![]() ![]() A multidisciplinary team evaluated data from the Study To Enhance Prevention by Understanding Practice (STEP-UP), a randomized clinical trial conducted to improve the delivery of evidence-based preventive services in 79 northeastern Ohio practices. Therefore, we developed a model of practice change using data from a quality improvement intervention that was successful in creating a sustainable practice improvement. Yet change is difficult, and the process by which practice improvement can be understood and facilitated has not been well elucidated. It also requires payment reform that supports practice development and a policy environment that sets reasonable expectations and time frames for the adoption of appropriate innovations.read more read lessĪbstract: Faced with a rapidly changing healthcare environment, primary care practices often have to change how they practice medicine. Additionally, transforming primary care requires synchronizing practice redesign with development of the health care "neighborhood," which is made up of a broad range of health and health care resources available to patients. Among other features, the transformation process requires an internal capability for organizational learning and development changes in the way primary care clinicians think about themselves and their relationships with patients as well as other clinicians on the care team and awareness on the part of primary care clinicians that they will need to make long-term commitments to change that may require three to five years of external assistance. The country's first national medical home demonstration, which ran from June 1, 2006, to May 31, 2008, and involved thirty-six practices, showed that this transformation can be lengthy and complex. Measuring the PCMH involves the following:Įfforts to transform practice to patient-centered medical homes must recognize, assess and value the fundamental features of primary care that provide personalized, equitable health care and foster individual and population health.read more read lessĪbstract: Many commentators view the conversion of small, independent primary care practices into patient-centered medical homes as a vital step in creating a better-performing health care system. The PCMH will continue to evolve as evidence comes in from hundreds of demonstrations and experiments ongoing around the country, and as the local and larger healthcare systems change. The needed practice organizational and health care system change aspects of the PCMH are still evolving in highly related ways. This value includes higher health care quality, better whole-person and population health, lower cost and reduced inequalities compared to healthcare systems not based on primary care. ![]() The value of the fundamental tenets of primary care is well established. All of these are focused on improving the health of whole people, families, communities and populations, and on increasing the value of healthcare. Abstract: The patient-centered medical home (PCMH) is four things: 1) the fundamental tenets of primary care: first contact access, comprehensiveness, integration/coordination, and relationships involving sustained partnership 2) new ways of organizing practice 3) development of practices’ internal capabilities, and 4) related health care system and reimbursement changes.
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