collaborative, there are now PCMH demonstration projects being conducted all over the country. Some of the principles of PCMH include:

  1. Ensuring patients have access to care
  2. Creating a partnership between the patient and their primary care team
  3. Ensuring patients find care that is safe, timely, effective, efficient, equitable, patient-centered and family-focused

I’ll be writing more about the concepts of PCMH soon. In the meantime, be sure to share your comments.

One Response to “Patient-Centered Care”

  1. Nice site, nice and easy on the eyes and great content too.

Comment or Reply